Maternity services report delivers a healthy set of recommendations
Charles Darwin University Professor Lesley Barclay and Griffith University's Dr Jenny Gamble write in Crikey 27.2.09:
The Federal Government’s new report on maternity services is feasible and could just be what is needed to start the process of reform very much needed in Australia’s fragmented maternity services.
While the report correctly identifies that our services are generally of high quality and safe, they could be safer, less costly and more humane.
Operative birth is unnecessarily expensive and is increasing health care costs and pressures on operating theatres, delaying other necessary surgery. Operative birth introduces additional risk to women and their infants. We should return to a justifiable rate of risk and expense attached to caesarean birth in this country.
New risks in our system are birth by the roadside, being seen in rural areas as a consequence of closing small maternity services and the service avoidance being practised by too many remote Aboriginal women. They are dissatisfied with care they receive and concerned about risks to other children that occur if they leave.
The other risk, though one that is too seldom identified, is the risk of psychological harm experienced by women in current systems. In studies investigating the experience of over 1000 women, 30% reported that the birth of their baby was traumatic and were experiencing several (three or more) symptoms of post-traumatic stress disorder at six weeks postpartum.
One suspects the strong response for the review from women themselves reflects some of this distress and a strong motivation to increase women-friendly models of care which are less traumatic. Australian research led by Dr Jenny Gamble is currently investigating how we can reduce this distress.
There are no insurmountable barriers to this report being the first step in action for improvement as its title suggests.
There is much goodwill between midwives, obstetricians and GPs to make it work. Leaving home birth out probably has helped move us forward.
There are significant benefits for jurisdictions to get funding to support their midwifery models that currently do not get sufficiently well reimbursed or supported to expand.
The College of Midwives has a well-accepted professional review and scrutiny process for midwives wishing to take advantage of this professional development process. Women are clamouring for more midwife-based models of care. Evidence shows these are very safe and of high quality. Even better if they reduce operative birth rates, can be local, provided economically, and help women build confidence rather than leave them distressed.
How is the Improving Maternity Services report going down?
Join the discussion at our health blog, Croakey.
Friday, February 27, 2009
Tuesday, February 24, 2009
PATEL TO FACE MANSLAUGHTER CHARGES
Blood scooped out of Jayant Patel surgery patient, court heras
February 23, 2009 11:32am, Daily Telegraph
Patel patient bled after surgery, court told
Patel 'had to reopen and scoop out blood'
Surgeon faces manslaughter charges
A PATIENT had to be reopened so that more than two litres of blood could be removed from his abdomen following an operation by Jayant Patel, a court has been told.
Gerry Kemps had lost so much blood after an oesophagectomy in December 2004 that Dr Patel had to scoop it from his abdomen with a kidney dish, former Bundaberg Base Hospital scrub nurse Katrina Zwolak told the Brisbane Magistrates Court today.
Ms Zwolak said more than 2.3 litres of blood was eventually removed in this manner, and through the use of sponges and a suction line.
Mr Kemps was reopened for the treatment of the internal bleeding about five hours after the oesophagectomy.
The court was told Dr Patel failed to stop the internal bleeding during the initial operation, then left Mr Kemps while he conducted non-emergency surgery on another patient.
It's alleged Dr Patel again failed to stop the bleeding during the second operation, and Mr Kemps died the next day.
Patel has been charged with Mr Kemps's manslaughter.
Ms Zwolak told the court Dr Patel had been "frantic'' when he couldn't find the source of the bleeding, and that he kept saying: "This is not from my surgery.''
However, during earlier evidence in the committal hearing, vascular surgeon Dr Brian Thiele told the court he believed the bleed was likely caused by damage during surgery, as spontaneous aortic ruptures were "extremely rare''.
He also said a competent surgeon should have been able to locate the source of the bleeding.
Dr Patel is facing 13 charges, including three of manslaughter
February 23, 2009 11:32am, Daily Telegraph
Patel patient bled after surgery, court told
Patel 'had to reopen and scoop out blood'
Surgeon faces manslaughter charges
A PATIENT had to be reopened so that more than two litres of blood could be removed from his abdomen following an operation by Jayant Patel, a court has been told.
Gerry Kemps had lost so much blood after an oesophagectomy in December 2004 that Dr Patel had to scoop it from his abdomen with a kidney dish, former Bundaberg Base Hospital scrub nurse Katrina Zwolak told the Brisbane Magistrates Court today.
Ms Zwolak said more than 2.3 litres of blood was eventually removed in this manner, and through the use of sponges and a suction line.
Mr Kemps was reopened for the treatment of the internal bleeding about five hours after the oesophagectomy.
The court was told Dr Patel failed to stop the internal bleeding during the initial operation, then left Mr Kemps while he conducted non-emergency surgery on another patient.
It's alleged Dr Patel again failed to stop the bleeding during the second operation, and Mr Kemps died the next day.
Patel has been charged with Mr Kemps's manslaughter.
Ms Zwolak told the court Dr Patel had been "frantic'' when he couldn't find the source of the bleeding, and that he kept saying: "This is not from my surgery.''
However, during earlier evidence in the committal hearing, vascular surgeon Dr Brian Thiele told the court he believed the bleed was likely caused by damage during surgery, as spontaneous aortic ruptures were "extremely rare''.
He also said a competent surgeon should have been able to locate the source of the bleeding.
Dr Patel is facing 13 charges, including three of manslaughter
CHANGE IN REFUGEE LAW
Refugee law to embrace more
February 24, 2009, SMH
AUSTRALIA will extend protection to people who are threatened with torture and death in their homelands but do not fall under the definition of "refugee".
The Government is to change the law to accommodate people not specifically included by regulations drafted to contend with the mass displacement of Europeans after World War II.
Under the United Nations Refugee Convention of 1951, refugees must demonstrate they are subject to persecution on the basis of their race, political alignment, religion or nationality.
This means that in Australia those persecuted for other reasons or who are stateless are not offered protection or are, at best, put in prolonged detention.
The Immigration Minister, Chris Evans, is considering offering such people what is known as complementary protection, which immigration lawyers say could save many lives.
"The Rudd Government is committed to humanity, fairness and integrity in its refugee policies," Senator Evans told the Herald.
New laws would ensure Australia was meeting its human rights obligations, he said.
It is understood Australian laws would offer those owed complementary protection the same rights as those deemed refugees, avoiding a two-tiered system.
Yuko Narushima
February 24, 2009, SMH
AUSTRALIA will extend protection to people who are threatened with torture and death in their homelands but do not fall under the definition of "refugee".
The Government is to change the law to accommodate people not specifically included by regulations drafted to contend with the mass displacement of Europeans after World War II.
Under the United Nations Refugee Convention of 1951, refugees must demonstrate they are subject to persecution on the basis of their race, political alignment, religion or nationality.
This means that in Australia those persecuted for other reasons or who are stateless are not offered protection or are, at best, put in prolonged detention.
The Immigration Minister, Chris Evans, is considering offering such people what is known as complementary protection, which immigration lawyers say could save many lives.
"The Rudd Government is committed to humanity, fairness and integrity in its refugee policies," Senator Evans told the Herald.
New laws would ensure Australia was meeting its human rights obligations, he said.
It is understood Australian laws would offer those owed complementary protection the same rights as those deemed refugees, avoiding a two-tiered system.
Yuko Narushima
MAFIA LINKS TO VISAS
Police to question MPs over cash-for-visa allegations
Nick McKenzie and Richard Baker. smh
February 24, 2009
THE Australian Federal Police has launched a fresh investigation into cash-for-visa allegations involving the Liberal Party and alleged Mafia figures.
Its Commissioner, Mick Keelty, said yesterday a previous inquiry was dropped in 2007 due to insufficient evidence. This looked into party donations by businessmen with suspected Mafia links who wanted to help an alleged criminal avoid deportation.
But Mr Keelty told a Senate hearing federal police had last month begun a new inquiry after they received fresh information about donations to the Liberals by supporters of Francesco Madafferi, who is facing a drug trafficking charge resulting from the world's biggest ecstasy bust last year.
It is expected federal police will question several serving or former federal MPs and their staff over the allegations, which included a claim that a former NSW Liberal aide expressed concern about the donations. Mr Keelty declined to discuss whether serving or former politicians, their staff and Liberal officials had been interviewed as part of the initial investigation.
"Given the nature of the investigation that has now been reopened I don't think it would be appropriate for me to describe who has been interviewed whether they be politicians, former politicians or staff," he said.
"It would be operational in terms of what they [AFP officers] did … and how far they took it."
In November 2005 Madafferi received a visa after the then immigration minister, Amanda Vanstone, intervened.
Her predecessor, Philip Ruddock, had decided to deport Madafferi to Italy because he was an illegal immigrant with an outstanding warrant in his home country, where he faced four years' jail.
But Ms Vanstone overturned the deportation order on "humanitarian" and mental health grounds.
Ms Vanstone, now the ambassador to Italy, has said that donations from Madafferi's supporters had no influence on her decision.
Among the donors is Antonio Madafferi, Francesco's brother, who is named in coronial inquiries as a member of a suspected Calabrian crime family.
At least three federal Liberal MPs and one NSW Liberal MP raised Madafferi's visa case with Ms Vanstone and the Immigration Department after being approached by businessmen from the Italian community.
Nick McKenzie and Richard Baker. smh
February 24, 2009
THE Australian Federal Police has launched a fresh investigation into cash-for-visa allegations involving the Liberal Party and alleged Mafia figures.
Its Commissioner, Mick Keelty, said yesterday a previous inquiry was dropped in 2007 due to insufficient evidence. This looked into party donations by businessmen with suspected Mafia links who wanted to help an alleged criminal avoid deportation.
But Mr Keelty told a Senate hearing federal police had last month begun a new inquiry after they received fresh information about donations to the Liberals by supporters of Francesco Madafferi, who is facing a drug trafficking charge resulting from the world's biggest ecstasy bust last year.
It is expected federal police will question several serving or former federal MPs and their staff over the allegations, which included a claim that a former NSW Liberal aide expressed concern about the donations. Mr Keelty declined to discuss whether serving or former politicians, their staff and Liberal officials had been interviewed as part of the initial investigation.
"Given the nature of the investigation that has now been reopened I don't think it would be appropriate for me to describe who has been interviewed whether they be politicians, former politicians or staff," he said.
"It would be operational in terms of what they [AFP officers] did … and how far they took it."
In November 2005 Madafferi received a visa after the then immigration minister, Amanda Vanstone, intervened.
Her predecessor, Philip Ruddock, had decided to deport Madafferi to Italy because he was an illegal immigrant with an outstanding warrant in his home country, where he faced four years' jail.
But Ms Vanstone overturned the deportation order on "humanitarian" and mental health grounds.
Ms Vanstone, now the ambassador to Italy, has said that donations from Madafferi's supporters had no influence on her decision.
Among the donors is Antonio Madafferi, Francesco's brother, who is named in coronial inquiries as a member of a suspected Calabrian crime family.
At least three federal Liberal MPs and one NSW Liberal MP raised Madafferi's visa case with Ms Vanstone and the Immigration Department after being approached by businessmen from the Italian community.
Monday, February 23, 2009
EUROPEANS AGREE ON THE NEED FOR GREATER REGULATION
European economies agree need for greater regulation
Richard Carter, February 23, 2009 - 3:54AM, smh
The heads of Europe's largest economies agreed Sunday on the need for greater regulation of stock markets and to double the IMF's funding in order to avoid a repeat of the finance crisis.
The leaders of Britain, France, Germany, Italy, Spain and the Netherlands met in Berlin to hammer out a joint European stance for the Group of 20 meeting of developed and developing countries in London on April 2.
They agreed that "all financial markets, products and participants -- including hedge funds and other private pools of capital which may pose a systemic risk -- must be subjected to appropriate oversight or regulation," a summary of the meeting said.
The leaders also agreed to add an extra 250 billion US dollars, doubling the current level of funding, to the International Monetary Fund (IMF) budget to allow it to intervene to prevent future financial crises.
British Prime Minister Gordon Brown said such a reinforced IMF would be able to help countries in central and eastern Europe which are swept up in a growing economic crisis as western European banks withdraw credit.
"We need international action to help for example in central and eastern Europe where a number of foreign banks have withdrawn to their home banking territories and where it is difficult to recapitalise the rest of the banking system and restructure it without the support of the international financial institutions," Brown told a news conference with his European counterparts.
"So we are proposing today... a 500-billion-dollar (390-billion-euro) IMF fund that enables the IMF not only to deal with crises when they happen but to prevent crises."
French President Nicolas Sarkozy said the stakes for the April summit -- which will be attended by US President Barack Obama -- were high.
"By April 2, we have to succeed and we cannot accept that anything or anyone gets in the way of that summit which will bear a historical responsibility... if we fail there will be no safety net," he said.
German Chancellor Angela Merkel said the Europeans were determined that a strengthened, better-regulated financial system would emerge from the wreckage of the deepest financial crisis for decades.
"It's not a case of talking up the situation but we want to send the message that we have a real opportunity to come out strengthened from this crisis," she said.
Merkel admitted that details of how hedge funds and complex financial products would be regulated still needed to be worked out.
But the stance on hedge funds -- highly speculative and lightly regulated entities that have been accused of fuelling instability in financial markets -- represents a shift in the long-held position of countries such as Britain.
London had previously resisted greater regulation of such funds, which supporters say benefit the economy by bearing risks that others are unwilling to take, although Brown has recently called for stronger rules.
A German government source said the need for direct regulation of hedge funds "is no longer questioned by any of the participants."
The world's major economic powers are under pressure to build on pledges made at the G20 summit in Washington in November, where they formulated an action plan for fighting the crisis.
But the global recession has worsened since then, prompting governments to push through massive economic stimulus packages and overshadowing efforts to reform the global financial system.
The national stimulus plans have sparked fears of protectionism which could hinder efforts to present a united European front.
The end-of-meeting statement however gave a watered-down assessment of protectionism, saying that Europe would only take "measures that keep distortions to competition to an absolute minimum, and we expect the other G20 states to behave likewise."
The results of Sunday's meeting will be discussed by all 27 European Union members at summits in March.
Richard Carter, February 23, 2009 - 3:54AM, smh
The heads of Europe's largest economies agreed Sunday on the need for greater regulation of stock markets and to double the IMF's funding in order to avoid a repeat of the finance crisis.
The leaders of Britain, France, Germany, Italy, Spain and the Netherlands met in Berlin to hammer out a joint European stance for the Group of 20 meeting of developed and developing countries in London on April 2.
They agreed that "all financial markets, products and participants -- including hedge funds and other private pools of capital which may pose a systemic risk -- must be subjected to appropriate oversight or regulation," a summary of the meeting said.
The leaders also agreed to add an extra 250 billion US dollars, doubling the current level of funding, to the International Monetary Fund (IMF) budget to allow it to intervene to prevent future financial crises.
British Prime Minister Gordon Brown said such a reinforced IMF would be able to help countries in central and eastern Europe which are swept up in a growing economic crisis as western European banks withdraw credit.
"We need international action to help for example in central and eastern Europe where a number of foreign banks have withdrawn to their home banking territories and where it is difficult to recapitalise the rest of the banking system and restructure it without the support of the international financial institutions," Brown told a news conference with his European counterparts.
"So we are proposing today... a 500-billion-dollar (390-billion-euro) IMF fund that enables the IMF not only to deal with crises when they happen but to prevent crises."
French President Nicolas Sarkozy said the stakes for the April summit -- which will be attended by US President Barack Obama -- were high.
"By April 2, we have to succeed and we cannot accept that anything or anyone gets in the way of that summit which will bear a historical responsibility... if we fail there will be no safety net," he said.
German Chancellor Angela Merkel said the Europeans were determined that a strengthened, better-regulated financial system would emerge from the wreckage of the deepest financial crisis for decades.
"It's not a case of talking up the situation but we want to send the message that we have a real opportunity to come out strengthened from this crisis," she said.
Merkel admitted that details of how hedge funds and complex financial products would be regulated still needed to be worked out.
But the stance on hedge funds -- highly speculative and lightly regulated entities that have been accused of fuelling instability in financial markets -- represents a shift in the long-held position of countries such as Britain.
London had previously resisted greater regulation of such funds, which supporters say benefit the economy by bearing risks that others are unwilling to take, although Brown has recently called for stronger rules.
A German government source said the need for direct regulation of hedge funds "is no longer questioned by any of the participants."
The world's major economic powers are under pressure to build on pledges made at the G20 summit in Washington in November, where they formulated an action plan for fighting the crisis.
But the global recession has worsened since then, prompting governments to push through massive economic stimulus packages and overshadowing efforts to reform the global financial system.
The national stimulus plans have sparked fears of protectionism which could hinder efforts to present a united European front.
The end-of-meeting statement however gave a watered-down assessment of protectionism, saying that Europe would only take "measures that keep distortions to competition to an absolute minimum, and we expect the other G20 states to behave likewise."
The results of Sunday's meeting will be discussed by all 27 European Union members at summits in March.
Sunday, February 22, 2009
WORKPLACE CONDITIONS LIKE THOSE IN THE INDUSTRIAL REVOLUTION
Workplace conditions like those in industrial revolution
20 February 2009 Content provided to you by AAP.
By Jeff Turnbull, MELBOURNE, Feb 19 AAP -
Australian workers are being exposed to conditions that have not improved since the industrial revolution, a workplace chief said on Thursday.
His comments come after two men suffered horrific injuries while carrying out routine maintenance work on a press.One man lost his hand while the other suffered a badly crushed hand.
The accident happened in the early hours of Thursday as they carried out maintenance work on a press at a Tullamarine factory.WorkSafe Victoria, which is investigating the accident, said the machine started up, trapping their hands, around 1.30am (AEDT).
The accidents came one day after an 18-year-old man died when he was caught up in a press at a cardboard factory in Thomastown.There have been four workplace deaths in the state so far this year, including that of firefighter David Balfour when a tree fell on him near Marysville earlier this week.
WorkSafe Victoria executive director John Merritt said the accidents reinforced his concern that many employers and workers had much more to do to create safer workplaces.
"The reality is that in too many Victorian workplaces, workers are still exposed to the things that were killing and maiming people at the start of the industrial revolution," Mr Merritt said.
"Unguarded machines along with inadequate training, poor supervision and dangerous work practices lead to many amputations, crushings and other serious injuries and deaths each year."
He said the obligations on employers and workers under Victoria's health and safety laws are clear and waiting until someone was hurt before safety problems are fixed was not an option.
He said people were falling into unguarded machines - something that occurred in 1809 and is still happening in 2009.
"In some ways it is worse because today's machines are bigger, faster and stronger," Mr Merritt said.
A workplace safety conference will be held in Melbourne in March.It will show that one in three supervisors say their senior management are not serious about safety while nine per cent say their bosses are "in denial", Mr Merritt said.
WorkSafe Victoria said 22 people died in Victorian businesses last year while another 30,000 were injured.
© 2008 AAP Disclaimer
20 February 2009 Content provided to you by AAP.
By Jeff Turnbull, MELBOURNE, Feb 19 AAP -
Australian workers are being exposed to conditions that have not improved since the industrial revolution, a workplace chief said on Thursday.
His comments come after two men suffered horrific injuries while carrying out routine maintenance work on a press.One man lost his hand while the other suffered a badly crushed hand.
The accident happened in the early hours of Thursday as they carried out maintenance work on a press at a Tullamarine factory.WorkSafe Victoria, which is investigating the accident, said the machine started up, trapping their hands, around 1.30am (AEDT).
The accidents came one day after an 18-year-old man died when he was caught up in a press at a cardboard factory in Thomastown.There have been four workplace deaths in the state so far this year, including that of firefighter David Balfour when a tree fell on him near Marysville earlier this week.
WorkSafe Victoria executive director John Merritt said the accidents reinforced his concern that many employers and workers had much more to do to create safer workplaces.
"The reality is that in too many Victorian workplaces, workers are still exposed to the things that were killing and maiming people at the start of the industrial revolution," Mr Merritt said.
"Unguarded machines along with inadequate training, poor supervision and dangerous work practices lead to many amputations, crushings and other serious injuries and deaths each year."
He said the obligations on employers and workers under Victoria's health and safety laws are clear and waiting until someone was hurt before safety problems are fixed was not an option.
He said people were falling into unguarded machines - something that occurred in 1809 and is still happening in 2009.
"In some ways it is worse because today's machines are bigger, faster and stronger," Mr Merritt said.
A workplace safety conference will be held in Melbourne in March.It will show that one in three supervisors say their senior management are not serious about safety while nine per cent say their bosses are "in denial", Mr Merritt said.
WorkSafe Victoria said 22 people died in Victorian businesses last year while another 30,000 were injured.
© 2008 AAP Disclaimer
Saturday, February 21, 2009
TOOTHACHE IN WRONG POSTCODE COSTS DOUBLE
Toothache in wrong postcode costs double
Josephine Tovey and Erin Somerville, smh
February 21, 2009
PATIENTS in Double Bay are paying up to twice as much for simple dental procedures as people in Bankstown, while the rate of complete tooth loss is almost twice as high among country people as it is among their capital-city dwelling counterparts, figures show.
These figures, released in the same week the Government pushed for a universal health care system, reveal dental care is characterised by inconsistencies and inequality.
Prices gathered by the Herald show vast differences in rates charged for the same procedure at different dental surgeries.
The Australian Dental Association, which criticised the Government's proposed Denticare scheme this week, said the disparity could be explained by different incurred costs.
"It all depends on how large the practice is, how many rooms, how many assistants … their rent might be more expensive in the more affluent areas and those costs have to be passed on," a spokeswoman for the association said.
But the Australian Consumers Association said yesterday this was only part of the explanation.
"Another part of it is what the market will bear; that's how markets work when they're not regulated," a consumers association spokesman said.
Meanwhile, a report released earlier in the week by the Australian Institute of Health and Welfare showed a gap between the dental health of Australians from urban and regional areas.
The report, Geographic Variation In Oral Health And Use Of Dental Services In The Australian Population 2004-06, showed people who live outside capital cities had almost double the prevalence of complete tooth loss compared to capital-city dwellers.
Among rural people, 9 per cent had lost all their teeth, while in capital cities it was only 5 per cent. People in rural areas were also less likely to have regular dental check-ups: only 48 per cent of residents outside capital cities compared with 61 per cent in capital cities.
Josephine Tovey and Erin Somerville, smh
February 21, 2009
PATIENTS in Double Bay are paying up to twice as much for simple dental procedures as people in Bankstown, while the rate of complete tooth loss is almost twice as high among country people as it is among their capital-city dwelling counterparts, figures show.
These figures, released in the same week the Government pushed for a universal health care system, reveal dental care is characterised by inconsistencies and inequality.
Prices gathered by the Herald show vast differences in rates charged for the same procedure at different dental surgeries.
The Australian Dental Association, which criticised the Government's proposed Denticare scheme this week, said the disparity could be explained by different incurred costs.
"It all depends on how large the practice is, how many rooms, how many assistants … their rent might be more expensive in the more affluent areas and those costs have to be passed on," a spokeswoman for the association said.
But the Australian Consumers Association said yesterday this was only part of the explanation.
"Another part of it is what the market will bear; that's how markets work when they're not regulated," a consumers association spokesman said.
Meanwhile, a report released earlier in the week by the Australian Institute of Health and Welfare showed a gap between the dental health of Australians from urban and regional areas.
The report, Geographic Variation In Oral Health And Use Of Dental Services In The Australian Population 2004-06, showed people who live outside capital cities had almost double the prevalence of complete tooth loss compared to capital-city dwellers.
Among rural people, 9 per cent had lost all their teeth, while in capital cities it was only 5 per cent. People in rural areas were also less likely to have regular dental check-ups: only 48 per cent of residents outside capital cities compared with 61 per cent in capital cities.
MIDWIFERY REBORN
Red News Readers,
If the Federal Government goes ahead with this recommendation of the National Health Reform Commission, these changes will be long overdue, but I am not sure that it will make midwfery services more affordable given that home birth midwives are quoted as costing $4000 per delivery. Changing the Medicare Rebate so that consumers can get reimbursed at least part of the cost is an essential part of the reforms.
Jenny Haines
Julie Robotham, Medical Editor, smh
21.2.09
MIDWIVES would be allowed to prescribe medicines and their services could, for the first time, attract a Medicare rebate under reforms to maternity provisions proposed in a national review of birth services.
The review was conducted amid rising caesarean rates and widespread closures of small birth units. Its recommendations would allow midwives to open private group practices, or contract their services to hospitals - improving choice for women and easing a shortage of people trained to deliver babies.
But the report, authored by the Commonwealth's chief nurse and midwifery officer, Rosemary Bryant, and to be published today, says midwives should undertake advanced education and accreditation before being eligible for such funding. And it stops short of recommending Medicare funding for home-births attended by midwives.
The report seeks to ease friction between midwives and obstetricians, with concessions to both groups. Specialist doctors have pointed to Australia's excellent safety record for mothers and babies as evidence in favour of the status quo and have strenuously resisted moves towards home birth. Midwives have accused obstetricians of hijacking normal birth and being responsible for a surgical delivery rate that has soared to one in three.
Ms Bryant said there was "a lack of unanimity within and between some groups of the medical and midwifery professions on the issue of how to deal with risk and consumer preferences".
Safety was paramount, she wrote in the report's preface, but most pregnancies and births were uneventful, and safety concerns should not "prevent us from acting on evidence that supports change to practice".
Midwifery-led birth has consistently been proven safe and preferred by women - particularly if they build a rapport during pregnancy with a midwife who assists them during the birth and afterwards.
The Government should examine expanding dedicated birth services for indigenous women and instituting a national telephone support line for pregnant women, Ms Bryant said. A solution should also be sought to the inability of independent midwives to acquire indemnity insurance - which prevents them attending private clients in hospitals. She said that many of the initiatives would need support from states and territories, which run public hospitals and community health services.
Ms Bryant said she had been struck by the volume of responses to the review: 407 submissions from individual women, many of whom had been dissatisfied by their hospital birth experience.
Chloe Coulthard's third son, Galileo, was delivered at her Dundas home last Friday by midwife Sonja MacGregor. This was her only option for a vaginal birth after the caesarean deliveries of Orlando, 4, and Fox, 2. Ms Coulthard, 26, said the first operation could have been avoided.
"When I read my medical notes it became clear it was not a failure of my labour to progress. It was a failure of the hospital to wait for my labour to progress. It's pretty upsetting."
She was happy to pay Ms MacGregor's full $4000 fee, which includes multiple home visits during pregnancy and afterwards, as well as the birth.
The Health Minister, Nicola Roxon, said: "I'm determined that our kids are given the best start in life. That means giving women the choices they need, wherever they live."
If the Federal Government goes ahead with this recommendation of the National Health Reform Commission, these changes will be long overdue, but I am not sure that it will make midwfery services more affordable given that home birth midwives are quoted as costing $4000 per delivery. Changing the Medicare Rebate so that consumers can get reimbursed at least part of the cost is an essential part of the reforms.
Jenny Haines
Julie Robotham, Medical Editor, smh
21.2.09
MIDWIVES would be allowed to prescribe medicines and their services could, for the first time, attract a Medicare rebate under reforms to maternity provisions proposed in a national review of birth services.
The review was conducted amid rising caesarean rates and widespread closures of small birth units. Its recommendations would allow midwives to open private group practices, or contract their services to hospitals - improving choice for women and easing a shortage of people trained to deliver babies.
But the report, authored by the Commonwealth's chief nurse and midwifery officer, Rosemary Bryant, and to be published today, says midwives should undertake advanced education and accreditation before being eligible for such funding. And it stops short of recommending Medicare funding for home-births attended by midwives.
The report seeks to ease friction between midwives and obstetricians, with concessions to both groups. Specialist doctors have pointed to Australia's excellent safety record for mothers and babies as evidence in favour of the status quo and have strenuously resisted moves towards home birth. Midwives have accused obstetricians of hijacking normal birth and being responsible for a surgical delivery rate that has soared to one in three.
Ms Bryant said there was "a lack of unanimity within and between some groups of the medical and midwifery professions on the issue of how to deal with risk and consumer preferences".
Safety was paramount, she wrote in the report's preface, but most pregnancies and births were uneventful, and safety concerns should not "prevent us from acting on evidence that supports change to practice".
Midwifery-led birth has consistently been proven safe and preferred by women - particularly if they build a rapport during pregnancy with a midwife who assists them during the birth and afterwards.
The Government should examine expanding dedicated birth services for indigenous women and instituting a national telephone support line for pregnant women, Ms Bryant said. A solution should also be sought to the inability of independent midwives to acquire indemnity insurance - which prevents them attending private clients in hospitals. She said that many of the initiatives would need support from states and territories, which run public hospitals and community health services.
Ms Bryant said she had been struck by the volume of responses to the review: 407 submissions from individual women, many of whom had been dissatisfied by their hospital birth experience.
Chloe Coulthard's third son, Galileo, was delivered at her Dundas home last Friday by midwife Sonja MacGregor. This was her only option for a vaginal birth after the caesarean deliveries of Orlando, 4, and Fox, 2. Ms Coulthard, 26, said the first operation could have been avoided.
"When I read my medical notes it became clear it was not a failure of my labour to progress. It was a failure of the hospital to wait for my labour to progress. It's pretty upsetting."
She was happy to pay Ms MacGregor's full $4000 fee, which includes multiple home visits during pregnancy and afterwards, as well as the birth.
The Health Minister, Nicola Roxon, said: "I'm determined that our kids are given the best start in life. That means giving women the choices they need, wherever they live."
Friday, February 20, 2009
THE INTERVENTION IN THE CITY - AN EXPERIMENT
20 Feb 2009
Send In Some Trucks
By Scott Mitchell, New Matilda.
City dwellers hold forth on the "Aboriginal problem", but do any of them know what they're talking about? Scott Mitchell on days five and six of his two week intervention
This article is part of newmatilda.com’s Urban Intervention experiment. For more information read this.
Day Five
The beach is free, but I think I'm getting cancer.
So is watching movies at people's houses. Free that is, not cancerous. I do that for most of the day and no-one says anything particularly interesting. I end up staying with someone. It saves me money and time getting home and I can't help but feel like a bit of a bum — because I don't even particularly want to be there. I feel like I'm using people.
Day Six
At the Beach Road Hotel they serve Schnitzels the size of whole chickens with a side of salad. My mate looks up over his bird and says, "Pretty f*cking good for the price". All I can think about is how many loaves of bread and litres of milk $13 buys.
I ask the bartender how much a gin and tonic is, he replies that it's $7.30 and moves to start making it, I say "I'll have one pink lemonade". He still thinks I'm ordering a G&T and when I clarify he looks completely confused — I'd like to think that he's confused at the idea of refusing to buy a drink for $7.30, but more likely he's confounded by the childish, emasculating choice. The lemonade is $2.30.
My friend Chris has ambitions to be an ambitious lieutenant in young Labor. Like every member of the ALP he's come to the conclusion that everyone else in the ALP is "f*cked".
Yet it is with stereotypical ALP swagger, confidence and self-righteousness that he proscribes his solution for Aboriginal people in the Northern Territory: "They should just have big trucks, like those mobile clinics" he imparts, "It would cost a lot, everyone says 'you're just throwing money at it', but sometimes it's worth it. You should have big trucks, with security and properly trained, high level doctors to look after these people instead of shipping out nursing students straight out of college".
The more that I read about the Northern Territory and the Intervention, the more absurd I find every argument, anecdote and opinion which seeks to address the "Aboriginal problem", without context. Even if you discount the different language groups and cultures which cover the vast swathes of land targeted by the Intervention there is enormous diversity. Few communities look the same. There are communities with serious social problems, just as there are communities with few. There are communities in which English is barely spoken, and some where everyone is fluent. There are different levels of education, infrastructure, health, housing, employment and crime all across the Territory and yet every community has been treated exactly the same — they have been treated as the worst case scenario. It's truly astonishing.
Both sides of the argument as to whether the Intervention has Aboriginal support also fall into the trap of assuming there's a singular voice on the issue.
The final Emergency Response Review Board report states that, "Many people with whom the board came into contact believed that income management did provide a new opportunity to manage their income". Despite this, a survey they conducted found that 85 per cent of respondents believe the Intervention was having a negative impact, while 90 per cent had problems receiving only half their welfare payments in cash. The report goes on to say that the "Testimony of many Aboriginal people, especially women... [supports the belief that many] families and children have benefited from income management".
Yet, the Review Board's survey, which was answered by more women than men found that, "No women reported an overall positive position regarding the Intervention changes", and that, "Of those few who do like using store cards, they are more likely to be male. Over 90 per cent of females disliked using store cards."
We watch The One Armed Boxer versus The Master of the Flying Guillotine and suddenly it's 1:00am. I'm too late to make the last train. Both my friends offer to pay for the cab fare, but I just go out and pay for it myself. It's a particularly depressing cab ride as I realise that despite trying to rein in my spending all weekend I only have about $50 dollars unquarantined with more than a week left.
Send In Some Trucks
By Scott Mitchell, New Matilda.
City dwellers hold forth on the "Aboriginal problem", but do any of them know what they're talking about? Scott Mitchell on days five and six of his two week intervention
This article is part of newmatilda.com’s Urban Intervention experiment. For more information read this.
Day Five
The beach is free, but I think I'm getting cancer.
So is watching movies at people's houses. Free that is, not cancerous. I do that for most of the day and no-one says anything particularly interesting. I end up staying with someone. It saves me money and time getting home and I can't help but feel like a bit of a bum — because I don't even particularly want to be there. I feel like I'm using people.
Day Six
At the Beach Road Hotel they serve Schnitzels the size of whole chickens with a side of salad. My mate looks up over his bird and says, "Pretty f*cking good for the price". All I can think about is how many loaves of bread and litres of milk $13 buys.
I ask the bartender how much a gin and tonic is, he replies that it's $7.30 and moves to start making it, I say "I'll have one pink lemonade". He still thinks I'm ordering a G&T and when I clarify he looks completely confused — I'd like to think that he's confused at the idea of refusing to buy a drink for $7.30, but more likely he's confounded by the childish, emasculating choice. The lemonade is $2.30.
My friend Chris has ambitions to be an ambitious lieutenant in young Labor. Like every member of the ALP he's come to the conclusion that everyone else in the ALP is "f*cked".
Yet it is with stereotypical ALP swagger, confidence and self-righteousness that he proscribes his solution for Aboriginal people in the Northern Territory: "They should just have big trucks, like those mobile clinics" he imparts, "It would cost a lot, everyone says 'you're just throwing money at it', but sometimes it's worth it. You should have big trucks, with security and properly trained, high level doctors to look after these people instead of shipping out nursing students straight out of college".
The more that I read about the Northern Territory and the Intervention, the more absurd I find every argument, anecdote and opinion which seeks to address the "Aboriginal problem", without context. Even if you discount the different language groups and cultures which cover the vast swathes of land targeted by the Intervention there is enormous diversity. Few communities look the same. There are communities with serious social problems, just as there are communities with few. There are communities in which English is barely spoken, and some where everyone is fluent. There are different levels of education, infrastructure, health, housing, employment and crime all across the Territory and yet every community has been treated exactly the same — they have been treated as the worst case scenario. It's truly astonishing.
Both sides of the argument as to whether the Intervention has Aboriginal support also fall into the trap of assuming there's a singular voice on the issue.
The final Emergency Response Review Board report states that, "Many people with whom the board came into contact believed that income management did provide a new opportunity to manage their income". Despite this, a survey they conducted found that 85 per cent of respondents believe the Intervention was having a negative impact, while 90 per cent had problems receiving only half their welfare payments in cash. The report goes on to say that the "Testimony of many Aboriginal people, especially women... [supports the belief that many] families and children have benefited from income management".
Yet, the Review Board's survey, which was answered by more women than men found that, "No women reported an overall positive position regarding the Intervention changes", and that, "Of those few who do like using store cards, they are more likely to be male. Over 90 per cent of females disliked using store cards."
We watch The One Armed Boxer versus The Master of the Flying Guillotine and suddenly it's 1:00am. I'm too late to make the last train. Both my friends offer to pay for the cab fare, but I just go out and pay for it myself. It's a particularly depressing cab ride as I realise that despite trying to rein in my spending all weekend I only have about $50 dollars unquarantined with more than a week left.
Tuesday, February 17, 2009
DENTISTS LASH DENTICARE
Red News Readers,
Those dentists already attacking the proposal for a Denticare Scheme should be consulting their Code of Ethics and their consciences. Speaking out against a scheme that may provide affordable dental care to the 40% of the population who cannot afford it, is one of the most blatant examples of self interst in the health system I have ever heard . These dentists do not know what is going on in Australian society - people living for weeks, months even in dental pain, people living on soft foods for months, years,waiting for access to public dental services, people prescribed antibiotics for a dental infection but no pain relief and so medicating themselves inappropriately, people having no access to dental services after hours and so turning up in emergency departments of public hospital begging for help.
The Dental profession needs to get down off their well heeled high horse and start addressing the real needs of those in Australian society who cannot afford their exorbitant fees. I recently spent $400 on the reconstruction of one tooth. I could have $10,000 worth of orthodontic work done, but I don't have the funds for that. Fortunately I can afford private dental care, but there are many in our community who can't and deserve more consideration from those who call themselves dental professionals.
Jenny Haines
Dentists lash out at free care plan
Mark Metherell, smh
February 17, 2009
DENTISTS have condemned a Medicare-style system for free universal dental care being considered by the Rudd Government as impractical, and massively expensive.
The Denticare plan is part of the National Health and Hospitals Reform Commission's sweeping makeover in hospital and health services, including for indigenous people, the aged and young people with mental illness.
-----------------------------------------------------------------------------------Tell us your experiences of visiting the dentist? Are dentists too expensive? Message 0424 SMS SMH (+61 424 767 764) or email us with your stories. -----------------------------------------------------------------------------------
Denticare would be financed by a 0.75 per cent income levy.
In its interim report released yesterday, the commission raised three options for reshaping state and federal governments' running of the health system.
The proposals range from an improved version of the existing system, through to the development of a European-style social insurance scheme financed by the Commonwealth under which people could choose from health fund plans which would purchase services on their behalf.
The commission is to decide which scheme it would favour in its final report to the Government expected by midyear.
The Health Minister, Nicola Roxon, said the Government was happy to have a debate about the possibility of a new tax to finance Denticare, which she described as a "fairly radical proposal … but we are interested in the community's response to this".
But Dr Neil Hewson, the president of the Australian Dental Association, representing private dentists, slammed the Denticare proposal, saying it could nearly double to $11 billion the cost of dentistry to the government and individual patients.
"The recommendation … for a universal Denticare scheme is impractical, nonsensical, overly simplistic and flies in the face of much of the deliberations that have taken place on this issue over the past decade," he said.
"It shows no appreciation of the real problems facing dental delivery in Australia."
The association believed the Government should target the 35 per cent of the community who could not access or afford proper dental care and said it would be fiscally irresponsible to introduce a universal scheme for dentistry.
The commission has also proposed an indigenous health authority to upgrade care indigenous Australians get, similar to the special arrangements made for veterans.
It has also called for schemes to boost health funding for rural communities, and for the introduction of more community services to counter mental illness among young people.
The commission strongly urged the introduction of individually controlled electronic personal health records which the commission's chairwoman, Dr Christine Bennett, described as "one of the most important systemic opportunities we have".
The report said there was an urgent need to tackle inequities in health status and outcomes and lack of access to health services for many groups in Australia. For indigenous Australians it proposed an increase in funding to reflect the much greater health needs.
A National Aboriginal and Torres Strait Islander Health Authority would purchase services specifically for indigenous patients and focus on results to ensure high quality and timely access to services.
The chief executive of the Australian Health Insurance Association, Dr Michael Armitage, said insurers would consider the dental care proposal and other recommendations and compile a response to the reform commission.
"The industry would support any plan to improve access to dental care for Australians but it is about more than that - it's about quality, safety and achieving better health outcomes - not just health financing," he said.
The Opposition's health spokesman, Peter Dutton, said taxpayers would pay billions of dollars in extra taxes for a national Denticare scheme.
"Almost 11 million Australians or 50 per cent of the population would pay more than they currently do to meet the costs of the Denticare scheme," he said.
The Age
Those dentists already attacking the proposal for a Denticare Scheme should be consulting their Code of Ethics and their consciences. Speaking out against a scheme that may provide affordable dental care to the 40% of the population who cannot afford it, is one of the most blatant examples of self interst in the health system I have ever heard . These dentists do not know what is going on in Australian society - people living for weeks, months even in dental pain, people living on soft foods for months, years,waiting for access to public dental services, people prescribed antibiotics for a dental infection but no pain relief and so medicating themselves inappropriately, people having no access to dental services after hours and so turning up in emergency departments of public hospital begging for help.
The Dental profession needs to get down off their well heeled high horse and start addressing the real needs of those in Australian society who cannot afford their exorbitant fees. I recently spent $400 on the reconstruction of one tooth. I could have $10,000 worth of orthodontic work done, but I don't have the funds for that. Fortunately I can afford private dental care, but there are many in our community who can't and deserve more consideration from those who call themselves dental professionals.
Jenny Haines
Dentists lash out at free care plan
Mark Metherell, smh
February 17, 2009
DENTISTS have condemned a Medicare-style system for free universal dental care being considered by the Rudd Government as impractical, and massively expensive.
The Denticare plan is part of the National Health and Hospitals Reform Commission's sweeping makeover in hospital and health services, including for indigenous people, the aged and young people with mental illness.
-----------------------------------------------------------------------------------Tell us your experiences of visiting the dentist? Are dentists too expensive? Message 0424 SMS SMH (+61 424 767 764) or email us with your stories. -----------------------------------------------------------------------------------
Denticare would be financed by a 0.75 per cent income levy.
In its interim report released yesterday, the commission raised three options for reshaping state and federal governments' running of the health system.
The proposals range from an improved version of the existing system, through to the development of a European-style social insurance scheme financed by the Commonwealth under which people could choose from health fund plans which would purchase services on their behalf.
The commission is to decide which scheme it would favour in its final report to the Government expected by midyear.
The Health Minister, Nicola Roxon, said the Government was happy to have a debate about the possibility of a new tax to finance Denticare, which she described as a "fairly radical proposal … but we are interested in the community's response to this".
But Dr Neil Hewson, the president of the Australian Dental Association, representing private dentists, slammed the Denticare proposal, saying it could nearly double to $11 billion the cost of dentistry to the government and individual patients.
"The recommendation … for a universal Denticare scheme is impractical, nonsensical, overly simplistic and flies in the face of much of the deliberations that have taken place on this issue over the past decade," he said.
"It shows no appreciation of the real problems facing dental delivery in Australia."
The association believed the Government should target the 35 per cent of the community who could not access or afford proper dental care and said it would be fiscally irresponsible to introduce a universal scheme for dentistry.
The commission has also proposed an indigenous health authority to upgrade care indigenous Australians get, similar to the special arrangements made for veterans.
It has also called for schemes to boost health funding for rural communities, and for the introduction of more community services to counter mental illness among young people.
The commission strongly urged the introduction of individually controlled electronic personal health records which the commission's chairwoman, Dr Christine Bennett, described as "one of the most important systemic opportunities we have".
The report said there was an urgent need to tackle inequities in health status and outcomes and lack of access to health services for many groups in Australia. For indigenous Australians it proposed an increase in funding to reflect the much greater health needs.
A National Aboriginal and Torres Strait Islander Health Authority would purchase services specifically for indigenous patients and focus on results to ensure high quality and timely access to services.
The chief executive of the Australian Health Insurance Association, Dr Michael Armitage, said insurers would consider the dental care proposal and other recommendations and compile a response to the reform commission.
"The industry would support any plan to improve access to dental care for Australians but it is about more than that - it's about quality, safety and achieving better health outcomes - not just health financing," he said.
The Opposition's health spokesman, Peter Dutton, said taxpayers would pay billions of dollars in extra taxes for a national Denticare scheme.
"Almost 11 million Australians or 50 per cent of the population would pay more than they currently do to meet the costs of the Denticare scheme," he said.
The Age
Monday, February 16, 2009
CHAVEZ WINS REFERENDUM
Chavez wins Venezuela referendum
from Al Jazeera feed on New Matilda, 16.2.09
Venezuela's president has won a referendum to scrap term limits for elected officials, allowing him to seek re-election indefinitely.
Hugo Chavez greeted cheering supporters at the presidential palace in Caracas on Sunday, moments after the country's electoral commission chief declared victory for the "yes" vote.
"Long live the revolution," shouted Chavez, as he stood pumping his fist on the palace balcony in front of thousands of flag-waving supporters.
After leading supporters in singing the national anthem, he said: "Today we opened wide the gates of the future. Venezuela will not return to its past of indignity."
Tibisay Lucena, the chief of the national electoral council, said that with 94 per cent of the vote counted, 54 per cent had backed the president's proposal - an unbeatable lead.
Festive mood
There was a festive mood on the streets of the capital, as Chavez supporters began celebrating the result.
In depth
Caracas split over Chavez changesIn pictures: Venezuela votesQ&A: Chavez referendumProfile: Hugo ChavezJoin the debate on Venezuela's referendumVideo: Venezuelans to vote on ChavezStudents battle over Venezuela voteVideo: Venezuela votes amid economic woes
"People here are ecstatic," Al Jazeera's Rob Winder, reporting from Chacao district in Caracas, said.
"There are hundreds of people in the street - people are riding around on motorbikes and dancing on the roofs of cars."
Chavez said he received a first message of congratulations from Fidel Castro, Cuba's former president and a mentor of Chavez.
"Dear Hugo, congratulations for you and for your people for a victory that, by its size, is impossible to measure," Castro wrote, according to Chavez.
Venezuela has been divided by the referrendum, which seeks to ammend five articles of the country's constitution to grant the president, mayors, local councilors, legislators and governors unlimited bids for re-election.
The vote was Chavez's second attempt to remove the two-term cap for presidents.
The win means he can seek re-election when his second term in office ends in 2013 and hold the presidency for as long as he continues to win elections.
Without the ammendments, the president is only allowed to hold two consecutive terms, which would mean that Chavez, elected in 1998 and again in 2006, would have to step down at the end of his second mandate.
Opposition defeated
The result is a huge blow for Venezuela's opposition which had made gains in city and state elections last year.
Opposition parties had pinned their hopes on a student movement spearheading the "No is No" vote, a reference to Chavez's failed effort in 2007 to push through constitutional changes to extend his presidency.
Chavez supporters poured on to the streets of Caracas to celebrate the win on Sunday [AFP]
Chavez had previously described winning the vote as key completing his transformation of Venezuela into a socialist state.
His supporters say he has given poor Venezuelans cheap food, free education and quality health care and empowered the poor, after decades of US-backed governments that favored the rich.
But analysts warn that Chavez's social programmes could be hard hit by tumbling oil prices.
"Independently from this referendum Chavez is facing a very acute financial and political crisis in the very near term," Gustavo Coronel, a former board member of the Venezuelan state oil company and an opponent to Chavez, told Al Jazeera. "So far he has been instituting a policy of handouts that have been very good for him. He is very popular among the poor because he has received more than $700bn in the last 10 years," he said.
"[But] the oil prices have plummeted ... I doubt this referendum really means a victory for him in the longer term. I think that, in fact, he might be fighting for his life before the end of the normal term of 2012."
About 100 international observers monitored the vote, but neither the Organisation of American States (OAS) nor the European Union had official observers in Venezuela.
from Al Jazeera feed on New Matilda, 16.2.09
Venezuela's president has won a referendum to scrap term limits for elected officials, allowing him to seek re-election indefinitely.
Hugo Chavez greeted cheering supporters at the presidential palace in Caracas on Sunday, moments after the country's electoral commission chief declared victory for the "yes" vote.
"Long live the revolution," shouted Chavez, as he stood pumping his fist on the palace balcony in front of thousands of flag-waving supporters.
After leading supporters in singing the national anthem, he said: "Today we opened wide the gates of the future. Venezuela will not return to its past of indignity."
Tibisay Lucena, the chief of the national electoral council, said that with 94 per cent of the vote counted, 54 per cent had backed the president's proposal - an unbeatable lead.
Festive mood
There was a festive mood on the streets of the capital, as Chavez supporters began celebrating the result.
In depth
Caracas split over Chavez changesIn pictures: Venezuela votesQ&A: Chavez referendumProfile: Hugo ChavezJoin the debate on Venezuela's referendumVideo: Venezuelans to vote on ChavezStudents battle over Venezuela voteVideo: Venezuela votes amid economic woes
"People here are ecstatic," Al Jazeera's Rob Winder, reporting from Chacao district in Caracas, said.
"There are hundreds of people in the street - people are riding around on motorbikes and dancing on the roofs of cars."
Chavez said he received a first message of congratulations from Fidel Castro, Cuba's former president and a mentor of Chavez.
"Dear Hugo, congratulations for you and for your people for a victory that, by its size, is impossible to measure," Castro wrote, according to Chavez.
Venezuela has been divided by the referrendum, which seeks to ammend five articles of the country's constitution to grant the president, mayors, local councilors, legislators and governors unlimited bids for re-election.
The vote was Chavez's second attempt to remove the two-term cap for presidents.
The win means he can seek re-election when his second term in office ends in 2013 and hold the presidency for as long as he continues to win elections.
Without the ammendments, the president is only allowed to hold two consecutive terms, which would mean that Chavez, elected in 1998 and again in 2006, would have to step down at the end of his second mandate.
Opposition defeated
The result is a huge blow for Venezuela's opposition which had made gains in city and state elections last year.
Opposition parties had pinned their hopes on a student movement spearheading the "No is No" vote, a reference to Chavez's failed effort in 2007 to push through constitutional changes to extend his presidency.
Chavez supporters poured on to the streets of Caracas to celebrate the win on Sunday [AFP]
Chavez had previously described winning the vote as key completing his transformation of Venezuela into a socialist state.
His supporters say he has given poor Venezuelans cheap food, free education and quality health care and empowered the poor, after decades of US-backed governments that favored the rich.
But analysts warn that Chavez's social programmes could be hard hit by tumbling oil prices.
"Independently from this referendum Chavez is facing a very acute financial and political crisis in the very near term," Gustavo Coronel, a former board member of the Venezuelan state oil company and an opponent to Chavez, told Al Jazeera. "So far he has been instituting a policy of handouts that have been very good for him. He is very popular among the poor because he has received more than $700bn in the last 10 years," he said.
"[But] the oil prices have plummeted ... I doubt this referendum really means a victory for him in the longer term. I think that, in fact, he might be fighting for his life before the end of the normal term of 2012."
About 100 international observers monitored the vote, but neither the Organisation of American States (OAS) nor the European Union had official observers in Venezuela.
ONE STOP SHOP HEALTH CENTRES
Red News Readers,
These proposals if implemented properly would certainly improve access to affordable primary health care, but they don't create or fund one more bed in a public hospital. They would in the longer term stop people deteriorating to the point where they need hospital care but the crying need now is for more beds in public hospitals, staffed by skilled and experienced staff, who are adequately resourced, and supported by a more caring and less budget focussed bureaucracy.
Jenny Haines
Proposal for one-stop-shop health centres
Mark Metherell, smh
February 16, 2009
ONE-STOP-SHOP health clinics aimed at reducing reliance on hospitals are proposed by the Rudd Government's reform team as a centrepiece of a federal takeover of community-based health.
The National Health and Hospitals Reform Commission is calling for a radical revamp of Australia's public health services and a bigger federal role in community-based health care, dental services and aged care.
The commission will release a 400-page interim report today containing proposals for a shake-up in health which will be refined in its final report to the Government in the middle of the year.
Some aspects could be developed by late next year.
While the Government-appointed commission will call for a federal takeover of primary care services, the commission is guarded on the issue of federal control of public hospitals, raising it as an "option".
This is despite a pledge by the Prime Minister, Kevin Rudd, to assume financial control of hospitals if states fail to improve their performance by midyear.
The commission has proposed the establishment of "comprehensive primary health care centres" - a larger-scale version of the Government's plans for 31 GP super clinics - to provide one-stop-shops for care by GPs, nurses, diagnostic services, family and child health and other professionals such as physiotherapists, psychologists and podiatrists.
The commission says the Commonwealth's primary care role should include the takeover of largely state-run community health centres, services such as those for women and children, sexual health and alcohol and drug treatment programs.
Another proposal by the commission is to provide young families and patients with chronic and complex conditions with the option to enrol in a single primary health-care service to improve continuity and co-ordination of care.
The commission says present state-federal funding arrangements impede the provision of "connected, comprehensive primary health care".
"Strong primary health care must also drive quality performance through ensuring the 'right care in the right place', including by reducing avoidable hospital visits and admissions by focusing on early intervention and supported self-management," the report says.
It poses the ideal of a connected health system which responds to changing needs, from infancy, through mental health services for young people, co-ordinated care for those with chronic diseases, and support for frail older people living in their homes.
Handing the Federal Government sole responsibility for primary health-care funding would give clear responsibility and accountability for a coherent national policy with identified goals and strategies supported by adequate funding.
The Australian Medical Association is likely to resist the primary health-care centres. It has previously criticised the quality of such care and says it would compete with GPs' practices.
These proposals if implemented properly would certainly improve access to affordable primary health care, but they don't create or fund one more bed in a public hospital. They would in the longer term stop people deteriorating to the point where they need hospital care but the crying need now is for more beds in public hospitals, staffed by skilled and experienced staff, who are adequately resourced, and supported by a more caring and less budget focussed bureaucracy.
Jenny Haines
Proposal for one-stop-shop health centres
Mark Metherell, smh
February 16, 2009
ONE-STOP-SHOP health clinics aimed at reducing reliance on hospitals are proposed by the Rudd Government's reform team as a centrepiece of a federal takeover of community-based health.
The National Health and Hospitals Reform Commission is calling for a radical revamp of Australia's public health services and a bigger federal role in community-based health care, dental services and aged care.
The commission will release a 400-page interim report today containing proposals for a shake-up in health which will be refined in its final report to the Government in the middle of the year.
Some aspects could be developed by late next year.
While the Government-appointed commission will call for a federal takeover of primary care services, the commission is guarded on the issue of federal control of public hospitals, raising it as an "option".
This is despite a pledge by the Prime Minister, Kevin Rudd, to assume financial control of hospitals if states fail to improve their performance by midyear.
The commission has proposed the establishment of "comprehensive primary health care centres" - a larger-scale version of the Government's plans for 31 GP super clinics - to provide one-stop-shops for care by GPs, nurses, diagnostic services, family and child health and other professionals such as physiotherapists, psychologists and podiatrists.
The commission says the Commonwealth's primary care role should include the takeover of largely state-run community health centres, services such as those for women and children, sexual health and alcohol and drug treatment programs.
Another proposal by the commission is to provide young families and patients with chronic and complex conditions with the option to enrol in a single primary health-care service to improve continuity and co-ordination of care.
The commission says present state-federal funding arrangements impede the provision of "connected, comprehensive primary health care".
"Strong primary health care must also drive quality performance through ensuring the 'right care in the right place', including by reducing avoidable hospital visits and admissions by focusing on early intervention and supported self-management," the report says.
It poses the ideal of a connected health system which responds to changing needs, from infancy, through mental health services for young people, co-ordinated care for those with chronic diseases, and support for frail older people living in their homes.
Handing the Federal Government sole responsibility for primary health-care funding would give clear responsibility and accountability for a coherent national policy with identified goals and strategies supported by adequate funding.
The Australian Medical Association is likely to resist the primary health-care centres. It has previously criticised the quality of such care and says it would compete with GPs' practices.
ROBERTSON ON ERC
New Robertson role a 'stitch-up'
Andrew Clennell and Alexandra Smith, smh
February 16, 2009
JOHN ROBERTSON'S role in government has been surprisingly bolstered by the Premier, Nathan Rees, putting the former union boss on the powerful expenditure review committee, without consulting the Treasurer, Eric Roozendaal.
The move has raised eyebrows among senior ministers but there is also conjecture that it may be part of a plan by Mr Rees to make life tough for Mr Robertson.
The former union boss has ambitions to be premier and some Labor Right MPs view him as a possible replacement for Mr Rees, despite being in the upper house.
Senior Government sources have suggested it was a serious attempt to "stitch up" Mr Robertson by giving him the prisons portfolio, where there is a privatisation agenda in play, and public sector reform, as his first portfolios as a minister.
Putting him on the expenditure review committee, which also contains the Treasurer, Finance Minister, Deputy Premier and Premier, could put him in the firing line when it comes to making cuts and taking on public sector unions.
A spokeswoman for the Premier, Korena Flanagan, said: "The very obvious answer [why he was put on the committee] is he is on the ERC because of his role as public sector reform minister."
Mr Rees's leadership has been strengthened for the short term after the federal and state Labor head offices intervened to stop further divisions in the NSW Right, amid speculation that a federal election will be held later this year.
The Herald has been told that a key reason for the appointment of Graeme Wedderburn as the Premier's chief of staff - organised by powerbroker Mark Arbib and national secretary Karl Bitar - was to stabilise the Rees regime for the looming federal election.
It is understood Mr Wedderburn was given the position partly to do a "federal job". The Herald has previously revealed he has been promised a Senate seat in return.
The Labor Party's head office recently forced the Police Minister, Tony Kelly, to cancel a barbecue he was to host for MPs in the Right faction not associated with the powerbrokers Eddie Obeid and Joe Tripodi in a bid to quell speculation that forces were gathering against Mr Rees.
A Right MP said party bosses were trying to "bottle up opposition" to Mr Rees until after a federal election.
"There is no doubt they are trying to put a lid on NSW because they don't want the focus to be on a caucus fight," the MP said. "The feeling is that there will be an election later this year and they want to keep NSW's problems off the radar."
The federal Finance Minister, Lindsay Tanner, attempted to hose down speculation of an election yesterday, which has also been fuelled by the fact the Labor party's national conference has been brought forward. The conference was moved from January 31, next year to July this year.
Mr Tanner told the Ten Network: "That's [an early election's] certainly the last thing on my mind, and I'm sure the last thing on the Government's mind. People … expect us to govern, deal with the crises we've been presented with.
"An election, I don't think, would … help us tackle the huge problems we have arising from the international recession. We are committed to doing what is needed to govern Australia to protect jobs."
Andrew Clennell and Alexandra Smith, smh
February 16, 2009
JOHN ROBERTSON'S role in government has been surprisingly bolstered by the Premier, Nathan Rees, putting the former union boss on the powerful expenditure review committee, without consulting the Treasurer, Eric Roozendaal.
The move has raised eyebrows among senior ministers but there is also conjecture that it may be part of a plan by Mr Rees to make life tough for Mr Robertson.
The former union boss has ambitions to be premier and some Labor Right MPs view him as a possible replacement for Mr Rees, despite being in the upper house.
Senior Government sources have suggested it was a serious attempt to "stitch up" Mr Robertson by giving him the prisons portfolio, where there is a privatisation agenda in play, and public sector reform, as his first portfolios as a minister.
Putting him on the expenditure review committee, which also contains the Treasurer, Finance Minister, Deputy Premier and Premier, could put him in the firing line when it comes to making cuts and taking on public sector unions.
A spokeswoman for the Premier, Korena Flanagan, said: "The very obvious answer [why he was put on the committee] is he is on the ERC because of his role as public sector reform minister."
Mr Rees's leadership has been strengthened for the short term after the federal and state Labor head offices intervened to stop further divisions in the NSW Right, amid speculation that a federal election will be held later this year.
The Herald has been told that a key reason for the appointment of Graeme Wedderburn as the Premier's chief of staff - organised by powerbroker Mark Arbib and national secretary Karl Bitar - was to stabilise the Rees regime for the looming federal election.
It is understood Mr Wedderburn was given the position partly to do a "federal job". The Herald has previously revealed he has been promised a Senate seat in return.
The Labor Party's head office recently forced the Police Minister, Tony Kelly, to cancel a barbecue he was to host for MPs in the Right faction not associated with the powerbrokers Eddie Obeid and Joe Tripodi in a bid to quell speculation that forces were gathering against Mr Rees.
A Right MP said party bosses were trying to "bottle up opposition" to Mr Rees until after a federal election.
"There is no doubt they are trying to put a lid on NSW because they don't want the focus to be on a caucus fight," the MP said. "The feeling is that there will be an election later this year and they want to keep NSW's problems off the radar."
The federal Finance Minister, Lindsay Tanner, attempted to hose down speculation of an election yesterday, which has also been fuelled by the fact the Labor party's national conference has been brought forward. The conference was moved from January 31, next year to July this year.
Mr Tanner told the Ten Network: "That's [an early election's] certainly the last thing on my mind, and I'm sure the last thing on the Government's mind. People … expect us to govern, deal with the crises we've been presented with.
"An election, I don't think, would … help us tackle the huge problems we have arising from the international recession. We are committed to doing what is needed to govern Australia to protect jobs."
Sunday, February 15, 2009
BLOWOUT IN DISABLED PENSION
Red News Readers,
Nice to see this Howard Government initiative failed!!
Jenny Haines
$3b blow-out in disabled pension
Josh Gordon, smh
February 15, 2009
THE Rudd Government is facing a $3 billion blow-out in the cost of the disability support pension, with new figures confirming earlier efforts to push recipients into paid work have failed.
The Howard government had predicted its 2005 plan to force people from the disability pension into paid work by tightening access rules would cut the number of recipients to 690,664 this year.
But internal Government figures show there are now 736,000 disability support pensioners on the public books - about 45,000 more than expected.
The federal budget is now straining to meet the rising cost of the scheme, which supports people assessed as unable to work because of a physical, intellectual or psychiatric impairment.
The scheme is already over budget by $369 million this financial year, with the blow-out expected to widen annually to create a financial hole worth more than $3 billion over the four years to 2011-12.
Family Minister Jenny Macklin accused the Howard government of squandering an opportunity during a period of strong economic growth to reform the disability support system in a way that would support people with disabilities into the future.
Parliamentary Secretary for Disabilities Bill Shorten said the challenge was to change community and employer attitudes to encourage people to hire workers with disabilities, warning that the scheme had become a "pension of last resort".
"If you've got a mental illness or a physical impairment or a mild intellectual disability, people just don't know how to talk to you," Mr Shorten said.
"So I see the DSP challenge as changing community attitudes and employer attitudes. The average time people are on the DSP is 11 years - it's a pension of last resort for people with an impairment."
It remains unclear what the Government intends to do about the burgeoning cost of the scheme, although suggestions include incentives to encourage employees to hire people with disabilities and extra payments to help people with disabilities meet work costs such as travel.
The rising cost of the scheme has been driven almost entirely by a surge in the number of female disability support pensioners following the closure of other payments, including the phasing out of widow and partner allowances.
Government figures show about 4.5 per cent with working age women are now receiving the pension, compared with about 1.5 per cent in the early 1990s.
The proportion of women receiving the pension is expected to continue rising until it reaches the male rate, about 6 per cent.
A single person on the disability support pension can get a maximum of $562.10 a fortnight, compared with about $449 a fortnight for people on the dole.
The Government's updated economic forecasts, released last week, added a further $101 million to the cost of the scheme in 2008-09 and $166 million in 2009-10.
Nice to see this Howard Government initiative failed!!
Jenny Haines
$3b blow-out in disabled pension
Josh Gordon, smh
February 15, 2009
THE Rudd Government is facing a $3 billion blow-out in the cost of the disability support pension, with new figures confirming earlier efforts to push recipients into paid work have failed.
The Howard government had predicted its 2005 plan to force people from the disability pension into paid work by tightening access rules would cut the number of recipients to 690,664 this year.
But internal Government figures show there are now 736,000 disability support pensioners on the public books - about 45,000 more than expected.
The federal budget is now straining to meet the rising cost of the scheme, which supports people assessed as unable to work because of a physical, intellectual or psychiatric impairment.
The scheme is already over budget by $369 million this financial year, with the blow-out expected to widen annually to create a financial hole worth more than $3 billion over the four years to 2011-12.
Family Minister Jenny Macklin accused the Howard government of squandering an opportunity during a period of strong economic growth to reform the disability support system in a way that would support people with disabilities into the future.
Parliamentary Secretary for Disabilities Bill Shorten said the challenge was to change community and employer attitudes to encourage people to hire workers with disabilities, warning that the scheme had become a "pension of last resort".
"If you've got a mental illness or a physical impairment or a mild intellectual disability, people just don't know how to talk to you," Mr Shorten said.
"So I see the DSP challenge as changing community attitudes and employer attitudes. The average time people are on the DSP is 11 years - it's a pension of last resort for people with an impairment."
It remains unclear what the Government intends to do about the burgeoning cost of the scheme, although suggestions include incentives to encourage employees to hire people with disabilities and extra payments to help people with disabilities meet work costs such as travel.
The rising cost of the scheme has been driven almost entirely by a surge in the number of female disability support pensioners following the closure of other payments, including the phasing out of widow and partner allowances.
Government figures show about 4.5 per cent with working age women are now receiving the pension, compared with about 1.5 per cent in the early 1990s.
The proportion of women receiving the pension is expected to continue rising until it reaches the male rate, about 6 per cent.
A single person on the disability support pension can get a maximum of $562.10 a fortnight, compared with about $449 a fortnight for people on the dole.
The Government's updated economic forecasts, released last week, added a further $101 million to the cost of the scheme in 2008-09 and $166 million in 2009-10.
EATING DISORDER DEATH AT RPAH INVESTIGATED
Red News Readers,
Outrage at the death of this young woman is justified. It is a pity that that outrage cannot be harnessed into action. There has been a crying need for beds for eating disorders for many years but the pleas of those in these mental health services have gone unnoticed and unlistened to by the health bureaucracy. People with eating disorders and those who work with them have very few advocates and not much power. Spending priorites are elsewhere.
Jenny Haines
Caroline Marcus, smh
15.2.09
THE family of a young woman who lost her eight-year battle with anorexia last week has accused the NSW health system of gross incompetence, saying she could have been saved.
Catena Di Mauro died at Royal Prince Alfred hospital on February 7. She was 20.
Her father, Frank, has demanded an investigation into her treatment and death.
"I told them [the hospital]: 'You are murderers. I will not rest until you come to justice."'
The family's claims against the hospital include that Catena — whose story featured on the front page of The Sun-Herald in January 2007 — was denied visits from them; could wait four days to have her feeding tubes reinserted after she had removed them; was given access to her own toilet where she could purge meals; tried to hang herself while under observation; and was subjected to a rape attempt by a fellow patient.
Yesterday Health Minister JohnDella Bosca vowed to have the family's claimsinvestigated.
A spokesman said the minister would help the family complain to the Health Care Complaints Commission and would request information from the area health service.
Mr Di Mauro said his daughter had been successfully treated at Newcastle's John Hunter Hospital, where she had gained 10kilograms in five months in 2006. But in July that year he was told the eating disorder unit would be closed because of a lack of funding and she would be transferred to the psychiatric ward at RPA. There, she shared a room with men suffering schizophrenia and drug addiction, and her condition quickly deteriorated.
She weighed just 28 kilograms when she turned 18.
Her twin brother, Paolo, said "she was treated like a dog".
Opposition Leader Barry O'Farrell said it was "appalling" that only four beds in NSW were dedicated to eating disorders.
Outrage at the death of this young woman is justified. It is a pity that that outrage cannot be harnessed into action. There has been a crying need for beds for eating disorders for many years but the pleas of those in these mental health services have gone unnoticed and unlistened to by the health bureaucracy. People with eating disorders and those who work with them have very few advocates and not much power. Spending priorites are elsewhere.
Jenny Haines
Caroline Marcus, smh
15.2.09
THE family of a young woman who lost her eight-year battle with anorexia last week has accused the NSW health system of gross incompetence, saying she could have been saved.
Catena Di Mauro died at Royal Prince Alfred hospital on February 7. She was 20.
Her father, Frank, has demanded an investigation into her treatment and death.
"I told them [the hospital]: 'You are murderers. I will not rest until you come to justice."'
The family's claims against the hospital include that Catena — whose story featured on the front page of The Sun-Herald in January 2007 — was denied visits from them; could wait four days to have her feeding tubes reinserted after she had removed them; was given access to her own toilet where she could purge meals; tried to hang herself while under observation; and was subjected to a rape attempt by a fellow patient.
Yesterday Health Minister JohnDella Bosca vowed to have the family's claimsinvestigated.
A spokesman said the minister would help the family complain to the Health Care Complaints Commission and would request information from the area health service.
Mr Di Mauro said his daughter had been successfully treated at Newcastle's John Hunter Hospital, where she had gained 10kilograms in five months in 2006. But in July that year he was told the eating disorder unit would be closed because of a lack of funding and she would be transferred to the psychiatric ward at RPA. There, she shared a room with men suffering schizophrenia and drug addiction, and her condition quickly deteriorated.
She weighed just 28 kilograms when she turned 18.
Her twin brother, Paolo, said "she was treated like a dog".
Opposition Leader Barry O'Farrell said it was "appalling" that only four beds in NSW were dedicated to eating disorders.
CLASS ACTION AGAINST PRIVATE POWER COMPANIES IN VICTORIA
Huge fire class action launched
Cameron Houston and Michael Bachelard, The Age
February 15, 2009
THE Brumby Government and a private electricity company face one of the largest class actions in Victorian history over last weekend's devastating firestorm.
The legal wrangle, which is expected to involve hundreds of millions of dollars and last for years, will centre on a fallen power line that is believed to have sparked the blaze that tore through Kinglake, Steels Creek and St Andrews, killing more than 100 people and destroying about 1000 homes.
The Phoenix taskforce is examining a two-kilometre stretch of power line in Kilmore East that snapped during strong winds and record heat about 11am last Saturday. Within minutes a nearby pine forest was ablaze. Within six hours the fire had destroyed nearly every building in the towns in its path.
On Thursday, police removed a length of the fallen power line and a pole as evidence.
The lawsuit will cover thousands of farmers, small business owners, tourist operators and residents who lost homes.
Yesterday Slidders Lawyers partner Daniel Oldham confirmed that a class action had been issued in the Supreme Court of Victoria on Friday against Singapore-owned electricity company SP AusNet, which is responsible for maintaining most of the power lines in eastern Victoria.
"It is believed that the claim will be made on the basis of negligent management of power lines and infrastructure," Mr Oldham said.
Gadens Lawyers will issue a separate claim against SP AusNet this week. Slater & Gordon has refused to rule out similar action, but said the firm would wait for the findings of a royal commission to be released late next year.
The Insurance Council of Australia has estimated the cost of the fires at about $500 million. But SP AusNet's legal liability has been capped at $100 million under a deal struck by the former Kennett government with private utility operators, when the former State Electricity Commission was privatised in 1995. Legal sources said this meant the Brumby Government could be forced to cover a shortfall of hundreds of millions of dollars.
Friday's Supreme Court action came as five Western Districts law firms, including Maddens Lawyers and Brown & Proudfoot, met to discuss a separate class action on behalf of victims of the Horsham bushfires, which were also caused by faulty power lines. Legal action is also expected over a separate fire sparked by a fallen power pole that burnt vast swathes of land in Mudgegonga and Dederang.
In other developments:
■ Marysville residents yesterday made the journey back to view their stricken town in a convoy of coaches.
■ The Department of Sustainability and Environment said favourable weather conditions had helped bring all but 12 remaining blazes under control last night, and an 800-kilometre containment line was close to completion.
■ Major-General John Cantwell, acting head of the Victorian Bushfire Reconstruction and Recovery Authority, said builders and other tradesmen would start work on fixing damaged homes this week.
■ A senior emergency services source confirmed that the triple-0 phone line was going unanswered during the crisis, preventing people from reporting new fires, and that CFA internal radio and paging services, and emergency notifications on CFA and DSE websites were clogged and inadequate.
■ Royal commission chairman Justice Bernard Teague acknowledged the "huge challenge" ahead, but would not elaborate on the terms of his inquiry until his appointment was made official tomorrow.
Melbourne barrister Tim Tobin, QC, successfully represented hundreds of victims of the 1983 Ash Wednesday fires in a class action against the State Electricity Commission. The statutory authority was forced to pay out more than $300 million to more than 5000 claimants, after clashing power lines were found to have caused fires at Mount Macedon, north of Melbourne, and Warrnambool, in the state's west.
Mr Tobin said private utility companies had a duty of care to Victorian communities.
"That means keeping electricity lines clear of trees and in a condition that won't cause fires. They must also have systems in place to identify and prevent risks occurring," Mr Tobin said.
A spokeswoman for SP AusNet said the power company would assist with investigations into the cause of the deadly blaze.
"Our priority is to restore power to fire-affected areas as quickly as possible," she said.
A spokesman for Energy Safe Victoria said the government body had audited the network's bushfire risk to make sure required distances between power lines and vegetation were maintained. Power companies had been given a clean bill of health, and electricity firms were judged to be "well prepared for the 2008-09 bushfire season".
He said there were no regulations applying to the distances between poles supporting electricity lines and spans of one kilometre were not unusual.
Cameron Houston and Michael Bachelard, The Age
February 15, 2009
THE Brumby Government and a private electricity company face one of the largest class actions in Victorian history over last weekend's devastating firestorm.
The legal wrangle, which is expected to involve hundreds of millions of dollars and last for years, will centre on a fallen power line that is believed to have sparked the blaze that tore through Kinglake, Steels Creek and St Andrews, killing more than 100 people and destroying about 1000 homes.
The Phoenix taskforce is examining a two-kilometre stretch of power line in Kilmore East that snapped during strong winds and record heat about 11am last Saturday. Within minutes a nearby pine forest was ablaze. Within six hours the fire had destroyed nearly every building in the towns in its path.
On Thursday, police removed a length of the fallen power line and a pole as evidence.
The lawsuit will cover thousands of farmers, small business owners, tourist operators and residents who lost homes.
Yesterday Slidders Lawyers partner Daniel Oldham confirmed that a class action had been issued in the Supreme Court of Victoria on Friday against Singapore-owned electricity company SP AusNet, which is responsible for maintaining most of the power lines in eastern Victoria.
"It is believed that the claim will be made on the basis of negligent management of power lines and infrastructure," Mr Oldham said.
Gadens Lawyers will issue a separate claim against SP AusNet this week. Slater & Gordon has refused to rule out similar action, but said the firm would wait for the findings of a royal commission to be released late next year.
The Insurance Council of Australia has estimated the cost of the fires at about $500 million. But SP AusNet's legal liability has been capped at $100 million under a deal struck by the former Kennett government with private utility operators, when the former State Electricity Commission was privatised in 1995. Legal sources said this meant the Brumby Government could be forced to cover a shortfall of hundreds of millions of dollars.
Friday's Supreme Court action came as five Western Districts law firms, including Maddens Lawyers and Brown & Proudfoot, met to discuss a separate class action on behalf of victims of the Horsham bushfires, which were also caused by faulty power lines. Legal action is also expected over a separate fire sparked by a fallen power pole that burnt vast swathes of land in Mudgegonga and Dederang.
In other developments:
■ Marysville residents yesterday made the journey back to view their stricken town in a convoy of coaches.
■ The Department of Sustainability and Environment said favourable weather conditions had helped bring all but 12 remaining blazes under control last night, and an 800-kilometre containment line was close to completion.
■ Major-General John Cantwell, acting head of the Victorian Bushfire Reconstruction and Recovery Authority, said builders and other tradesmen would start work on fixing damaged homes this week.
■ A senior emergency services source confirmed that the triple-0 phone line was going unanswered during the crisis, preventing people from reporting new fires, and that CFA internal radio and paging services, and emergency notifications on CFA and DSE websites were clogged and inadequate.
■ Royal commission chairman Justice Bernard Teague acknowledged the "huge challenge" ahead, but would not elaborate on the terms of his inquiry until his appointment was made official tomorrow.
Melbourne barrister Tim Tobin, QC, successfully represented hundreds of victims of the 1983 Ash Wednesday fires in a class action against the State Electricity Commission. The statutory authority was forced to pay out more than $300 million to more than 5000 claimants, after clashing power lines were found to have caused fires at Mount Macedon, north of Melbourne, and Warrnambool, in the state's west.
Mr Tobin said private utility companies had a duty of care to Victorian communities.
"That means keeping electricity lines clear of trees and in a condition that won't cause fires. They must also have systems in place to identify and prevent risks occurring," Mr Tobin said.
A spokeswoman for SP AusNet said the power company would assist with investigations into the cause of the deadly blaze.
"Our priority is to restore power to fire-affected areas as quickly as possible," she said.
A spokesman for Energy Safe Victoria said the government body had audited the network's bushfire risk to make sure required distances between power lines and vegetation were maintained. Power companies had been given a clean bill of health, and electricity firms were judged to be "well prepared for the 2008-09 bushfire season".
He said there were no regulations applying to the distances between poles supporting electricity lines and spans of one kilometre were not unusual.
Saturday, February 14, 2009
NATIONAL DENTAL SCANDAL DRAGS ON
Red News Readers,
What does it take to get governments moving on the need for a national dental scheme? The situation is a scandal and has been for some time ever since the Howard Government abolished the Commonwealth Dental Scheme. I am aware of people living with severe dental pain for weeks; people who need emergency care and cannot afford it so turn up at hospital emergency departments begging for help; people living on soft food and fluids for months and years, losing weight and becoming malnourished. We are a wealthy country. This should not be happening in this country. And as for the dental profession, where is your compassion?
Jenny Haines
National dental scheme urged for needy
Mark Metherell, smh
February 14, 2009
THE ailing state of public dental care has prompted a call from the Government's health reform experts for a national scheme to provide care to needy patients with bad teeth.
The Australian Health and Hospitals Reform Commission will release an interim report on Monday which will propose a significant rethink of health policies in areas such as public hospitals, indigenous health and spreading Medicare payments beyond doctors to other professionals.
The report is understood to have targeted the widespread deterioration in dental health as a priority for revamped federal intervention. It is estimated 650,000 people who cannot afford dental care are in need of dental treatment.
The report proposes novel approaches, including the expanded use of new dental graduates to increase publicly financed services that have failed to meet current demands from patients in most states including NSW.
The proposal comes as the Rudd Government baulks at a Commonwealth dental scheme that it claims would provide 1 million services over three years to needy patients.
The Health Minister, Nicola Roxon, has refused to implement the scheme pledged before the election until opposition parties agree to legislation axing the previous government's Medicare dental scheme for patients with chronic medical conditions.
The Government has introduced a dental scheme for teenagers, but dentist organisations say both that scheme and the proposed Commonwealth scheme are poorly targeted and rely on under-resourced public dental services.
An expert report to the reform commission last year identified "two worlds" in dentistry: the 39 per cent of adults who saw dentists regularly and the 61 per cent who did not, and who had poorer oral health and many times the rate of tooth extractions - a precursor of poorer quality of life.
The report by Adelaide University population dental health experts, Professor John Spencer and Dr Jane Harford, also said primary school children's oral health "has plateaued and then deteriorated by around 20 per cent across the last 8-10 years".
The commission's interim report is expected to float a range of proposals to upgrade the health system in preparation for its final report to the Government in June. It is expected to raise the option of a federal takeover of public hospitals. The Prime Minister, Kevin Rudd, will decide on this issue by the middle of the year.
The commission has considered a vast range of proposals which were presented to it in more than 500 submissions.
In its 400-page report, the commission is likely to put more pressure on the Government in sensitive areas including performance payments for doctors and dealing with inequities in the health system that tend to deliver more publicly subsidised services to well-off people living in well-served areas.
However, the Government has ordered the commission to stay away from a subject which has been much criticised in Labor ranks - the $4 billion private health insurance subsidy.
.
What does it take to get governments moving on the need for a national dental scheme? The situation is a scandal and has been for some time ever since the Howard Government abolished the Commonwealth Dental Scheme. I am aware of people living with severe dental pain for weeks; people who need emergency care and cannot afford it so turn up at hospital emergency departments begging for help; people living on soft food and fluids for months and years, losing weight and becoming malnourished. We are a wealthy country. This should not be happening in this country. And as for the dental profession, where is your compassion?
Jenny Haines
National dental scheme urged for needy
Mark Metherell, smh
February 14, 2009
THE ailing state of public dental care has prompted a call from the Government's health reform experts for a national scheme to provide care to needy patients with bad teeth.
The Australian Health and Hospitals Reform Commission will release an interim report on Monday which will propose a significant rethink of health policies in areas such as public hospitals, indigenous health and spreading Medicare payments beyond doctors to other professionals.
The report is understood to have targeted the widespread deterioration in dental health as a priority for revamped federal intervention. It is estimated 650,000 people who cannot afford dental care are in need of dental treatment.
The report proposes novel approaches, including the expanded use of new dental graduates to increase publicly financed services that have failed to meet current demands from patients in most states including NSW.
The proposal comes as the Rudd Government baulks at a Commonwealth dental scheme that it claims would provide 1 million services over three years to needy patients.
The Health Minister, Nicola Roxon, has refused to implement the scheme pledged before the election until opposition parties agree to legislation axing the previous government's Medicare dental scheme for patients with chronic medical conditions.
The Government has introduced a dental scheme for teenagers, but dentist organisations say both that scheme and the proposed Commonwealth scheme are poorly targeted and rely on under-resourced public dental services.
An expert report to the reform commission last year identified "two worlds" in dentistry: the 39 per cent of adults who saw dentists regularly and the 61 per cent who did not, and who had poorer oral health and many times the rate of tooth extractions - a precursor of poorer quality of life.
The report by Adelaide University population dental health experts, Professor John Spencer and Dr Jane Harford, also said primary school children's oral health "has plateaued and then deteriorated by around 20 per cent across the last 8-10 years".
The commission's interim report is expected to float a range of proposals to upgrade the health system in preparation for its final report to the Government in June. It is expected to raise the option of a federal takeover of public hospitals. The Prime Minister, Kevin Rudd, will decide on this issue by the middle of the year.
The commission has considered a vast range of proposals which were presented to it in more than 500 submissions.
In its 400-page report, the commission is likely to put more pressure on the Government in sensitive areas including performance payments for doctors and dealing with inequities in the health system that tend to deliver more publicly subsidised services to well-off people living in well-served areas.
However, the Government has ordered the commission to stay away from a subject which has been much criticised in Labor ranks - the $4 billion private health insurance subsidy.
.
Thursday, February 12, 2009
NURSES IGNORED BY PATEL
Patel 'gave all-clear on patient who died'
Article from: AAP
February 12, 2009 11:36am
SURGEON Jayant Patel called the wife of one of his alleged victims and told her the operation he had just performed had been a complete success, a court has been told.
Judy Kemps told the Brisbane Magistrates Court today Dr Patel had said her husband Gerry was experiencing "a little bit of bleeding" following an operation on his oesophagus at the Bundaberg Base Hospital in December 2004.
She said the 58-year-old doctor sounded happy with how the operation had gone, and said the bleeding was nothing to worry about.
However, the court was told Mr Kemps died the following day from internal bleeding.
Dr Patel is facing 13 charges, including three of manslaughter, relating to his time as director of surgery at the hospital from 2003 to 2005.
The crown alleged Dr Patel failed to stop the blood loss during Mr Kemps' operation, and that he left Mr Kemps bleeding for several hours so he could conduct non-emergency surgery on another patient.
Prosecutor Ross Martin SC told the court that when Dr Patel returned to check on Mr Kemps, he did not seek specialist help and completed further surgery without stopping the bleeding.
Nurse Gail Doherty, who helped with the operation on Mr Kemps, told the court she was worried about the amount of bleeding.
She said she expressed her concerns to Dr Patel and the anaesthetists, but that she was ignored.
Nurse Marie Goatham said she was also "very uncomfortable" with the way the operation on Mr Kemps went, and she went home that night and made detailed notes on the procedure.
She said she too had tried to raise concerns with Dr Patel about the bleeding, but that he had ignored her.
The committal hearing continues.
Article from: AAP
February 12, 2009 11:36am
SURGEON Jayant Patel called the wife of one of his alleged victims and told her the operation he had just performed had been a complete success, a court has been told.
Judy Kemps told the Brisbane Magistrates Court today Dr Patel had said her husband Gerry was experiencing "a little bit of bleeding" following an operation on his oesophagus at the Bundaberg Base Hospital in December 2004.
She said the 58-year-old doctor sounded happy with how the operation had gone, and said the bleeding was nothing to worry about.
However, the court was told Mr Kemps died the following day from internal bleeding.
Dr Patel is facing 13 charges, including three of manslaughter, relating to his time as director of surgery at the hospital from 2003 to 2005.
The crown alleged Dr Patel failed to stop the blood loss during Mr Kemps' operation, and that he left Mr Kemps bleeding for several hours so he could conduct non-emergency surgery on another patient.
Prosecutor Ross Martin SC told the court that when Dr Patel returned to check on Mr Kemps, he did not seek specialist help and completed further surgery without stopping the bleeding.
Nurse Gail Doherty, who helped with the operation on Mr Kemps, told the court she was worried about the amount of bleeding.
She said she expressed her concerns to Dr Patel and the anaesthetists, but that she was ignored.
Nurse Marie Goatham said she was also "very uncomfortable" with the way the operation on Mr Kemps went, and she went home that night and made detailed notes on the procedure.
She said she too had tried to raise concerns with Dr Patel about the bleeding, but that he had ignored her.
The committal hearing continues.
Wednesday, February 11, 2009
HE DID HIS BEST
Karen Kissane, smh
11.2.09
PAUL HENDRIE, captain of the Kinglake Country Fire Authority, woke up on Saturday knowing it was going to be a "really, really bad day".
City folks want to know why so many people died in Kinglake; why there was no warning, and why there were no fire trucks in town to protect them.
Mr Hendrie can tell them.
And he can also tell them how it was that so many were saved, because he was the one who helped organise it.
That morning, Mr Hendrie went to the CFA station at the end of the main street. He and his team listened to the radio and scanner and used the internet to map nearby fires.
They checked that the town's two water tankers were ready to roll. Then they waited, as the calls became more urgent and the maydays began.
In the afternoon they received a call for help from the town of St Andrews, about 15 kilometres down the mountain. Mr Hendrie sent down one of Kinglake's tankers.
"Then we got another call. And against my better judgment we sent the second tanker out, which meant there was nothing on the mountain. There were no tankers on the mountain.
"The plan was that tankers would stay on the mountain but when you have got a fire, you go. You fight the fire you've got. You can't predict the predicament that will come."
Mr Hendrie found himself at the station with just a command car and three or four crew members.
The radio traffic hotted up; the fire had jumped a road and right into St Andrews. Mr Hendrie knew some Kinglake people were fleeing in that direction. He called police to ask for a blockade but they were already stretched too tight.
He jumped in a brigade car with a white-knuckled colleague and they sped down the St Andrews road, watching out for spot fires, seeing embers burning in the leaves along its edges. As he passed cars going down he shouted at them: "Get back up! Just go, go, go!"
He reached a man fleeing back to Kinglake who told him he only got out of St Andrews just in time. It was then that Mr Hendrie did a U-turn and herded the other cars back to town. "You know those T-shirts that say, 'I'm a firefighter. If you see me running, follow'? It was like that," he said.
Back in Kinglake, he used cars and a horse trailer to block the start of the St Andrews road.
There were cars everywhere. People were asking him where they should go. He knew they couldn't go to Kinglake West in one direction and St Andrews in the other. "What could I do? How could I advise them where to go?"
Then the wind changed and the flames moved up the mountain. Many families realised their danger only when they heard the roar of the flames - by which time it was too late to flee.
Mr Hendrie told frightened residents all he could offer them was the main street of town, which he thought would be fairly safe. There was a clear piece of parkland, and he thought the shops would resist the fire pretty well. Hundreds of people gathered in the parkland, and hundreds more in the metal shed that is the CFA station. Those in the oval covered themselves in towels wet with ice from a chest that had spent the previous night at a buck's party.
"Then all of a sudden there was this black. The column of fire came up virtually over us. It spotted into the paddock and the trees behind the station. It burnt it all. We heard cars exploding. The service station went up. Hundred-pound gas tanks were going up - just going BANG, the loudest sound I have ever heard. It just got worse and there was blackness all over. "
And then it passed. "We could see buildings burning in the main street - the pizza place and the servo went together."
The wounded began to arrive. Some had burns, others had injured airways because of the smoke and heat.
Ambulances could not get up the mountain to rescue those needing hospital care. But a CFA strike team and SES crews with bulldozers cleared a path and local police ferried the injured in their patrol cars.
Next Mr Hendrie had to deal with the burning houses that were still alight. "It was sort of like I went through two days in one day. When the fire came over there was darkness and then it came light again." He was on his feet for 40 hours straight, and many of his crew were, too. Then he got four hours sleep and began all over again.
Of the people who sheltered with him, he says: "I'm not sure that I saved them. I'm sure it was luck that we didn't have a massive ember attack in this street."
This fire took houses that should not have been vulnerable and had deluge sprinkler systems. It took a church and a kindergarten that were newly rebuilt after arson attacks a few years ago.
Mr Hendrie has had 33 years in firefighting and he says he has never seen this fire's match in either speed or ferocity. He is concerned that when his crews finally stop, the shock of what they have seen will hit them.
He has his own feelings to deal with too. He wept with relief when he got to the driveway of his daughter's house after the fire had passed and discovered that his children and grandchildren were all safe. Like many others in the Kinglake team, he had to fight fires in one place knowing that his family was under attack somewhere else.
But the stress has left its mark on him. He will stick with the CFA but seems a little relieved that his stint as captain finishes in June.
He feels he has done his bit.
11.2.09
PAUL HENDRIE, captain of the Kinglake Country Fire Authority, woke up on Saturday knowing it was going to be a "really, really bad day".
City folks want to know why so many people died in Kinglake; why there was no warning, and why there were no fire trucks in town to protect them.
Mr Hendrie can tell them.
And he can also tell them how it was that so many were saved, because he was the one who helped organise it.
That morning, Mr Hendrie went to the CFA station at the end of the main street. He and his team listened to the radio and scanner and used the internet to map nearby fires.
They checked that the town's two water tankers were ready to roll. Then they waited, as the calls became more urgent and the maydays began.
In the afternoon they received a call for help from the town of St Andrews, about 15 kilometres down the mountain. Mr Hendrie sent down one of Kinglake's tankers.
"Then we got another call. And against my better judgment we sent the second tanker out, which meant there was nothing on the mountain. There were no tankers on the mountain.
"The plan was that tankers would stay on the mountain but when you have got a fire, you go. You fight the fire you've got. You can't predict the predicament that will come."
Mr Hendrie found himself at the station with just a command car and three or four crew members.
The radio traffic hotted up; the fire had jumped a road and right into St Andrews. Mr Hendrie knew some Kinglake people were fleeing in that direction. He called police to ask for a blockade but they were already stretched too tight.
He jumped in a brigade car with a white-knuckled colleague and they sped down the St Andrews road, watching out for spot fires, seeing embers burning in the leaves along its edges. As he passed cars going down he shouted at them: "Get back up! Just go, go, go!"
He reached a man fleeing back to Kinglake who told him he only got out of St Andrews just in time. It was then that Mr Hendrie did a U-turn and herded the other cars back to town. "You know those T-shirts that say, 'I'm a firefighter. If you see me running, follow'? It was like that," he said.
Back in Kinglake, he used cars and a horse trailer to block the start of the St Andrews road.
There were cars everywhere. People were asking him where they should go. He knew they couldn't go to Kinglake West in one direction and St Andrews in the other. "What could I do? How could I advise them where to go?"
Then the wind changed and the flames moved up the mountain. Many families realised their danger only when they heard the roar of the flames - by which time it was too late to flee.
Mr Hendrie told frightened residents all he could offer them was the main street of town, which he thought would be fairly safe. There was a clear piece of parkland, and he thought the shops would resist the fire pretty well. Hundreds of people gathered in the parkland, and hundreds more in the metal shed that is the CFA station. Those in the oval covered themselves in towels wet with ice from a chest that had spent the previous night at a buck's party.
"Then all of a sudden there was this black. The column of fire came up virtually over us. It spotted into the paddock and the trees behind the station. It burnt it all. We heard cars exploding. The service station went up. Hundred-pound gas tanks were going up - just going BANG, the loudest sound I have ever heard. It just got worse and there was blackness all over. "
And then it passed. "We could see buildings burning in the main street - the pizza place and the servo went together."
The wounded began to arrive. Some had burns, others had injured airways because of the smoke and heat.
Ambulances could not get up the mountain to rescue those needing hospital care. But a CFA strike team and SES crews with bulldozers cleared a path and local police ferried the injured in their patrol cars.
Next Mr Hendrie had to deal with the burning houses that were still alight. "It was sort of like I went through two days in one day. When the fire came over there was darkness and then it came light again." He was on his feet for 40 hours straight, and many of his crew were, too. Then he got four hours sleep and began all over again.
Of the people who sheltered with him, he says: "I'm not sure that I saved them. I'm sure it was luck that we didn't have a massive ember attack in this street."
This fire took houses that should not have been vulnerable and had deluge sprinkler systems. It took a church and a kindergarten that were newly rebuilt after arson attacks a few years ago.
Mr Hendrie has had 33 years in firefighting and he says he has never seen this fire's match in either speed or ferocity. He is concerned that when his crews finally stop, the shock of what they have seen will hit them.
He has his own feelings to deal with too. He wept with relief when he got to the driveway of his daughter's house after the fire had passed and discovered that his children and grandchildren were all safe. Like many others in the Kinglake team, he had to fight fires in one place knowing that his family was under attack somewhere else.
But the stress has left its mark on him. He will stick with the CFA but seems a little relieved that his stint as captain finishes in June.
He feels he has done his bit.
Tuesday, February 10, 2009
PATEL LIED
Patel lied to get job in Australia: court
10 February 2009 Content provided to you by AAP.
By Christine Flatley and Jessica Marszalek,
BRISBANE, Feb 9 AAP -
Jayant Patel was almost unemployable in the United States when he lied to Australian authorities that he was a highly successful surgeon who just wanted to help people, a court has been told.
Dr Kees Nydam, who helped recruit Patel to the Bundaberg Base Hospital in 2002, said the Indian-trained surgeon told him he wanted "an opportunity to give back to the community anywhere in the world".
Patel, 58, allegedly told Dr Nydam that money was no issue because he had become incredibly wealthy while working in the US.He didn't reveal, the Brisbane Magistrates Court was told on Monday, that he had been forced to resign from his position in Oregon because of medical negligence, and had had his licence cancelled in New York state.Dr Nydam said Patel never mentioned this in correspondence leading up to his employment, and that he would not have been hired if he had."I would not have employed him," Dr Nydam said.
Dr Nydam was giving evidence on the first day of a committal hearing into charges against Patel during his time as director of surgery at the hospital in southern Queensland between 2003 and 2005.
Patel faces 13 charges, including three of manslaughter, two of grievous bodily harm, eight fraud, as well as one alternative charge of negligent acts causing harm.
It's alleged Patel performed botched operations that led to death or permanent incapacity for several patients.
Prosecutor Ross Martin, SC, said Patel had misdiagnosed patients, performed surgeries he was barred from doing in the US and severely harmed five patients, three of whom died.
In one case, Patel failed to stop internal bleeding during an operation on the oesophagus of Gerry Kemps in December 2004, leaving the patient so he could conduct non-emergency surgery on another patient.Mr Martin said when Patel returned five hours later to stop the internal bleeding, he did not seek specialist help and eventually completed surgery without stopping the bleeding.Mr Kemps died the next day.
In another case, Patel allegedly wrongly told a patient he had cancer and substantially removed his bowel without running the required tests in October 2004.He also removed a healthy salivary gland, missing a cancerous mass, in another patient in 2005.
The fraud charges centre on allegations he falsely represented his qualifications.The committal hearing was told more than 70 witnesses would appear over the next three weeks.
Bundaberg Hospital Patients Support Group spokeswoman Beryl Crosby said outside court the wait had been a long one for all those involved."We are strong, we're very strong," she said.
"We've got to be strong for the other patients - we'll be OK."The committal hearing was adjourned until Wednesday due to the unavailability of witnesses on Tuesday.
© 2008 AAP Disclaimer
10 February 2009 Content provided to you by AAP.
By Christine Flatley and Jessica Marszalek,
BRISBANE, Feb 9 AAP -
Jayant Patel was almost unemployable in the United States when he lied to Australian authorities that he was a highly successful surgeon who just wanted to help people, a court has been told.
Dr Kees Nydam, who helped recruit Patel to the Bundaberg Base Hospital in 2002, said the Indian-trained surgeon told him he wanted "an opportunity to give back to the community anywhere in the world".
Patel, 58, allegedly told Dr Nydam that money was no issue because he had become incredibly wealthy while working in the US.He didn't reveal, the Brisbane Magistrates Court was told on Monday, that he had been forced to resign from his position in Oregon because of medical negligence, and had had his licence cancelled in New York state.Dr Nydam said Patel never mentioned this in correspondence leading up to his employment, and that he would not have been hired if he had."I would not have employed him," Dr Nydam said.
Dr Nydam was giving evidence on the first day of a committal hearing into charges against Patel during his time as director of surgery at the hospital in southern Queensland between 2003 and 2005.
Patel faces 13 charges, including three of manslaughter, two of grievous bodily harm, eight fraud, as well as one alternative charge of negligent acts causing harm.
It's alleged Patel performed botched operations that led to death or permanent incapacity for several patients.
Prosecutor Ross Martin, SC, said Patel had misdiagnosed patients, performed surgeries he was barred from doing in the US and severely harmed five patients, three of whom died.
In one case, Patel failed to stop internal bleeding during an operation on the oesophagus of Gerry Kemps in December 2004, leaving the patient so he could conduct non-emergency surgery on another patient.Mr Martin said when Patel returned five hours later to stop the internal bleeding, he did not seek specialist help and eventually completed surgery without stopping the bleeding.Mr Kemps died the next day.
In another case, Patel allegedly wrongly told a patient he had cancer and substantially removed his bowel without running the required tests in October 2004.He also removed a healthy salivary gland, missing a cancerous mass, in another patient in 2005.
The fraud charges centre on allegations he falsely represented his qualifications.The committal hearing was told more than 70 witnesses would appear over the next three weeks.
Bundaberg Hospital Patients Support Group spokeswoman Beryl Crosby said outside court the wait had been a long one for all those involved."We are strong, we're very strong," she said.
"We've got to be strong for the other patients - we'll be OK."The committal hearing was adjourned until Wednesday due to the unavailability of witnesses on Tuesday.
© 2008 AAP Disclaimer
Sunday, February 08, 2009
NSW HEALTH SYSTEM FINANCES
Hospitals further into crisis
By Clair Weavers, smh
February 08, 2009 12:00am
NSW public hospitals have officially hit rock bottom, producing their worst financial results on record.
The NSW Health annual report, to be tabled in Parliament next month, reveals all the State's health services blew their budgets during 2007-08, plunging them into unprecedented debt.
In total, health services overspent by $159.4 million - a result 500 per cent worse than in the previous year.
Despite this, patients are being forced to wait longer for beds and more medical mistakes are being made.
The disastrous results have prompted the State Government to declare a crackdown on spending and tighter monitoring of budgets.
But staff cutbacks are likely to have a detrimental impact on services to patients this financial year.
The Northern Sydney and Central Coast regions sank deepest into the red, racking up debts of $63.3 million - more than double the total health service overspend in 2006-07.
The debt-laden Greater Western and North Coast area health services each went over budget by about $30 million.
Unpaid bills also reached new highs, leaving businesses that supply hospitals struggling to stay afloat.
The value of accounts not paid within a benchmark of 45 days skyrocketed from zero in 2007 to $75.1 million in 2008.
South Eastern Sydney Illawarra was the worst offender, owing creditors $24.3 million. Greater Western had not paid $20.9 million and Greater Southern accumulated bills of $12.7 million.
This is the worst level of creditor payment on record - and the figure has increased since results were compiled.
Last week, NSW Health admitted the total amount owed to creditors was now at $117.5 million.
The report also revealed worrying slumps in key performance indicators.
One in four patients waited more than 30 minutes to be offloaded from an ambulance at emergency departments.
This transfer, described as "a challenge", is supposed to be as quick as possible to improve a patient's chance of survival and ambulance efficiency.
Nearly a quarter of emergency department patients waited more than eight hours for an inpatient bed.
Mistakes are also on the rise. There were 583 serious safety incidents "in which death or serious harm to a patient has occurred", the highest figure in at least five years.
NSW Health claimed, however, this was because of a change of definitions and better reporting.
There were also more incorrect procedures, including surgery mistakes, and more deaths of hospital patients in falls.
Overall, NSW Health's expenses amounted to a record $13.12 billion in 2007-08 - nearly $36 million a day.
By Clair Weavers, smh
February 08, 2009 12:00am
NSW public hospitals have officially hit rock bottom, producing their worst financial results on record.
The NSW Health annual report, to be tabled in Parliament next month, reveals all the State's health services blew their budgets during 2007-08, plunging them into unprecedented debt.
In total, health services overspent by $159.4 million - a result 500 per cent worse than in the previous year.
Despite this, patients are being forced to wait longer for beds and more medical mistakes are being made.
The disastrous results have prompted the State Government to declare a crackdown on spending and tighter monitoring of budgets.
But staff cutbacks are likely to have a detrimental impact on services to patients this financial year.
The Northern Sydney and Central Coast regions sank deepest into the red, racking up debts of $63.3 million - more than double the total health service overspend in 2006-07.
The debt-laden Greater Western and North Coast area health services each went over budget by about $30 million.
Unpaid bills also reached new highs, leaving businesses that supply hospitals struggling to stay afloat.
The value of accounts not paid within a benchmark of 45 days skyrocketed from zero in 2007 to $75.1 million in 2008.
South Eastern Sydney Illawarra was the worst offender, owing creditors $24.3 million. Greater Western had not paid $20.9 million and Greater Southern accumulated bills of $12.7 million.
This is the worst level of creditor payment on record - and the figure has increased since results were compiled.
Last week, NSW Health admitted the total amount owed to creditors was now at $117.5 million.
The report also revealed worrying slumps in key performance indicators.
One in four patients waited more than 30 minutes to be offloaded from an ambulance at emergency departments.
This transfer, described as "a challenge", is supposed to be as quick as possible to improve a patient's chance of survival and ambulance efficiency.
Nearly a quarter of emergency department patients waited more than eight hours for an inpatient bed.
Mistakes are also on the rise. There were 583 serious safety incidents "in which death or serious harm to a patient has occurred", the highest figure in at least five years.
NSW Health claimed, however, this was because of a change of definitions and better reporting.
There were also more incorrect procedures, including surgery mistakes, and more deaths of hospital patients in falls.
Overall, NSW Health's expenses amounted to a record $13.12 billion in 2007-08 - nearly $36 million a day.
Tuesday, February 03, 2009
REVIEW: THE PATIENT
Take control, patients urged
By Health editor Adam Cresswell , The Australian, 1.2.09
A high-profile surgeon argues it's time for put-upon patients to fight for their rights.
Health editor Adam Cresswell reports
DON'T expect Mohamed Khadra's new book to be comforting reading if you're about to go into hospital.The author of the acclaimed Making the Cut and a professor of surgery at the University of Sydney, he is about to publish a follow-up that makes crystal clear the fact that unappealing food is the smallest of the many hazards facing patients admitted onto public wards.
The new book, called The Patient, is being published next week. It tells the story of a fictional male professional, Jonathan Brewster, who discovers mid-career that he has a bladder cancer.
The book follows him through the various stages of his treatment, noting in pitiless detail along the way the impersonality of the health system, the strains it places on the legions of dedicated yet sleep-deprived staff, and also the unprofessional attitudes of some doctors and nurses.It also documents the cavalcade of cock-ups, major and minor, that go on behind the scenes.
But while the story is fictionalised -- like Brewster, the Victoria Hospital in which it is set does not exist -- The Patient is not fiction. Khadra, the book's sole real character, says most of the things that happen to the unfortunate Brewster and to others within the hospital are drawn from real-life experience.
The book confronts head-on the ``corruption'' of the health system: the fact that patients handed a cancer diagnosis who need an urgent specialist's appointment can effectively jump the queue, simply by having the right social connections -- while other patients without strings to pull have to wait weeks or months.
It spells out the extreme patient-unfriendliness of a system that can bandy about terms such as ``triage'' that barely a handful of people understand. It scores in painful detail the rudeness of some doctors, nurses and other staff; the clock-watching, officious culture of the newer breed of nurses, and the madness of a health bureaucracy that alienates its own permanent nursing and medical staff by paying double rates to last-minute agency fill-ins.
Perhaps most tellingly, the book exposes the extraordinary lack of compassion that can be found in every corner of the system -- from the receptionist who keeps a pain-wracked patient on his feet while she slowly fills in a form, to the haughty consultant whose aloof arrogance scarcely conceals his disdain for public patients, who he believes contribute less to his income and prestige than those paying privately.
Khadra -- who received a huge response to the criticisms of the health system in his previous book -- says a prime motivation for writing The Patient was to help patients understand better what a spell in hospital involves.
``Day in, day out, I sit across the desk from people who are planning their next holiday, they've just been married, they've just bought a house, they've just started a new job -- and I look down at a piece of paper that has words on it or numbers on it that are radically going to change their life for the worse over the next couple of years, or even curtail their life,'' Khadra says.``And I find people just aren't prepared. They have this sense that the health system is a benevolent creation of the government that will look after them; they aren't prepared spiritually, they aren't prepared physically and financially.''
But it's also a call to arms. Khadra himself has been a patient, after being diagnosed 10 years ago -- just as he and his wife had bought a new house, were raising two boys, and as their careers were taking off -- with a thyroid cancer that had already spread to his chest and neck.``I had an extensive period of treatment,'' he recalls. ``And what I saw of the health system then, and what continues -- if anything -- to get worse over the ensuing 10 years, is a health system that ... doesn't deliver compassionate health care to people most in need.
``And my basic feeling is that what has occurred in the 20-year period since the 1980s, when I trained, is a cancerous growth in the bureaucracy of health.``The basic aim of the bureaucracy is to avoid making mistakes. And what that creates is a paralysis of decision-making throughout the system that now has kneecapped every single hospital general manager, health leader, and nursing leader.'
Such a critique could not come at a more poignant time: NSW Health and its minister, John Della Bosca, have been deeply embarrassed this week by further revelations of chronic late payment of debts -- to the extent that some tradesmen and suppliers of drugs, food and other consumables are refusing to deal with hospitals in the west of the state.It chimes with Khadra's own experience. He tells of a general manager of one hospital he worked at who was unable to spend just $55 on a medical textbook without getting clearance from the central health department.
At the ward level, Khadra says the solution is to take the power away from the bureaucrats and give it instead to the clinicians and managers within each hospital who would then once again have the power, and incentive, to ensure their own units ran efficiently.
In a different way, power should be claimed by the patients themselves.``There wasn't a ward I could walk into 20 years ago, in any hospital, where I couldn't go to the nursing unit manager and say `How's Mr Jones', and that nurse would be able to tell me that his cousin visited yesterday, that his toenails have been clipped today, and that he's been moved six times overnight to help with his pressure sores,'' Khadra says, echoing a criticism that earned him widespread public support following the publication of his previous book.``Now, even from the nurse looking after the patient, I'd struggle to get any sense of what's going on with the patient.``What has happened?
What has happened is that local single-point accountability has been taken away from the hospital, so there isn't that opportunity for someone to say this needs to be changed.``If the ward is unclean, who do I go to? The boss of that cleaner is somewhere in town, because it's all outsourced. If the food that I'm putting in front of the patient is unappetising, who do you go to? It's all outsourced somewhere, and there are policies upon policies that obstruct any sort of feedback on that.''
Khadra -- who says he received overwhelming backing from his peers after the publication of Making the Cut in 2007 -- urges patients to ditch the passive role they suffered 50 years ago and claim a greater responsibility for their own care.He accepts he might receive a ``cold shoulder'' from one or two doctors who take umbrage at the portrayal of their profession in the character of David Johnson, an arrogant, glib and dismissive consultant urologist who regards patients as stupid and their questions as irritants to be discouraged.But he stresses the book also portrays ``a number of heroic doctors ... who really are compassionate, who really are competent''.
``The point that I make in The Patient -- if you are dealing with a doctor who isn't communicative, who isn't able to sit down and really go through the benefits and risks of a particular procedure, who isn't transparent about why they are doing it and involves you in a shared decision-making capacity -- perhaps you are going to the wrong doctor,'' he says.``I welcome it when my patients are questioning about every step of the way. Why am I having a PSA test? Why am I having a prostatectomy? What are the alternatives? What are the risks of this, what are the benefits?``Gee, I love those questions, truly -- it shows an involved, informed patient. And we know now there's some evidence to suggest that the outcomes for that type of patient are actually much better, because they are involved in their healthcare, they feel empowered in their own health care.
``Are there doctors out there who avoid that glare of light on their own practice? The answer is yes. But I can tell you the vast majority of competent doctors would welcome that type of questioning."
By Health editor Adam Cresswell , The Australian, 1.2.09
A high-profile surgeon argues it's time for put-upon patients to fight for their rights.
Health editor Adam Cresswell reports
DON'T expect Mohamed Khadra's new book to be comforting reading if you're about to go into hospital.The author of the acclaimed Making the Cut and a professor of surgery at the University of Sydney, he is about to publish a follow-up that makes crystal clear the fact that unappealing food is the smallest of the many hazards facing patients admitted onto public wards.
The new book, called The Patient, is being published next week. It tells the story of a fictional male professional, Jonathan Brewster, who discovers mid-career that he has a bladder cancer.
The book follows him through the various stages of his treatment, noting in pitiless detail along the way the impersonality of the health system, the strains it places on the legions of dedicated yet sleep-deprived staff, and also the unprofessional attitudes of some doctors and nurses.It also documents the cavalcade of cock-ups, major and minor, that go on behind the scenes.
But while the story is fictionalised -- like Brewster, the Victoria Hospital in which it is set does not exist -- The Patient is not fiction. Khadra, the book's sole real character, says most of the things that happen to the unfortunate Brewster and to others within the hospital are drawn from real-life experience.
The book confronts head-on the ``corruption'' of the health system: the fact that patients handed a cancer diagnosis who need an urgent specialist's appointment can effectively jump the queue, simply by having the right social connections -- while other patients without strings to pull have to wait weeks or months.
It spells out the extreme patient-unfriendliness of a system that can bandy about terms such as ``triage'' that barely a handful of people understand. It scores in painful detail the rudeness of some doctors, nurses and other staff; the clock-watching, officious culture of the newer breed of nurses, and the madness of a health bureaucracy that alienates its own permanent nursing and medical staff by paying double rates to last-minute agency fill-ins.
Perhaps most tellingly, the book exposes the extraordinary lack of compassion that can be found in every corner of the system -- from the receptionist who keeps a pain-wracked patient on his feet while she slowly fills in a form, to the haughty consultant whose aloof arrogance scarcely conceals his disdain for public patients, who he believes contribute less to his income and prestige than those paying privately.
Khadra -- who received a huge response to the criticisms of the health system in his previous book -- says a prime motivation for writing The Patient was to help patients understand better what a spell in hospital involves.
``Day in, day out, I sit across the desk from people who are planning their next holiday, they've just been married, they've just bought a house, they've just started a new job -- and I look down at a piece of paper that has words on it or numbers on it that are radically going to change their life for the worse over the next couple of years, or even curtail their life,'' Khadra says.``And I find people just aren't prepared. They have this sense that the health system is a benevolent creation of the government that will look after them; they aren't prepared spiritually, they aren't prepared physically and financially.''
But it's also a call to arms. Khadra himself has been a patient, after being diagnosed 10 years ago -- just as he and his wife had bought a new house, were raising two boys, and as their careers were taking off -- with a thyroid cancer that had already spread to his chest and neck.``I had an extensive period of treatment,'' he recalls. ``And what I saw of the health system then, and what continues -- if anything -- to get worse over the ensuing 10 years, is a health system that ... doesn't deliver compassionate health care to people most in need.
``And my basic feeling is that what has occurred in the 20-year period since the 1980s, when I trained, is a cancerous growth in the bureaucracy of health.``The basic aim of the bureaucracy is to avoid making mistakes. And what that creates is a paralysis of decision-making throughout the system that now has kneecapped every single hospital general manager, health leader, and nursing leader.'
Such a critique could not come at a more poignant time: NSW Health and its minister, John Della Bosca, have been deeply embarrassed this week by further revelations of chronic late payment of debts -- to the extent that some tradesmen and suppliers of drugs, food and other consumables are refusing to deal with hospitals in the west of the state.It chimes with Khadra's own experience. He tells of a general manager of one hospital he worked at who was unable to spend just $55 on a medical textbook without getting clearance from the central health department.
At the ward level, Khadra says the solution is to take the power away from the bureaucrats and give it instead to the clinicians and managers within each hospital who would then once again have the power, and incentive, to ensure their own units ran efficiently.
In a different way, power should be claimed by the patients themselves.``There wasn't a ward I could walk into 20 years ago, in any hospital, where I couldn't go to the nursing unit manager and say `How's Mr Jones', and that nurse would be able to tell me that his cousin visited yesterday, that his toenails have been clipped today, and that he's been moved six times overnight to help with his pressure sores,'' Khadra says, echoing a criticism that earned him widespread public support following the publication of his previous book.``Now, even from the nurse looking after the patient, I'd struggle to get any sense of what's going on with the patient.``What has happened?
What has happened is that local single-point accountability has been taken away from the hospital, so there isn't that opportunity for someone to say this needs to be changed.``If the ward is unclean, who do I go to? The boss of that cleaner is somewhere in town, because it's all outsourced. If the food that I'm putting in front of the patient is unappetising, who do you go to? It's all outsourced somewhere, and there are policies upon policies that obstruct any sort of feedback on that.''
Khadra -- who says he received overwhelming backing from his peers after the publication of Making the Cut in 2007 -- urges patients to ditch the passive role they suffered 50 years ago and claim a greater responsibility for their own care.He accepts he might receive a ``cold shoulder'' from one or two doctors who take umbrage at the portrayal of their profession in the character of David Johnson, an arrogant, glib and dismissive consultant urologist who regards patients as stupid and their questions as irritants to be discouraged.But he stresses the book also portrays ``a number of heroic doctors ... who really are compassionate, who really are competent''.
``The point that I make in The Patient -- if you are dealing with a doctor who isn't communicative, who isn't able to sit down and really go through the benefits and risks of a particular procedure, who isn't transparent about why they are doing it and involves you in a shared decision-making capacity -- perhaps you are going to the wrong doctor,'' he says.``I welcome it when my patients are questioning about every step of the way. Why am I having a PSA test? Why am I having a prostatectomy? What are the alternatives? What are the risks of this, what are the benefits?``Gee, I love those questions, truly -- it shows an involved, informed patient. And we know now there's some evidence to suggest that the outcomes for that type of patient are actually much better, because they are involved in their healthcare, they feel empowered in their own health care.
``Are there doctors out there who avoid that glare of light on their own practice? The answer is yes. But I can tell you the vast majority of competent doctors would welcome that type of questioning."
Monday, February 02, 2009
MISERY IN HARARE
20 . Letter from ... Harare
A Harare resident writes in Crikey 2.2.09:
I was standing in my bucket washing my body when the phone rang. I had to get out and fling a towel over my soapy body to go and answer it. It could be critical, as phones so seldom work. It was a friend who had been desperate to contact for four days.
After washing, the bucket water has to be lifted into the cistern for flushing the loo. Diarrhoea is a problem as we don't have enough water to keep the loos flushed. Then one becomes so exhausted that there is no strength for carrying and lifting water.
This morning I have carried six buckets of water from the tank outside the kitchen into the bathroom. The physical exertion is exhausting. Dish washing water and body washing water have to be heated on the stove and then carried to whereever they are needed. One litre of water in a plastic basin has to do for face washing and hand washing throughout the day, then it is carried outside to water plants.
The public do not receive statements for water, rates, electricity or telephone anymore. Each person has to go physically into town to their respective offices to find out what they have to pay. Imagine the enormous expense of travel, the waste of a full day queueing away from work and the frustration of dealing with arrogant, incompetent officials who imagine themselves as Gods.
It is ridiculous! The public are terrified to miss payment dates or amounts as they then get cut off permanently or are heavily fined, beyond their ability to pay.
I won't bore you further with the travails of life here. Tomorrow I am going to a friend to do my washing in her machine, which does not spin, so I will have to bring soaking washing back home to dry.
However, she has water and power, so that is a boon.
Send Crikey a letter from wherever you live or may be passing through to boss@crikey.com.au with the title "Letter from" in the subject field.
A Harare resident writes in Crikey 2.2.09:
I was standing in my bucket washing my body when the phone rang. I had to get out and fling a towel over my soapy body to go and answer it. It could be critical, as phones so seldom work. It was a friend who had been desperate to contact for four days.
After washing, the bucket water has to be lifted into the cistern for flushing the loo. Diarrhoea is a problem as we don't have enough water to keep the loos flushed. Then one becomes so exhausted that there is no strength for carrying and lifting water.
This morning I have carried six buckets of water from the tank outside the kitchen into the bathroom. The physical exertion is exhausting. Dish washing water and body washing water have to be heated on the stove and then carried to whereever they are needed. One litre of water in a plastic basin has to do for face washing and hand washing throughout the day, then it is carried outside to water plants.
The public do not receive statements for water, rates, electricity or telephone anymore. Each person has to go physically into town to their respective offices to find out what they have to pay. Imagine the enormous expense of travel, the waste of a full day queueing away from work and the frustration of dealing with arrogant, incompetent officials who imagine themselves as Gods.
It is ridiculous! The public are terrified to miss payment dates or amounts as they then get cut off permanently or are heavily fined, beyond their ability to pay.
I won't bore you further with the travails of life here. Tomorrow I am going to a friend to do my washing in her machine, which does not spin, so I will have to bring soaking washing back home to dry.
However, she has water and power, so that is a boon.
Send Crikey a letter from wherever you live or may be passing through to boss@crikey.com.au with the title "Letter from" in the subject field.
Subscribe to:
Posts (Atom)
