Saturday, January 31, 2009

MORE HOSPITAL HORRORS

Tammy Hams - lying in agony on hospital floor

By Richard Noone

January 30, 2009 12:00am

TAMMY Hams thought she was "going to die" when she was offered a blanket and told to lie on a waiting room floor because staff at her local hospital could not find her a bed.

Ms Hams was booked in for surgery at Wyong Hospital to remove possible cancerous lesions when doctors discovered a huge abscess causing "agonising pain".

The 29-year-old said she spent 3½ hours writhing in agony on the waiting room floor of the hospital's surgical ward on Wednesday before she was eventually given a bed.

Staff at the hospital "categorically deny" her claims.

Rees quiet on Rudd hospital bailout

The incident comes amid yet another hospital outrage, in which a 24-year-old man was discharged from Griffith Hospital early on Monday after complaining of sinus pain.

The following day he again presented to the hospital and was flown immediately to Sydney's St Vincent's where he died from unknown causes.

Tell us your hospital horror stories below

Greater Southern Health has launched an investigation into why he was discharged.

And in Dubbo, doctors are threatening to quit because they routinely run out of basic medications.

Ms Hams said her GP had been trying to get her into hospital since Friday when she began feeling stabbing pains in her stomach.

A biopsy four months ago revealed pre-cancerous lesions on her cervix, which if left would turn cancerous.

"I thought I was going to die," Ms Hams told The Daily Telegraph yesterday from her hospital bed.

"I have never been in that much pain in my life - it was agony."

She was booked-in for a hysterectomy and told to arrive at 9am.

Her mother Jenny Leatham said she was "crying and doubled-over in pain" and could not sit on the waiting room chairs or stand, so they pleaded for a bed.

"They gave her a blanket and said the best she could do was lie on the floor," Mr Leatham said.

"The staff were so nice and you could see they were upset about what was happening. This is just unfair, I'm not rubbishing the staff. There just wasn't enough beds.

"The system has to change."

A North Sydney Central Coast Health spokeswoman said an investigation found there was no shortage of beds and Ms Hams was "treated in a caring and timely manner".

"It is unacceptable for a patient to be expected to lie on the floor and staff on duty when Ms Hams arrived at the hospital deny making any such recommendation," the spokeswoman said.

The hospital argues she was assessed by an anaesthetist at 10.10am and that she asked for the blanket.

Mrs Leatham said by 12.30pm staff found her daughter a bed and she was operated on at 2pm.

When surgeons cut her open they discovered a huge abscess pushing on her cervix.

Unable to perform the hysterectomy they removed as much of the infection as they could and inserted a tube to drain it over the next seven to 10 days.

"If the abscess had burst while she was in the waiting room she would have died," Mrs Leatham said.

Wyong Hospital is just one of the state's many hospitals plagued with debt, bed shortages and a lack of specialist doctors.

Last week its emergency department - one of the busiest in the state - lost all but one of its specialist doctors to Gosford Hospital so it could retain its status as a teaching hospital.

Senior doctors at Dubbo Base Hospital threatened to walk off the job after they ran out of morphine because the hospital could not afford to pay pharmaceutical companies.

Patients in intensive care also sweltered for days in record temperatures because contractors could not be paid to fix the air conditioning.

The Greater Western Area Health Service reportedly owes more than $23 million to suppliers.

Many are no longer prepared to provide food or medical equipment.

The situation across the state is expected to get far worse before it gets any better.

A report by auditing firm PriceWaterhouseCoopers last month revealed the state's health budget would blow out by as much as $900 million by March if dramatic changes were not made.

Source: The Daily Telegraph

JUSTICE KIRBY RETIRES

Justice Kirby retires, but has eyes on post with UN

David Marr, smh

January 31, 2009

Latest related coverage

Now history will be the judge

MONDAY will see Michael Kirby presiding all alone in the High Court over an immense party he has organised in his honour. After half a lifetime on the bench, he is packing his gavel and departing. He has no choice for in a few weeks he turns 70 and the constitution says he must go.

Traditionally only chief justices are formally farewelled by the court. The rest are expected to disappear without fuss. That isn't Kirby's way. He drew up a list of speakers for the occasion that begins with the federal Attorney-General, Robert McClelland, and a guestlist topped, according to rumour - a rumour fiercely denied - by the Dalai Lama.

Tickets are scarce. The judge's admirers will fill two courts. He is the longest-serving judicial officer in the nation, whose career on the bench began 35 years ago in the Whitlam era when Lionel Murphy appointed him to the Conciliation and Arbitration Commission. Controversies that began then are still running now.

On the High Court he earned the title the Great Dissenter. It's a title he loathes.

Addressing a conference of state and federal judges on Australia Day, Kirby played down his isolation on the bench.

"My disagreement in the disposition of proceedings that have gone to a full hearing stands in toto, as about 35 per cent." That still makes him the court's great loner.

His invitation warns: "Unfortunately the court will not be providing hospitality following the farewell." But he will barely have time to relax anyway. It may be his last, but Monday will be an ordinary working day.

At 2.15pm he will be back on the bench to hand down a last five judgments in which the Rudd Government will learn, among other things, whether Medicare is unconstitutional for imposing civil conscription on doctors.

Then it's out the door. He's hanging up his shingle in Phillip Street. Like many grandees of the bench, Kirby will now be available for private arbitration. Universities are lining up to have him teach. As always there are speeches to deliver on every subject under the sun.

But the job he really wants is with the United Nations. Last November he was recommended for the new UN Appeals Tribunal. But there is a hurdle yet to be overcome. He must be elected to
the position by the General Assembly. Kirby is facing the verdict of the world.

Friday, January 30, 2009

BACK TO WORKCHOICES IN WA

WA: Individual agreements part of new state IR regime: Buswell

30 January 2009 Content provided to you by AAP.

By Jo Prichard

Individual workplace agreements will be part of a new industrial relations regime in Western Australia, Treasurer Troy Buswell says.

Mr Buswell told a Senate committee inquiring into the Fair Work Bill in Perth that WA will not be signing up to the new federal system.Employers should have the flexibility to be able to make individual contracts a precondition of employment, he told the inquiry on Thursday.

NSW Senator Doug Cameron, a member of the committee, asked Mr Buswell how it would work.

"That would be part of the discussion and the understanding of the decision to take a job or not," Mr Buswell replied.

"So it's 'my way or the highway' ... back to Work Choices?" Senator Cameron asked."It's our view that ... (employees and employers should) arrange their affairs to have flexibility as they see fit,"

Mr Buswell said."You don't have to take the job, at the end of the day."

Outside the hearing, Mr Buswell said it was not the state's intention to return to building a new industrial relations system.

"In most aspects, the Fair Work Bill will provide a base to start from in recrafting a new WA industrial relations system, but we acknowledge we do have some issues with some aspects of that," he said.

"We're not going to revisit industrial relations history in Western Australia," he said, referring to the former WA IR regime run by Liberal minister Graham Kierath.

"Our starting point will be to examine the Fair Work legislation and then to work from there."

Unions WA Secretary Dave Robinson said it was clear Mr Buswell planned to adopt part of the former federal government's Work Choices legislation in the new WA laws.

"He is saying ... you have to sign up to an individual flexibility agreement before you get the job ... that is very very similar to what occurred under Work Choices," Mr Robinson said.

© 2008 AAP Disclaimer

SOLDIER SUICIDES HIT RECORD IN 2008: US ARMY

Soldier suicides hit record in 2008: US Army

January 30, 2009, smh

Suicides among active duty soldiers hit a record high last year for the second year in a row, the US Army reported, acknowledging that stress on the war-time force was a major factor.

The number of soldiers who took their lives in 2008 rose to as many as 143 from 115 the previous year, the army said.

Among the deaths, 128 have been "confirmed suicides and 15 are still being investigated for a determination," said Lieutenant Michelle Martin-Hing, adding that on average "90 percent of unconfirmed go on to be confirmed."

The total has climbed in each of the past four years as the wars in Iraq and Afghanistan have intensified, according to the army.

"Why do the numbers continue to go up?" asked Army Secretary Pete Geren. "We do not know."

Army officials said no single factor explained the increased incidence of suicides.

But General Peter Chiarelli, vice chief of the army, tied the rise to the lengthened combat deployments and high tempo of operations that have strained soldiers and their families.

"There is no doubt in my mind that stress is a factor in the trend we are seeing," he said.
Army statistics released Thursday found that 30 percent of those who committed suicide last year were deployed at the time of their death, and of those more than three quarters were on their first deployment.

About 35 percent had never been deployed before; another 35 percent killed themselves after being deployed, in most cases more than a year after returning to their home bases.

Last year's suicide rate among active duty soldiers rose to 20.2 per 100,000, surpassing a demographically adjusted national suicide rate of 19.5 per 100,000 in 2005, the latest year on record.

The army has responded to the growing problem with more suicide prevention programs, efforts to screen soldiers for mental health problems, and campaigns to reduce the stigma that prevents soldiers from seeking treatment.

But officials indicated it was unclear how well they were working.

Chiarelli announced that units throughout the army will undergo special training sessions beginning February 15 to teach soldiers what to do if they see behaviors in themselves or their friends that could lead to suicide.

It also has enlisted the National Institute of Mental Health to do a long-study of factors affecting soldiers' mental health, and identify ways to decrease the incidence of suicides.

© 2009 AFPThis story is sourced direct from an overseas news agency as an additional service to readers.

GWAHS BUREAUCRATS WON'T BE SACKED

Minister won't sack health bosses over unpaid bills

Louise Hall and Kate Benson, smh

January 30, 2009

Latest related coverage:

Federal hospitals takeover
Out-of-pocket doctor quits in disgust
While the creditors wait, the minister spins and spins

THE Health Minister, John Della Bosca, has refused to sack any of the chief executives in charge of the eight area health services and the Children's Hospital at Westmead, despite all but two failing to meet NSW Health's strict creditor payment policy.

The Area Performance Agreement for chief executives says paying all creditors within the benchmark 45 days is a key performance indicator.

In 2006, the State Government promised to tighten controls to ensure that creditors are paid on time after an Auditor-General's report found the common practice of not paying bills was leading to the suspension of services, delays in supplying goods and additional time wasted in trying to have the orders filled.

The then-health minister, John Hatzistergos, insisted that area health service chief executives would be held personally accountable for unpaid bills.

"I've made it quite clear to area health chief executives … that their obligations and their performance is going to be measured by the extent to which they comply with the creditor payments policy," he said.

But despite figures released by NSW Health on Wednesday showing there was $117.5 million in overdue invoices across the system at the end of this month, not one senior bureaucrat has been held accountable.

In a clear backflip on his predecessor's promise, Mr Della Bosca said yesterday: "It's not about blaming individuals. I'm making everybody in the system accountable [and] the only way you can do this is by sharing the responsibility."

However, the chief executive of Greater Western Area Health Service, Claire Blizard, told the Herald she was ashamed to walk the streets of Dubbo after meat, fruit, vegetables and drug supplies to scores of hospitals had been cut off after bills went unpaid for months.

As doctors in the state's west threatened to walk off the job at 5pm today, Mr Della Bosca authorised an emergency $1.8 million payroll run last night to cover months of outstanding invoices from numerous visiting medical officers in Dubbo, Bathurst and Orange. "We're on top of that problem," he said.

Mr Della Bosca said the Greater Western service covered an area the size of Germany and about 100 health facilities, which had led to the difficulties in paying bills.

He dismissed calls for a return to local hospital boards but did not rule out a federal takeover of health. "The health system for a few generations has been a joint enterprise by Commonwealth and state governments and clearly that … has worked well when you consider the entire postwar period, and that relationship has led to us having one of the best health systems in the world."

The Australian Medical Association's NSW president, Brian Morton, said a number of doctors had already resigned from the public hospital system because they felt they could not offer safe care. "Inability to pay suppliers is symptomatic of deeper problems and the ultimate concern is the welfare of patients," he said.

The chairwoman of the medical staff council at Orange Base Hospital, Ruth Arnold, said doctors' hands were tied. They could insist on the area health service paying interest if their bills were not settled in 45 days but the "service is so strapped for cash that we would rather the money be spent on patient care".

She said some doctors had been paid since October but it was unacceptable that they had to make a fuss before they got their money.

WALL STREET MORALLY BANKRUPT

Wall Street is morally and financially bankrupt

Adam Schwab writes in Crikey 30.1.09:

Last year a German survey claimed that investment bankers were as "unpopular as convicted criminals and prostitutes". It is possible however that the world’s oldest professionals are being unfairly slighted in the comparison. Yesterday, the New York State Comptroller stated that despite US banks receiving around US$300 billion dollars in taxpayer handouts, its executives still saw fit to doll out an estimated US$18.4 billion in bonuses -- the sixth highest on record.

The New York Times noted that the quantum bonus payments made was similar to those paid in 2004 -- when the Dow Jones index was around 10,000 (it is now 8,149). President Obama dubbed the bonus payments as being "shameful" and "the height of irresponsibility".

But it isn’t only bonus payments which have infuriated Main Street and the White House.

Until recently, Citigroup was the world’s largest financial institution. Not any more. In the past six months, Citi has received US$45 billion in taxpayer funds, which is more than double Citi’s current market capitalisation of US$22 billion. Citi also received a government guarantee on more than US$300 billion of toxic assets stuck on the bank’s books. Notwithstanding the bailout, Citi executives only last Monday saw fit to cancel an order for a Dassault Falcon 7X corporate jet, which was ordered back in 2005 was set to cost the stricken bank US$50 million.

One would have thought that someone at Citi would have cancelled the order last year, around the time that they accepted the taxpayer bailout. Apparently not. Or when the bank announced a fourth quarter loss last year of US$8.3 billion. Nup. Instead, it took a rebuke from President Obama for Citi to finally realize that five corporate jets were probably enough for a morally and (and without government help) financially bankrupt institution.

But while Citi appears to have the market cornered in incompetence, it appears that pure greed has a new name, and its name is John Thain. Thain was the CEO of Merrill Lynch, which was recently acquired by Bank of America. BoA was not what one would describe as a willing suitor, having only completed the acquisition after being prodded by the Government and tempted with another US$20 billion from taxpayers.

The second bailout was needed because in its last three months of existence, Merrill managed to lose US$15 billion. Notwithstanding the red ink, Thain requested that Merrill pay him a bonus of US$10 million for completing the BoA sale (Thain reluctantly withdrew the request when it became public last December). Aside from the fact that the transaction only happened because of a taxpayer bailout, Thain didn’t exactly need the money -- he received US$83 million in remuneration last year and is believed to have been paid around US$300 million during his time at Goldman Sachs.

If that wasn’t bad enough, Thain has joined Tyco’s Dennis Kozlowski in setting new standards of Wall Street greed. You may remember Kozlowski as the CEO who accepted loans of more than US$25 million from Tyco to decorate his New York apartment, most notably, spending US$6,000 on the world’s most famous shower curtain. Dennis later spent US$1 million of company funds on his wife’s 40th birthday party in Sardinia, before being jailed for larceny.

While Thain is not believed to have purchased any gold shower curtains, he did see fit to spend US$1,405 on the world’s most famous rubbish bin -- a "parchment waste paper basket". In total, Thain spent more than US$1.22 million office decorations (including a US$87,784 rug and a US$25,713 mahogany pedestal) -- that money of course came from Merrill shareholders, or taxpayers.

But perhaps Citi and Thain are merely creations of Wall Street -- of a system which is designed to take other people’s money and give it to bankers and brokers, regardless of the value created (or destroyed) by them. The system of entitlement is so engrained that despite the US financial system requiring taxpayer bailouts to survive, "a poll of 900 financial industry employees released on Wednesday by eFinancialCareers.com, a job search Web site, found that while nearly eight out of 10 got bonuses, 46 percent thought they deserved more."

Thursday, January 29, 2009

SUMMIT FAILS ZIMBABWE

SADC Summit fails Zimbabwe, focus shifts to African Union

Zimbabwe Information Centre Inc, Australia, January 28, 2009

The poverty of leadership at the Southern African Development Community was rudely exposed this week when its leaders claimed they had resolved the crisis in Zimbabwe, and the party which won the march 29 2008 elections there said the opposite. The Movement for Democratic

Change will hold a meeting this Friday to determine its response, but the immediate focus will be the African Union Summit in Addis Ababa from February 1-3, 2009.

Reported cases of cholera have now passed 53,000 and the number dead is more than 2,800.

This is worse than the death toll from three weeks of intensive Israeli bombardment and assaults on the population of Gaza.

Despite dire predictions that it had been beaten into submission, MDC held to its principled stand that the people of Zimbabwe need urgent help and that it can only come from a government where MDC has real power to make change. MDC deserves admiration for this constancy, but more so, it needs the urgent support of the African Union to end the deadly farce presided over by SADC and Robert Mugabe’s ZANU-PF.

Wednesday, January 28, 2009

ENs AND AINs REPLACE RNs

Red News Readers,

Judith Kiejda may claim in the Letters Column of the Sydney Morning Herald that the claims that the Nurses Association sanctions the use of Assistants in Nursing in place of Registered and Enrolled nurses are wrong, but the facts are that the nursing workforce is deskilling. Enrolled Nurses and Assistants in Nursing do fill Registered Nurse positions on a one for one basis. This process has been well underway for over 8 years now, despite a lengthy dispute over these issues at RPAH in 2001-3, and only now, when the change to Enrolled Nurse education is being implemented, has the Association put on the Agenda with the State Government as part of the Mini Budget package, the formulation of ratios of Enrolled Nurses and Assistants in Nursing to Registered Nurse positions. Even where nurses work in teams, there is a heavy burden on the registered nurse who is responsible for supervising Enrolled Nurses and Assistants in Nursing in their clinical work. If there is a mix of a Registered Nurses, Enrolled Nurses and Assistants in Nursing where formerly there was a team of Registered Nurses, the public cannot expect the same standard of care.

Jenny Haines

LETTER FROM JUDITH KIEJDA, 28.1.09

No nursing shortcuts

Claims that the NSW Nurses Association "sanctions the use of assistants in nursing in place of registered and enrolled nurses" (Letters, January 26) are wrong.

It is inappropriate and unsafe to replace registered nurses with less qualified nurses as a shortcut to overcoming the registered nurse shortage or to cut costs.

It is sometimes acceptable to build nursing teams in which enrolled nurses and assistants in nursing support registered nurses. However, the skill mix must be properly assessed and a clear role identified for assistants, appropriate to their level of knowledge and skill.

The association wants a recognised qualification for nursing assistants, which they should have before being employed.

Judith Kiejda Acting general secretary, NSW Nurses Association, Camperdown

LETTER FROM AN EN, 28.1.09

From my experience of nursing training - through TAFE as a medication-endorsed enrolled nurse and then as a registered nurse through university - I believe the paid TAFE/hospital model should remain.

It should be a mandatory precursor for degree-level studies. You cannot pass through training as an enrolled nurse and not come out with an appreciation of the realities of nursing.

A government with vision would view the paid-training model as a means of increasing the number and quality of nurses. It represents a gamble in terms of participants remaining in nursing after enrolment, but those who do are there because they are motivated and interested - something money cannot buy. They are also in a position to make a more meaningful and better qualified (and better paid) contribution while they do their degree.

The move to offer training at cost through the private sector may make more places available to those who can pay, but this should not be to the detriment of those who cannot. Several colleagues in my group at TAFE - all excellent contributors to the profession - would not be where they are now without the state's investment in human capital.

Wendy Peddell. Newtown.

Monday, January 26, 2009

UNTRAINED NURSES COMPROMISE CARE

Red News Readers,

My letter to the SMH in support of a letter from a nurse today, 26.1.09:

I couldn't have said it better myself Andrew Hopton of Prestons. The public need to carefully take note of Andrew's letter. Despite the money spent on the Garling Report, despite the public concern about standards of care in the health system, NSW Health and health system managers are continuing to deskill the nursing workforce in the name of budgetary efficiency, certainly not better standards of care, and those who should be watchdogs and raising concerns and issues of public interest. are actually puppy dogs lying on their backs getting their tummies scratched! It is time for the public to be alert and alarmed.

Jenny Haines

Letter:

As an enrolled nurse, and trainee registered nurse, I write in the hope that John Della Bosca and Jillian Skinner will take note. Axing an avenue for people to become enrolled nurses and then registered nurses risks plunging the state's health care into further peril ("Infighting leaves nurses in limbo", January 23).

Look at the figures for nursing released by the Health Department. Even if every nurse were to graduate in 2010, there would still be a big shortfall in nursing numbers.

This cannot be solved by the introduction of an underqualified workforce. The Labour Party (and Mr Della Bosca in particular) is flagrantly abusing the health care system with the introduction of assistants in nursing to substitute for registered and enrolled nurses.

Worse is that the Nurses Association of NSW has allowed the rights of nurses to be eroded, and sanctions the use of assistants in nursing in place of registered and enrolled nurses in hospitals and mental health units.

The public's days of receiving treatment from qualified registered and enrolled nurses are numbered as a result. This means patients may be taken care of by somebody who is underqualified and unregistered, and therefore unaccountable for their actions on the hospital floor, and the overall standard of care in the health system will suffer. Lives are at risk.

If Mr Della Bosca has faith in the introduction of this system, presumably he would not mind if the treatment of a member of his family were in the hands of such a person.

Andrew Hopton Prestons

Sunday, January 25, 2009

CRIMINAL NURSES ?

Victorian Nurses Board approves 103 registrations of criminal nurses

By Grant McArthur, Herald Sun

January 24, 2009 03:47am

NURSES guilty of manslaughter, sex offences, arson and torturing animals have been allowed to care for the sick and vulnerable in Victoria.In the past three years the Nurses Board approved registration of 103 nurses who had admitted being found guilty of crimes such as theft, stalking, drug trafficking, possessing child pornography and manslaughter.

The board cancelled registration of two nurses because of their criminal pasts, while the results on another three nurses are unclear, the Herald Sun reports.

Patient advocates and the Opposition want an immediate investigation of registration of some nurses, as well as the process, in light of documents obtained by the Herald Sun through Freedom of Information requests.

But the Nurses Board says it is not concerned that at least 103 of Victoria's 86,000 registered nurses have serious criminal records. Its says its investigation processes ensure public safety.

In 2006 it became mandatory for nurses to disclose their crimes when renewing their registration each year.

Since then the board has been told of:

A NURSE convicted of manslaughter in 1994 whom it re-registered.

THREE nurses guilty of indecent assault who had their registration renewed.

TWO nurses guilty of cruelty to animals.

THREE nurses guilty of recklessly causing serious injury and others who committed serious assault, common assault, unlawful assault, intentionally causing serious injury and negligently causing serious injury.

TWO nurses convicted of stalking.

A NURSE caught with a drug of dependence and taking it into a prison in 2005.

A HOST of theft, fraud and social security offences.

In one instance the board renewed a nurse's registration despite being aware of 19 convictions for arson.

Some offences date back many years, but all were disclosed to the board after 2006.

Medical Error Action Group spokeswoman Lorraine Long accused the state's medical authorities of placing the interests of nurses above those of their patients.

"The Nurses Board is looking at the rights of nurses, but the patients are part of this equation and where are their rights? Who is protecting them?" she said.

Health Services Commissioner Beth Wilson said she had not urged an investigation because the new disclosure requirements may lead to better processes. "When you get a whole lot of disclosures all at once like this you can't possibly investigate them all, particularly when some of them go back to the 1980s . . . What is more important is the nurse's record. Have they been a good nurse and are they well supervised?

"It might be that sometimes people who make mistakes in their life could actually be better nurses."

Opposition health spokeswoman Helen Shardey demanded the board investigate the most serious offences

HOSPITAL MANAGEMENT AND STAFF PASS THE BUCK

Red News Readers,

What angers me most about stories like this is that all of this was avoidable, the concerns about standards of care in the health system and the political embarassment for the government. There have been huge changes in the way the health system is administered and staffed over the past 40 years. Not all change is good, or leads to good outcomes. There have been many, many conscientious health system staff who have spoken out over those 40 years about their concern at the pace of change, often it seemed change for change sake, and the lack of concern about the consequences for patient care. Many of those conscientious staff missed out on promotion, were demoted, or even worse pushed out of the workforce because their care and concern was not seen as a priority in the ongoing push for a rationalised budget efficient system. Health care is about more than the provision of minimum cost care, there has to be room for patient or client centred care.

It is true that since Campbelltown Camden there is a far more effective quality system in parts of the health system and a greater willingness by some to be reflective about clinical practice but clinicians must be supported in their concerns about standards of care by administators, not subject to constant demands for tight budgets that compromise patient care.

Jenny Haines

Hospital management and staff pass the buck

Louise Hall, Health Reporter, smh

January 25, 2009

A FOUR-YEAR study of NSW hospitals has revealed staff and senior health bureaucrats blame each other for shocking errors, including deaths of patients.

The statewide "safety check" found patients were at significant risk of death or injury from falls, medication errors, staffing levels, lax infection control and mistakes in diagnosis and treatment.

Doctors and nurses overwhelmingly agreed that chronic understaffing and heavy reliance on inexperienced junior staff was a major risk - especially after-hours and in complex areas such as emergency and intensive care. But the area health service managers blamed adverse incidents on mistakes made by medical and nursing staff rather than problems with skill mix.

Opposition Health spokeswoman Jillian Skinner said it was "scandalous" that it has been five years since the Walker inquiry into 21 deaths at Campbelltown and Camden hospitals recommended an urgent audit of risks in the health system. Since then internal reports into 85 deaths over two years at western Sydney hospitals revealed that at least 49 of the patients did not receive adequate care.

Most of the avoidable deaths were due to a delay in responding to a rapidly deteriorating patient, the Annual Review of Root Cause Analysis 2006 and 2007 found.

But the chief executive of the $55 million Clinical Excellence Commission, Professor Clifford Hughes, defended the Quality Systems Assessment report released today, saying a great deal of developmental work had been done to get an accurate picture of the state's complex health system.

Professor Hughes said allowing everyone from the ward staff to hospital managers to top-level administrators to nominate their three highest risks to patient safety showed there was a significant disparity between the issues front-line staff saw as important, and the priorities of management.

The report found dozens of patient safety programs had been implemented since 2004 but very few had been reviewed to assess if they actually worked. Four of the eight area health services, and the Children's Hospital at Westmead, did not have any systems or processes for reviewing deaths. It also found confusion and lack of clear policy in many areas.

The director of the Institute of Health Innovation at the University of NSW, Jeffrey Braithwaite, commended the report but said collecting information was just the first step. "On too many initiatives in NSW we've seen things chopping and changing."

Health Minister John Della Bosca said 89 per cent of respondents felt there had been an improvement in patient safety and quality culture in the past two years. "This rigorous program is a world first for the assessment of quality and safety processes in a health system that will help us achieve ongoing improvements."

THE MAJOR RISKS

- Falls

- Medication errors

- Understaffing

- Inappropriate skill mix

- Mistakes in diagnosis

- Failure to recognise a patient rapidly deteriorating

- Infection control

- Inconsistent practices on death review, internal auditing, safety alerts

- Wrong patient or wrong body parts being operated on

Saturday, January 24, 2009

WHO NEEDS TO PULL TOGETHER?

Red News Readers,

Can Australian workers pull together for the greater good, asks David Humphries today in the SMH. Correct me if I am wrong but Australian workers have been pulling together for the common good for more than 20 years now since the implementation of the Prices and Incomes Accordi, sacrificing pay increases and working conditions, working overtime, often forced, and missing out on family and social life in the interests of company or corporate profitability. It wasn’t the working people of this country that created this financial crisis. It seems to me that those who did create this crisis, the “financial entrepreneurs” shall we call them, in this country and overseas, were the ones who lacked any sense of the common good or the interests of the people. It’s a bit rich to now say to the workers of this country that due to the mistakes and stupidity of finance capitalism, you are the ones who bear the burden of consideration of the common good.

Jenny Haines
It's only just begun

January 24, 2009

After two decades without responsibility, can Australians pull together for the greater good?
David Humphries reports.

Latest related coverage:

From boom town to bust

Economists, it's been said, are always right; it's a question only of timing. This is not a gratuitous slap at practitioners of the dismal science but underscores the importance of reliable timeframes to economic forecasting. Knowing the property market or sharemarket will rise and fall does no one much good without knowing when.

When forecasters warned Australians that the economic slowdown, indeed the likelihood of recessionary downturn, would not ease until the second half of this calendar year, it was meant as a prediction of gloom. Instead, against the backdrop of a deepening global crisis scaring the wits out of the very technocrats and politicians trying to assuage our fears, the scenario of a recovery in the latter half of 2009 looks daily more a case of we should be so lucky.

"This is the big one, like the 1930s," says Percy Allan, a previously cautious economic commentator with a penchant for eschewing alarmism. "I just hope the monetary and fiscal authorities know what they're doing because so far there's little sign they do." Now an economic consultant, Allan headed the NSW Treasury for the Labor and Coalition governments and was Boral's finance director.

Kevin Rudd is not in denial. The Prime Minister is appealing to our better nature - for Australians to pull together in this hardship - a message that will struggle to resonate after a quarter of a century of Australians being encouraged to go it alone, of an ethos of everyone for themselves. More on that later.

Rudd wants it known that the "crisis is not of Australia's making" but "we must acknowledge things could even get worse". If Australia is buffeted by economic tumult that began elsewhere, it stands to reason its recovery will be constrained by prolonged global dystrophy.

That makes American research findings on the longevity of recessions even more depressing. In a paper presented this month to the American Economic Association in San Francisco, researchers - Harvard's Kenneth Rogoff and Maryland University's Carmen Reinhart - found downturns typically endure for seven years after severe banking crises. According to The Economist magazine, the research shows an individual's share of national output falls by more than 9 per cent and takes two years to reach bottom.

Unemployment increases by an average of 7 percentage points and falls for five years before recovery begins. If that follows here, the unemployment rate will indeed exceed the 11 per cent mark tipped by some economic commentators who are dismissed as alarmist.

House prices typically fall by 36 per cent and take five years to reach their nadir. Sharemarkets fall for more than three years and lose 56 per cent of value, and real government debt rises by an average of 86 per cent, not so much because of the costs of bailing out banks but because of falling tax revenue and Keynesian pump priming.

Princeton University's Alan Blinder said the long and deep recession had barely begun. The International Monetary Fund chief economist, Olivier Blanchard, said the economy might turn the corner in a year if recession-fighting policies are appropriate.

The thousands of shop assistants, miners, finance workers and others who have lost their jobs, or stand to lose them, might be wondering just how effective Australia's policy suite has been.

BHP Billiton announced this week it would shed 3400 Australian jobs (6000 worldwide), including 1800 at the $2 billion Ravensthorpe nickel mine in Western Australia because of falling commodity prices. The world's biggest miner didn't mention the billions of dollars of shareholder funds squandered in the ultimately abandoned pursuit of rival Rio Tinto, which is also getting rid of workers as demand for its raw materials diminishes. There will be layoffs at CSR, as well as the retailers Harvey Norman and David Jones. The list goes on and on.

Harvey Norman's principal, Gerry Harvey, welcomed December's $9 billion giveaway to families and pensioners and this week pronounced the retail stimulus effort a dud.

If the strategies of the Government and the Reserve Bank of spending the $21 billion surplus and cutting interest rates (a year ago the focus was on fighting inflation) are keeping wolves from the door, the savages are barking at the front gate. Why?

For many intersecting reasons, not least the revelation that we've done our dough punting on the resilience of a flagging Chinese boom to offset meltdowns elsewhere. And yet the capitalist world has embraced, almost unanimously, financial rescues by the Government - loans, guarantees, direct capital injections amounting to thousands of billions of taxpayer dollars.

The black hole's bottom has not been plumbed. The $US700 billion ($1070 billion) pumped into US banks and other financial institutions may yet spin out to more than $US2 trillion. Having committed billions to its own banking system, the Australian Government is working up a scheme to spare Australian businesses likely to be denied renewal of up to $75 billion in offshore loans due to expire within two years. In the meantime, many corporate borrowers live on lines of credit akin to credit cards.

Why such renewal of faith in government intervention in markets? Well, it sounds like common sense in a blackness where everyone is stumbling for answers to problems few understand. "We did not foresee the all-important cessation of interbank lending," says Horace Brock, head of the American economics firm Strategic Economic Decisions. Rather than "blaming greedy and incompetent people", Brock wrote in a December paper on the crisis that "the answer lies in what happened to traditional interbank lending".

Because banks survive by mutual benefit lending and borrowing within the banking circle, the unprecedented cessation of interbank lending last Australian winter and spring meant "banks everywhere were obliged to stop lending to a significant degree". Brock added: "As a result, the Main Streets of the world came to a halt … If we think of credit as the oxygen flowing to the lungs of Main Street, then we have witnessed the first outbreak of global emphysema."

So if banks won't prop each other up and keep money flowing because they know banks' balance sheets are putrid with toxic and immeasurable liabilities that stem from eroding asset values, reckless lending and dubious and unfathomable financial securities, taxpayers become an obvious port of call. Government injections start the ball rolling again, and economic activity begets economic activity. Right? Yes and no.

Much of the faith in Keynesian pump priming has its origins in Franklin Roosevelt's Depression New Deal in the mid-1930s. Suffice to say there is much argument today as to whether American economic recovery was under way before the New Deal was launched, and whether government intervention merely accelerated that comeback. Post hoc ergo propter hoc - after this therefore because of this.

There is another potential flaw. The more governments feel compelled to sink public billions into a floundering private sector, the higher the public anxiety about the depth of financial woes. Says Percy Allan: "There is a risk that the more desperate governments become at throwing money at the problem, the more alarmed the public becomes and so tightens its purse strings."

Get the paradox? With one of the highest levels of household indebtedness in the world - it doubled in 10 years to about 160 per cent of household annual disposable income - Australians are particularly vulnerable to the pain of unemployment and should pay down their debt, but the Government wants them to spend up to stimulate economic exchange. Nothing in economics goes quite how you want it to.

Gorging on the international credit binge of the past 30 years - encouraged in Australia by financial deregulation - were people and institutions incapable of repaying their debts. They were forced into selling assets at fire-sale prices when paying down debt began to avalanche in late 2007.

Lower interest rates, pump priming and bank guarantees are "all good Keynesian stuff", says Allan, but they failed to lift Japan from the doldrums after its asset bubble burst in 1990. Japan survived by exporting into a booming world. "Now that the music has stopped globally, Japan [the biggest buyer of Australian exports] is sinking into a deep recession."

Australia's response to private economy contraction throughout the world, says Rudd, is "to do everything humanly possible to fill that gap, to fill that space". In an address in Hobart on Thursday, the Prime Minister amplified his call for a new togetherness. "It will test governments, national and state. It will test our businesses, it will test our unions, it will test our communities, it will test our basic sense of solidarity.

"Our responsibility is to reach out and help," said Rudd, "at the level of government, at the level of community and at the level of being someone's neighbour."

Rudd's denunciation of unregulated global financial markets, of extreme capitalism, of market fundamentalism and of "extreme greed and excess" might strike a chord with audiences left wondering whether they'll be working in a month, or what happened to their retirement nest eggs. But he should forgive those scratching their heads over his call to lock arms, to dump the ethos of a generation and to embrace our neighbour. After all, many cannot remember when greed and selfishness weren't officially endorsed. And after 18 recession-free years, with all the assurances of unprecedented prosperity, how match-toughened is Australia for the bruising encounters ahead?

Baby boomers, says the historian Kay Saunders, were raised in postwar affluence, but family reminiscences were dominated by talk of Depression and war. "We at least know there were hard times," says Saunders, who heads the Brisbane Institute and was professor of Australian history at Queensland University. "Young people today have only a sense of entitlement, not of responsibility. The spoilt little pusses are into instant gratification. They have no sense of historical consequence. Teaching taught me they're also quite unsympathetic to past hardship; they're totally dissociated from it. Hardship will bewilder them."

Saunders challenges the conventional wisdom that Australians naturally draw together in hardship. "After 1942, Australia pulled together because the Japanese were at our door. But World War I was the greatest point of divide since the convict period - intensely ideologically, racially full of aggression and protest." Similarly, the Depression saw the rise of communism and right-wing activism and threat from the New Guard.

Hugh Mackay, the social commentator, argues that people naturally rally around each other in times of stress, and leaders thrive on hardship. "The four peaks of John Howard's popularity were Port Arthur, 9/11, the invasion of Iraq and Bali," says Mackay. "Human response doesn't require leadership but Rudd must be careful to avoid the appearance of soft options. People expect tough and effective interventions from government."

Michael Pusey, professor of sociology at the University of NSW, says the transition-to-hardship argument is built on the false proposition that Australians travelled comfortably for the past 20 years. To the contrary, says Pusey, the duration of working lives has been compressed, Australians work harder with less job security, pay more for housing and education and health, and are well aware that economic restructuring has diminished quality of life.

"Even during the boom, households have been running up the down escalator. We've been told for a generation there's no free lunch, to make your own opportunities, every person for themselves," says Pusey. "Social solidarity has been systematically undermined by economic restructuring and thrown everyone on to their own resources, to view others as competitors for scarce resources.

"And now Kevin Rudd poorly articulates a change of rhetoric. Ho hum."

Friday, January 23, 2009

NURSE INFIGHTING

Infighting leaves nurses in limbo

Author: Louise Hall, Health Reporter,

Date: 23/01/2009Words: 748Source: SMH

Publication: Sydney Morning HeraldSection: News and FeaturesPage: 3

INFIGHTING within the State Government has put thousands of nursing students in limbo as the departments of health and education argue over who should pay for nursing tuition.

NSW Health has decided to cut the popular Enrolled Nurse Education Program, which paid student nurses a salary and contracted TAFE NSW to provide the theory for the 12-month course.

But after the April 2009 intake, Health will no longer pay TAFE institutes to run classes for the 1200 trainees who go through the program each year.

The Department of Education and Training (DEET) has refused to provide training for free and has withdrawn all enrolled nursing certificate and diploma courses at TAFE NSW institutes.

While bureaucrats scramble, aspiring nurses are being told that public hospitals are no longer recruiting trainee enrolled nurses and they can expect to pay $15,000 in fees and perform 700 hours of unpaid clinical placements before they are qualified to work (see breakout).

The NSW Nurses' Association says the decision will exacerbate the severe nursing shortage, particularly for mature-age students, those with families and those who cannot afford to go to university.

The acting general secretary of the union, Judith Kiedja, said trainee enrolled nurses (TENs) were paid a salary of $34,197 and many used the qualification to put themselves through uni.

She said there is widespread concern among nurses that shifts filled by TENs will be left vacant, or filled by lesser-qualified assistants-in-nursing. "If the department listened to the Garling report, they would replace TENs with graduate registered nurses, which would give wards a better skill mix, but that's a more expensive option so the department won't go for that," she said.

NSW already faces a projected shortage of 12,000 nurses by 2010 as baby boomers, which make up about 20 per cent of the workforce, retire en masse.

The Opposition spokeswoman for health, Jillian Skinner, said the decision was baffling because the mini-budget had ordered hospitals to substitute university-trained registered nurses with enrolled and trainee nurses to save $32 million within four years.

"It makes no sense to cut nurse training and throw up barriers for prospective nursing students at a time when recruiting more nurses should be a priority," Mrs Skinner said.

A spokesman for the Health Minister, John Della Bosca, said axing the Enrolled Nurse Education Program would bring NSW into line with all other states and territories, who do not pay their enrolled nurses during training.

He said it was not ideal to shift the cost burden onto individual students but who should pay the students' fees was "the subject of lots of discussions between NSW Health and the education department".

A spokesman for DEET was unable to say if it would offer any enrolled nursing courses after April. He was also unable to say if TAFE nursing teachers would lose their jobs. "It's all under discussion with NSW Health."

Private colleges, including the College of Nursing in Burwood, are rushing to gain accreditation from the NSW Nurses and Midwives Board to fill the gap left by the confusion. Similar courses can cost up to $15,000 in other states.

Maryanne Crakers, from the National Enrolled Nurse Association, said most state and territory governments subsidised placements in the TAFE and private sector so "students usually only have to find $800 or $900".

"I can only assume the rationale in NSW is to save money," she said.

Willing, able and left waiting

NICOLE HICKMAN has dreamed of becoming a nurse since she broke her ankle in three places and spent weeks in hospital a few years ago.

Proposed changes to the way enrolled nurses are trained in NSW have left her in limbo. "I'm banging my head against the wall, I can't get a straight answer," she said yesterday.

The 21-year-old from Erina completed two introductory nursing assistant courses at TAFE NSW last year to give herself the best chance at securing a job as a trainee enrolled nurse in a public hospital this year.

But unlike applicants for more than 20 years before her, she was told not only will she not receive a wage, but no institute will offer the Certificate IV in Nursing (Enrolled Nurse) course after April.

"All I want is to become a nurse and care for people. Why are they making it so hard for young people these days?"

Career advisers at TAFE and NSW Health have told Ms Hickman enrolled nursing will be run through the private sector and she can expect about $10,000 in upfront fees.

She said she has no hope of finding that kind of money.

Thursday, January 22, 2009

NSW GOVT MAKES PEACE WITH TEACHERS

State makes peace with teachers

Anna Patty Education Editor, smh

January 22, 2009

THE State Government has shelved plans to give school principals greater powers to recruit staff of their choice, in a peace deal to resolve a long-running industrial dispute with the NSW Teachers Federation.

The Government has also backed down on a staff transfer policy it had wanted to phase out from next year.

The teacher union yesterday accepted a salary offer brokered by the NSW Industrial Commission, which provides a cumulative 12.48 per cent increase over three years for TAFE and school teachers.

In accepting the increase, which was 2.5 per cent below what they had sought, teachers traded off some conditions.

There has been a reduction in their sick-leave entitlements from 33 days to 15 days a year, and they can no longer use accumulated leave to top up workers compensation payments.

The Director-General of Education, Michael Coutts-Trotter, yesterday said it was "a decent pay rise for teachers and one that's affordable for taxpayers".

The Premier, Nathan Rees, had ordered government departments to negotiate trade-offs to pay for any wage increases for public servants exceeding 2.5 per cent a year.

The Government announced last year that it would phase out lower-priority "service transfers" for teachers from next year, providing school principals with more opportunities to hire teachers of their choice. Such transfers allow teachers to earn points towards gaining a position in more sought-after locations.

Under the new three-year staffing agreement, finalised yesterday, the Government will retain preliminary arrangements it introduced last April, which allow principals to alternate between advertising teacher vacancies and accepting a service transfer.

The president of the NSW Teachers Federation, Bob Lipscombe, said the staffing and salary agreements were a good outcome "especially in the current economic climate".

NSW GOVT MAKES PEACE WITH TEACHERS

State makes peace with teachers

Anna Patty Education Editor, smh

January 22, 2009

THE State Government has shelved plans to give school principals greater powers to recruit staff of their choice, in a peace deal to resolve a long-running industrial dispute with the NSW Teachers Federation.

The Government has also backed down on a staff transfer policy it had wanted to phase out from next year.

The teacher union yesterday accepted a salary offer brokered by the NSW Industrial Commission, which provides a cumulative 12.48 per cent increase over three years for TAFE and school teachers.

In accepting the increase, which was 2.5 per cent below what they had sought, teachers traded off some conditions.

There has been a reduction in their sick-leave entitlements from 33 days to 15 days a year, and they can no longer use accumulated leave to top up workers compensation payments.

The Director-General of Education, Michael Coutts-Trotter, yesterday said it was "a decent pay rise for teachers and one that's affordable for taxpayers".

The Premier, Nathan Rees, had ordered government departments to negotiate trade-offs to pay for any wage increases for public servants exceeding 2.5 per cent a year.

The Government announced last year that it would phase out lower-priority "service transfers" for teachers from next year, providing school principals with more opportunities to hire teachers of their choice. Such transfers allow teachers to earn points towards gaining a position in more sought-after locations.

Under the new three-year staffing agreement, finalised yesterday, the Government will retain preliminary arrangements it introduced last April, which allow principals to alternate between advertising teacher vacancies and accepting a service transfer.

The president of the NSW Teachers Federation, Bob Lipscombe, said the staffing and salary agreements were a good outcome "especially in the current economic climate".

Tuesday, January 20, 2009

OBAMA'S HEALTH CARE REFORM

Why health will be a headache for Obama

Dr Lesley Russell, of the Menzies Centre for Health Policy, writes in Crikey 20.01.09:

One of the many major challenges confronting President Barack Obama is reform of the US health care system.

Among industrialised nations, the US spends well over twice the per capita average on health care and soaring health costs are expected to reach 20 percent of Gross Domestic Product by 2015. High spending, however, has not translated into better health: Americans do not live as long as citizens of a number of other comparable countries, including Australia, and disparities are pervasive, with widespread differences in access to care based on insurance status, income, race, and ethnicity.

Most people currently get their health insurance through their employers, but government programs for the elderly, disabled, children, veterans and the poor account for over 45 percent of health care expenditures. The US government is the largest insurer in the nation -- an ironic fact given the substantial public opposition to national health insurance.

Over a third of the population is uninsured, unstably insured, or underinsured, and at any time some 16 percent of the population, or 47 million people, are without health insurance. Health insurance costs are rising faster than wages or inflation, and "medical causes" are cited by about half of those filing for bankruptcy.

As the economic crisis bites deeply, and more people lose their jobs and their health cover, health care issues will become even more crucial for American families. Health insurance expenses are the fastest growing cost component for employers who spend 11.3 percent of payroll on employees’ health care.

The three major motor car manufacturers, GM, Ford and Chrysler, have medical obligations of $US114 billion and in 2005 GM estimated that it spent more than $1,500 in employee medical expenses for each new car sold. If these companies go under, there will be major ramifications for health care with the health insurance for 2 million people tied to auto workers' jobs.

The divergent opinions of the US public on health care priorities and reforms, how these should be achieved and who should pay for them, offer ample ammunition for both reformers and their opponents. While presidential campaigns are ill-suited to the task of designing policy reforms, they represent critical periods for setting an incoming administration’s agenda.

President-elect Obama has moved quickly to out his Administration in place, and has nominated former Senator Tom Daschle as both the Secretary of Health and Human Services and head of health policy in the White House. At the same time, the Democrats in the Congress are undertaking preliminary work to assist the passage of legislation, hopefully learning from the problems encountered by the Clinton proposal in 1993-94.

The passage of President Obama’s health reform proposals will be facilitated by the surge of public support for reforms, and by the strong Democrat majorities in both houses of the Congress.

With at least four committees in the Congress having a role in the passage of this legislation, strong leadership from the White House and the ability to develop broad agreement by those in power on the critical details of reform will be essential.

Economic issues will be the primary focus of the new president’s first 100 days in office, but we can expect that Obama will begin the process of outlining his health care reform plans soon after he is inaugurated. While he is not required to give a State of the Union speech, we should expect such an address before the end of January, and his first budget is due in the middle of February.

In order to see timely progress on health care reforms, it will be essential for Obama to not hold the attainable goals of universal coverage and quality improvement hostage to the more unattainable goal of health cost control.

My full paper, Health Care Reform in the 2008 U.S. Presidential Campaign, is available here.

Lesley Russell is Menzies Foundation Fellow at the Menzies Centre for Health Policy University of Sydney/Australian National University and Research Associate, US Studies Centre, University of Sydney

LABOR BREAKS DETENTION PROMISE

Labor breaks detention promise

http://www.theage.com.au/national/labor-breaks-detention-promise-20090119-7ku5.html

Jewel Topsfield, The Age.

January 20, 2009

CONTROVERSIAL prison operator G4S will have its contract to run Australia's immigration detention centres extended until at least July 31 despite Labor's pre-election promise that the public sector would manage the centres.

And detention centres will remain in private hands for several years after the Government confirmed it would proceed with the retendering process started by the Howard government.

In 2006 the former government announced it would not extend G4S's $300 million contract when it expired at the end of 2007, and all detention services would be retendered.Labor criticised the decision and said the contract with G4S (formerly GSL) should be terminated and the centres returned to government control so there was a clear line of responsibility back to the minister.

"This is the private company that has people coming in the doors with no mental health problems and going out as broken human beings," then Labor immigration spokesman Tony Burke said.

"There is one answer and one answer alone, and that is there have been enough breaches of this contract for the government to take action to terminate the privatisation of our detention centres. It was a bad idea from the start. It should not have taken place. It should not be continued."

The ALP's 2007 platform also stated that the public sector would manage the detention centres.

But The Age has learnt that G4S's contract has been extended until July 31, with the contract allowing for further extensions if necessary.

Immigration Minister Chris Evans said the retendering was well advanced when the Rudd Government came into office and the lack of alternative public-service providers would have required the current contract to be extended for at least two years anyway.

"After weighing up all the issues and costs, and giving detailed and serious consideration to the options available, the Government has determined the most prudent way forward is to finalise the current tender process," he said. The successful tenderer will be announced within six months.

Senator Evans said policy on managing detention centres would be reviewed at the end of the new contract."We will impose higher standards on the detention services contractors and the department will be monitoring the contract more closely than before," he said. "It is a question of the values that apply rather than who applies them."

When G4S began running detention centres in 2003, critics claimed it introduced a punitive regime, including solitary confinement.The company was fined $500,000 in 2005 after staff refused detainees food, water and access to a toilet on a seven-hour bus trip between the Maribyrnong and Baxter detention centres.

But in his annual report on detention centres, Human Rights Commissioner Graeme Innes said staff attitudes, services and activities in the centres had generally improved in the past few years.

Monday, January 19, 2009

AUSTRALIA IMPORTS FOOD FROM ZIMBABWE

Food, flowers imported from Zimbabwe

Author: Cynthia Banham, Diplomatic Editor, smh

Date: 17/01/2009

AUSTRALIA is importing fresh produce from Zimbabwe, a nation run by a man whose policies have caused almost half the population to go malnourished, leading the United Nations to warn the country is on the brink of a food emergency.

The Department of Agriculture, Fisheries and Forestry has confirmed Australia imports snow peas from Zimbabwe "on a regular basis", as well as cut flowers. "Australia has imported cut flowers (mainly roses) and snow peas from Zimbabwe for at least 20 years," a department spokesman said.

The department admitted it does not know whether the items are produced by farms controlled by the President Robert Mugabe. "The question is irrelevant to [the Australian Quarantine and Inspection Service's] responsibilities and authority," a spokeswoman said.

Many of the farms still operating in Zimbabwe since President Mugabe began his campaign to seize land from white farmers nine years ago are controlled by the dictator and members of his regime. But the Agriculture Department said it had no mechanisms to ensure imported goods were not profiting the regime.

"The question is irrelevant to AQIS's responsibilities and authority," the spokeswoman repeated. "AQIS is a border agency charged with managing pest and disease risks to Australia."

A spokeswoman for the Foreign Minister, Stephen Smith, said "imports from Zimbabwe are not covered" by sanctions that have been in place against the Mugabe regime since 2002.

"To date, Australia and other like-minded countries have taken the view that general trade sanctions against Zimbabwe, as opposed to financial sanctions targeting the regime and its close supporters, would do more harm than good," she said.

The spokeswoman also said "imports of cut flowers and fresh vegetables from Zimbabwe have been very small in recent years".

Cut flower imports totalled $33,000 in 2007-08 while fresh vegetable imports totalled $20,000-25,000 at most over the past two financial years.

Hyperinflation in Zimbabwe is so advanced that the country will introduce a $100 trillion note, state media said yesterday. The new bill would have been worth about $450 at Thursday's exchange rate.

THE SECRECY OF MISCARRIAGE

Red News Readers,

Monica Dix is on to something. Miscarriage is often not spoken about even within families. It is kept private to the couple, sometimes just the woman herself. Some women see miscarriage as a sign of their failure as a woman and seem to fear being devalued within their family, or their community. But miscarriage is one of those things that happens, maybe for biological reasons. There is no need for shame, or fear, or secrecy. A mature society should be able offer women all the support that is offered at the time of any other death in a family, and that includes the staff of emergency departments and miscarrying women.

Jenny Haines

Time to end secrecy and face the anguish of miscarriage

Monica Dux, smh

January 19, 2009

Awoman miscarried in an emergency room toilet at Maitland Hospital earlier this month, reprising a similar episode at Royal North Shore Hospital in September 2007. Many newspaper reports included gruesome, visceral detail, such as the fact the woman found herself having to dispose of the foetus in the toilet.

The media outrage was predictable but there's another sense in which the reports were quite unusual. Reportage of these women's experiences represents a rare occasion when the brutal reality of miscarriage is publicly discussed.

Expectant women are often advised that they should not publicly reveal their pregnancy until they are past the 12-week mark. One reason given is the high chance of miscarriage in the first trimester. The assumption is that if you were to have a miscarriage, the last thing you'd want is for anyone to know about it. It is a misfortune which we are expected to keep to ourselves.

I recently suffered a miscarriage. I was deeply shaken by the physical process and by the intensity of my grief. But because I followed the accepted wisdom, very few people were aware I'd even been pregnant. And because the pregnancy was a secret, its loss was doubly hard to broach.

Yet, as word of my "secret" slowly spread through my social circle, I was stunned by the number of miscarriage stories women suddenly had to share, as if I'd been admitted to a secret society.

Some talked of long, excruciating waits before they could confirm the "failed pregnancy" diagnosis, others of their anguish as they passed a recognisable foetus. One acquaintance confided the disappointment of five lost pregnancies had been the biggest factor in the breakdown of her marriage. All the women spoke of how difficult it was to publicly express their grief, and of the silence that permeates the experience.

The Australian Longitudinal Study on Women's Health recently reported that, for every three women who have given birth by their early 30s, one has had a miscarriage. Yet despite its frequency, miscarriage is an almost invisible phenomenon. It seems our society is not geared towards grieving, or even acknowledging, the loss of an early pregnancy. As the American author Peggy Orenstein has observed, the English language doesn't even have a word for a lost foetus.

Women have always been expected to keep their biology discretely hidden in the messy "women's business" box. Menstruation is the archetypal example of this social discomfort, epitomised by the clinical blue fluid used in those often lampooned tampon advertisements.

Lost pregnancies are treated very much like menstruation - shameful, discomforting and best spoken of in euphemism. Yet when it comes to miscarriage, our collective desire for silence may have actually increased over the past two or three decades.

We live in an era in which women are supposed to have unprecedented control over their lives, including their bodies and their reproductive processes. As a result we are shadowed by the figure of the ideal women, who defies her biology by never ageing, who makes career and child-rearing look effortless.

This pressure to perform is particularly acute when it comes to pregnancy. The rise of IVF has encouraged the perception that women's bodies are things to be manipulated and controlled; if we fail to get pregnant, it's probably because we haven't tried hard enough. On this logic, a miscarriage is, perhaps, the ultimate failure of womanhood.

It seems that as we've (thankfully) gained more control over our fertility, we've become increasingly disconnected from the messy and sometimes emotionally devastating realities of pregnancy and its complications.

When the experience of miscarrying is so little spoken of, and even then only in hushed tones, it can be hard to define what you are grieving. Yet this is what most of the women I spoke to longed for above all: to make their grief concrete, to frame it in a way that legitimised it.

Without such a frame of social acknowledgment, women who miscarry are left to deal with their pain not only in silence but also in the confusion that comes from a loss that is unquantified.

The Royal North Shore incident triggered a ministerial directive that miscarrying women be taken directly to the maternity department and given appropriate care. This is an institutional move toward according miscarriage the weight it deserves. Our deeper cultural discomfort, and the social expectation of silence that still surrounds miscarriage, will be far harder to reform.

Monica Dux is the co-author of The Great Feminist Denial.

EAST TIMORESE AT SEVERE RISK IN CHILDBIRTH

East Timorese at severe risk in childbirth

January 19, 2009, smh

WOMEN in East Timor are 380 times more likely to die in childbirth than women in Australia, says a report that highlights the huge discrepancies in maternal health care across the region.

The UNICEF 2009 State of the World's Children report shows one in 33 Laotian women, one in 35 East Timorese, one in 55 Papua New Guinean, one in 97 Indonesian and one in 100 Solomon Islands women will die in childbirth or from pregnancy-related complications, compared with one in 13,300 in Australia and one in 5900 in New Zealand.

"It's extraordinary in a country an hour to the north of Australia in this day and age, to have women bleeding to death in childbirth at such a high rate," said UNICEF Australia's chief executive, Carolyn Hardy.

Some basic interventions could fix the problem, Ms Hardy said, listing among them provision of skilled attendants for delivery, educating women and girls to know more about their health, and improving basic sanitation.

Connie Levett

Sunday, January 18, 2009

VILLAWOOD TO BE KNOCKED DOWN

Yuko Narushima, smh

January 18, 2009

THE ageing and cramped Villawood detention centre will be knocked down, with a new facility to be built on Commonwealth land either close to the existing site or the airport.

The latter option is preferable because of the large number of people who are refused entry to Australia and are detained for one or two days before flying out of the country.

Funding for the new centre is expected in next year's Budget following a $1.1 million redevelopment study that is close to being finalised and believed to say the existing centre is no longer viable.

Villawood's maximum security zone, known as Stage 1, was attacked again last week in a report by the Human Rights Commissioner Graeme Innes.

Mr Innes said Villawood remained the most "prison-like" of all the detention centres on the mainland and should be demolished as a matter of urgency.

"It is shameful, not only that it remains standing but that people are still being detained there in its utterly miserable conditions.

"The buildings are ageing and dilapidated. The dormitory bedrooms are cramped and almost completely lacking in privacy. There is no grassy outdoor space for sports. The dining room and the visitors' facilities are both bleak and inhospitable."

Minister for Immigration Chris Evans last year described Villawood as "unacceptable" but is yet to act on conditions in the centre.

The Labor MP for the federal seat of Blaxland, Jason Clare, said a redevelopment of Villawood was essential and Stage 1 should be bulldozed. Possible new sites include Commonwealth land abutting the existing site, near the Villawood train station, or close to the airport to assist with the large load of turnaround cases.

Villawood was recently given $7 million to improve visitor facilities and detainee accommodation but refurbishment beyond that at the current site is unlikely.

Villawood began as a migrant hostel in the 1950s. At that time, it housed assisted migrants and people displaced by World War II, mostly from Europe and Britain. It is remembered for its corrugated iron Nissen huts, one of which remains on site today.

The national co-ordinator for advocacy group A Just Australia, Kate Gauthier, said Villawood should return to that community style of accommodation.

OBAMA RE-ENACTS LINCOLN'S TRAIN JOURNEY

January 18, 2009 - 11:45AM, smh

For the tens of thousands gathering to see President-elect Barack Obama at a pre-inaugural rally in Baltimore, the mood was buoyant despite a long wait in bitter cold.

"What cold?" said Nicole Harris, 32, smiling under her winter hat.

The African-American flight attendant showed up at 7.30am to make sure she got a front-row spot for Mr Obama's late afternoon rally in Baltimore, where his train will stop on its symbolic journey to Washington.

"From the first time I heard him speak I was so deeply moved. I just thought he was the person to help us move in the right direction," Ms Harris said.

"I've been electrified since then."

The queue to enter the event began forming before dawn. By early afternoon the line snaked up to 16 city blocks, with a carnival atmosphere keeping the crowd warm as they filed through tight security enforced by police and army reservists.

With temperatures well below freezing, chants for Mr Obama broke out among the diverse crowd filling up the War Memorial Plaza, decorated with huge American flags and red, white and blue banners. The chants were often accompanied by spontaneous calisthenics to fend off the cold.

"I'm starving, cold and my feet are numb," said Dyone Watson, 20. "But it's definitely worth it."

Even along the train route from Philadelphia to the capital, thousands of exuberant supporters gathered to cheer and wave the vintage railcar on its historic journey, carrying Mr Obama three days before he is sworn in as the first African-American president of the United States.

"It's just beautiful. It just makes me want to do more with my life," said Will Moore, 22, as he stood with his two-year-old niece.

"It's just a joy for everybody. It's about time that we needed change ... He [Mr Obama] is showing us we can do whatever we put our minds to. Just keep on trying, never give up."

"Everybody's very excited and seems to be enjoying themselves," said Walter Massey, 54, an elementary school teacher.

Mr Massey was first in line for the Baltimore rally, having showed up at 4.30am.

"I've got about 12 layers on," he joked, stamping his feet to keep warm.

Like others waiting in the cold, he said he had come to witness history.

"This is truly a historical moment. This was an opportunity to see him, be involved in it. It's probably the most historic thing that will happen in my lifetime," he said.

Mr Obama's victory in November had restored his faith in his compatriots, he said.

"I did not think America was mature enough to elect an African-American as president," said Mr Massey, who is white.

Authorities blocked off a whole section of the city centre for the rally, with buses parked across intersections amid a heavy police presence.

After the event in Baltimore, 57 kilometres from Washington, Mr Obama's train was due to make its way to the US capital.

While the train tour was meant to echo former president and Obama hero Abraham Lincoln's rail ride from the Civil War era, Mr Obama's stop in Baltimore at a rally in daylight marks a break with Lincoln's experience in 1861.

The threat of assassination forced Lincoln to slip through Baltimore at nightfall on his way to Washington, and his train made no stop in a city that at the time had strong Southern sympathies.

For many residents of what is now a predominantly African-American city, a chance to hear Mr Obama speak only days before his swearing-in was the event of a lifetime.

"I came to see history being made. I wanted to see our first African-American president, right here in Baltimore city," said Mrs Harris, 32, sitting on a portable chair with a blanket wrapped around her legs.

"It's just absolutely wonderful, really it is," she said.

With the economy in deep trouble, she said Mr Obama had his work cut out for him.

"It's going to be extremely hard for him. But he's not a man who's going to leave a task undone. I do believe change is going to come," she said.

"We've got to be patient. We've been patient all these years so we can be patient a little bit longer."

AFP

Friday, January 16, 2009

REFUGEES DROWN AT SEA

4 Afghan immigrants die after detention breakout

The Associated Press

Published: January 15, 2009

JAKARTA, Indonesia:

Four illegal Afghan immigrants drowned at sea and five others were missing after a brazen escape from a detention facility in eastern Indonesia, officials said Thursday.

The men were among 18 Afghan and Myanmarese nations who overpowered guards at the facility in Kupang on Wednesday, seriously injuring three. The escaped men then boarded a motorboat that capsized in a storm hours later, police spokesman Okto Riwu said.

Nine survivors were returned to custody and a search team scoured the choppy waters off Kupang for the missing, he said.

They were apparently trying to arrange a boat trip to Australia when they were detained in Kupang in December without proper identification. Indonesia has long been a transit point for people from poor, often conflict-ridden countries hoping to enter wealthy Australia.

In recent years, most migrants have come from Iraq or Afghanistan. They typically fly to Indonesia before continuing to Australia aboard cramped, barely seaworthy ships.

Indonesia's vast seas are treacherous, particularly during high tides in the tropical rainy season.

On Sunday, a ferry capsized off the west coast of Sulawesi and 230 people are missing and presumed dead.

MISCARRIAGE NIGHTMARES

Woman's toilet miscarriage nightmares, Broken Hill Hospital

January 16, 2009 01:56pm, Daily Telegraph

A NSW woman is "having nightmares" after losing her baby in a hospital toilet when she was 23 weeks pregnant with twins, her husband says.

She is the latest in a string of women to reveal their harrowing stories of poor treatment while miscarrying at NSW public hospitals.

Michelle Corradini went to Broken Hill Base Hospital in the state's far west on December 17 when she discovered she was bleeding, said Dr Claire Blizard, chief executive of the Greater Western Area Health Service.

Once at the hospital's emergency department, she was categorised as a "priority three" patient in a range of between one and five, with one being unconscious.

She was seen in 20 minutes by a doctor, within the appropriate timeframe for her category, Dr Blizard said.

"Once it was confirmed that she was in fact miscarrying, the obstetrician was contacted and the obstetrician said, 'Get her round to the maternity unit'," she said.

"While the staff were waiting to transfer her to the maternity unit she went to the toilet and she delivered the first baby.

"She was transferred round to the maternity unit where she delivered the second baby on a bed, which was tragically stillborn as well," she added.

Ms Corradini's husband Andrew Corradini said his wife was left "absolutely devastated" by the incident.

"She's having nightmares," he told ABC Radio on Friday. "Basically, it's shattered me."

News of the tragedy comes just a week after at least three women complained about the care they received while miscarrying at Maitland Hospital in the Hunter Valley.

Lisa Watt, 39, said she was haunted "every day" after having to flush her baby down the emergency department toilet at Maitland on May 19 last year, because there was no bed available.

New protocols say women suspected of miscarrying should be transferred immediately to a maternity ward.

They were developed after a government inquiry into the case of Jana Horska, who miscarried in a toilet at Sydney's Royal North Shore Hospital in September 2007.

Mr Corradini said he felt let down by the health service.

"You go up to hospital thinking you're going to get the best of care and this happens," he said.

"The health minister said after the last time it happened, that they were going to bring protocols in and that it should never happen."

Dr Blizard said there was "very little" a hospital could do to stop a woman from miscarrying.

She said the health service had launched an investigation into the incident, according to normal procedures, with the results expected "within the next week or so".

The investigation, delayed due to key people being away over Christmas, would focus on how the patient was managed clinically as well as emotionally, she said.

She added that the hospital had "been maintaining contact with the family, offering them support".

Thursday, January 15, 2009

NURSES TO STRIKE OVER JOB CUTS

Nurses to strike as at least 500 face the axe

By Kate Sikora, Daily Telegraph

January 15, 2009 12:00am

UP TO 500 nurses could lose their jobs as the State Government desperately tries to claw back $64 million in savings - despite spending almost the same amount on a recruitment drive.

Nurses have begun striking at hospitals around the state over the job cuts which will affect country hospitals such as Dubbo and Orange which are already struggling to provide services.

But health officials deny the cuts will affect bedside nurses.

The Daily Telegraph understands at least seven of the eight area health services plan on cutting nursing positions, but only one will publicly state how many jobs are to go.

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Yesterday cash-strapped Greater Western Area Health Service confirmed 129 nursing positions will be slashed.

North Coast hospitals will also lose about the same number as management looks to shed 460 full-time equivalent positions, including cleaners and wardsmen, across the area.

NSW Nurses Association Judith Kaiedja said other hospitals would also axe nursing positions to rid themselves of debt.

"They claim it is not frontline staff but these positions are causal or agency staff," she said.

"They are nurses who are needed because someone is off sick, annual leave and maternity or we can't fill the positions.

"While I don't want to say it, the number could be 500 or even more. We know seven of the eight area health services have been told to cut their budgets."

The union believes there are about 1100 nursing vacancies, a number which has stayed static for the past two years as the Government desperately attempts to recruit more nurses. It will throw $43.6 million at recruiting and retaining nurses this financial year, a 5.2 per cent increase.

An ageing population also means NSW continues to lose about 10 per cent, or 4200, of its nurses each year. The Federal Government promised $81 million to train and recruit an extra 9250 nurses for Australia's hospital system, but the plan has so far failed.

The scheme included greater funding for nursing places at universities as well as bonuses of $6000 to attract 7750 nurses who had been out of the health workforce for more than a year.

Opposition health spokeswoman Jillian Skinner said the Government needed to come clean on how many nurses would lose their jobs. "The question Health Minister John Della Bosca must answer is how many other area health services across NSW will be sacking frontline nurses

Wednesday, January 14, 2009

ACTU: GOVT BROKE PROMISE TO DITCH WORKCHOICES

Govt broke election promise to ditch Work Choices - ACTU

14 January 2009 Content provided to you by AAP.

By Kate Hannon, National Political EditorCANBERRA, Jan 13 AAP - Labor has broken its election promise to ditch the Howard government's Work Choices industrial laws, the ACTU says.

The peak union body says restrictions on matters allowed in enterprise bargaining under proposed new industrial laws mean Labor's election promise to allow "free bargaining" has not been fulfilled.

The ACTU, which has been largely supportive of Labor's plans, also attacked the award modernisation process which it said could reduce wages and conditions, undermining the safety net.

The criticisms are contained in a 100-page submission, released on Tuesday, to the Senate inquiry into the government's proposed Fair Work Bill designed to replace Work Choices at the end of the year.

In the submission, the ACTU suggests more than 150 amendments to fix "flaws" in the bill now before the Senate.

The ACTU also described as "absurd" a right to request flexible working conditions, which could include extended parental leave, because the request could be denied by employers on "reasonable business grounds".

"This is absurd, and leaves employees worse off than they were under Work Choices," the submission said.

On the bargaining process, it said the proposed rules undermined a workers' fundamental right to representation.

Releasing the submission, ACTU secretary Jeff Lawrence said it was "crunch time" for Labor to deliver on its election promise and he also challenged the Opposition to support the bill in the Senate.

"Working Australians who voted for change at the last election will be very disappointed if these flaws are not corrected by the Senate," Mr Lawrence said.

But Workplace Relations Minister Julia Gillard rejected the ACTU's concerns saying the Fair Work bill delivered on the government's policy released before the last election.

"The Government understands that not every side of the debate has got everything they wanted," a spokeswoman for Ms Gillard said."We believe that means our new laws have got the balance right.

"The Australian Retailers' Association also attacked the proposed new laws in its submission, also released on Tuesday, saying small business is ill-equipped to cope with the new industrial system.It said the new laws risked creating an environment which pays lip service to employers' rights.

"This proposed bill discriminates heavily against small business - the engine room of Australia's economy," the association says.

"The one size fits all approach to industrial relations is old world thinking and fails to take into account the needs of the modern workplace.

"The inquiry will hold public hearings in all capital cities except Darwin starting from January 27 and is due to report to the Senate on February 27.

© 2008 AAP Disclaimer

REFUGEES IN MISERY

13 January 2009

New report highlights ongoing problems in immigration detention

Releasing the 2008 report on conditions in immigration detention today, Human Rights Commissioner Graeme Innes called on the government to translate its ‘new directions’ for Australia’s immigration detention system into policy, practice and legislative change as soon as possible.

“While it is true we have seen improvements in the way Australia treats immigration detainees, our report shows we are still seeing children being held in detention facilities, people being detained for prolonged and indefinite periods and dilapidated detention centres being used for accommodation,” said Mr Innes, “and now we also have the disturbing reality that the massive prison-like Christmas Island facility is open for business.”

Commissioner Innes said the major recommendations in the report include that:
* minimum standards for conditions and treatment of persons in immigration detention should be legislated
* the Migration Act should be amended so that immigration detention is the exception rather than the norm and the decision to detain a person is subject to prompt review by a court
* detention of people on Christmas Island should be ceased
* the recommendations of the national inquiry into children in immigration detention should be implemented by the government.

Mr Innes said he was particularly concerned that, while children are no longer held in immigration detention centres, they are held in other closed detention facilities on the mainland and Christmas Island.

“The time is now for the government to amend Australia’s immigration laws to ensure they comply with the Convention on the Rights of the Child,” Commissioner Innes said. “Detention of children in any type of immigration detention facility should only be used as an absolute last resort.”

Commissioner Innes said he also had serious concerns that, despite the end of the so-called ‘Pacific solution’, asylum seekers are still being detained and processed on the very remote Christmas Island – 2600 km from the nearest Australian capital city.

“The island’s isolation makes it difficult for external groups from the mainland to monitor what is going on there, and the island community is so small that detainees find it very hard to access basic services.”

Citing the dilapidated infrastructure at some of the mainland detention centres as particularly worrying, Mr Innes said the stage 1 section at Villawood was the worst of all. “We have repeatedly called for the demolition of Villawood stage 1,” Commissioner Innes said. “It is shameful, not only that it remains standing, but that people are still being detained there in its utterly miserable conditions.”

The 2008 Immigration detention report covers inspections of the immigration detention facilities around Australia, including Christmas Island, between June and September 2008. In addition to those listed above, the report contains a comprehensive set of recommendations about Australia’s immigration detention system.

A summary factsheet about the report is available at www.humanrights.gov.au/human_rights/immigration/sum_factsheet.html

The full report can be downloaded from www.humanrights.gov.au/human_rights/immigration/idc2008.html


From AAP

Treatment of asylum seekers no better under Rudd: report
Date: January 13 2009

ASYLUM seekers are still being held in miserable conditions despite the softening of immigration policy, a new report finds.

The Australian Human Rights Commission's annual report on detention found the Rudd Government has not made the changes to detention policy it announced last July. The report found asylum seekers, including children, continue to be held indefinitely.

The report also found that the prison-like environment, particularly at the Villawood facility, had not been improved.

One detainee was identified as being held for more than six years despite Labor's policy to detain people only as a last resort and for the minimum amount of time.

People being processed on Christmas Island do not have adequate access to basic services, the report says. And access to interpreters, translated documents, and recreational and educational activities at all detention centres is lacking.

Government policy says all detainees will have access to legal representation and the opportunity to appeal Immigration Department decisions.

The Human Rights Commissioner, Graeme Innes, said it was "shameful" that people continued to be held in "utterly miserable" conditions.

The report recommends closing the Christmas Island facility and legislation to set standards for the treatment of detainees.

It calls for the Migration Act to be amended so detention is the exception rather than the norm, and any decision to detain a person be subject to prompt review by a court.

The Immigration Department says it is working to address the concerns raised in the report but many improvements had been made.


AAP
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