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ANNUAL REPORT

supporting general practitioners in the delivery of comprehensive primary health care

2006-2007

General Practice

Canning Division of

Introduction

The Canning Division of General Practice is part of a comprehensive network of Divisions operating across Australia committed to support the General Practitioner in the delivery of comprehensive Primary Health Care. We will uphold the following values in all of the Division's activities: Integrity Excellence Diligence Respect Flexibility Canning Division covers a geographical area of 1,040 square kilometers that encompasses two area health services (Bentley and Armadale). The Division has a population of 294,068 (2004). Canning Division is an ISO 9001:2000 Quality Endorsed Company. Patients in the region have access to 205 FTE practitioners with a population per GP of 1:1,684 ­ above both the WA (1,531) and Australian (1,403) ratios.

Contents

Board of Directors and Committees Chairman's Address From the Finance Director From the Chief Executive Officer Aboriginal Health 3 4 5 5 7 Chronic Disease Practice Support - Education Practice Support - Systems GP After Hours Clinics Financial Statements 8 10 12 14 15

Canning Division of General Practice Ltd

Unit 4 1140 Albany Highway (off Ewing Street) Bentley WA 6102 PO Box 268 Bentley 6982 Tel (08) 9458 0505 Fax (08) 9458 8733 Email [email protected] www.canningdivision.com.au ACN 061 656 577

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CANNING DIVISION OF GENERAL PRACTICE LTD

Board of Directors Back row from left: Dr Joseph Thomas, Dr Velupillay Kulaendra, Dr Gary Fernandez, Dr Nick Bretland.

Front row from left: Dr Kanwal Singh, Dr Ivor Desouza (Chair), Dr Neda Meshgin Varan, Dr Nagappan (Sri) Srigandan. ABSENT (pictured left): Dr Roly Bott, Dr Katrina Alexander

Committees

FARM/Executive Committee (March 2007 - June 2007) Dr Ivor Desouza (Chair) Dr Nagappan (Sri) Srigandan Dr Kanwal Singh Matthew Tweedie Rodney Redmond An additional Board member on a sessional basis Community Advisory Group Peter Johnston (Chair) Dr Ivor Desouza Grant Adams Matthew Tweedie Louise Gray Dr Charlene Caspersz Brian Woodroffe GP Consultants 2006-07 Dr Nick Bretland Dr Maree Creighton Dr Stuart Burton Dr Neda Meshgin Varan Dr Charlene Caspersz Dr Kanwal Singh Dr Jenny Sudbury Dr Roger Lekias Editorial Committee Dr Charlene Caspersz Matthew Tweedie Coby Pearson Alessandra Sippl

Hospital Liaison GPs Dr Jacquie Garton-Smith, RPH Dr Marianne Wood, RPH Executive Committee (July 2006 - March 2007) Dr Ivor Desouza (Chair) Dr Nagappan (Sri) Srigandan Dr Kanwal Singh Dr Roly Bott Finance Committee (July 2006 - March 2007) Dr Kanwal Singh (Chair) Dr Ivor Desouza Dr Nagappan (Sri) Srigandan Matthew Tweedie Rodney Redmond

ANNUAL REPORT 2005/2006

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Chairman's Address

Another year has passed and at Canning Division it was a year of change, achievement and maturity. During 2005, we had a change in our CEO and with it, the wind of change in some of our staff and line managers. It is now just 18 months, and having worked closely with Matt Tweedie during this time I must say he is an excellent choice for our transition at that time and to how this Division has developed today. A very large part of this success is due to Matt's ability to be a leader amongst his staff and to work with them to get the maximum commitment to the mission and vision that this Division upholds. His ability to make strong links with our stakeholders cannot go unnoticed. His ability to forge strong alliances with other Divisional CEOs is commendable. Matt worked with other CEOs to develop a State Based Office that represents the views of all general practitioners in this state. He has become well known at the AGPN, our National Division Network as we attempt to reach consensus regarding the role of our national body in representing all Divisions across Australia. From my point of view, working with Matt Tweedie and seeing his sheer commitment to the values and mission of our Division has been a great learning experience. I thank him for a wonderful year of achievement. This year, with the commitment of the Board and our staff, Canning Division developed a strategic plan and implemented a development plan that provides a template to work with over the next three years. Our vision for our Division is that we will expand in the next five years either via virtual amalgamation or through strong links with other Divisions to become a powerful negotiator for funds with various stakeholders in both the government and non-government sector. We can then grow in the provision of our services to general practitioners and, through GPs, to our community. We will increase our emphasis on primary health care and maintain our focus on general practitioners as the leaders in the delivery of comprehensive multidisciplinary care. Our mission statement has been changed and is now simply: "To support the general practitioner in the delivery of comprehensive primary health care." Our values are to always carry out our duties with integrity, excellence, diligence, respect, and flexibility. We understand the Division will need to be flexible if in the next five years we are to: address the ageing population manage our increase in chronic disease address changing environmental factors manage workforce issues within our profession meet financial pressures and ensure efficient spending of the health dollar keep up with technology (and its integration) in the health arena. These are big strategic challenges, and you might say that they are pie in the sky ideals, but we can at least make a start. We can do this by negotiating appropriate funds, collaborating with others in our desire to make the health of our community better, and by being flexible as the need arises. Our immediate development plan falls into three main categories: 1) Practice support 2) Sustainability of our organisation 3) Partnerships If you look through the reports from the CEO, Financial Director and line managers, and the audit of our figures, you will find that our goals and strategies are aligned with these three main key performance areas. It remains for me to congratulate all the staff in our Division who are dedicated and committed to our vision. My thanks go to Rodney Redmond for his role as Company Secretary. To my fellow Board members, you have shown good leadership to our colleagues and staff members. Sincere thanks to: Deputy chair Dr Nagappan Srigandan for always bringing good thought and debate on various topics, and always representing the rights and expectations of GPs in the debate. Dr Kanwal Singh for working very hard in keeping a good record of how the money is spent, and ensuring that projects are fulfilled, our organisation solvent, and all financial risks minimised. Dr Joseph Thomas for his input into accountability and transparency, and his contribution to policy making at the Board level. Dr Gary Fernandez and Dr Velupillay Kulaendra for their willingingness to join sub-committees to help make recommendations to the Board. Dr Nick Bretland and his tireless commitment to aged care, research projects, and making sure that at the national level everyone knew what our Division was doing for aged care. Dr Roly Bott for providing leadership in our after hours clinics initiative amalgamating them and contributing to running these clinics smoothly. His experience on the Board and advice and debate are always appreciated. Dr Katrina Alexander and Dr Neda Meshgin, thanks for both your timely inputs in focus groups, sub-committees and the Board. There are many committed GPs who give up their time and contribute regularly to the Division. I would especially like to mention Dr Maree Creighton and Dr Charlene Casperz for their continual contribution. I feel this year is the beginning for oncoming success from the shared effort of a committed team. It is easy to be the leader of a wonderful team and great to work with you. This year's achievements are all yours, please stand up and take a bow. Dr Ivor De Souza Chairman

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CANNING DIVISION OF GENERAL PRACTICE LTD

From the Finance Director

I am pleased to announce that Canning Division had a successful financial year last year. The Canning Division has recorded a 19% increase in its revenue, from $3.2 million in 2005/06 to $3.8 million in 2006/07. Due to increased revenue and efficient utilisation of the funding, our financial position remains sound. Canning Division continues to remain in robust financial health so that we can meet our obligations in the event of any funding crunch. The consolidated revenue base is being consistently broadened, resulting in core funding now representing only 20% of the company's revenue. Eighty percent of our revenue is provided from other DOHA grants, state funding and revenue from other primary health care activities. At present our Division's staff remains committed to keep general practice as its focus and as a Board we are committed to maintain this direction. With our transparent accounting procedure and ethical utilisation of resources we are highly respected at state and federal government level. As the Finance Director I assure you that our finance department is committed to the highest professional standards. Thank you to our Chief Financial Officer, Rod Redmond, and his assistant Jenny Findlay who have diligently adhered to the best accounting practices and the continued streamlining of the company's financial systems. We now have a strong presence in various government departments. For example, in the area of Aboriginal and Torres Strait Islander Health, we remain a major non-governmental organisation with a strong ATSI staff presence. Our After Hours Clinics have performed successfully in providing more services to our community and general practices providing the opportunity to many GPs to experience the after hours rosters. There has been across the board increased participation from our fellow GPs in Division activities and I would like to see more of this happening in the future. Canning Division is committed to involve more and more GPs into its programs, either as participants or as consultants, and I believe we will see more of that happening in coming years. I wish you another happy year. Dr Kanwal Singh Finance Director

From the Chief Executive Officer

Canning Division has a reputation for embracing change and innovation. In 2006/2007 the Division positioned itself to take advantage of its range of investments so that we can continue to support GPs in the delivery of comprehensive primary health care. This report focuses on the innovative investments made by the Division and the progress achieved to date.

Chronic Disease

National Primary Care Collaboratives (NPCC)

CDGP staff developed the data extraction tool which underpins this successful chronic disease initiative (diabetes and CHD). The Commonwealth government has recognised this success and will fund a new three year program which will see the number of participants increase by 200% to 1300 practices. CDGP looks forward to working in the collaborative initiative over the next three years.

Chronic Disease Self Management (CDSM)

The Australian Government will reward CDGP's investment in providing health professional training and delivering patient based chronic disease self management programs. CDGP will be funded to provide training as part of the Australian Government commitment to the Australian Better Health Initiative (ABHI). We will provide 14 courses in the Flinders and Lorig chronic disease self management models to health organisation employees and health professionals employed throughout Western Australia.

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COPD Community Linkage

A successful partnership with Perth and Hills Division of Gerneral Practice and the Respiratory Department of Royal Perth Hospital has resulted in over 400 patients with COPD accessing a comprehensive community based rehabilitation program. The first of its type in WA, the program provides a mix of physiotherapy, specialist and nurse medical care in partnership with participating GPs. From November 2005 to January 2007 the service has demonstrated a decrease in bed days from 990 to 573 - a saving of 417 bed days High early GP uptake maintained with 33% of total referrals received from GPs. The program provides a working model of community based integrated care in chronic disease.

practice basis. This comprehensive database will be fully operational early in 2008 and will greatly improve our ability to communicate effectively on issues which your practice determines are important.

IT/IM

The Division has dedicated considerable resources to developing the Canning Data Extraction Tool. This business planning tool will be further enhanced and used by our staff to assist GPs and their practices to make informed business decisions in areas including best use of the MBS, PIP, SIP and practice nurse payments, clinical audit of best practice prescribing, proactive patient recall and best use of patient registers/data.

Aged Care

CDGP has launched its 2008 Aged Care Strategy focused on assisting GPs to use remote IT to reduce duplication in patient notes and documentation, and to improve quality of care through enhanced prescribing for patients in residential aged care facilities.

HeartBeat

A unique partnership with South Metropolitan Area Health Service, HeartBeat is a self management program specifically targeting patients who have suffered their first myocardial infarct or at significant risk of having their first heart event. 194 patients were enrolled this year. Evaluation results from July 2004 to July 2007 demonstrate an average of 5% reduction in BMI, and 15% reduction in blood cholesterol at nine month follow ups. Approximately 680 bed days have been saved for the 194 patients in the program. HeartBeat represents a significant achievement in terms of GP uptake, patient outcomes and sustainability of an effective community based rehabilitation program.

Mental Health

The Division continues to work in the southern corridor towards coordinated youth mental health services to better assist GPs in managing this difficult and complex area of health.

GP After Hours

The Division acknowledges GPs need for time of their own and has extended its original commitment to three GP After Hours Clinics now providing employment for 40 doctors, nine nurses and 10 practice staff. The service provides a quality after hours service for the local community and is designed to refer patients back to their usual GP emphasising the importance of a continuum of care. The Division will continue to strive for excellence as we work with our members and various funders to improve support for GPs in their critical role in improving the health of our community. I must record my acknowledgement and thanks to your Board and the staff of Canning Division for their outstanding professionalism and commitment as we strive to support you in your task to improve the health of our community. Matt Tweedie Chief Executive Officer

Aboriginal Health

and Torres

Strait

Islander

An initial investment by Royal Perth Hospital and the Division into the "GP Links" program has evolved into a growing Aboriginal and Torres Strait Islander health program. This now includes primary health and welfare service linkages, adult and child health checks, a roving GP initiative and Medicare provider numbers for our team of Aboriginal health workers. The Division works in partnership with participating GPs and the Aboriginal health sector to improve equity, and access to culturally appropriate care.

Family and Domestic Violence

Originally a 12 month pilot, this program will be expanded across the metropolitan area in a partnership approach with metropolitan Divisions of General Practice. The program will inform GPs about available local family and domestic violence resources they can access for their patients through a focused 12 month GP workshop and promotion program.

Systems Management

Division Information System (DIS)

You made us aware that the Division needed to better inform itself of its members' needs. DIS is a customer relationship database that will enable us to track when, what and how much of our service we are providing on a practice by

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CANNING DIVISION OF GENERAL PRACTICE LTD

Aboriginal Health

Canning Division was funded to provide two Aboriginal and Torres Strait Islander (ATSI) health programs in 2006­2007.

Of the 550 health checks completed in 2006/07, 419 were conducted by the AHO and 131 health checks were carried out by a GP in conjunction with an AHO. Follow up included 446 home visits to support clients requiring health tests, appointments and referrals. Two new initiatives were introduced earlier this year: the Roving GP and Medicare Provider Numbers for the Division's AHOs.

GP Links Program (RPH/SMAHS)

This discharge program links Royal Perth Hospital (RPH) ATSI patients to mainstream services through direct referral to general practitioners in the south eastern metropolitan area of Perth. The Division's Aboriginal health officers (AHOs) attend RPH five days a week and identify Aboriginal people residing in the Canning area from the hospital's inpatient lists. Patients are recruited as inpatients and are then contacted for follow up within 10 days from their discharge. Achievements for 2006/07 include several educational and promotional presentations offered by GP Links staff. These presentations were provided at a range of Aboriginal open days, community organisations, and to RPH overseas medical officers and new medical staff. Cultural awareness training for general practice staff has also been provided on request. Evaluation of the program was carried out over 2006/07 and the findings indicate a saving of 1.4 bed days per patient to RPH, which equates to savings of over $400,000. During the period 2006/07 the AHOs provided support to 85 new clients discharged from RPH. During the same period the AHOs have provided follow up support by undertaking 212 home visits, linking 45 clients to general practitioners and referring 180 ATSI clients to allied health services. The program has concentrated on building relationships with RPH emergency department which has led to a referral system in place for the follow up of ATSI clients attending RPH emergency department.

The Roving GP

To further enhance the child and adult health check program the Division has employed a general practitioner to support the AHOs and to provide medical services to at-risk clients who do not have a regular GP. ATSI clients can now receive ATSI services on the child and adult health check program in either special schools or in a group environment at the designated centres in Maddington and Armadale. To date, over 60 assessments and several follow up services have been provided. Through the Roving GP, Canning Division has been able to improve services for the ATSI population by providing health checks to high risk clients in a community setting accessing clients not readily able to visit a GP increased flexibility and access linking clients to a mainstream GP accessing an increased number of clients.

Provider Numbers for AHW

Canning Division's AHOs have recently obtained a Medicare provider number that enables them to receive Medicare rebates for Item 10950 ­ services provided by an Aboriginal health worker. The Division is currently implementing this initiative as part of its child and adult health check program which will assist ATSI clients' follow up after the initial health check. These rebates are also available to clients with a chronic condition and/or complex care needs being managed by their GP under an Enhanced Primary Care (EPC) plan. GPs are able to access this initiative for their Indigenous clients for a maximum of 10 services per client in a calendar year.

Child and Adult Health Check Program - Item 710 (DoHA)

Canning Division was initially funded for one year to provide adult health check assessments (Item 710) to the ATSI population aged between 15-54 years and residing in the Canning Division area. The program commenced on July 1st 2005 with the aim of implementing a health surveillance system in general practice to facilitate primary prevention, intervention and continuity of care for Aboriginal people. An extension of the program during 2006/07 to include children aged 0-14 years has been very successful. The program now receives recurrent funding.

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Chronic Disease

Heartbeat

RPH Readmissions

In April 2007, readmissions to RPH were examined for 322 people who registered with HeartBeat between October 2000 and December 2005 (inclusive). Participants were divided into two groups: those who completed HeartBeat (111), and those who did not participate in the program (211).

Readmission Rate 6.3 18.5 Relative Risk 0.34 2.93

In the past financial year 144 education and 144 exercise sessions were held at Bentley and Armadale locations. HeartBeat received 529 referrals of which 182 people registered with their GP and commenced Incidence of non elective readmissions the program. 74% of the participants completed more Total No. No. not than two thirds of the program. A survey taken to people readmitted readmitted assess satisfaction showed that all participants were HB 111 7 104 very satisfied with the education sessions and 95% were Non HB 211 39 172 very satisfied/satisfied with the exercise sessions. The HeartBeat project team continues to work with GPs, Royal Perth Hospital, Armadale Hospital and other referrers to improve participation so that more patients will be empowered to reduce their risk factors and manage their health in a positive way. Total Referrals 2006-2007 Referral Source Armadale Hospital RPH (Cardiology Nurses) Fremantle Physiotherapy RPH Physiotherapy Self GP Other Total Jan-Jun 06 4 130 9 12 44 20 16 235 Jul-Dec 06 57 117 8 3 26 18 18 247 Jan-Jun 07 107 97 11 4 43 12 8 282

A higher proportion of people who did not participate in HeartBeat (39 out of 211 or 18.5%) had non elective readmissions for cardiac conditions compared to people who did HeartBeat (7 out of 111 or 6.3%). The relative risk of readmission for both groups is shown below.

The co-ordinators would like to thank the GPs who have been involved in referring patients to the HeartBeat program. continued on page 9...

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HealthPartners

The aim of HealthPartners is to embed chronic disease self management (CDSM) principles into the community. This is done through training people with chronic disease (lay leaders) and health professionals in self management principles. HealthPartners continued to train health professionals on a fee-for-service basis in the Stanford Chronic Disease Self Management and the Flinders Chronic Disease models; as well as providing chronic disease self management workshops to patients within the Canning catchment area. Canning Division looks forward to continuing as a leader in the training of health professionals with the support of the federal and state governments.

Community Linkage Service started in July 2005 and commenced service delivery to patients in November 2005. In excess of 400 patients have been referred into the service from more than 30 referral sources. GPs represent 33.5% of all referrals. The COPD Community Linkage Service aims to reduce unplanned hospital admissions by: Improving access to medical care, close to where people live Providing a `one stop shop' in the community offering community-based specialist assessment and review, access to spirometry, pulmonary rehabilitation, self management education and social supports Strengthening the interface between general practice and specialist COPD services to improve the capacity in general practice to provide optimal care.

COPD Community Linkage Service

The COPD Community Linkage Service is a comprehensive community-based COPD service and was developed as a collaboration between the SMAHS (RPH) and the Perth and Hills and Canning Divisions of General Practice. The COPD

Overall analysis has demonstrated that short admissions related to uncomplicated exacerbations have fallen. The average length of stay (LOS) has risen as the admissions reflect the complications from co-morbidities or more severe episodes that require tertiary specialist input. This positive finding has been demonstrated in a very short period and is extremely encouraging as it relates to the impact of the service. Admissions for COPD and resulting bed days for all patients in the service - before and after recruitment to the service - based on disease severity Mild Before After 24 15 112 66 4.67 4.4 Moderate Before After 27 27 145 210 5.73 7.77 Severe Before After 102 74 990 753 6.78 6.44

Admissions (n) Total bed days Average LOS

ANNUAL REPORT 2006-2007

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Practice Support Education

Quality Use of Medicines (QUM)

The Quality Use of Medicines program educates in the wise selection of medicine management options and encourages suitable choices of medicines which are safe and effective. This program is supported by the National Prescribing Service (NPS), a member-based organisation providing accurate, balanced, evidence-based information and services to health professionals and the community on Quality Use of Medicines (QUM). The pharmacist at the Division conducts one-on-one educational visits, small group case study meetings and clinical audits using the latest evidence-based medicine information. In 2006-2007, we have recorded 262 GP attendances in these activities and most of these GPs attend a second activity. The educational topics offered included: COPD: Interventions for better outcomes Analgesic choices in persistent pain Selective use of antibiotics Preventing osteoporosis and reducing fracture risk Some of the case studies were attended by pharmacists and practice nurses. The pharmacist also presented Common colds need common sense ­ not antibiotics to child care centres during the winter coinciding with the delivery of the Selective use of antibiotics topic to the GPs and pharmacists. Managing your medicines presentations were given to several community groups to encourage the consumers to learn more about their medicines.The audience consisted of patients on the Heartbeat Program, and/or in aged care facilities and lifestyle villages.

Home Medicines Reviews (HMR) have also continued to be promoted to consumers, GP practices and pharmacists. Some of the promotional activities included: Stall at the Pharmacy Trade Fair in July 2006 where pharmacists were encouraged to become accredited and support given to pharmacies Consumer talks and promotion A comprehensive Pharmacy Visiting Program, to assist pharmacies with the HMR process Practice visits both educational one-on-one visits and case studies with a HMR focus Educational events at the Division for GPs, pharmacists and practice nurses.

Aged Care

Canning Division of General Practice covers a large area including: 39 residential aged care facilities (RACFs) 2498 beds 50% RCS Category 1 142 visiting GPs The Aged Care GP Panels Initiative is aimed at improving access for patients in residential aged care facilities to quality medical care and assisting GPs to work in partnership with RACFs. Canning Division continues to build on the outstanding success of the Aged Care Panel Initiative which to date has achieved the following outcomes: 22 RACFs and 41 visiting GPs implementing new cooperative strategies to benefit patients and improve use of GP time RACFs reported that prior to the program only 40% of residents had timely access to GPs; this improved to 100% GP involvement in RACF Quality Improvement Activities and patient safety improved continued on page 11...

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CANNING DIVISION OF GENERAL PRACTICE LTD

CDGP has developed teaching aids for GPs to teach registered nurses and carers in RACFs Fentanyl patches available for non-cancer pain ­ a successful submission to PBAC by the Panel resulted in Fentanyl patches being made available for RACF residents with terminal pain not due to cancer Presentation at Australian General Practice Network (AGPN) national forum 2006 WA Strategic Solutions Workshop to distribute and clarify workable solutions with other Divisions A GP after hours roster. A "Showcase & Promotional" dinner was held in June 2007. It was a successful event with 26 staff representing 13 residential aged care facilities and 21 GPs attended. At this dinner the Division showcased the last 12 months and promoted the next 12 months. Following this event a number of RACFs and GPs have expressed interest in joining our NPCC/Aged Care model and will be attending three workshops over the current year.

The introduction of the new mental health MBS item numbers in November 2006 caused some confusion and angst among GPs about getting the paperwork right. Staff from the InFocus counselling team organised an information session about the MBS item numbers and provided copies of assessment and management plan templates and outcome measurement tools. This was followed up with general practice visits which included providing service information and referral kits to GPs. Given the population demographics, the gap fees charged as well as the dearth of registered psychologists in this region, referrals to the service have increased rather than decreased. Both GPs and clients report that it continues to be a highly professional, low cost service provided close to the community.

Family and Domestic Violence

The Family and Domestic Violence project continues to work towards increasing the knowledge, confidence and skills of those working in general practice to identify and respond to situations where family and domestic violence is occurring. An external evaluation was conducted of the initial 12 month period of the Family and Domestic Violence project at Canning Division. This evaluation demonstrated that GPs and practice staff who attended workshops and/or practice visits increased their knowledge, skills and confidence in identifying and responding to survivors and perpetrators of domestic violence. The evaluation also reported an incremental increase in GP referrals to specialist family and domestic violence services. In recognition of the positive results of the project, a Commonwealth funding contract commenced in May 2007 with the National Community Crime Prevention Program to provide the "Working with General Practice to Reduce Family Violence Project'. This will enable the Canning Division project model to be extended throughout the Perth metropolitan area via Divisions of General Practice. This is a collaborative project working with all metropolitan Divisions and family and domestic violence services. It is funded for the next 18 months to provide education workshops, practice visits and resources for GPs and practice staff.

Mental Health and InFocus Counselling

The Division continues to work with local mental health service providers, participating on two regional networks and a south metropolitan wide GP Liaison Advisory Group. In particular we work closely with Bentley Mental Health Service, meeting regularly to discuss issues of mutual concern and to deliver quality, evidence based education and training on a range of mental health topics. Under the shared care arrangement the GP Liaison team continues to work closely with GPs within the general practice setting to best meet the needs of their clients. The InFocus counselling program is one of a number of the Division's successful client services. The service has slowly grown over the past four years, with 75 referrals received from 24 GPs in the first year to 325 referrals in this financial year. There are more than 80 GPs who now regularly refer to the program.

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Practice Support - Systems

Practice Support in 2006 ­ 2007 has been based around the Comprehensive Needs Assessment of practices undertaken between October and December 2006. 59 (72%) practice managers/senior reception staff responded and 74 (~25%) GPs from 34 practices took part. Results of the needs assessment were collated for planning, and results from individual practices formed the basis of the support offered to each practice. Practice Support involved practice visits, a telephone help desk, Practice Manager Network, Practice Nurse Network, and practice manager/staff education workshops. The practice staff workshops conducted this year were biased toward CPR training, the topic that attracted by far the greatest interest in the needs assessment. Accreditation has been at the forefront of Practice Support during the period with the new 3rd edition standards coming into play during 2006. Nine practices were assisted with accreditation over the course of the year. Support has taken the form of patient survey analyses, mock accreditation surveys, assistance with policy and procedure manuals and visits.

activities offered through the Division were implemented to cover the topics requested. Topics included CPR training, immunisation updates, diabetes updates including chronic disease management and asthma updates. A range of guest speakers presented at the educational updates including medical specialists from DoHA Communicable Disease and Control Division, diabetes educators and community health nurses to name a few. The target of practice nurse attendance at educational workshops of 150 has been achieved. The educational evaluations for these sessions were overwhelmingly positive with 78% of participants stating the workshops were definitely relevant to their practice. 74% of participants stated that the content of the workshops definitely met their expectations. The information gained from the survey and the introduction of the Division Information System (DIS) have led to a more comprehensive database on practice nurses working within the Division. Future workshops and professional development activities to be planned for the next 12 month period will be guided by the information gained from the practice nurse survey.

Practice Nurse Network

Funding was sought in February 2007 and received from the WAGP Network, Nursing in General Practice (NiGP) program. The purpose of the funding was to conduct a comprehensive survey of nurses working in general practice within the Canning Division. The aim of the survey was to: 1. Establish an accurate record of the number of practice nurses (PNs) working in general practice in CDGP 2. Establish a systematic way to collate information such as contact details, hours worked by each nurse, nursing qualifications and experience, current and future roles in the practice 3. Provide CDGP with insight into the PN profiles, including support and professional development required 4. Provide CDGP with insight into expertise available amongst the practice nurse population of the Division. The comprehensive information gained from the survey led to improvements in service delivery, i.e. the New Nurse Kit, which is provided by the Division's practice nurse support officer to new nurses when they commence at a practice. Practice nurses requested additional information on the role of the nurse in general practice and nurse competencies. This has now been included in the "Kit" and discussed more at length with the new nurse during the induction process. Professional development opportunities have been designed to reflect the needs of the practice nurses. Educational

Ambulatory Blood Pressure Monitoring

The ABPM monitors were used by five different practices for a total of 28 weeks. The Division provided training for practice staff in using BP monitors and downloading data. This year all five practices were able to download the results electronically into the patient's file on their practice software. Of the five practices taking advantage of the service, two did so for the first time.

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CANNING DIVISION OF GENERAL PRACTICE LTD

Monitors were set up on 158 patients and 138 completed the 24 hour study. This resulted in the diagnosis of 24 cases of white coat hypertension and the identification of 39 cases of poorly controlled blood pressure. Consequently 62 people had their medications adjusted.The Practice Support team is looking forward to continuing this service in 2007-2008.

Immunisation

The Canning Division of General Practice provided immunisation-related services to 62 practices within the Division boundaries over the year. Services were predominantly in data cleansing, Australian Childhood Immunisation Register (ACIR) access and support, schedule changes and cold chain management. The Division assisted 46 practices with the ACIR website, through either gaining access to the site, or by providing subsequent support with the ACIR site. During the year the Division held a workshop covering the schedule, planned changes, travel immunisation and treatment of anaphylaxis. The Division's immunisation statistics are currently 87.1% following the May 2007 re-calculation. After the May 2007 re-calculation, 73% of GPII practices in the Division achieved the national target of 90% or higher. The Division is being pro-active in supporting practices to rise above and maintain an immunisation rate of 90%. purchased by 43 other Divisions of General Practice. The tool can now aggregate and summarise data on a number of chronic conditions (asthma, cardiovascular disease, diabetes, cervical cancer) from six different brands of medical software. The objective of data extraction is to use the information contained in the database to enhance patient care, decrease stress in the practice and enhance practice financial viability. This will assist each practice to view their situation from a new perspective and provide an opportunity to streamline or enhance practice systems. The Division plans to increase support in using the software to each practice that has the tool, as well as increasing the number of compatible databases it can work with. At a local level, the IM/IT department has continued to provide critical support to the Division's programs in COPD, GP Links, Infocus, ATSI Adult Health Check, HeartBeat, NPS, GP After Hours Clinics, and also to the internal office network which underpins the work of the whole Canning operation. The Canning Division website has also been completely revamped, and is now providing more information, is easier to navigate, and provides the opportunity to register for events online. See: www.canningdivision.com.au Thank you to the members who provided imput and ideas. During the last year the Division commenced sending reminder letters to parents of children who are at least three months overdue. Early evaluation of this initiative indicates that twice as many children who received the letter are removed from the overdue list than children who have not received the letter.

National Primary Care Collaborative

The goal of the National Primary Care Collaborative (NPCC) is to support general practices to improve clinical outcomes, reduce lifestyle risk factors, help maintain good health for people with chronic conditions, and improve access to services through promoting a culture of quality improvement in general practice. The current program is to be completed by December 2007. As part of the 2007/08 Budget, the Australian Government has announced that the Collaboratives Program will be continued and expanded with total funding of $34.6 million over four years. 19 Canning Division practices have taken part. Nationally, 615 Australian general practices are involved, with another 800 practices scheduled to join in the next two years. continued on page 14...

IM/IT

Canning Division continued its strong commitment to general practice information management this year. On a national level, the Division is at the cutting edge of data extraction technology. The Division has been supported by the Australian General Practice Network (AGPN) and Flinders University to provide the data extraction capability in their tender for rollout of the next phase in the National Primary Care Collaboratives (NPCC). The "Canning Tool" as it is now widely known, has been installed in 29 Canning Division practices, and has been

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Topics

Current topics are diabetes, coronary heart disease (CHD) and access to general practice services. New topics, possibly in areas such as asthma, mental health, preventive health, cancer or other chronic diseases, may be introduced at a later stage.

GP After Hours Clinics

The Canning Division now provides out of hours medical services at both Bentley and Fremantle. These Clinics are located on the Canning Division's premises at the Bentley Shopping Centre and at the Fremantle Hospital. In addition, the Division project manages both the GP After Hours Armadale and Antenatal Clinics situated at the Armadale Health Service. The above clinics currently offer part-time employment for approx 40 GPs, nine nurses and 10 reception staff. The clinics with a current throughput in excess of 21,000 patients have been a resounding success in reducing out-of-hours patient attendee pressure at the hospital emergency departments.

Learning workshops

One GP and one non-GP from each practice have participated in at least three learning workshops. Peer presentations dominate the learning workshops taking place in Melbourne or Perth. Presentations from the four local learning workshops run in collaboration with two other Perth Divisions (Perth and Hills Division and Fremantle GP Network) are available here: http://www.canningdivision.com.au/prg_npcc.html

Activity periods

Activity periods follow each learning workshop to allow practices to participate in quality improvement activities in their own practice.

Data reporting and feedback

Practices submit relevant data on a monthly basis and receive feedback on their performance and suggestions on how to improve their data. Participating practices have achieved outstanding results, particularly in the two clinical areas.

14

CANNING DIVISION OF GENERAL PRACTICE LTD

Canning Division of General Practice Ltd. Financial Statements for the year ended 30 June 2007

ANNUAL REPORT 2006-2007

15

CANNING DIVISION OF GENERAL PRACTICE LTD DIRECTORS REPORT FOR THE YEAR ENDED 30 JUNE 2007

Your Directors submit the financial statements of the company for the year ended 30 June 2007. Directors The names of the Directors in office at the date of this report are: Name: Katrina Alexander Qualifications MBBS `78 Dip. Obst Dip. Fam. M DRANZCOG FPC MBBS `71 MBBS `81 BSc FRACGP MRCGP (UK) DRCOG MBBS `77 BSC DRACOG Grad. Dip. Fam. M MBBS `93 FRACGP MBBS `71 FRCGP MBBS `82 MS FRACGP MBBS `82 FRACGP MBBS (Singapore) `78 AMC (Australia) `85 FAAA (Acupuncture) MBBS `91 FRACGP Experience 29 years

Donald Roland Bott Nicholas Peter Bretland

36 years 26 years

Ivor Francis Desouza

30 years

Gary Jude Fernandez

13 years

Velupillay Kulaendra

36 years

Kanwal Jit Singh

25 years

Nagappan Srigandan

25 years

Joseph Thomas

29 years

Neda Meshgin Varan

15 years

The company contracts with the above directors to provide their services to the Company when required.

16

CANNING DIVISION OF GENERAL PRACTICE LTD

CANNING DIVISION OF GENERAL PRACTICE LTD DIRECTORS REPORT (CONT) FOR THE YEAR ENDED 30 JUNE 2007

COMPANY SECRETARY The name of the Company Secretary in office at the date of this report is: Name Rodney Redmond Qualifications CPA Experience 22 years

There were 11 meetings of the company's directors held during the financial year. Attendance of directors at those meetings were as follows: Name: Katrina Alexander Donald Roland Bott Ivor Francis Desouza Neda Meshgin Varan Kanwal Jit Singh Gary Fernandez Joseph Thomas Nagappan Srigandan Velupillay Kulaendra Nick Bretland PRINCIPAL ACTIVITIES To enhance the health of the local community by promoting the central role of General Practitioners in the planning and delivery of primary health care in our region. No significant change in the nature of these activities occurred during the financial year. OPERATING RESULTS The net profit of the company amounted to $245,832 (2006: Profit of $89,572). DIVIDENDS PAID OR RECOMMENDED No dividends will be paid nor recommended to be paid. SIGNIFICANT CHANGES IN THE STATE OF AFFAIRS There have been none. Number Eligible to Attend 11 11 11 6 11 11 11 11 11 11 Number Attended 7 8 11 4 10 9 10 8 10 9

ANNUAL REPORT 2006-2007

17

18

CANNING DIVISION OF GENERAL PRACTICE LTD

ANNUAL REPORT 2006-2007

19

20

CANNING DIVISION OF GENERAL PRACTICE LTD

ANNUAL REPORT 2006-2007

21

Consolidated Income Statements

for the year ended 30th June 2007

Note

Consolidated 2007 $ 3,223,836 1,087,690 4,311,526

Canning Division 2007 $ 3,233,836 594,272 3,828,108 183,681 159,774 316,181 2,375,173 547,467 3,582,276 245,832

Consolidated 2006 $ 2,880,708 457,164 3,337,872 174,362 110,168 633,407 1,792,915 537,448 3,248,300 89,572

Canning Division 2006 $ 2,880,708 267,311 3,148,019 174,362 110,168 444,313 1,792,915 536,689 3,058,447 89,572

REVENUE Revenue From Govt and Other Funding Bodies Other revenue from Ordinary activities TOTAL REVENUE Depreciation and Amortisation Expense Occupancy expenses GP Service and Related Payments Wages and Other Service Expenses Administration and Other Expenses from Ordinary Activities 3 2 2

183,681 159,774 806,973 2,375,173 550,093 4,075,694

PROFIT FROM ORDINARY ACTIVITIES BEFORE RELATED INCOME TAX EXPENSE Income Tax Expense NET PROFIT NON OWNER TRANSACTION CHANGES IN EQUITY: Total Revenues, Expenses and Valuation Adjustments Recognised Directly in Equity Total Changes in Equity from Non Owner Related Transactiuons Attributable to the Members of the Company

3

245,832

12

245,832

245,832

89,572

89,572

14 -141,178 -141,205 -15,971 -15,971

104,654

104,627

73,601

73,601

The Income Statements are to be read in conjunction with the attached notes.

22

CANNING DIVISION OF GENERAL PRACTICE LTD

Detailed Consolidated Income Statements

for the year ended 30th June 2007

Consolidated Canning Division 2007 2007 $ $ INCOME

Grant Revenue Release Revenue from After Hours clinics Sponsorship Other Interest Received Profit on disposal of fixed assets 210,276 86,672 507,600 86,672 155,255 68,496 198,815 68,496 3,233,836 790,742 3,233,836 2,880,708 233,413 2,880,708

Consolidated 2006 $

Canning Division 2006 $

TOTAL INCOME EXPENDITURE

Advertising Auditor's Remuneration Bank Charges Computer IT Costs Depreciation / Amortisation Directors' Costs Board / Management Director Costs Representation and Program Involvement Evaluation Expenses External Consultancies Program Development GP Payments divisional activities GP Payments After Hours Cinics GP Conference / External Workshop Costs GP Practice Support Costs Insurance Leasing Costs Legal costs Light and Power Loss on Disposal of Fixed assets Meeting Costs Postage, Printing and Stationery Program Service Costs ( Lecturers,Specialists etc ) Rent & Outgoings Repairs & Maintenance Office Cleaning Other Expenses Security Staff Wages and Contract Personnel Staff Amenities Staff Training / Conferences Staff Superannuation Subscriptions Telephone and Facsimile Travel Expenses ( Kilometres )

4,321,526

3,828,108

3,337,872

3,148,019

38,978 23,513 4,352 26,223 183,681 71,015 56,522 6,480 29,443 177,318 490,792 11,326 48,025 25,519 9,833 18,737 48,537 59,959 41,397 159,774 25,217 25,555 65,340 90,974 1,992,129 2,903 37,248 214,750 9,600 42,509 38,045

38,978 23,513 1,947 26,223 183,681 71,015 56,522 6,480 29,443 177,318 11,326 48,025 25,519 9,833 18,737 48,537 59,959 41,397 159,774 25,217 25,555 65,119 90,974 1,992,129 2,903 37,248 214,750 9,600 42,509 38,045

82,527 20,490 2,811 23,598 174,362 88,453 70,260 28,258 47,739 279,326 189,094 6,273 43,225 14,201 13,389 14,950 34,751 76,643 48,266 110,168 13,982 23,556 74,671 43,350 1,484,475 4,020 25,133 140,837 8,874 33,207 27,411

82,527 20,490 2,052 23,598 174,362 88,453 70,260 28,258 47,739 279,326 6,273 43,225 14,201 13,389 14,950 34,751 76,643 48,266 110,168 13,982 23,556 74,671 43,350 1,484,475 4,020 25,133 140,837 8,874 33,207 27,411

TOTAL EXPENDITURE NET PROFIT

4,075,694 245,832

3,582,276 245,832

3,248,300 89,572

3,058,447 89,572

The Income Statements are to be read in conjunction with the attached notes.

ANNUAL REPORT 2006-2007

23

Consolidated Balance Sheets

for the year ended 30th June 2007

Note Consolidated 2007 $ 1,566,180 148,117 61,660 1,775,957 Canning Division 2007 $ 1,493,818 101,108 140,052 1,734,978 Consolidated 2006 $ 1,447,412 119,189 28,638 1,595,239 Canning Division 2006 $ 1,431,049 103,743 37,979 1,572,771

CURRENT ASSETS Cash Receivables Other TOTAL CURRENT ASSETS NON-CURRENT ASSETS Plant , Equipment and Fixtures TOTAL NON-CURRENT ASSETS TOTAL ASSETS CURRENT LIABILITIES Payables Provisions TOTAL CURRENT LIABILITIES NON CURRENT LIABILITIES Provisions TOTAL NON CURRENT LIABILITIES TOTAL LIABILITIES NET ASSETS 11 137,963 137,963 1,185,324 849,283 137,963 137,963 1,144,372 849,256 81,758 81,758 1,213,648 744,629 81,758 81,758 1,191,180 744,629 10 11 906,324 141,037 1,047,361 865,372 141,037 1,006,409 1,020,551 111,339 1,131,890 998,083 111,339 1,109,422 9 258,650 258,650 2,034,607 258,650 258,650 1,993,628 363,038 363,038 1,958,277 363,038 363,038 1,935,809 6 7 8

EQUITY Retained Profits Asset Reserve TOTAL EQUITY 12 13 627,423 221,860 849,283 627,423 221,833 849,256 381,591 363,038 744,629 381,591 363,038 744,629

The Balance Sheets are to be read in conjunction with the attached notes.

24

CANNING DIVISION OF GENERAL PRACTICE LTD

Statement of Changes in Equity

for the year ended 30th June 2007

Consolidated 2007 $ RETAINED EARNINGS Balance at Beginning of year Net Profit for year Balance at Year End ASSET RESERVE Balance at Beginning of year Movement for year Balance at Year End EQUITY AT YEAR END 363,038 -141,178 221,860 849,283 381,591 245,832 627,423

Canning Division 2007 $

Consolidated 2006 $

Canning Division 2006 $

381,591 245,832 627,423

292,019 89,572 381,591

292,019 89,572 381,591

363,038 -141,205 221,833 849,256

379,009 -15,971 363,038 744,629

379,009 -15,971 363,038 744,629

The Statement of Changes in Equity is to be read in conjunction with the attached notes.

ANNUAL REPORT 2006-2007

25

Consolidated Statement of Cash Flows

for the year ended 30th June 2007

Note

Consolidated 2007 $

Canning Division 2007 $

Consolidated 2006 $

Canning Division 2006 $

CASH FLOWS FROM OPERATING ACTIVITIES Funding Grants and Related Revenue Payments to Suppliers and Employees Interest and Bill Discount Revenue NET CASH PROVIDED BY OPERATING ACTIVITIES Proceeds from Ordinary and Special Unit holders Proceeds from sale of Plant and Equipment Payments for Plant and Equipment NET CASH USED IN INVESTING ACTIVITIES CASH FLOWS FROM FINANCING ACTIVITIES NET INCREASE (DECREASE) IN CASH HELD CASH AT THE BEGINNING OF THE YEAR CASH AT THE END OF THE YEAR 6 118,768 1,447,412 1,566,180 62,769 1,431,049 1,493,818 477,026 970,386 1,447,412 460,663 970,386 1,431,049 14 4,683,913 (4,571,976) 86,107 198,044 15 551 (79,842) (79,276) 551 (79,842) (79,291) (171,589) (158,383) 4,112,473 (4,056,129) 85,716 142,060 3,859,491 (3,290,755) 66,673 635,409 12 13,194 (171,589) (158,395) 3,685,097 (3,132,712) 66,673 619,058

The Statement of Changes in Equity is to be read in conjunction with the attached notes.

26

CANNING DIVISION OF GENERAL PRACTICE LTD

Notes to and forming part of the Financial Statements

for the year ended 30th June 2007

NOTE 1 STATEMENT OF SIGNIFICANT ACCOUNTING POLICIES The financial statements are a general purpose financial report that have been prepared in accordance with Accounting Standards, Urgent Issues Group Consensus Views, other authoritative pronouncements of the Australian Accounting Standards Board and the Corporations Act 2001. The financial statements have also been prepared on the basis of historical costs and do not take into account changing money values or, fair values of non-current assets. The accounting policies have been consistently applied, unless otherwise stated. Basis of Preparation The Company is an Australian company which has prepared financial statements in accordance with applicable Australian Equivalents to International Financial Reporting Standards (AIFRS). The accounting policies set out below have been consistently applied to all years presented. The following is a summary of the significant accounting policies adopted by the Company in the preparation of the financial statements. a) Consolidation The consolidated Group comprises Canning Division Of General Practice Ltd ( " the Parent Entity " ) and the entities it controlled during the year. At year end the Parent Entity held 100% of the issued captital of its controlled entity, GP Bentley Network Pty Ltd. Transactions within the Consolidated Group are eliminated in full. b) Plant and Equipment Plant and equipment are brought to account at cost, less, where applicable, any accumulated depreciation or amortisation. The carrying amount of plant and equipment is reviewed annually by the directors to ensure it is not in excess of the recoverable amount from these assets. The recoverable amount is assessed on the basis of the expected net cash flows which will be received from the assets employment and subsequent disposal. The depreciable amount of all fixed assets including buildings and capitalised lease assets, but excluding freehold land, is depreciated at depreciation rates set by the Commissioner of Taxation. The depreciation rates used for Plant and Equipment are 7.5 % - 100%. c) Income Tax The Company receives grant revenue from government and other funding bodies and is not carried on for the purpose of profit or gain to its individual members. In accordance with Division 50 Section 50-10 of the Income Tax Assessment Act 1997, the Company is exempt from tax. d) Cash For the purpose of the statement of cash flows, cash includes: i) Cash on hand and in at call deposits with banks or financial institution, net of bank overdrafts; and ii) Investments in money market instruments with less than 14 days maturity. e) Employee Entitlements Provision is made in respect of the Company's liability for employee entitlements arising from services rendered by employees to balance date. Employee entitlements expected to be settled within one year together with entitlements arising from wages and salaries, annual leave and sick leave which will be settled after one year, have been measured at their nominal amount. Other employee entitlements payable later than one year have been measured at the present value of the estimated future cash outflows to be made for those entitlements. Contributions are made by the company to employee superannuation funds and are charged as expenses when incurred. f) Grants Received Grants received are brought to account as income in the year in which they are expended, in order to properly match income with expenditure. g) Goods and Services Tax Revenue expenses and assets are recognised net of the amount of Goods and Services Tax (GST) except where the amount of GST incurred is not recoverable from the Australian Taxation Office (ATO). In these circumstances the GST is recognised as part of the cost of acquisition of the asset or as part of an item of the expense. Receivables and payables are stated with the amount of GST included. The net amount of GST Recoverable from, or payable to, the ATO is included as a current asset or liability in the Statement of Financial Position. Cash Flows are included in the Statement of Cash Flows on a gross basis. The GST component of cash flows arising from investing and financing activities which are recoverable from or payable to the ATO are classified as operating cash flows. h) Impairment of Assets At each reporting date the Company reviews the carrying value of its assets to determine whether there is any indication that those assets have been impaired. If such an indication exists the recoverable amount of the asset, being the higher of the asset's fair value less costs to sell and value in use, is compared to the assets carrying value. Any excess of the assets carrying value over its recoveable amount is expensed to the income statement. i) Leases Leases of fixed assets where substantially all the risks and benefits incidental to the ownership of the assets, but not the legal ownership that is transferred to entities in the economic entity, are classified as finance leases. Finance leases are capitalised by recording an asset and a liability at the lower of the amounts equal to the fair value of the leased property or the present value of the minimum lease payments, including any guaranteed residual values. Lease payments are allocated between the reduction of the lease liability and the lease interest expense for the period. Leased assets are depreciated on a straight-line basis over the shorter of their estimated useful lives or the lease term. Lease payments for operating leases, where substantially all the risks and benefits remain with the lessor, are charged as expenses in the periods which they are incurred. Lease incentives under operating leases are recognised as a liability and amortised on a straight-line basis over the life of the lease term.

ANNUAL REPORT 2006-2007

27

Notes to and forming part of the Financial Statements

for the year ended 30th June 2007

j) Financial Instruments Recognition Financial instruments are initially measured at cost on trade date, which includes transaction costs, when the related contractual rights or obligations exist. Subsequent to initial recognition these instruments are measured as set out below. Financial assets at fair value through profit and loss A financial asset is classified in this category if acquired principally for the purpose of selling in the short term or if so designated by management and within the requirements of AASB 139: Recognition and Measurement of Financial Instruments. Derivatives are also categorised as held for trading unless they are designated as hedges. Realised and unrealised gains and losses arising from the changes in the fair value of these assets are included in the income statement in the period in which they arise. Loans and receivables Loans and receivables are non-derative financial assets with fixed or determinable payments that are not quoted in an active market and are stated at amortised cost using the effective interest rate method. Held-to-maturity investments These investments have fixed maturities, and it is the group's intention to hold these investments to maturity. Any held-to-maturity investments held by the group are stated at amortised cost using the effective interest rate method. Available-for-sale financial assets Available-for-sale financial assets include any financial assets not included in the above categories. Available-for-sale financial assets are reflected at fair value. Unrealised gains and losses arising from changes in fair value are taken directly to equity. Financial liabilities Non-derative financial liabilities are recognised at amortised costs, comprising original debt less principal payments and amortisation. Fair value Fair value is determined based on current bid prices for all quoted investments. Valuation techniques are applied to determine the fair value for all unlisted securities, including recent arm's length transactions, reference to similar instruments and option pricing models.

Consolidated 2007 $ 3,233,836 86,672 210,276 790,742 1,087,690 Canning Division 2007 $ 3,233,836 86,672 507,600 Consolidated 2006 $ 2,880,708 68,496 155,255 233,413 457,164 Canning Division 2006 $ 2,880,708 68,496 198,815

2

REVENUE FROM ORDINARY ACTIVITIES Grant Revenue from Government and Other Funding Bodies Other Revenues : Interest Other Income GP After Hours Clinic Revenue Profit Sale Fixed Assets Total other revenues

594,272

267,311

Total Revenue From Ordinary Activities

4,321,526

3,828,108

3,337,872

3,148,019

3

PROFIT FROM ORDINARY ACTIVITIES BEFORE INCOME TAX HAS BEEN ARRIVED AT AFTER CHARGING THE FOLLOWING ITEMS: Auditors Fees Auditing the accounts Other Services 23,513 Depreciation of: Furniture and Equipment Leasehold Improvements Other Total Depreciation and Amortisation Net expenses from movements in provision for Employee entitlements Rental Expense ( Operating Lease ) Leasing Operations 183,681 29,498 159,774 25,519 183,681 29,498 159,774 25,519 174,362 38,711 110,168 14,201 174,362 38,711 110,168 14,201 52,707 130,974 52,707 130,974 67,422 106,940 67,422 106,940 23,513 23,513 23,513 10,560 9,930 20,490 10,560 9,930 20,490

4

KEY MANAGEMENT PERSONNEL COMPENSATION Compensation of Key Management Personnel comprises: -salaries, wages and fees -superannuation -bonuses -non monetary benefits Total Short Term Employee Benefits Post Employment Benefits including -pensions Toatl Post Employment Benefits Other Long Term Benefits paid including -long service Total Long Term benefits Termination benefits Total Key Manangement Personnel Compensation Note: The figure for salaries, wages and fees is inclusive of directors involvement in the Parent Company programs. The consolidated figure includes amounts paid for Practice Services from GP Bentley Network Pty Ltd. 369,343 369,343 300,843 281,140 292,545 76,798 292,545 76,798 221,167 79,676 201,464 79,676

369,343

369,343

300,843

281,140

28

CANNING DIVISION OF GENERAL PRACTICE LTD

Notes to and forming part of the Financial Statements

for the year ended 30th June 2007

5 MEMBER'S GUARANTEE The company is limited by guarantee. If the company is wound up, the Articles of Association state that each member is required to contribute a maximum of $10 each towards meeting any outstanding obligations of the company. At 30th June 2007 the number of financial members was 179 (30th June 2006 - 178) Consolidated 2007 $ 6 CASH Petty Cash Cash at bank ( Division ) Cash at bank 30/60 Day Bills Corporate Credit Card Security Deposit 1,893 171,925 72,362 1,300,000 20,000 1,566,180 1,893 171,925 1,300,000 20,000 1,493,818 540 10,509 16,363 1,400,000 20,000 1,447,412 540 10,509 1,400,000 20,000 1,431,049 Canning Division 2007 $ Consolidated 2006 $ Canning Division 2006 $

7

RECEIVABLES Debtors 148,117 148,117 101,108 101,108 119,189 119,189 103,743 103,743

8

OTHER CURRENT ASSETS Prepayments Other Loan to Subsidiary Company 31,828 29,831 61,659 31,828 108,224 140,052 28,638 28,638 24,183 13,796 37,979

9

PLANT & EQUIPMENT Office furniture and equipment At Cost Accumulated depreciation Motor Vehicle At Cost Accumulated Depreciation Leasehold Improvements 1140 Albany Highway At Cost Accumulated Depreciation Leasehold Improvements 1133 Albany Highway At Cost Accumulated Amortisation Written Down Values 258,650 258,650 363,038 363,038 396,709 293,593 103,116 60,268 20,878 39,390 388,263 272,119 116,144 396,709 293,593 103,116 60,268 20,878 39,390 388,263 272,119 116,144 351,996 248,262 103,734 20,082 12,500 7,582 392,866 141,144 251,722 351,996 248,262 103,734 20,082 12,500 7,582 392,866 141,144 251,722

Reconciliations Office Furniture and Equipment Carrying Amount at Beginning of Year Additions Disposals Depreciation Carrying Amount at end of the Year Motor Vehicle Carrying Amount at Beginning of Year Additions Disposals Depreciation Carrying Amount at end of the Year Leasehold Improvements 1140 Albany Highway Carrying Amount at Beginning of Year Additions Disposals Amortisation Carrying Amount at end of the Year Leasehold Improvements 1133 Albany Highway Carrying Amount at Beginning of Year Additions Disposals Amortisation Carrying Amount at end of the Year 251,722 (4,604) (130,974) 116,144 251,722 (4,604) (130,974) 116,144 272,413 100,164 (13,914) (106,941) 251,722 272,413 100,164 (13,914) (106,941) 251,722 7,582 40,186 (8,378) 39,390 7,582 40,186 (8,378) 39,390 14,082 (6,500) 7,582 14,082 (6,500) 7,582 103,735 44,099 (44,718) 103,116 103,735 44,099 (44,718) 103,116 92,513 72,144 (60,922) 103,735 92,513 72,144 (60,922) 103,735

ANNUAL REPORT 2006-2007

29

Notes to and forming part of the Financial Statements

for the year ended 30th June 2007

Consolidated 2007 $ 10 PAYABLES Current DHA ( MFA ) Other Funding Body Funds Trade Creditors Current Tax Liabilities Other Creditors 64,269 393,217 242,483 116,831 89,524 906,324 64,269 393,217 242,483 116,831 48,572 865,372 70,003 308,745 436,858 86,306 118,641 1,020,553 70,003 308,745 436,858 86,306 96,173 998,085 Canning Division 2007 $ Consolidated 2006 $ Canning Division 2006 $

11 PROVISIONS Current Provision for Holiday Pay Provision for Sick Pay Provision Toil 99,096 40,614 1,327 141,037 99,096 40,614 1,327 141,037 73,873 30,972 6,494 111,339 73,873 30,972 6,494 111,339

Non Current Provision for Long Service Leave Provision Lease Refurbishment 82,363 55,600 137,963 82,363 55,600 137,963 59,758 22,000 81,758 59,758 22,000 81,758

12 RETAINED PROFITS Retained profits at beginning of the year Net Profit Retained funds at end of the year 381,591 245,832 627,423 381,591 245,832 627,423 292,019 89,572 381,591 292,019 89,572 381,591

13

RESERVES Reserves at beginning of the year Additions during the year Reductions during the year Reserves at end of year 363,050 39,522 (180,712) 221,860 363,038 39,507 (180,712) 221,833 379,009 170,663 (186,634) 363,038 379,009 170,663 (186,634) 363,038

14

RECONCILIATION OF NET CASH PROVIDED (USED) BY OPERATING ACTIVITIES TO OPERATING SURPLUS / (DEFICIT) Operating Surplus Depreciation Amortisation Gain on Sale of Fixed Assets Loss on Disposal of Fixed assets Change in assets and liabilities ( Increase ) / Decrease in Debtors Increase / ( Decrease ) in Asset Reserves Increase / ( Decrease ) in Creditors and Borrowings Increase / ( Decrease ) in Accrued Charges and Provisions Net Cash Provided ( Used ) by Operating Activities 245,832 52,707 130,974 245,832 52,707 130,974 89,572 67,422 106,941 89,572 67,422 106,941

(61,964) (141,178) (114,230) 85,903 198,044

(99,438) (141,205) (132,713) 85,903 142,060

24,840 (15,970) 290,721 71,883 635,409

30,945 (15,970) 268,265 71,883 619,058

15

OPERATING LEASE FUTURE COMMITMENTS not later than one year later than one year & not later than five years later than five years Total Operating Lease Commitments 120,842 120,842 114,253 58,016 172,269 114,253 58,016 172,269

120,842

120,842

30

CANNING DIVISION OF GENERAL PRACTICE LTD

Notes to and forming part of the Financial Statements

for the year ended 30th June 2007

16 FINANCIAL INSTRUMENTS (a) Financial Risk Management The Company's financial instruments consist mainly of deposits with banks, accounts receivable and payables. The Company does not have any derivative instruments at 30 June 2007. Financial Risks The main risks the Company is exposed to through its financial instruments are interest rate risk, liquidity risk and credit risk. Interest Rate Risk The Company's exposure to interest rate risk, which is the risk that a financial instrument's value will fluctuate as a result of changes in market interest rates and the effective weighted average interest rates on those financial assets and liabilities, is limited only to its cash holdings with a number of banks. Liquidity Risk The Company manages liquidity risk by monitoring forecast cash flows and ensuring that adequate cash reserves are maintained. Credit Risk The maximum exposure to credit risk, excluding the value of any collateral or other security, at balance date to recognised financial assets, is the carrying amount, net of any provisions for impairment of those assets, as disclosed in the balance sheet and notes to the financial statements. The Company does not have any material credit risk exposure to any single receivable or group of receivables under financial instruments entered into by the Company. Price Risk The Company is not exposed to any material commodity price risk. (b) Net Fair Values Aggregate net fair values of financial assets and financial liabilities at balance date approximate their carrying values. The aggregate net fair values and carrying amounts of financial assets and financial liabilities are disclosed in the balance sheet and in the notes to the financial statements. 17 IMPACT OF NEW ACCOUNTING STANDARDS NOT YET EFFECTIVE AASB Amendment Standards Affected

AASB 1 First-time adoption of AIFRS ASSB 101 Presentation of Financial Statements AASB 114 Segment Reporting AASB 117 Leases AASB 139 Financial Instruments: Recognition and Measurement AASB 132 Financial Instruments: Disclosure and Presentation

Outline of Amendment

The disclosure requirements of AASB 132: Financial Instruments: Disclosure and Presentation have been replaced due to the issuing of AASB 7 Financial Instruments Disclosures in August 2005. These amendments will involve changes to financial instrument disclosures within the financial report.However, there will be no direct impact on amounts included in the financial report as it is a disclosure standard. As above:

Application date of Standard 1 Jan 2007

Application Date for Group 1 July 2007

AASB 2005-10 Amendments to Australian Accounting Standards

AASB 7 Financial Instruments: Disclosures

1 Jan 2007 Percentage Owned 2007

1 July 2007 Percentage Owned 2006

18 SUBSIDIARY COMPANY Parent Entity: The Canning Division OF General Practice Ltd Subsidiaries of the Canning Division OF General Practice Ltd: GP Bentley Network Pty Ltd ( Incorporated In Australia ) 19 ECONOMIC DEPENDANCY A significant portion of revenue is provided by the Federal Government and accordingly the Company is economically dependant on the continuation of this funding.

100

100

ANNUAL REPORT 2006-2007

31

Canning Division of General Practice Ltd

Unit 4 1140 Albany Highway (off Ewing Street) Bentley WA 6102 PO Box 268 Bentley 6982 Tel (08) 9458 0505 Fax (08) 9458 8733 Email [email protected] www.canningdivision.com.au ACN 061 656 577

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