3.           About the Spinal Surgery Clinical Committee

The Spinal Surgery Clinical Committee (the Committee) was established in July 2016.

The origins of the MBS Review of Spinal Surgery stem back to 2014, before the establishment of the MBS Review Taskforce. At this time, spinal fusion/discectomy for back pain was identified as appropriate for MBS review at a Safety, Quality and Sustainability (SQS) Forum meeting (the SQS Forum assisted the Department to identify services for review). At the same time as, the issue of claiming multiple surgical item numbers for a single episode of care was found pertinent to spinal surgery practice when compared to other surgical areas. This prompted the Department’s proposal that all spinal surgery items (excluding paediatric items) be included in a review, to assess whether they represent contemporary clinical practice, and whether some items needed to be consolidated or re-worded to remove ambiguity and clarify 'complete' medical services.

The proposal to review the MBS items for spinal surgery was ultimately agreed to by the specialist medical profession in February 2015, when the Department met with the spinal surgery Review Working Group (the Working Group). Membership of the Working Group includes representatives from the Australian Orthopaedic Association (AOA), the Neurosurgical Society of Australasia (NSA), Spine Society of Australia (SSA), Australian Society of Orthopaedic Surgeons (ASOS), Royal Australasian College of Surgeons (RACS) and Australian Medical Association (AMA).

Since February 2015, the review has remained clinician led, with the Working Group meeting independently to develop a new schedule of items for spinal surgery (further discussed in Section 5).

Regarding any review of evidence, the 2015 Department policy decision for the spinal surgery review not to focus on a review of effectiveness should be noted. This decision was informed by an independent high-level literature overview completed at the time. The Working Group were advised that the most appropriate pathway for new services, not currently claimed under current spinal surgery items, is an application to the Medical Services Advisory Committee (MSAC).

Following the establishment of the MBS Review Taskforce it was decided that to fulfil the requirements of the broader program of work being complete across the entire MBS, additional steps were required for the MBS Review of Spinal Surgery including:

1. Review and input by a clinical committee comprising broad clinical and consumer membership; and

2. Public consultation.

 


3.1        Committee members

Table A: Spinal Surgery Clinical Committee Members

Name

Position/Organisation

Declared conflict of interest

Dr Michael Johnson (Chair)

Orthopaedic Spinal Surgeon, Epworth Hospital, Melbourne; Chair of Professional Development and Standards, Australian Orthopaedic Association; Executive member,  Spine Society of Australia

 

Provider of MBS services

Dr Mark Davies

Head of Department, Neurosurgery, St George Hospital; Chairman, Surgical Education and Training Board in Neurosurgery, Royal Australasian College of Surgeons/Neurosurgical Society of Australasia

Provider of MBS services

Dr Lawrie Malisano

Orthopaedic Surgeon

Provider of MBS services

A/Prof Richard O'Brien

Rheumatologist

Provider of MBS services

A/Prof Geoff Askin

Orthopaedic Spinal Surgeon, Mater Private Hospital & Lady Cilento Children’s Hospital, Brisbane.

Provider of MBS services

Dr Janet Wale

Consumer Representative; Previous Chair HTAi Patient and Citizen Involvement Interest Groups; Cochrane Consumer Network

Nil

 


3.2        Working Group members

Table B: Spinal Surgery Review Working Group Members

Name

Organisation

Dr Michael Johnson (Chair)

Australian Orthopaedic Association

Dr Mark Davies

Neurosurgical Society of Australasia

Dr Peter Wilde

Australian Society of Orthopaedic Surgeons

Dr Graeme Brazenor

Royal Australian College of Surgeons

Dr Rob Kuru

Australian Medical Association

Dr Peter Woodland

Spine Society of Australia

Dr William Sears

Spine Society of Australia

Dr Andrew Kam

Neurosurgical Society of Australasia

Dr Matthew McDonald

Neurosurgical Society of Australasia

Dr Peter Turner

Australian Orthopaedic Association

All Working Group members listed in Table B are spinal surgeons and participated in the review as a representative of the listed organisations.

3.3        Conflicts of interest

All members of the Taskforce, Clinical Committees and Working Groups are asked to declare any conflicts of interest at the start of their involvement and reminded to update their declaration periodically.