Mental health act ensures families no longer in dark
RUTH POLLARD
March 22, 2010
MATTHEW MURPHY'S mind snapped 11 months too early.
Had the 41-year-old been able to endure the crippling depression that enveloped him for a while longer, the state's new Mental Health Act would have required hospital staff to tell his family what was happening with his care. It may have saved his life.
But when he was taken by police to the Mater Hospital in Newcastle early on December 3, 2006, after telling his father he planned to shoot himself, his family were kept in the dark.
Less than two hours after he left the hospital - against medical advice and with doctors failing to pass on any information to his deeply worried parents and wife - he killed himself.
On Friday the deputy state coroner Paul MacMahon, handed down his findings into Mr Murphy's death.
He reiterated the need for communication - between police, doctors and family members - and noted the eternal struggle between protecting a patient's right to privacy and keeping them alive.
Police training should emphasise that family members can provide important background information and police handover forms should include family or carer contact details, the coroner recommended.
''The existence of a plan by Mr Murphy to kill himself was important for diagnostic purposes and that information was not provided to the hospital by police,'' he noted. He was critical of the police for dissuading Pat Murphy, Matthew Murphy's father, from going to the hospital, saying: ''Had he been there he would have been a source of information for the doctors and a support to [his son].''
Mr MacMahon also recommended the Mater Hospital amend its suicide policy to suggest that information can be obtained from family or carers without the consent of the patient if ''there is a risk to the patient''.
At a broader level, he said, doctors working in emergency departments must be made aware of the provisions of the NSW Mental Health Act, which gives them the power to contact family members without the consent of the patient.
It is a change that has been a long time coming, said the head of Lifeline, Dawn O'Neil.
''Family members have been saying for a very long time that when somebody has a mental illness their capacity to make decisions about their own care can be impaired, and the family members, in order to look after them, need information,'' Ms O'Neil said.
''When someone is at risk of suicide we have to take that very, very seriously - that person needs to be in intensive care … for some period of time.''
Pat Murphy campaigned tirelessly for an inquest into his son's death and is pleased with the coroner's recommendations, but has vowed to continue his campaign until the changes are adopted.
''There is no requirement on the local police and the area health service to enact these changes, but we have spent all this time and effort to try to get change - I will be following this all the way through,'' he told the Herald yesterday.
A spokeswoman said Hunter New England Health Service welcomed the coroner's findings and is giving the recommendations careful consideration.
Lifeline: 131114
Monday, March 22, 2010
NSW NURSES TO VOTE ON WAGES PROPOSAL
NSW nurses to vote on wages proposal
AAP
March 21, 2010, 3:21 pm
NSW nurses and midwives will start voting this week on a proposed wages and conditions claim, which includes a five per cent annual pay rise over four years.
The NSW Nurses Association (NSWNA) says nurses and midwives are also asking for mandated minimum nurse-to-patient ratios to be set to improve patient safety.
NSWNA general secretary Brett Holmes said a lot of work had been done over the last ten years rebuilding nursing as an attractive career option in financial terms and this was at risk of being lost.
"In the last couple of years nurses have again started to fall behind equivalent professions, such as the allied health professions, and if that continues we risk undoing what success we have had dealing with the nurse shortage," Mr Holmes said.
He said the majority of nurses and midwives were about $2500 per year or $50 per week behind physiotherapists.
"Our wage claim is, as well as properly rewarding the effort and dedication of nurses, aimed at keeping nursing and midwifery `up there' financially in terms of career options."
The NSWNA wants NSW Health to agree to a new four-year wages and conditions agreement, which includes a five per cent per year pay rise for all public hospital and community health nurses and midwives.
A five per cent pay rise on July 1, would provide the majority of clinical nurses and midwives with a pay rise of nearly $70 per week, Mr Holmes said.
AAP
March 21, 2010, 3:21 pm
NSW nurses and midwives will start voting this week on a proposed wages and conditions claim, which includes a five per cent annual pay rise over four years.
The NSW Nurses Association (NSWNA) says nurses and midwives are also asking for mandated minimum nurse-to-patient ratios to be set to improve patient safety.
NSWNA general secretary Brett Holmes said a lot of work had been done over the last ten years rebuilding nursing as an attractive career option in financial terms and this was at risk of being lost.
"In the last couple of years nurses have again started to fall behind equivalent professions, such as the allied health professions, and if that continues we risk undoing what success we have had dealing with the nurse shortage," Mr Holmes said.
He said the majority of nurses and midwives were about $2500 per year or $50 per week behind physiotherapists.
"Our wage claim is, as well as properly rewarding the effort and dedication of nurses, aimed at keeping nursing and midwifery `up there' financially in terms of career options."
The NSWNA wants NSW Health to agree to a new four-year wages and conditions agreement, which includes a five per cent per year pay rise for all public hospital and community health nurses and midwives.
A five per cent pay rise on July 1, would provide the majority of clinical nurses and midwives with a pay rise of nearly $70 per week, Mr Holmes said.
Sunday, March 21, 2010
PUTTING WEALTH INTO HEALTH IS WISEST
Putting wealth into health is wisest
By Paul Howes
From: The Sunday Telegraph March 21, 2010 12:02PM
ANY parent with young children can tell you there's nothing more anxiety-inducing than a trip to hospital when one of the little ones is ill.
Since the age of two, my son Sam has suffered from severe bouts of chronic asthma.
He developed it when we lived in Melbourne and at one point my wife and I felt the Royal Children's Hospital was like a second home.
Now returned to Sydney, Sam still frequently requires hospitalisation.
Recently he developed a bit of a cough, my wife took him to hospital and it turned out he had double walking pneumonia and a collapsed lung, on top of his asthma.
I'm always amazed by the dedication and long working hours of the nurses, doctors and support staff at the Sydney Children's Hospital, Randwick when we are there.
The level of care is second to none and despite the clear lack of resources I'm in awe of how hard the health professionals work, and thankful for the life-saving treatment provided to Sam by those professionals on a regular basis.
Start of sidebar. Skip to end of sidebar.
Related CoverageHospital reform died on the table The Australian, 1 day ago
PM warms to health fight The Australian, 1 day ago
States revolt on health plan The Australian, 7 Mar 2010
Reform vital for sick system Courier Mail, 3 Mar 2010
Better Health, Better Hospitals speech The Australian, 3 Mar 2010
.End of sidebar. Return to start of sidebar.
But despite the dedication of the nurses, doctors and staff in the hospitals, it's not hard to notice the clear lack of available resources in our public hospitals.
Many times when the doctors have admitted my son, there has been a long wait in emergency until a bed becomes available in an intensive care unit or on the wards.
On the corridors of the hospitals you can see the strain and stress in the eyes of the nurses and doctors who work so hard, and the difficulty they face in trying to find beds for critically ill children.
That's why I'm so pleased health is shaping up this year as a key federal election issue.
Prime Minister Kevin Rudd's proposed national health and hospitals network represents the most significant shake-up of our health system since the introduction of Medicare.
The proposed reforms have significant implications for the structure of our health and hospitals system.
Local hospitals will be empowered to make decisions about local health management, and hospitals will be paid directly for what they actually do.
Most significantly, it means the federal government will now take direct responsibility for the funding of our health system.
This guarantees certainty for our health system and also means the state budgets can be freed up in the future to focus on other areas that have been neglected for far too long.
Once some certainty is achieved in the NSW Budget, the state government can focus on areas such as public transport and infrastructure.
It means that we should be able to build the missing links in our road system -- like finally getting the M4 to connect western Sydney directly to the CBD and extending the light-rail network to places such as the University of NSW and Dulwich Hill.
The implications of the reforms for the people that deliver health-care services are significant.
Brett Holmes, secretary of the NSW Nurses' Association, has said that although the union is still working through the detail of the proposed reforms, it is important that the federal government becomes the central funding body for health services.
"The real issues in hospital and healthcare are funding, staffing and skill mix," he said. "The plan initially commits the federal government to 60 per cent of hospital funding and 100 per cent of primary or community health funding.
The ongoing challenge is 60 and 100 per cent of what amount?
In the end, it's real dollars, not percentages, that buy hospital and primary health care.
This is an important point. As Brett Holmes knows, at the end of the day it's the dollars that matter, which is why it's important that we examine carefully what Tony Abbott did to health funding when he was the health minister under John Howard.
Tony Abbott is running a million miles a hour away from his record of funding cuts, but the fact of the matter is that $1 billion was cut from public health funding during his time as health minister. He began by cutting $108 million in the 2003 Budget, then $172 million in 2004, $264 million in 2005 and $372 million in 2006.
Mr Abbott, the great oppositionist, is opposing the reforms. Not for long though, I imagine, because it's not a popular stance.
This week an Auspoll survey of 1000 respondents found that 76 per cent of those questioned supported Mr Rudd's plan to put the decision-making power regarding our hospitals into the hands of locals.
It also found 72 per cent wanted to see less "user-pays" health care and an increase in the proportion of government funding.
There will always be debates about the structure and delivery methods of our health system.
But we all know that we need more investment, more accountability, fewer bureaucrats and more doctors and nurses taking charge.
We need to end the state and federal blame game and this is what Labor's plan seeks to achieve.
Paul Howes is national secretary of the Australian Workers' Union
By Paul Howes
From: The Sunday Telegraph March 21, 2010 12:02PM
ANY parent with young children can tell you there's nothing more anxiety-inducing than a trip to hospital when one of the little ones is ill.
Since the age of two, my son Sam has suffered from severe bouts of chronic asthma.
He developed it when we lived in Melbourne and at one point my wife and I felt the Royal Children's Hospital was like a second home.
Now returned to Sydney, Sam still frequently requires hospitalisation.
Recently he developed a bit of a cough, my wife took him to hospital and it turned out he had double walking pneumonia and a collapsed lung, on top of his asthma.
I'm always amazed by the dedication and long working hours of the nurses, doctors and support staff at the Sydney Children's Hospital, Randwick when we are there.
The level of care is second to none and despite the clear lack of resources I'm in awe of how hard the health professionals work, and thankful for the life-saving treatment provided to Sam by those professionals on a regular basis.
Start of sidebar. Skip to end of sidebar.
Related CoverageHospital reform died on the table The Australian, 1 day ago
PM warms to health fight The Australian, 1 day ago
States revolt on health plan The Australian, 7 Mar 2010
Reform vital for sick system Courier Mail, 3 Mar 2010
Better Health, Better Hospitals speech The Australian, 3 Mar 2010
.End of sidebar. Return to start of sidebar.
But despite the dedication of the nurses, doctors and staff in the hospitals, it's not hard to notice the clear lack of available resources in our public hospitals.
Many times when the doctors have admitted my son, there has been a long wait in emergency until a bed becomes available in an intensive care unit or on the wards.
On the corridors of the hospitals you can see the strain and stress in the eyes of the nurses and doctors who work so hard, and the difficulty they face in trying to find beds for critically ill children.
That's why I'm so pleased health is shaping up this year as a key federal election issue.
Prime Minister Kevin Rudd's proposed national health and hospitals network represents the most significant shake-up of our health system since the introduction of Medicare.
The proposed reforms have significant implications for the structure of our health and hospitals system.
Local hospitals will be empowered to make decisions about local health management, and hospitals will be paid directly for what they actually do.
Most significantly, it means the federal government will now take direct responsibility for the funding of our health system.
This guarantees certainty for our health system and also means the state budgets can be freed up in the future to focus on other areas that have been neglected for far too long.
Once some certainty is achieved in the NSW Budget, the state government can focus on areas such as public transport and infrastructure.
It means that we should be able to build the missing links in our road system -- like finally getting the M4 to connect western Sydney directly to the CBD and extending the light-rail network to places such as the University of NSW and Dulwich Hill.
The implications of the reforms for the people that deliver health-care services are significant.
Brett Holmes, secretary of the NSW Nurses' Association, has said that although the union is still working through the detail of the proposed reforms, it is important that the federal government becomes the central funding body for health services.
"The real issues in hospital and healthcare are funding, staffing and skill mix," he said. "The plan initially commits the federal government to 60 per cent of hospital funding and 100 per cent of primary or community health funding.
The ongoing challenge is 60 and 100 per cent of what amount?
In the end, it's real dollars, not percentages, that buy hospital and primary health care.
This is an important point. As Brett Holmes knows, at the end of the day it's the dollars that matter, which is why it's important that we examine carefully what Tony Abbott did to health funding when he was the health minister under John Howard.
Tony Abbott is running a million miles a hour away from his record of funding cuts, but the fact of the matter is that $1 billion was cut from public health funding during his time as health minister. He began by cutting $108 million in the 2003 Budget, then $172 million in 2004, $264 million in 2005 and $372 million in 2006.
Mr Abbott, the great oppositionist, is opposing the reforms. Not for long though, I imagine, because it's not a popular stance.
This week an Auspoll survey of 1000 respondents found that 76 per cent of those questioned supported Mr Rudd's plan to put the decision-making power regarding our hospitals into the hands of locals.
It also found 72 per cent wanted to see less "user-pays" health care and an increase in the proportion of government funding.
There will always be debates about the structure and delivery methods of our health system.
But we all know that we need more investment, more accountability, fewer bureaucrats and more doctors and nurses taking charge.
We need to end the state and federal blame game and this is what Labor's plan seeks to achieve.
Paul Howes is national secretary of the Australian Workers' Union
Saturday, March 20, 2010
SWAHS STAFF SHORTAGES COMPROMISE CARE
Red News Readers,
As I understand it this area health service is almost broke!! Its good that the Nurses Association had this Rally although the numbers supporting it were disappointing, but that may reflect a number of factors – as the wards are short it is hard for nurses to get away, they may have faced intimidation from management (usual when these rallies are held), the largely overseas born staff are not used to participating in union rallies and tend to shy away from them. But what now? If the Area HealthService is broke and needs money from the State and Federal Government, it is going to take a lot more than one Rally to get that happening.
Jenny Haines
Staff shortages compromise care: nurses
LISA MARTIN, SMH
March 18, 2010
AAP
Nurses at six western Sydney hospitals claim patient care is being compromised because a lack of state funding has forced the area health service to freeze hiring.
About 700 Sydney West Area Health Service (SWAHS) nurses protested about staff shortages at Westmead, Auburn, Blacktown, Mt Druitt, Nepean, Katoomba and Lithgow hospitals during their lunch breaks on Thursday.
NSW Nurses Association general secretary Brett Holmes addressed a protest rally at Nepean Hospital in Penrith.
The health service had not advertised positions externally since February 2009 as it struggled to cut expenditure, he told AAP.
"We have got lots of vacancies in positions that aren't being filled on a permanent basis," he said.
He said at Nepean Hospital there were 20 full-time positions unfilled in the maternity section and 14.5 vacancies in the emergency department.
At Mount Druitt and Blacktown the emergency departments were short 13 nurses, and 10 mental health beds had been closed across the health service.
There was also a shortage of cleaners.
Mr Holmes said staff were worried patient care was suffering and called for a cash injection to fill the vacancies.
"The staff are feeling they're not really in a position to be providing the level of care that is required," he said.
"People get moved out of the emergency department at the start of the shift to fill vacancies in wards.
"Then when the emergency departments get busy ... it's very hard to shift them back."
Opposition health spokeswoman Jillian Skinner said the situation was unacceptable, and the nurse shortage was increasing waiting times in emergency departments and elective surgery waiting lists.
"Nurses are fed up to the back teeth," she said.
"The rally at Nepean Hospital was told there was something like 30 vacancies. It's interesting that when you go to the government's website ... they admit to only three."
"They're freezing vacancies ... so when nurses either resign, go on maternity leave ... those who remain are working even harder, and they are becoming disillusioned and they leave."
But SWAHS denied the hiring freeze.
"There is no staff freeze in Sydney West Area Health Service," it said in a statement said.
"SWAHS continues to recruit to frontline positions.
"All SWAHS hospitals have strategies in place to ensure that wards and services are appropriately staffed to maintain safety for patients and staff.
"Casual and agency staff are used as required."
The health service said its chief executive is willing to meet with the NSW Nurses Association to discuss staffing concerns.
© 2010 AAP
As I understand it this area health service is almost broke!! Its good that the Nurses Association had this Rally although the numbers supporting it were disappointing, but that may reflect a number of factors – as the wards are short it is hard for nurses to get away, they may have faced intimidation from management (usual when these rallies are held), the largely overseas born staff are not used to participating in union rallies and tend to shy away from them. But what now? If the Area HealthService is broke and needs money from the State and Federal Government, it is going to take a lot more than one Rally to get that happening.
Jenny Haines
Staff shortages compromise care: nurses
LISA MARTIN, SMH
March 18, 2010
AAP
Nurses at six western Sydney hospitals claim patient care is being compromised because a lack of state funding has forced the area health service to freeze hiring.
About 700 Sydney West Area Health Service (SWAHS) nurses protested about staff shortages at Westmead, Auburn, Blacktown, Mt Druitt, Nepean, Katoomba and Lithgow hospitals during their lunch breaks on Thursday.
NSW Nurses Association general secretary Brett Holmes addressed a protest rally at Nepean Hospital in Penrith.
The health service had not advertised positions externally since February 2009 as it struggled to cut expenditure, he told AAP.
"We have got lots of vacancies in positions that aren't being filled on a permanent basis," he said.
He said at Nepean Hospital there were 20 full-time positions unfilled in the maternity section and 14.5 vacancies in the emergency department.
At Mount Druitt and Blacktown the emergency departments were short 13 nurses, and 10 mental health beds had been closed across the health service.
There was also a shortage of cleaners.
Mr Holmes said staff were worried patient care was suffering and called for a cash injection to fill the vacancies.
"The staff are feeling they're not really in a position to be providing the level of care that is required," he said.
"People get moved out of the emergency department at the start of the shift to fill vacancies in wards.
"Then when the emergency departments get busy ... it's very hard to shift them back."
Opposition health spokeswoman Jillian Skinner said the situation was unacceptable, and the nurse shortage was increasing waiting times in emergency departments and elective surgery waiting lists.
"Nurses are fed up to the back teeth," she said.
"The rally at Nepean Hospital was told there was something like 30 vacancies. It's interesting that when you go to the government's website ... they admit to only three."
"They're freezing vacancies ... so when nurses either resign, go on maternity leave ... those who remain are working even harder, and they are becoming disillusioned and they leave."
But SWAHS denied the hiring freeze.
"There is no staff freeze in Sydney West Area Health Service," it said in a statement said.
"SWAHS continues to recruit to frontline positions.
"All SWAHS hospitals have strategies in place to ensure that wards and services are appropriately staffed to maintain safety for patients and staff.
"Casual and agency staff are used as required."
The health service said its chief executive is willing to meet with the NSW Nurses Association to discuss staffing concerns.
© 2010 AAP
Wednesday, March 03, 2010
FEDERAL FUNDING OF HEALTH
Federal takeover of health. Mr Rudd makes a bold announcement - which raises more questions than it answers. The only certainty is continuing federal under funding of hospitals for the next 4 years - or much, much longer if the states do not accept.
By Con Costa, as updated after Mr Rudd's Announcement of the Federal funding of hospitals.
On a weekend when 3 major Sydney hospitals announced downgrading of their ED services and ambulances to divert to other already overcrowded centre, Medibank Private announced its latest gimmick to attract membership – private ED service where for $195 patients could “jump the ED queue”. This comes at a time when federal share of hospital funding now down from the traditional 50/50 split with the states to an official 35%!
The public system is under increasing strain because it is becoming the default of an increasingly dysfunctional health system (including being the default for the private system). There is chronic under funding of hospitals at the federal level and the impact of federal privatisation policies on the community, health and aged care services.
Example 1. They rang me from the nursing home because the elderly woman had returned from the hospital with the intra venous line still in her arm. They had rung me several days earlier because her blood pressure was a bit high and she was complaining of headache, but despite my careful instructions over the phone they could not wait for me to arrive. The staff member on the other end of the phone had no nursing experience, and no other nursing staff available on the shift. So it was much easier to call the ambulance and send the elderly woman to hospital. Clearly both ends of the service equation were not working – and at great cost to the system.
Example 2. Across Australia millions of Australians are too often “treated” by their GP with simply a prescription, blood test or radiological investigation – again at very high cost to the system and sometimes questionable benefit to the patient. Seems its much quicker to order a simple blood test than to spend time with the patient taking a full history, perform an examination and then sit down and talk to the patient.
Thousands of men are now having a simple blood test as the sole means of assessing their prostate – called Prostatic Specific Antigen (PSA). The test is not reliable. Public authorities advise GPs against relying on this blood test as a screening test and that “its more trouble than its worth”. Nevertheless, it is now almost exclusively used by time poor Australian GPs for diagnosing prostate disease.
Patients who end up with a blood test, or some other investigation - in place of quality time spent with their GP, usually leave the doctor unhappy or are put at risk of further and more invasive investigations and treatments including referral to specialist - or they simply take themselves off to the Emergency Room at their local hospital because their problem has not been not properly dealt with or because they just get sicker.
Privatisation and economic rationales policies have strongly impacted on people’s health - to the point where GP consultations are well up. Privatisation of aged care facilities means trained nursing staff are often passed over for cheaper untrained staff. Economic rationalist policies has led to the biggest doctor shortage in Australia’s history - dating since the Productivity Commission advised the incoming Howard government in the early 1990’s along the lines that “if you cannot stop bulk billing, then less GPs would save costs through less bulk billing”.
The acute doctor shortage means that family GPs have an abundance of patients and never have to leave their medical clinic. Many sick or dying people in the community have learned to simply call an ambulance as the best way to receive care. Having a doctor visit at home, or dying peacefully at home is now rarely an option. Perfunctory medical care in the nursing homes means most end up in the hospital ED even for minor complaints. Thus the inevitable call from aged care facilities for the ambulance….
Following PM Rudds recent major statement on health it has been widely admitted that the federal share of hospital funding is now down to 35%. (Traditionally funding of our public hospitals a 50/ 50 split between the federal gvt and the states.) Mal administration of hospitals at the state level is a factor (area health boards in NSW could be somewhat reduced in size and hospital medical staff should have a greater role in regards to the planning and organization of the work they perform) - but even the best administered health board is doomed to fail while federal under funding of hospitals continues at this level – and despite Mr Rudds bold new plan, hospital federal share of hospital funding not set to increase for 3 or 4 years, and only if the states accept his new deal.
The federal government’s shirking of their fair share of public hospital funding is even more puzzling given the massive amounts of taxpayer money that the Rudd gvt has flushed through the system as a response to the GFC – including the notorious insulation program whose failure the PM partly excused based on the urgent need for the government to spend money at the time.
The Rudd government has shown little inclination to redress the real funding problems which beset the public hospital system, and this raises the worry that he is looking to more privatisation, more economc rationalist solutions for our ailing health system. Why else Christine Bennett from the private health insurance sector to lead the NHHRC? Why his quarantining of the failed 30% PHI rebate and the private walk in walk out system under which we pay our private doctors?
Yes, the recent major announcements by the PM on health financing sound bold and statesman- like. But where is the rest of the policy. You get the feeling they may be making up as they go. Or worse still that they may be holding something back which may prove the end game for the public system and introduction of a US style managed care.
The real worry may be that, under Rudd’s new new presidential style power within the Labor Party – the leader now able to hand pick his own cabinet and where Cabinet Ministers watch their own portfolios and are careful “not to tread on someone else’s turf”, there has been a tightening of the PM’s control over policy within his own Party - including greater power to his advisers and the treasury mandarins, together with his Health Minister, and the rest of the parliamentary wing no longer on watch.
The PM could do a lot worse than to immediately restore the 50/50 funding of hospitals with the states. He could set guidelines for privatised Aged Care that make it obligatory to have at least one trained nursing staff on each shift. And as an initial move away from rapid turnstile medicine in primary care, he could put all GP trainees on salaried payments – to encourage them to spend time with their patients and to provide some desperately needed house calls and nursing home care in the community. This would certainly build support for his “health reforms” with the community and the States.
Otherwise, next time you need to wait many hours to see a doctor in the public ED or you have to be transferred through busy city traffic while having your heart attack because your hospital ED has been downgraded, or your GP offers you a simple blood test instead of a quality time, or your elderly relative is yet again admitted to hospital from the nursing home for the third time in as many weeks - remember that you are not alone and it is mainly the federal under funding and economic rationalist policies which are to blame. And without something being done about that, Mr Rudd’s plans to “take over the hospital system” may be doomed from the start.
By Con Costa, as updated after Mr Rudd's Announcement of the Federal funding of hospitals.
On a weekend when 3 major Sydney hospitals announced downgrading of their ED services and ambulances to divert to other already overcrowded centre, Medibank Private announced its latest gimmick to attract membership – private ED service where for $195 patients could “jump the ED queue”. This comes at a time when federal share of hospital funding now down from the traditional 50/50 split with the states to an official 35%!
The public system is under increasing strain because it is becoming the default of an increasingly dysfunctional health system (including being the default for the private system). There is chronic under funding of hospitals at the federal level and the impact of federal privatisation policies on the community, health and aged care services.
Example 1. They rang me from the nursing home because the elderly woman had returned from the hospital with the intra venous line still in her arm. They had rung me several days earlier because her blood pressure was a bit high and she was complaining of headache, but despite my careful instructions over the phone they could not wait for me to arrive. The staff member on the other end of the phone had no nursing experience, and no other nursing staff available on the shift. So it was much easier to call the ambulance and send the elderly woman to hospital. Clearly both ends of the service equation were not working – and at great cost to the system.
Example 2. Across Australia millions of Australians are too often “treated” by their GP with simply a prescription, blood test or radiological investigation – again at very high cost to the system and sometimes questionable benefit to the patient. Seems its much quicker to order a simple blood test than to spend time with the patient taking a full history, perform an examination and then sit down and talk to the patient.
Thousands of men are now having a simple blood test as the sole means of assessing their prostate – called Prostatic Specific Antigen (PSA). The test is not reliable. Public authorities advise GPs against relying on this blood test as a screening test and that “its more trouble than its worth”. Nevertheless, it is now almost exclusively used by time poor Australian GPs for diagnosing prostate disease.
Patients who end up with a blood test, or some other investigation - in place of quality time spent with their GP, usually leave the doctor unhappy or are put at risk of further and more invasive investigations and treatments including referral to specialist - or they simply take themselves off to the Emergency Room at their local hospital because their problem has not been not properly dealt with or because they just get sicker.
Privatisation and economic rationales policies have strongly impacted on people’s health - to the point where GP consultations are well up. Privatisation of aged care facilities means trained nursing staff are often passed over for cheaper untrained staff. Economic rationalist policies has led to the biggest doctor shortage in Australia’s history - dating since the Productivity Commission advised the incoming Howard government in the early 1990’s along the lines that “if you cannot stop bulk billing, then less GPs would save costs through less bulk billing”.
The acute doctor shortage means that family GPs have an abundance of patients and never have to leave their medical clinic. Many sick or dying people in the community have learned to simply call an ambulance as the best way to receive care. Having a doctor visit at home, or dying peacefully at home is now rarely an option. Perfunctory medical care in the nursing homes means most end up in the hospital ED even for minor complaints. Thus the inevitable call from aged care facilities for the ambulance….
Following PM Rudds recent major statement on health it has been widely admitted that the federal share of hospital funding is now down to 35%. (Traditionally funding of our public hospitals a 50/ 50 split between the federal gvt and the states.) Mal administration of hospitals at the state level is a factor (area health boards in NSW could be somewhat reduced in size and hospital medical staff should have a greater role in regards to the planning and organization of the work they perform) - but even the best administered health board is doomed to fail while federal under funding of hospitals continues at this level – and despite Mr Rudds bold new plan, hospital federal share of hospital funding not set to increase for 3 or 4 years, and only if the states accept his new deal.
The federal government’s shirking of their fair share of public hospital funding is even more puzzling given the massive amounts of taxpayer money that the Rudd gvt has flushed through the system as a response to the GFC – including the notorious insulation program whose failure the PM partly excused based on the urgent need for the government to spend money at the time.
The Rudd government has shown little inclination to redress the real funding problems which beset the public hospital system, and this raises the worry that he is looking to more privatisation, more economc rationalist solutions for our ailing health system. Why else Christine Bennett from the private health insurance sector to lead the NHHRC? Why his quarantining of the failed 30% PHI rebate and the private walk in walk out system under which we pay our private doctors?
Yes, the recent major announcements by the PM on health financing sound bold and statesman- like. But where is the rest of the policy. You get the feeling they may be making up as they go. Or worse still that they may be holding something back which may prove the end game for the public system and introduction of a US style managed care.
The real worry may be that, under Rudd’s new new presidential style power within the Labor Party – the leader now able to hand pick his own cabinet and where Cabinet Ministers watch their own portfolios and are careful “not to tread on someone else’s turf”, there has been a tightening of the PM’s control over policy within his own Party - including greater power to his advisers and the treasury mandarins, together with his Health Minister, and the rest of the parliamentary wing no longer on watch.
The PM could do a lot worse than to immediately restore the 50/50 funding of hospitals with the states. He could set guidelines for privatised Aged Care that make it obligatory to have at least one trained nursing staff on each shift. And as an initial move away from rapid turnstile medicine in primary care, he could put all GP trainees on salaried payments – to encourage them to spend time with their patients and to provide some desperately needed house calls and nursing home care in the community. This would certainly build support for his “health reforms” with the community and the States.
Otherwise, next time you need to wait many hours to see a doctor in the public ED or you have to be transferred through busy city traffic while having your heart attack because your hospital ED has been downgraded, or your GP offers you a simple blood test instead of a quality time, or your elderly relative is yet again admitted to hospital from the nursing home for the third time in as many weeks - remember that you are not alone and it is mainly the federal under funding and economic rationalist policies which are to blame. And without something being done about that, Mr Rudd’s plans to “take over the hospital system” may be doomed from the start.
Friday, February 19, 2010
ASYLUM SEEKERS KNEW OF PLAN.
Red News Readers,
So if a Tony Abbott led government is going to turn the boats around and send them back out to sea, there will be more desperate actions like this.
Jenny Haines
Asylum seekers knew of plan
LINDSAY MURDOCH DARWIN CORRESPONDENT, SMH.
February 19, 2010
MANY of the asylum seekers aboard a boat that exploded near Ashmore Reef killing five people were aware of a plan to set it alight, the Northern Territory coroner says.
Greg Cavanagh said he held the reasonable view that a crime was committed on the boat known as SIEV36 before the explosion and would refer allegations against three Afghan men to authorities for possible criminal charges.
But Mr Cavanagh said it may well be that no charges are laid because any one of 49 people on the boat could have ignited the fuel, causing the explosion.
Summing up evidence at a three-week inquest into the deaths, Stephen Walsh, QC, counsel assisting the coroner, said it was likely that Sabzali Salman, Arman Ali Brahimi and Mohammad Anwar Mohammadi acted in concert to implement a plan that involved a series of deliberate acts to ensure they could not be sent back to Indonesia.
"The petrol was spilled by an Afghan passenger and it was ignited by an Afghan passenger at a point somewhere near the hatch of the bow or possibly a little towards the larger hatch at the front of the cabin," Mr Walsh said.
"The purpose was to disable the boat and prevent what was perceived to be their return to Indonesian waters."
But Mr Walsh said it was likely those involved did not expect there to be an explosion.
Peter Hanks, QC, counsel for the Commonwealth, said the lighting of the fuel "was a deliberate and malicious act and those involved must have known it would put lives at risk".
"It is clear that many of the passengers have knowledge of the events but have not come forward with that information," he said.
Mr Walsh said the asylum seekers became agitated and started screaming after they had been read an "inappropriate" warning notice which they mistakenly thought meant they were going to be forced to return to Indonesia.
He said the explosion could have been prevented if Australian Defence Force personnel had followed procedures.
"Clearly the most direct reason why the explosion was not avoided was because the unleaded petrol was not secured," Mr Walsh said.
Mr Walsh said the explosion may have been avoided if Australian Defence personnel who boarded the boat had confiscated lighters and matches.
He said the asylum seekers should have been simply and clearly told they were not going to be forced to return to Indonesia and would be taken to Australia.
Mr Walsh said changes in the way the ADF handles unauthorised arrivals meant Mr Cavanagh need not consider making any recommendations to the ADF.
"The lessons of SIEV36 have been appropriately learnt and actioned," he said.
Mr Walsh said if asylum seekers had been wearing lifejackets "it is possible some of the persons who died may have survived."
Lifejackets are now more readily available.
Other changes since the explosion include that warning notices are no longer issued to unauthorised boats and language cards have been issued to naval boarding parties.
Mr Walsh said no adverse finding can be made about ADF personnel rescuing their colleagues before the asylum seekers because more people may have died "if the navy officers had not acted as they did."
He said the evidence shows that an ADF medic, Sharon Jager, may have died if navy seaman Adrian Medbury had not kicked, forcing an asylum seeker hanging on to her to let go. He said the man who fell back into the water from a rescue vessel was rescued.
The inquest has been adjourned.
So if a Tony Abbott led government is going to turn the boats around and send them back out to sea, there will be more desperate actions like this.
Jenny Haines
Asylum seekers knew of plan
LINDSAY MURDOCH DARWIN CORRESPONDENT, SMH.
February 19, 2010
MANY of the asylum seekers aboard a boat that exploded near Ashmore Reef killing five people were aware of a plan to set it alight, the Northern Territory coroner says.
Greg Cavanagh said he held the reasonable view that a crime was committed on the boat known as SIEV36 before the explosion and would refer allegations against three Afghan men to authorities for possible criminal charges.
But Mr Cavanagh said it may well be that no charges are laid because any one of 49 people on the boat could have ignited the fuel, causing the explosion.
Summing up evidence at a three-week inquest into the deaths, Stephen Walsh, QC, counsel assisting the coroner, said it was likely that Sabzali Salman, Arman Ali Brahimi and Mohammad Anwar Mohammadi acted in concert to implement a plan that involved a series of deliberate acts to ensure they could not be sent back to Indonesia.
"The petrol was spilled by an Afghan passenger and it was ignited by an Afghan passenger at a point somewhere near the hatch of the bow or possibly a little towards the larger hatch at the front of the cabin," Mr Walsh said.
"The purpose was to disable the boat and prevent what was perceived to be their return to Indonesian waters."
But Mr Walsh said it was likely those involved did not expect there to be an explosion.
Peter Hanks, QC, counsel for the Commonwealth, said the lighting of the fuel "was a deliberate and malicious act and those involved must have known it would put lives at risk".
"It is clear that many of the passengers have knowledge of the events but have not come forward with that information," he said.
Mr Walsh said the asylum seekers became agitated and started screaming after they had been read an "inappropriate" warning notice which they mistakenly thought meant they were going to be forced to return to Indonesia.
He said the explosion could have been prevented if Australian Defence Force personnel had followed procedures.
"Clearly the most direct reason why the explosion was not avoided was because the unleaded petrol was not secured," Mr Walsh said.
Mr Walsh said the explosion may have been avoided if Australian Defence personnel who boarded the boat had confiscated lighters and matches.
He said the asylum seekers should have been simply and clearly told they were not going to be forced to return to Indonesia and would be taken to Australia.
Mr Walsh said changes in the way the ADF handles unauthorised arrivals meant Mr Cavanagh need not consider making any recommendations to the ADF.
"The lessons of SIEV36 have been appropriately learnt and actioned," he said.
Mr Walsh said if asylum seekers had been wearing lifejackets "it is possible some of the persons who died may have survived."
Lifejackets are now more readily available.
Other changes since the explosion include that warning notices are no longer issued to unauthorised boats and language cards have been issued to naval boarding parties.
Mr Walsh said no adverse finding can be made about ADF personnel rescuing their colleagues before the asylum seekers because more people may have died "if the navy officers had not acted as they did."
He said the evidence shows that an ADF medic, Sharon Jager, may have died if navy seaman Adrian Medbury had not kicked, forcing an asylum seeker hanging on to her to let go. He said the man who fell back into the water from a rescue vessel was rescued.
The inquest has been adjourned.
THE END OF ELECTRICITY PRIVATISATION??
Powerless: electricity sale stalls
ANDREW CLENNELL AND BRIAN ROBINS, SMH
February 19, 2010
THE state government has delayed the sale of its electricity retail assets, raising questions as to whether the sale will proceed at all before the election next year.
A day after the Herald revealed the government would defer construction of the metro system, in effect meaning the project is doomed, another key project has been postponed.
''The state is stalled,'' said the opposition treasury spokesman, Mike Baird.
''We have full-on paralysis.''
The Treasurer, Eric Roozendaal, announced the deferral of the $5 billion-$10 billion proposed sale of EnergyAustralia, Integral Energy and Country Energy, and electricity trading rights yesterday.
Mr Roozendaal said the sale, first proposed by the premier Morris Iemma in 2007, would be complete by the end of the year, but there was widespread scepticism about this in political and industry circles yesterday.
Sources said the complexity of the government's sale proposal had put off banks and electricity companies alike. Credit ratings agencies had warned that failure to privatise electricity could jeopardise the state's triple A credit rating.
The former finance minister Joe Tripodi, who spent $300,000 on an around-the-world trip to spruik the sale, came up with the complex Gen-Trader model, under which generation trading rights would be sold in a virtual stock exchange with the retailers.
One industry source said: ''There have been issues with getting private sector confidence in the Gen-Trader model. I know we had a lot of trouble getting our head around it.''
After Mr Roozendaal's statement yesterday, potential buyers threatened to walk away. A spokesman for Origin Energy said it would ''consider other, competing, investment options''.
Mr Roozendaal is hiring the former head of the department of premier and cabinet Col Gellatly, another former senior public servant, John Dermody, and the former minister Kim Yeadon to help the sale through, the Herald has learnt.
Do you know more? contact@smh.com.au
ANDREW CLENNELL AND BRIAN ROBINS, SMH
February 19, 2010
THE state government has delayed the sale of its electricity retail assets, raising questions as to whether the sale will proceed at all before the election next year.
A day after the Herald revealed the government would defer construction of the metro system, in effect meaning the project is doomed, another key project has been postponed.
''The state is stalled,'' said the opposition treasury spokesman, Mike Baird.
''We have full-on paralysis.''
The Treasurer, Eric Roozendaal, announced the deferral of the $5 billion-$10 billion proposed sale of EnergyAustralia, Integral Energy and Country Energy, and electricity trading rights yesterday.
Mr Roozendaal said the sale, first proposed by the premier Morris Iemma in 2007, would be complete by the end of the year, but there was widespread scepticism about this in political and industry circles yesterday.
Sources said the complexity of the government's sale proposal had put off banks and electricity companies alike. Credit ratings agencies had warned that failure to privatise electricity could jeopardise the state's triple A credit rating.
The former finance minister Joe Tripodi, who spent $300,000 on an around-the-world trip to spruik the sale, came up with the complex Gen-Trader model, under which generation trading rights would be sold in a virtual stock exchange with the retailers.
One industry source said: ''There have been issues with getting private sector confidence in the Gen-Trader model. I know we had a lot of trouble getting our head around it.''
After Mr Roozendaal's statement yesterday, potential buyers threatened to walk away. A spokesman for Origin Energy said it would ''consider other, competing, investment options''.
Mr Roozendaal is hiring the former head of the department of premier and cabinet Col Gellatly, another former senior public servant, John Dermody, and the former minister Kim Yeadon to help the sale through, the Herald has learnt.
Do you know more? contact@smh.com.au
Tuesday, February 16, 2010
MENTAL HEALTH PATIENTS NO-ONE CARES ABOUT.
The mental patients no one cares about
By Richard Noone
From: The Daily Telegraph February 16, 2010 12:00AM
NSW HOSPITALS are being turned into dumping grounds for the mentally ill.
The situation has inflamed tense relations between frontline police, paramedics and hospital staff forced to deal with the constant influx.
Paramedics are reluctant to restrain and transport violent patients and hospitals refuse to admit them if they show signs of intoxication.
"I didn't sign up to arrest people," one paramedic said. "I didn't get into this job to be smacked in the mouth by a mental health patient."
Figures reveal that from January to November last year paramedics used medical restraints 128 times.
From January to December police responded to 22,926 mental health incidents, often having to baby-sit patients overnight in police custody cells which were not equipped to accommodate them.
Related CoverageEditorial: The cruel result of good intentions
Latest Australian Institute of Health and Welfare figures show 77,699 mental health patients went or were taken to NSW emergency departments, 43.5 per cent of the 178,595 mental patients presenting in Australia and more than twice that of any other state or territory.
But the figures, collected in 2006-07 and only released late last year, could be much worse.
Given a diagnosis is only reported in 72 per cent of all patients going to emergency, it is estimated the figure could be closer to 100,000.
Mental Health Council of Australia boss David Crosbie said of those presenting only about 21,000 were later admitted.
"So . . . what happens to the other people?" he said.
Most, he said, were sent away until they deteriorated to the point where:
*THEY were forced to return to hospital emergency points;
* THEY hurt themselves; or
* THEY committed a crime and ended up in jail where, according to NSW prison data, 80 per cent of inmates have a mental illness.
Mental health experts argue the alarming rise in these numbers reflects a glaring failure of the NSW mental health system.
They blame the Government of trying to play catch-up by ploughing billions of dollars into hospital-run psychiatric beds instead of investing in community-based residential care.
Community-based residential care employs trained on-site staff to rehabilitate, treat and care for patients for up to 24 hours a day.
Mr Crosbie said adequate community-based care - 30 beds per 100,000 people - could cut emergency visits by 40 per cent.
NSW announced a record $1.171 billion spend on mental health in 2009-10, trebling the state's mental health budget over the past 15 years.
But NSW Mental Health Consumer Advisory Group executive officer Karen Oakley said it was not just a case of the Government spending more money.
"We have become such a crisis-driven system that people usually only get seen during a crisis and at that point it's too late," she said.
At the same time, NSW Police figures show a huge rise in the number of incidents they attended involving the mentally ill - from 2882 in 2000 to 39,352 in 2007.
Anecdotal evidence suggested this figure had since fallen after mental health intervention teams were set up with officers who are specifically trained in mental illness.
By Richard Noone
From: The Daily Telegraph February 16, 2010 12:00AM
NSW HOSPITALS are being turned into dumping grounds for the mentally ill.
The situation has inflamed tense relations between frontline police, paramedics and hospital staff forced to deal with the constant influx.
Paramedics are reluctant to restrain and transport violent patients and hospitals refuse to admit them if they show signs of intoxication.
"I didn't sign up to arrest people," one paramedic said. "I didn't get into this job to be smacked in the mouth by a mental health patient."
Figures reveal that from January to November last year paramedics used medical restraints 128 times.
From January to December police responded to 22,926 mental health incidents, often having to baby-sit patients overnight in police custody cells which were not equipped to accommodate them.
Related CoverageEditorial: The cruel result of good intentions
Latest Australian Institute of Health and Welfare figures show 77,699 mental health patients went or were taken to NSW emergency departments, 43.5 per cent of the 178,595 mental patients presenting in Australia and more than twice that of any other state or territory.
But the figures, collected in 2006-07 and only released late last year, could be much worse.
Given a diagnosis is only reported in 72 per cent of all patients going to emergency, it is estimated the figure could be closer to 100,000.
Mental Health Council of Australia boss David Crosbie said of those presenting only about 21,000 were later admitted.
"So . . . what happens to the other people?" he said.
Most, he said, were sent away until they deteriorated to the point where:
*THEY were forced to return to hospital emergency points;
* THEY hurt themselves; or
* THEY committed a crime and ended up in jail where, according to NSW prison data, 80 per cent of inmates have a mental illness.
Mental health experts argue the alarming rise in these numbers reflects a glaring failure of the NSW mental health system.
They blame the Government of trying to play catch-up by ploughing billions of dollars into hospital-run psychiatric beds instead of investing in community-based residential care.
Community-based residential care employs trained on-site staff to rehabilitate, treat and care for patients for up to 24 hours a day.
Mr Crosbie said adequate community-based care - 30 beds per 100,000 people - could cut emergency visits by 40 per cent.
NSW announced a record $1.171 billion spend on mental health in 2009-10, trebling the state's mental health budget over the past 15 years.
But NSW Mental Health Consumer Advisory Group executive officer Karen Oakley said it was not just a case of the Government spending more money.
"We have become such a crisis-driven system that people usually only get seen during a crisis and at that point it's too late," she said.
At the same time, NSW Police figures show a huge rise in the number of incidents they attended involving the mentally ill - from 2882 in 2000 to 39,352 in 2007.
Anecdotal evidence suggested this figure had since fallen after mental health intervention teams were set up with officers who are specifically trained in mental illness.
WHO TRUSTS ABBOTT ON IR??
Fed: Survey reveals Australians don't trust Abbott on IR
15 February 2010 | Content provided to you by AAP.
CANBERRA, Feb 15 AAP - Most Australians believe federal Opposition Leader Tony Abbott would bring back Work Choices if elected, a poll has found.
The ACTU poll comes as both sides of politics gear up for an election with industrial relations again to be a key feature.
Mr Abbott has previously said the Work Choices industrial relations regime introduced by the Howard government was "dead" and that he had no intention of reviving it.
However, the poll of 2099 people found just 18 per cent believe it is unlikely the coalition will reintroduce Work Choices.
More than half of those surveyed (53 per cent) believe it is likely or very likely the coalition would seek to reintroduce Work Choices or a similar system under a different name.
ACTU president Sharan Burrow said the results showed Australians had deep suspicions about Mr Abbott's support for hardline industrial relations policies.
"Australians remember the damage caused by Work Choices under the former Liberal government in which Tony Abbott and Joe Hockey were senior ministers," Ms Burrow said.
15 February 2010 | Content provided to you by AAP.
CANBERRA, Feb 15 AAP - Most Australians believe federal Opposition Leader Tony Abbott would bring back Work Choices if elected, a poll has found.
The ACTU poll comes as both sides of politics gear up for an election with industrial relations again to be a key feature.
Mr Abbott has previously said the Work Choices industrial relations regime introduced by the Howard government was "dead" and that he had no intention of reviving it.
However, the poll of 2099 people found just 18 per cent believe it is unlikely the coalition will reintroduce Work Choices.
More than half of those surveyed (53 per cent) believe it is likely or very likely the coalition would seek to reintroduce Work Choices or a similar system under a different name.
ACTU president Sharan Burrow said the results showed Australians had deep suspicions about Mr Abbott's support for hardline industrial relations policies.
"Australians remember the damage caused by Work Choices under the former Liberal government in which Tony Abbott and Joe Hockey were senior ministers," Ms Burrow said.
Monday, February 15, 2010
ABBOTT WANTS HOSPITAL BOARDS
Red News Readers,
Re-establishing hospital boards will not change anything in the health system. Abbott’s policy is just a gift to those doctors who support the Coalition. And in fact, hospital boards may become the scapegoat in the system, so those doctors advocating the return of hospital boards may want to think carefully about what they are proposing. Having a few elite members of an institution attend a board meeting, is not going to do anything for elective surgery waiting times, or emergency department access, or clinical standards performance by inexperienced staff lacking adequate supervision from more experienced staff. These are the immediate issues that need to be dealt with, not establishing a meeting where doctors get a warm feeling in their tummy that they have their power back.
Jenny Haines
Abbott plans boards to rescue ailing hospitals
JACOB SAULWICK AND CONRAD WALTERS, SMH
February 15, 2010
NSW hospitals are so bad they need a Northern Territory-style intervention, says Tony Abbott, who wants local boards to assume control of the state's major public hospitals.
The opposition leader was flanked by his predecessor, Malcolm Turnbull, as he announced his first major health policy, which was immediately dismissed by the government as a Band-Aid solution, inadequate to the health system's problems.
Under a Coalition government, chief executive officers would manage hospitals in NSW and Queensland. These officers would be accountable to management boards made up of community and business leaders and doctor and nurse representatives, and who would control the hospital's funding.
Governments would set the overall funding for a hospital, but would not be able to cut spending on a hospital if it raised money from private patients or fund-raising. The idea mirrors a proposal Mr Abbott made while health minister in the Howard government.
''That is the change that our public hospital system needs … particularly in NSW and Queensland where chronic, systemic mismanagement really requires federal intervention along the lines of the intervention in the Northern Territory's remote communities back in 2007,'' Mr Abbott said yesterday, alongside his health spokesman, Peter Dutton, and Mr Turnbull.
The hospital where Mr Abbott chose to make his announcement, St Vincent's, is in Mr Turnbull's electorate.
The Health Minister, Nicola Roxon, said Mr Abbott's policy was a ''minor-league solution'' to a ''major-league problem''.
She said it would not make any difference for three reasons. It was not a national policy; it did not do anything to manage waste or duplication in the health system; and it provided no additional funding for doctors or beds.
The government is due to announce its own health policy in coming months, and yesterday stressed its policy would tackle the duplication of funding across state and federal governments.
But Ms Roxon did not rule out empowering local boards along the lines of Mr Abbott's idea.
The Prime Minister, Kevin Rudd, has said that one of the key comments he heard while consulting hospitals was that clinicians wanted more control over finances. Yesterday he conceded he had taken longer than planned to put in place reform, but said the delay was needed to get it right.
''We believe the system requires urgent surgery, we need more hospital beds, we need the elimination of waste between the Commonwealth and the states, and that is why a bold reform plan for the future is necessary,'' Mr Rudd said.
Tim Woodruff, president of the Doctors Reform Society, said the health system needed more co-ordination, not to be divided up along the lines suggested by Mr Abbott. ''Our feeling is that this is a move back to the 1950s,'' he said. ''Hospital boards throughout the country would simply result in a lot more infighting.''
In its budget submission, released today, the Business Council of Australia calls for federal and state health funding to be combined to reduce the duplication of programs.
Re-establishing hospital boards will not change anything in the health system. Abbott’s policy is just a gift to those doctors who support the Coalition. And in fact, hospital boards may become the scapegoat in the system, so those doctors advocating the return of hospital boards may want to think carefully about what they are proposing. Having a few elite members of an institution attend a board meeting, is not going to do anything for elective surgery waiting times, or emergency department access, or clinical standards performance by inexperienced staff lacking adequate supervision from more experienced staff. These are the immediate issues that need to be dealt with, not establishing a meeting where doctors get a warm feeling in their tummy that they have their power back.
Jenny Haines
Abbott plans boards to rescue ailing hospitals
JACOB SAULWICK AND CONRAD WALTERS, SMH
February 15, 2010
NSW hospitals are so bad they need a Northern Territory-style intervention, says Tony Abbott, who wants local boards to assume control of the state's major public hospitals.
The opposition leader was flanked by his predecessor, Malcolm Turnbull, as he announced his first major health policy, which was immediately dismissed by the government as a Band-Aid solution, inadequate to the health system's problems.
Under a Coalition government, chief executive officers would manage hospitals in NSW and Queensland. These officers would be accountable to management boards made up of community and business leaders and doctor and nurse representatives, and who would control the hospital's funding.
Governments would set the overall funding for a hospital, but would not be able to cut spending on a hospital if it raised money from private patients or fund-raising. The idea mirrors a proposal Mr Abbott made while health minister in the Howard government.
''That is the change that our public hospital system needs … particularly in NSW and Queensland where chronic, systemic mismanagement really requires federal intervention along the lines of the intervention in the Northern Territory's remote communities back in 2007,'' Mr Abbott said yesterday, alongside his health spokesman, Peter Dutton, and Mr Turnbull.
The hospital where Mr Abbott chose to make his announcement, St Vincent's, is in Mr Turnbull's electorate.
The Health Minister, Nicola Roxon, said Mr Abbott's policy was a ''minor-league solution'' to a ''major-league problem''.
She said it would not make any difference for three reasons. It was not a national policy; it did not do anything to manage waste or duplication in the health system; and it provided no additional funding for doctors or beds.
The government is due to announce its own health policy in coming months, and yesterday stressed its policy would tackle the duplication of funding across state and federal governments.
But Ms Roxon did not rule out empowering local boards along the lines of Mr Abbott's idea.
The Prime Minister, Kevin Rudd, has said that one of the key comments he heard while consulting hospitals was that clinicians wanted more control over finances. Yesterday he conceded he had taken longer than planned to put in place reform, but said the delay was needed to get it right.
''We believe the system requires urgent surgery, we need more hospital beds, we need the elimination of waste between the Commonwealth and the states, and that is why a bold reform plan for the future is necessary,'' Mr Rudd said.
Tim Woodruff, president of the Doctors Reform Society, said the health system needed more co-ordination, not to be divided up along the lines suggested by Mr Abbott. ''Our feeling is that this is a move back to the 1950s,'' he said. ''Hospital boards throughout the country would simply result in a lot more infighting.''
In its budget submission, released today, the Business Council of Australia calls for federal and state health funding to be combined to reduce the duplication of programs.
Monday, February 08, 2010
STATES PUSH AGAINST NATIONAL TAKEOVER
Red News Readers,
Having been in the health system a very long time, I take a jaundiced view of promises for more funding for community based services. There have been several attempts at this over the last 40 years with some initial success, but as soon as economic circumstances change, it is community based services that take the cuts to services and staffing levels first, and usually without much protest, as it is an area that unions find hard to organise into activity. Health bureaucrats mouth platitudes about their commitment to community based health and mental health services but they don't like the autonomy of the services and the practitioners in them and they certainly don't like community based services that overrun their budget, hence the latest move over the last couple of years, placing community health and mental health under the operational control of hospitals. It all seems to go around in one big cycle!
Jenny Haines
States push back against national hospital takeover
MARK METHERELL AND JULIE ROBOTHAM
February 8, 2010
THE federal government appears increasingly unlikely to seek a mandate to take over public hospitals, as a revamp of community health and GP services instead moves to the centre of the national health reform agenda.
The Prime Minister's pledge before the last election to seek a federal takeover of public hospital funding if the state governments failed to fix them before the middle of last year is being undermined by state resistance.
Having injected an extra $20 billion over five years into public hospitals, the federal government faces a growing campaign to expand primary care in the community provided by doctors, nurses and other health professionals. This is being seen as a more practicable way of reducing the pressure on public hospitals, whose defenders say they have been hit by crises because of years of inadequate funding.
Last week the Health Minister, Nicola Roxon, repeated the threat of taking the issue of a federal health takeover to the election or a referendum if the states failed to join the government's health reforms.
But yesterday the Victorian Premier, John Brumby, dismissed any notion of a federal takeover. His view is also shared by the NSW Government. Both states say, however, they want to see a co-operative arrangement to dispense with blame-shifting and cost-shifting, which blights health administration.
A recent top-level meeting between NSW and federal government representatives is believed to have focused on a restructure of primary healthcare services, electronic health records and workforce issues, rather than a wholesale takeover of public hospitals.
Under the proposals, being driven by federal treasury and the Department of the Prime Minister and Cabinet along with the Department of Health and Ageing, general practitioner services - now paid for by the federal government - would be integrated with state-funded community health services.
The resulting services could either be directly funded by the federal government or in a state-federal partnership, would give doctors incentives to work in a team, and would aim to reduce the number of people admitted to hospital because of inadequate treatment of a long-term condition.
Australians are 20 to 30 per cent more likely to be admitted to hospital overnight than people in Britain or US, according to the Australian Institute of Health and Welfare, which says 9 per cent of all hospital stays are potentially preventable, involving complications from diabetes and other chronic illnesses.
Electronic health records, to support integrated GP and hospital treatment, also figured prominently in the discussions, along with planning for the expanded health workforce needed to handle increasing disease in an ageing population. State-run public hospitals argue they need more federal support to accommodate a massive influx of inexperienced new doctors, nurses and health workers.
The talks also canvassed increasing performance-based health funding to states.
The federal government has continued its predecessor's policy of tying large grants to reducing emergency department and elective surgery waiting times and hospital infections, in a strategy which increases the federal control over public hospital priorities while avoiding administrative responsibility.
Having been in the health system a very long time, I take a jaundiced view of promises for more funding for community based services. There have been several attempts at this over the last 40 years with some initial success, but as soon as economic circumstances change, it is community based services that take the cuts to services and staffing levels first, and usually without much protest, as it is an area that unions find hard to organise into activity. Health bureaucrats mouth platitudes about their commitment to community based health and mental health services but they don't like the autonomy of the services and the practitioners in them and they certainly don't like community based services that overrun their budget, hence the latest move over the last couple of years, placing community health and mental health under the operational control of hospitals. It all seems to go around in one big cycle!
Jenny Haines
States push back against national hospital takeover
MARK METHERELL AND JULIE ROBOTHAM
February 8, 2010
THE federal government appears increasingly unlikely to seek a mandate to take over public hospitals, as a revamp of community health and GP services instead moves to the centre of the national health reform agenda.
The Prime Minister's pledge before the last election to seek a federal takeover of public hospital funding if the state governments failed to fix them before the middle of last year is being undermined by state resistance.
Having injected an extra $20 billion over five years into public hospitals, the federal government faces a growing campaign to expand primary care in the community provided by doctors, nurses and other health professionals. This is being seen as a more practicable way of reducing the pressure on public hospitals, whose defenders say they have been hit by crises because of years of inadequate funding.
Last week the Health Minister, Nicola Roxon, repeated the threat of taking the issue of a federal health takeover to the election or a referendum if the states failed to join the government's health reforms.
But yesterday the Victorian Premier, John Brumby, dismissed any notion of a federal takeover. His view is also shared by the NSW Government. Both states say, however, they want to see a co-operative arrangement to dispense with blame-shifting and cost-shifting, which blights health administration.
A recent top-level meeting between NSW and federal government representatives is believed to have focused on a restructure of primary healthcare services, electronic health records and workforce issues, rather than a wholesale takeover of public hospitals.
Under the proposals, being driven by federal treasury and the Department of the Prime Minister and Cabinet along with the Department of Health and Ageing, general practitioner services - now paid for by the federal government - would be integrated with state-funded community health services.
The resulting services could either be directly funded by the federal government or in a state-federal partnership, would give doctors incentives to work in a team, and would aim to reduce the number of people admitted to hospital because of inadequate treatment of a long-term condition.
Australians are 20 to 30 per cent more likely to be admitted to hospital overnight than people in Britain or US, according to the Australian Institute of Health and Welfare, which says 9 per cent of all hospital stays are potentially preventable, involving complications from diabetes and other chronic illnesses.
Electronic health records, to support integrated GP and hospital treatment, also figured prominently in the discussions, along with planning for the expanded health workforce needed to handle increasing disease in an ageing population. State-run public hospitals argue they need more federal support to accommodate a massive influx of inexperienced new doctors, nurses and health workers.
The talks also canvassed increasing performance-based health funding to states.
The federal government has continued its predecessor's policy of tying large grants to reducing emergency department and elective surgery waiting times and hospital infections, in a strategy which increases the federal control over public hospital priorities while avoiding administrative responsibility.
CALL TO STOP COMPULSORY INCOME QUARANTINING
Call to stop compulsory income quarantining
ADELE HORIN, SMH.
February 8, 2010
THE government's plan to roll out compulsory income management across Australia for long-term welfare recipients, including sole parents and young people, is based on flimsy and contradictory evidence from the Northern Territory intervention and should be stopped, the nation's peak welfare organisation says.
In a stinging attack, the Australian Council of Social Service says extension of the scheme across the country to quarantine 50 to 70 per cent of the income of welfare recipients would prove expensive, intrusive and unnecessary.
Clare Martin, the chief executive officer of ACOSS, said: ''The government is presuming whole categories of Australians are irresponsible with the small income they get, when there is no evidence for that. This will waste money on administration when it could go to target assistance to those who need it.''
The government has introduced three bills to address the racial discriminatory aspects of the Coalition's intervention in the Northern Territory, to bring in new income quarantine measures, exclude recipients such as age and disability pensioners who are presently affected, and to roll out the scheme beyond the territory.
It is considered one of the most significant shifts in the history of social security policy, and involves the government declaring certain communities ''disadvantaged'' and imposing income management on particular groups of welfare recipients who normally live there.
In a submission to the Senate inquiry into the legislation, ACOSS says it is concerned a national roll-out is proposed despite the ''weak and conflicting evidence'' from Northern Territory indigenous communities.
ACOSS says measures that, if well-targeted, might suit a few would be imposed on many, subjecting them to humiliation and discrimination. Compulsory income management would create ''a perception that long-term[welfare] recipients are unable or unwilling to manage their very limited finances''.
The groups affected include people who have been on a Newstart Allowance or Parenting Payment or Special Benefit for more than a year in the past two; ''disengaged'' youth in receipt of a payment for more than 13 of the past 26 weeks; people deemed ''vulnerable'' to financial crisis, domestic violence or economic abuse; and where there are child protection concerns.
ACOSS understand the scheme will first be rolled out across the Northern Territory by mid-2011, and then, after evaluation, across the country. Affected welfare recipients, including mature-age long-term unemployed, would have to use a card in order to spend half of their payments on allowed items, and would be limited to shopping in designated stores. ACOSS says this has major implications for consumer choice and retail competition.
The government argues the measure would reduce spending on alcohol, cigarettes, gambling and porn, and would ''encourage socially responsible behaviour''.
ACOSS says the aim of social security policy is to reduce poverty, and it should not to used to effect ''broader social or behaviour change''.
It says restricted-use payment schemes, such as income management, are much more expensive to administer than cash payments because of the need for electronic payment systems, store licensing schemes and significantly increased client contact with government agencies.
ACOSS says the annual administrative cost of expanding the scheme across the Northern Territory is $4400 per person, and funds would be better spent on services.
ADELE HORIN, SMH.
February 8, 2010
THE government's plan to roll out compulsory income management across Australia for long-term welfare recipients, including sole parents and young people, is based on flimsy and contradictory evidence from the Northern Territory intervention and should be stopped, the nation's peak welfare organisation says.
In a stinging attack, the Australian Council of Social Service says extension of the scheme across the country to quarantine 50 to 70 per cent of the income of welfare recipients would prove expensive, intrusive and unnecessary.
Clare Martin, the chief executive officer of ACOSS, said: ''The government is presuming whole categories of Australians are irresponsible with the small income they get, when there is no evidence for that. This will waste money on administration when it could go to target assistance to those who need it.''
The government has introduced three bills to address the racial discriminatory aspects of the Coalition's intervention in the Northern Territory, to bring in new income quarantine measures, exclude recipients such as age and disability pensioners who are presently affected, and to roll out the scheme beyond the territory.
It is considered one of the most significant shifts in the history of social security policy, and involves the government declaring certain communities ''disadvantaged'' and imposing income management on particular groups of welfare recipients who normally live there.
In a submission to the Senate inquiry into the legislation, ACOSS says it is concerned a national roll-out is proposed despite the ''weak and conflicting evidence'' from Northern Territory indigenous communities.
ACOSS says measures that, if well-targeted, might suit a few would be imposed on many, subjecting them to humiliation and discrimination. Compulsory income management would create ''a perception that long-term[welfare] recipients are unable or unwilling to manage their very limited finances''.
The groups affected include people who have been on a Newstart Allowance or Parenting Payment or Special Benefit for more than a year in the past two; ''disengaged'' youth in receipt of a payment for more than 13 of the past 26 weeks; people deemed ''vulnerable'' to financial crisis, domestic violence or economic abuse; and where there are child protection concerns.
ACOSS understand the scheme will first be rolled out across the Northern Territory by mid-2011, and then, after evaluation, across the country. Affected welfare recipients, including mature-age long-term unemployed, would have to use a card in order to spend half of their payments on allowed items, and would be limited to shopping in designated stores. ACOSS says this has major implications for consumer choice and retail competition.
The government argues the measure would reduce spending on alcohol, cigarettes, gambling and porn, and would ''encourage socially responsible behaviour''.
ACOSS says the aim of social security policy is to reduce poverty, and it should not to used to effect ''broader social or behaviour change''.
It says restricted-use payment schemes, such as income management, are much more expensive to administer than cash payments because of the need for electronic payment systems, store licensing schemes and significantly increased client contact with government agencies.
ACOSS says the annual administrative cost of expanding the scheme across the Northern Territory is $4400 per person, and funds would be better spent on services.
Tuesday, February 02, 2010
WHY DO PEOPLE OFTEN VOTE AGAINST THEIR OWN INTERESTS?
BBC NEWS WEBSITE, 30.1.10
The Republicans' shock victory in the election for the US Senate seat in Massachusetts meant the Democrats lost their supermajority in the Senate. This makes it even harder for the Obama administration to get healthcare reform passed in the US.
Political scientist Dr David Runciman looks at why there is often such deep opposition to reforms that appear to be of obvious benefit to voters.
Last year, in a series of "town-hall meetings" across the country, Americans got the chance to debate President Obama's proposed healthcare reforms.
What happened was an explosion of rage and barely suppressed violence.
Polling evidence suggests that the numbers who think the reforms go too far are nearly matched by those who think they do not go far enough.
But it is striking that the people who most dislike the whole idea of healthcare reform - the ones who think it is socialist, godless, a step on the road to a police state - are often the ones it seems designed to help.
In Texas, where barely two-thirds of the population have full health insurance and over a fifth of all children have no cover at all, opposition to the legislation is currently running at 87%.
Anger
Instead, to many of those who lose out under the existing system, reform still seems like the ultimate betrayal.
Why are so many American voters enraged by attempts to change a horribly inefficient system that leaves them with premiums they often cannot afford?
Why are they manning the barricades to defend insurance companies that routinely deny claims and cancel policies?
It might be tempting to put the whole thing down to what the historian Richard Hofstadter back in the 1960s called "the paranoid style" of American politics, in which God, guns and race get mixed into a toxic stew of resentment at anything coming out of Washington.
But that would be a mistake.
Drew Westen argues that stories rather than facts convince voters
If people vote against their own interests, it is not because they do not understand what is in their interest or have not yet had it properly explained to them.
They do it because they resent having their interests decided for them by politicians who think they know best.
There is nothing voters hate more than having things explained to them as though they were idiots.
As the saying goes, in politics, when you are explaining, you are losing. And that makes anything as complex or as messy as healthcare reform a very hard sell.
Stories not facts
In his book The Political Brain, psychologist Drew Westen, an exasperated Democrat, tried to show why the Right often wins the argument even when the Left is confident that it has the facts on its side.
He uses the following exchange from the first presidential debate between Al Gore and George Bush in 2000 to illustrate the perils of trying to explain to voters what will make them better off:
Gore: "Under the governor's plan, if you kept the same fee for service that you have now under Medicare, your premiums would go up by between 18% and 47%, and that is the study of the Congressional plan that he's modelled his proposal on by the Medicare actuaries."
Bush: "Look, this is a man who has great numbers. He talks about numbers.
"I'm beginning to think not only did he invent the internet, but he invented the calculator. It's fuzzy math. It's trying to scare people in the voting booth."
Mr Gore was talking sense and Mr Bush nonsense - but Mr Bush won the debate. With statistics, the voters just hear a patronising policy wonk, and switch off.
For Mr Westen, stories always trump statistics, which means the politician with the best stories is going to win: "One of the fallacies that politicians often have on the Left is that things are obvious, when they are not obvious.
"Obama's administration made a tremendous mistake by not immediately branding the economic collapse that we had just had as the Republicans' Depression, caused by the Bush administration's ideology of unregulated greed. The result is that now people blame him."
Reverse revolution
Thomas Frank, the author of the best-selling book What's The Matter with Kansas, is an even more exasperated Democrat and he goes further than Mr Westen.
He believes that the voters' preference for emotional engagement over reasonable argument has allowed the Republican Party to blind them to their own real interests.
The Republicans have learnt how to stoke up resentment against the patronising liberal elite, all those do-gooders who assume they know what poor people ought to be thinking.
Right-wing politics has become a vehicle for channelling this popular anger against intellectual snobs. The result is that many of America's poorest citizens have a deep emotional attachment to a party that serves the interests of its richest.
Thomas Frank thinks that voters have become blinded to their real interests
Thomas Frank says that whatever disadvantaged Americans think they are voting for, they get something quite different:
"You vote to strike a blow against elitism and you receive a social order in which wealth is more concentrated than ever before in our life times, workers have been stripped of power, and CEOs are rewarded in a manner that is beyond imagining.
"It's like a French Revolution in reverse in which the workers come pouring down the street screaming more power to the aristocracy."
As Mr Frank sees it, authenticity has replaced economics as the driving force of modern politics. The authentic politicians are the ones who sound like they are speaking from the gut, not the cerebral cortex. Of course, they might be faking it, but it is no joke to say that in contemporary politics, if you can fake sincerity, you have got it made.
And the ultimate sin in modern politics is appearing to take the voters for granted.
This is a culture war but it is not simply being driven by differences over abortion, or religion, or patriotism. And it is not simply Red states vs. Blue states any more. It is a war on the entire political culture, on the arrogance of politicians, on their slipperiness and lack of principle, on their endless deal making and compromises.
And when the politicians say to the people protesting: 'But we're doing this for you', that just makes it worse. In fact, that seems to be what makes them angriest of all.
This edition of Turkeys Voting for Christmas was first broadcast on BBC Radio 4 on Sunday 24 January and repeated on Wednesday 27 January at 2045 GMT. Listen via the BBC iPlayer.
The Republicans' shock victory in the election for the US Senate seat in Massachusetts meant the Democrats lost their supermajority in the Senate. This makes it even harder for the Obama administration to get healthcare reform passed in the US.
Political scientist Dr David Runciman looks at why there is often such deep opposition to reforms that appear to be of obvious benefit to voters.
Last year, in a series of "town-hall meetings" across the country, Americans got the chance to debate President Obama's proposed healthcare reforms.
What happened was an explosion of rage and barely suppressed violence.
Polling evidence suggests that the numbers who think the reforms go too far are nearly matched by those who think they do not go far enough.
But it is striking that the people who most dislike the whole idea of healthcare reform - the ones who think it is socialist, godless, a step on the road to a police state - are often the ones it seems designed to help.
In Texas, where barely two-thirds of the population have full health insurance and over a fifth of all children have no cover at all, opposition to the legislation is currently running at 87%.
Anger
Instead, to many of those who lose out under the existing system, reform still seems like the ultimate betrayal.
Why are so many American voters enraged by attempts to change a horribly inefficient system that leaves them with premiums they often cannot afford?
Why are they manning the barricades to defend insurance companies that routinely deny claims and cancel policies?
It might be tempting to put the whole thing down to what the historian Richard Hofstadter back in the 1960s called "the paranoid style" of American politics, in which God, guns and race get mixed into a toxic stew of resentment at anything coming out of Washington.
But that would be a mistake.
Drew Westen argues that stories rather than facts convince voters
If people vote against their own interests, it is not because they do not understand what is in their interest or have not yet had it properly explained to them.
They do it because they resent having their interests decided for them by politicians who think they know best.
There is nothing voters hate more than having things explained to them as though they were idiots.
As the saying goes, in politics, when you are explaining, you are losing. And that makes anything as complex or as messy as healthcare reform a very hard sell.
Stories not facts
In his book The Political Brain, psychologist Drew Westen, an exasperated Democrat, tried to show why the Right often wins the argument even when the Left is confident that it has the facts on its side.
He uses the following exchange from the first presidential debate between Al Gore and George Bush in 2000 to illustrate the perils of trying to explain to voters what will make them better off:
Gore: "Under the governor's plan, if you kept the same fee for service that you have now under Medicare, your premiums would go up by between 18% and 47%, and that is the study of the Congressional plan that he's modelled his proposal on by the Medicare actuaries."
Bush: "Look, this is a man who has great numbers. He talks about numbers.
"I'm beginning to think not only did he invent the internet, but he invented the calculator. It's fuzzy math. It's trying to scare people in the voting booth."
Mr Gore was talking sense and Mr Bush nonsense - but Mr Bush won the debate. With statistics, the voters just hear a patronising policy wonk, and switch off.
For Mr Westen, stories always trump statistics, which means the politician with the best stories is going to win: "One of the fallacies that politicians often have on the Left is that things are obvious, when they are not obvious.
"Obama's administration made a tremendous mistake by not immediately branding the economic collapse that we had just had as the Republicans' Depression, caused by the Bush administration's ideology of unregulated greed. The result is that now people blame him."
Reverse revolution
Thomas Frank, the author of the best-selling book What's The Matter with Kansas, is an even more exasperated Democrat and he goes further than Mr Westen.
He believes that the voters' preference for emotional engagement over reasonable argument has allowed the Republican Party to blind them to their own real interests.
The Republicans have learnt how to stoke up resentment against the patronising liberal elite, all those do-gooders who assume they know what poor people ought to be thinking.
Right-wing politics has become a vehicle for channelling this popular anger against intellectual snobs. The result is that many of America's poorest citizens have a deep emotional attachment to a party that serves the interests of its richest.
Thomas Frank thinks that voters have become blinded to their real interests
Thomas Frank says that whatever disadvantaged Americans think they are voting for, they get something quite different:
"You vote to strike a blow against elitism and you receive a social order in which wealth is more concentrated than ever before in our life times, workers have been stripped of power, and CEOs are rewarded in a manner that is beyond imagining.
"It's like a French Revolution in reverse in which the workers come pouring down the street screaming more power to the aristocracy."
As Mr Frank sees it, authenticity has replaced economics as the driving force of modern politics. The authentic politicians are the ones who sound like they are speaking from the gut, not the cerebral cortex. Of course, they might be faking it, but it is no joke to say that in contemporary politics, if you can fake sincerity, you have got it made.
And the ultimate sin in modern politics is appearing to take the voters for granted.
This is a culture war but it is not simply being driven by differences over abortion, or religion, or patriotism. And it is not simply Red states vs. Blue states any more. It is a war on the entire political culture, on the arrogance of politicians, on their slipperiness and lack of principle, on their endless deal making and compromises.
And when the politicians say to the people protesting: 'But we're doing this for you', that just makes it worse. In fact, that seems to be what makes them angriest of all.
This edition of Turkeys Voting for Christmas was first broadcast on BBC Radio 4 on Sunday 24 January and repeated on Wednesday 27 January at 2045 GMT. Listen via the BBC iPlayer.
Monday, February 01, 2010
ANTI OZ RAGE IN NEW DELHI
Red News Readers,
Good on Vahn Rudd and his friend for their action at the tennis. Those who oppose racism in this country need to demonstrate to India that racism should not be tolerated in Australia, and that there are citizens here who are appalled at what has happened in some of these attacks. I was working a nursing shift in Westmead ED recently, and a young 20 year old Indian male presented after being bashed. Two white skinned men he did not know got out of a car, and charged at his friend but could not catch him, so they bashed the patient instead. Fortunately he sustained only minor injuries.
Jenny Haines
Anatomy of hate as magazine unleashes anti-Australian rage
MATT WADE IN NEW DELHI, smh
February 1, 2010
Venom … the influential magazine devotes 10 pages to its inflammatory cover story.
IT IS a magazine cover that will make the hearts of Australian university bosses and diplomats sink.
"Why the Aussies hate us" screams the cover of this week's influential Indian news magazine Outlook.
The 10-page coverage includes stories of young Indian victims of violence and racial abuse and describes how Indian students in Melbourne feel afraid on the streets.
Van Thanh Rudd, an anti-racism activist and Kevin Rudd's nephew - recently criticised for wearing a Ku Klux Klan outfit to protest against attacks on Indians - told Outlook the "dominant culture in Australia'' was racist, and that he had no doubt the attacks had been racially motivated.
The magazine quotes far-right politicians and says it has found ''evidence that 'curry-bashing' is becoming a fun game for white Australians". Outlook, a centre-left weekly, is one of India's top-selling English-language magazines with a circulation of 1.5 million and a big online following.
The story was introduced on the Outlook website with the headline "Anatomy of hate". The report is the latest in a stream of negative publicity about violence against Indians in Australia.
There are signs the Indian government is increasingly impatient with Australia's response. The External Affairs Minister, S.M.Krishna, met the Australian Foreign Minister, Stephen Smith, in London twice last week. An Indian government statement said Mr Krishna told Mr Smith it was increasingly difficult to accept the attacks were devoid of any racial motives and that he complained there had ''been no visible progress so far into most of the investigations''.
The editor-in-chief of Outlook, Vinod Mehta, defended the coverage and denied allegations that the Indian media were overreacting. He told the Herald: "We sent two correspondents to Australia and they found that an overwhelming number of these incidents were racial and they found that Indians in Australia live in fear. There is tremendous outrage in this country. I don't think the Australians realise that."
Mr Mehta said one reason for the anger was the "smug and superior attitude of the Australian government for denying there was racism and then telling the Indians not to hype this up".
Mr Mehta said he published the story with great regret.
"I like Australia a great deal but you have to see there is a problem, and by denying it you won't get anywhere."
The story includes comments by right-wing groups in Australia. Outlook quotes Jim Saleam, the head of the anti-immigration party Australia First, that Indians are ''becoming a serious threat to white Australians in the job market". Bob Vinnicombe of One Nation is quoted as saying Australia ''should actively encourage bringing in Christians and white people from Zimbabwe and South Africa".
But the magazine does not report that three people charged with the murder of Ranjodh Singh were Indian nationals.
Reports about attacks on Indians have damaged Australia's $15 billion a year international education industry.
Good on Vahn Rudd and his friend for their action at the tennis. Those who oppose racism in this country need to demonstrate to India that racism should not be tolerated in Australia, and that there are citizens here who are appalled at what has happened in some of these attacks. I was working a nursing shift in Westmead ED recently, and a young 20 year old Indian male presented after being bashed. Two white skinned men he did not know got out of a car, and charged at his friend but could not catch him, so they bashed the patient instead. Fortunately he sustained only minor injuries.
Jenny Haines
Anatomy of hate as magazine unleashes anti-Australian rage
MATT WADE IN NEW DELHI, smh
February 1, 2010
Venom … the influential magazine devotes 10 pages to its inflammatory cover story.
IT IS a magazine cover that will make the hearts of Australian university bosses and diplomats sink.
"Why the Aussies hate us" screams the cover of this week's influential Indian news magazine Outlook.
The 10-page coverage includes stories of young Indian victims of violence and racial abuse and describes how Indian students in Melbourne feel afraid on the streets.
Van Thanh Rudd, an anti-racism activist and Kevin Rudd's nephew - recently criticised for wearing a Ku Klux Klan outfit to protest against attacks on Indians - told Outlook the "dominant culture in Australia'' was racist, and that he had no doubt the attacks had been racially motivated.
The magazine quotes far-right politicians and says it has found ''evidence that 'curry-bashing' is becoming a fun game for white Australians". Outlook, a centre-left weekly, is one of India's top-selling English-language magazines with a circulation of 1.5 million and a big online following.
The story was introduced on the Outlook website with the headline "Anatomy of hate". The report is the latest in a stream of negative publicity about violence against Indians in Australia.
There are signs the Indian government is increasingly impatient with Australia's response. The External Affairs Minister, S.M.Krishna, met the Australian Foreign Minister, Stephen Smith, in London twice last week. An Indian government statement said Mr Krishna told Mr Smith it was increasingly difficult to accept the attacks were devoid of any racial motives and that he complained there had ''been no visible progress so far into most of the investigations''.
The editor-in-chief of Outlook, Vinod Mehta, defended the coverage and denied allegations that the Indian media were overreacting. He told the Herald: "We sent two correspondents to Australia and they found that an overwhelming number of these incidents were racial and they found that Indians in Australia live in fear. There is tremendous outrage in this country. I don't think the Australians realise that."
Mr Mehta said one reason for the anger was the "smug and superior attitude of the Australian government for denying there was racism and then telling the Indians not to hype this up".
Mr Mehta said he published the story with great regret.
"I like Australia a great deal but you have to see there is a problem, and by denying it you won't get anywhere."
The story includes comments by right-wing groups in Australia. Outlook quotes Jim Saleam, the head of the anti-immigration party Australia First, that Indians are ''becoming a serious threat to white Australians in the job market". Bob Vinnicombe of One Nation is quoted as saying Australia ''should actively encourage bringing in Christians and white people from Zimbabwe and South Africa".
But the magazine does not report that three people charged with the murder of Ranjodh Singh were Indian nationals.
Reports about attacks on Indians have damaged Australia's $15 billion a year international education industry.
RECORD LOTTERIES PROFITS
Red News Readers,
This makes the privatisation of the Lotteries completely loopy!! Why would the State Government give this revenue to the private sector?
Jenny Haines
NSW gambling's record lotteries profits
By Linda Silmalis
From: The Sunday Telegraph January 31, 2010
NSW residents tried to gamble their way out of the global financial crisis, producing record profits for the soon-to-be-privatised NSW Lotteries.
State Government figures show a record $1327.62 million worth of Lotto, Powerball, Scratchie, Oz Lotto and Lottery tickets were sold last financial year - $100 million more than in previous years.
Despite the volume of sales, however, fewer punters became millionaires than in previous years - 63 punters last year, down from 69 in 2008.
The total prize money given out also declined, from $754.42 million in 2007-08 to $738.06 million in 08-09.
NSW Lotteries chief executive officer Nick Nichles said sales during the economic downturn exceeded all expectations. NSW Lotteries, which the State Government plans to sell this year, had cautioned that sales records set in 2008 were not expected to be repeated for many years, but the corporation made $19 million more than it had anticipated last year.
"Happily, we did it all over again in 2009, only on an even bigger scale," Mr Nichles said.
He said the sales target had been $1160 million. Mr Nichles had received a $30,500 performance bonus as part of his $216,208 remuneration package for the result.
The biggest winner was the State Government, which reaped record revenue from the sales frenzy.
The figures show NSW Treasury collected $402.4 million in taxes and duty, up $41 million from last year.
Punters also bet on the races in record amounts last year, with NSW TAB turnover to exceed all records.
Racing industry sources indicated if current levels of betting activity were sustained until the end of the 2008-09 financial year, NSW TAB turnover on thoroughbred racing was expected to exceed $5 billion for the first time.
Turnover was $4.7 billion last year.
For the first time in a decade, NSW turnover has outstripped rises in Victorian TAB betting.
The revenue windfall has triggered calls from the NSW Greens for Premier Kristina Keneally to direct the windfall to transport and health.
NSW Greens MP Lee Rhiannon said the funds should be returned to the community.
"Premier Keneally should ensure this money, which has fallen in the Government's lap like manna from heaven, is earmarked for essential services like public transport and health," she said. "The Government has picked up this multi-million-dollar revenue boost from luck, not good management.
"Now, the challenge is with the Premier to use it wisely."
A spokeswoman for NSW Treasurer Eric Roozendaal said the State Government would announce the successful tender to take over NSW Lotteries in the next few months.
"Short-listed proponents are currently performing their due-diligence process," she said.
The financial result was helped by NSW Lotteries putting some of its products online to make it easier for punters in remote and regional areas to gamble.
The corporation is planning to expand the type of bets people can make online this year.
This makes the privatisation of the Lotteries completely loopy!! Why would the State Government give this revenue to the private sector?
Jenny Haines
NSW gambling's record lotteries profits
By Linda Silmalis
From: The Sunday Telegraph January 31, 2010
NSW residents tried to gamble their way out of the global financial crisis, producing record profits for the soon-to-be-privatised NSW Lotteries.
State Government figures show a record $1327.62 million worth of Lotto, Powerball, Scratchie, Oz Lotto and Lottery tickets were sold last financial year - $100 million more than in previous years.
Despite the volume of sales, however, fewer punters became millionaires than in previous years - 63 punters last year, down from 69 in 2008.
The total prize money given out also declined, from $754.42 million in 2007-08 to $738.06 million in 08-09.
NSW Lotteries chief executive officer Nick Nichles said sales during the economic downturn exceeded all expectations. NSW Lotteries, which the State Government plans to sell this year, had cautioned that sales records set in 2008 were not expected to be repeated for many years, but the corporation made $19 million more than it had anticipated last year.
"Happily, we did it all over again in 2009, only on an even bigger scale," Mr Nichles said.
He said the sales target had been $1160 million. Mr Nichles had received a $30,500 performance bonus as part of his $216,208 remuneration package for the result.
The biggest winner was the State Government, which reaped record revenue from the sales frenzy.
The figures show NSW Treasury collected $402.4 million in taxes and duty, up $41 million from last year.
Punters also bet on the races in record amounts last year, with NSW TAB turnover to exceed all records.
Racing industry sources indicated if current levels of betting activity were sustained until the end of the 2008-09 financial year, NSW TAB turnover on thoroughbred racing was expected to exceed $5 billion for the first time.
Turnover was $4.7 billion last year.
For the first time in a decade, NSW turnover has outstripped rises in Victorian TAB betting.
The revenue windfall has triggered calls from the NSW Greens for Premier Kristina Keneally to direct the windfall to transport and health.
NSW Greens MP Lee Rhiannon said the funds should be returned to the community.
"Premier Keneally should ensure this money, which has fallen in the Government's lap like manna from heaven, is earmarked for essential services like public transport and health," she said. "The Government has picked up this multi-million-dollar revenue boost from luck, not good management.
"Now, the challenge is with the Premier to use it wisely."
A spokeswoman for NSW Treasurer Eric Roozendaal said the State Government would announce the successful tender to take over NSW Lotteries in the next few months.
"Short-listed proponents are currently performing their due-diligence process," she said.
The financial result was helped by NSW Lotteries putting some of its products online to make it easier for punters in remote and regional areas to gamble.
The corporation is planning to expand the type of bets people can make online this year.
A CALL TO PRIVATISE RAIL SERVICES
A call to privatise rail services
Rhys Haynes Transport Reporter Daily Telegraph
From: The Daily Telegraph January 01, 2010
CITYRAIL should be run by a private operator who would face millions of dollars in fines if its services ran late, Australia's largest infrastructure company said.
As the network hits full capacity today with commuters returning to school and work, the nation's peak infrastructure body Infrastructure Partnerships Australia has decided enough is enough.
With the backing of Tony Shepherd - the chairman of Transfield Services, one of the Australia's largest infrastructure companies - IPA has called for Premier Kristina Keneally to follow the Victorian Government lead and allow a private operator to run CityRail.
Known as franchising, the ownership of the state's rail assets would remain in public hands but a private company would be responsible for the running of the service.
"The rail service is the backbone of the transport network, if it's not functioning well it affects millions of people, drives up congestion and costs billions to the state economy," IPA executive director Brendan Lyon said. "It's already been done in Brisbane, Melbourne and Adelaide and on the Manly route for Sydney Ferries, with excellent results.
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"Franchising Sydney's transport networks will simply bring NSW into the 21st century."
A private consortium running the CityRail network would be forced to meet on-time targets and pay significant financial penalties when trains were late, cancelled or dirty, according to Mr Shepherd, one of the pioneers of public-private partnerships in Australia.
"Franchising is a very good way to go in terms of public transport reform because it is not privatisation - it leaves the assets in the hands of the state and the public."
Sydney commuters welcomed the idea of taxpayers being rewarded if trains weren't arriving on time. Many said they were delayed last Monday, for example, when defective track signal cable at Penrith had to be replaced between 7am and 9:30am.
Cityrail said 28 services out of Penrith were delayed, causing chaos during the morning peak.
Dulwich Hill resident Sarah Brown, 20, said she would welcome a private operator to improve reliability. "It's never good having a late train, but it would make me feel better knowing that [taxpayers] would get the money if the private company had to pay for being late," she said.
Rhys Haynes Transport Reporter Daily Telegraph
From: The Daily Telegraph January 01, 2010
CITYRAIL should be run by a private operator who would face millions of dollars in fines if its services ran late, Australia's largest infrastructure company said.
As the network hits full capacity today with commuters returning to school and work, the nation's peak infrastructure body Infrastructure Partnerships Australia has decided enough is enough.
With the backing of Tony Shepherd - the chairman of Transfield Services, one of the Australia's largest infrastructure companies - IPA has called for Premier Kristina Keneally to follow the Victorian Government lead and allow a private operator to run CityRail.
Known as franchising, the ownership of the state's rail assets would remain in public hands but a private company would be responsible for the running of the service.
"The rail service is the backbone of the transport network, if it's not functioning well it affects millions of people, drives up congestion and costs billions to the state economy," IPA executive director Brendan Lyon said. "It's already been done in Brisbane, Melbourne and Adelaide and on the Manly route for Sydney Ferries, with excellent results.
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"Franchising Sydney's transport networks will simply bring NSW into the 21st century."
A private consortium running the CityRail network would be forced to meet on-time targets and pay significant financial penalties when trains were late, cancelled or dirty, according to Mr Shepherd, one of the pioneers of public-private partnerships in Australia.
"Franchising is a very good way to go in terms of public transport reform because it is not privatisation - it leaves the assets in the hands of the state and the public."
Sydney commuters welcomed the idea of taxpayers being rewarded if trains weren't arriving on time. Many said they were delayed last Monday, for example, when defective track signal cable at Penrith had to be replaced between 7am and 9:30am.
Cityrail said 28 services out of Penrith were delayed, causing chaos during the morning peak.
Dulwich Hill resident Sarah Brown, 20, said she would welcome a private operator to improve reliability. "It's never good having a late train, but it would make me feel better knowing that [taxpayers] would get the money if the private company had to pay for being late," she said.
Friday, January 29, 2010
THE ILLEGALITY OF THE IRAQ WAR
War post mortem checking for blood on the hands of lawyers
January 29, 2010, Richard Ackland, SMH
Iraq backflip by top UK lawyer
The British government's former top lawyer gives evidence at an inquiry into the 2003 invasion of Iraq.
Lawyers are incredibly keen on preening themselves about their ''independence''. Little crests with mottos abound: Without fear or favour; Servants of all, yet of none; All are equal under the law.
Frequently it helps if these little warrior calls are in Latin.
We shouldn't get too misty eyed. The Chilcot inquiry in London comes as a handy reminder, if we needed one, that beside all the nifty mission statements in which the law wraps itself, there's another overriding one: he who pays the piper plays the tune.
The Chilcot inquiry is examining Britain's involvement in the invasion of Iraq, the events that preceded the invasion and the conduct of the war.
What has been the subject of its most immediate concentration is the legal advice about the legality or illegality of the war.
This week has seen evidence from three key British lawyers. Lord Goldsmith, former Labour attorney-general, former president of the English and Welsh bar, former deputy High Court judge and previously known as Pete Goldsmith from Liverpool; Sir Michael Wood, the most senior lawyer in the Foreign Office at the time of the invasion; and Elizabeth Wilmshurst, deputy to Wood at the FO.
It has been nothing short of fascinating. All three at various points in the preparation for the war advised the Government that an invasion of Iraq without a specific UN Security Council resolution to that end would be unlawful.
The civil service lawyers could be ignored by the politicians, and they were. Goldsmith as attorney-general was a different kettle of fish. He was the Government's most senior and theoretically independent legal adviser. Wilmshurst was asked by Sir John Chilcot whether it made any difference that her views were rejected by the foreign secretary Jack Straw, himself a lawyer. ''He's not an international lawyer,'' she shot back.
Elizabeth Wilmshurst resigned from the Foreign Office because she believed that what the Government was embarking upon was utterly devoid of any legitimacy.
Lord Boyce, chief of the defence staff, asked for a clear ''unequivocal'' legal position about the war.
From telling Tony Blair two months before the invasion that its lawfulness was questionable, Goldsmith subsequently saw the light - this war would be legal. And he explained it all in one page.
He had the advantage of a trip to Washington where various of Bush's rogue lawyers got him in a headlock. He came back refreshed and with a new independent opinion. Straw and Blair's people were also applying the thumbscrews to the first law officer. Like a good barrister, Goldsmith had the law coming out of both sides of his mouth.
Why is this important at all? Most people in the pubs couldn't give a fig about it. The short answer is that the military made it clear that to go to war on the basis of equivocal advice was untenable. It needed ''certainty''. To that extent, as the London barrister Philippe Sands, QC, has written: ''The attorney-general had his finger on the trigger.''
Not an insignificant position to be in, considering the vast amount of national treasure to be lavished, the countless lives to be spent and the pending waste and destruction.
Importantly, it enabled prime minister John Howard to wave a bit of paper, Chamberlain-like, and say Australia's participation in the coalition of the willing was entirely ''valid''. He told Parliament on March 18, 2003: ''Our legal advice . . . is unequivocal . . . This legal advice is consistent with that provided to the British Government by its attorney-general.''
Howard claquers in the media were also beating out the message, ''This war is legal''.
Whereas the politicians in Britain were ignoring the critical advice of the civil service lawyers, in Australia the opinion of legal people in the relevant departments was being warmly embraced.
The key advice the Government relied on came from Bill Campbell, QC, first assistant secretary, office of international law in the Attorney-General's Department, and Chris Moraitis, senior legal adviser, Department of Foreign Affairs.
It was essentially predicated on the view that an earlier UN Security Council resolution dealing with Iraq's invasion of Kuwait in 1990 and a more recent resolution giving Saddam the nudge to comply with previous resolutions were the basis for legitimising the invasion.
At the time the opinion was torn apart by other authorities. The former solicitor-general, Gavan Griffith, said the advice was ''fanciful . . . an Alice in Wonderland inversion of meaning of plain words in the resolutions themselves. It is unsupportable. The authors are making it up.''
The vast preponderance of legal advice was clearly of the view that for war to be legitimised there had to be a specific and clear resolution of the Security Council. The US opposed going to an extra resolution. That was the end of it.
The law had to fit the exigencies and importantly the politicians had to find lawyers with suitable honorifics to sprinkle holy water on their position.
It has got to the point now where there are judicial rulings that the laws of war don't apply to war.
The president has to decide what is appropriately legal in these circumstances.
Likewise, as Jonathan Freedland said, writing in The Guardian: ''The war was legal - because Tony Blair said it was legal.''
One foot down the corridor of a dark place leads to other compromises: black hole prisons, illegal detention and ''trial'', plus liberal applications of torture - to mention a few.
justinian@lawpress.com.au
January 29, 2010, Richard Ackland, SMH
Iraq backflip by top UK lawyer
The British government's former top lawyer gives evidence at an inquiry into the 2003 invasion of Iraq.
Lawyers are incredibly keen on preening themselves about their ''independence''. Little crests with mottos abound: Without fear or favour; Servants of all, yet of none; All are equal under the law.
Frequently it helps if these little warrior calls are in Latin.
We shouldn't get too misty eyed. The Chilcot inquiry in London comes as a handy reminder, if we needed one, that beside all the nifty mission statements in which the law wraps itself, there's another overriding one: he who pays the piper plays the tune.
The Chilcot inquiry is examining Britain's involvement in the invasion of Iraq, the events that preceded the invasion and the conduct of the war.
What has been the subject of its most immediate concentration is the legal advice about the legality or illegality of the war.
This week has seen evidence from three key British lawyers. Lord Goldsmith, former Labour attorney-general, former president of the English and Welsh bar, former deputy High Court judge and previously known as Pete Goldsmith from Liverpool; Sir Michael Wood, the most senior lawyer in the Foreign Office at the time of the invasion; and Elizabeth Wilmshurst, deputy to Wood at the FO.
It has been nothing short of fascinating. All three at various points in the preparation for the war advised the Government that an invasion of Iraq without a specific UN Security Council resolution to that end would be unlawful.
The civil service lawyers could be ignored by the politicians, and they were. Goldsmith as attorney-general was a different kettle of fish. He was the Government's most senior and theoretically independent legal adviser. Wilmshurst was asked by Sir John Chilcot whether it made any difference that her views were rejected by the foreign secretary Jack Straw, himself a lawyer. ''He's not an international lawyer,'' she shot back.
Elizabeth Wilmshurst resigned from the Foreign Office because she believed that what the Government was embarking upon was utterly devoid of any legitimacy.
Lord Boyce, chief of the defence staff, asked for a clear ''unequivocal'' legal position about the war.
From telling Tony Blair two months before the invasion that its lawfulness was questionable, Goldsmith subsequently saw the light - this war would be legal. And he explained it all in one page.
He had the advantage of a trip to Washington where various of Bush's rogue lawyers got him in a headlock. He came back refreshed and with a new independent opinion. Straw and Blair's people were also applying the thumbscrews to the first law officer. Like a good barrister, Goldsmith had the law coming out of both sides of his mouth.
Why is this important at all? Most people in the pubs couldn't give a fig about it. The short answer is that the military made it clear that to go to war on the basis of equivocal advice was untenable. It needed ''certainty''. To that extent, as the London barrister Philippe Sands, QC, has written: ''The attorney-general had his finger on the trigger.''
Not an insignificant position to be in, considering the vast amount of national treasure to be lavished, the countless lives to be spent and the pending waste and destruction.
Importantly, it enabled prime minister John Howard to wave a bit of paper, Chamberlain-like, and say Australia's participation in the coalition of the willing was entirely ''valid''. He told Parliament on March 18, 2003: ''Our legal advice . . . is unequivocal . . . This legal advice is consistent with that provided to the British Government by its attorney-general.''
Howard claquers in the media were also beating out the message, ''This war is legal''.
Whereas the politicians in Britain were ignoring the critical advice of the civil service lawyers, in Australia the opinion of legal people in the relevant departments was being warmly embraced.
The key advice the Government relied on came from Bill Campbell, QC, first assistant secretary, office of international law in the Attorney-General's Department, and Chris Moraitis, senior legal adviser, Department of Foreign Affairs.
It was essentially predicated on the view that an earlier UN Security Council resolution dealing with Iraq's invasion of Kuwait in 1990 and a more recent resolution giving Saddam the nudge to comply with previous resolutions were the basis for legitimising the invasion.
At the time the opinion was torn apart by other authorities. The former solicitor-general, Gavan Griffith, said the advice was ''fanciful . . . an Alice in Wonderland inversion of meaning of plain words in the resolutions themselves. It is unsupportable. The authors are making it up.''
The vast preponderance of legal advice was clearly of the view that for war to be legitimised there had to be a specific and clear resolution of the Security Council. The US opposed going to an extra resolution. That was the end of it.
The law had to fit the exigencies and importantly the politicians had to find lawyers with suitable honorifics to sprinkle holy water on their position.
It has got to the point now where there are judicial rulings that the laws of war don't apply to war.
The president has to decide what is appropriately legal in these circumstances.
Likewise, as Jonathan Freedland said, writing in The Guardian: ''The war was legal - because Tony Blair said it was legal.''
One foot down the corridor of a dark place leads to other compromises: black hole prisons, illegal detention and ''trial'', plus liberal applications of torture - to mention a few.
justinian@lawpress.com.au
NSW HOSPITALS THE WORST
A poor state of health: NSW hospitals the worst in the country
ARI SHARP, smh
January 29, 2010
PUBLIC hospitals in NSW are the worst performing in the country when it comes to causing death and serious injuries to patients.
New Productivity Commission figures on ''sentinel events'' - severely harmful incidents that occur due to a failure of hospital systems - showed 59 cases in NSW, compared with 28 in Victoria, the next worst-performing state, and 147 nationwide.
Even accounting for NSW having the largest population and the largest number of hospital admissions, the figures still show the state performing worse than the rest of the country, with 40 per cent of sentinel events but only 30 per cent of public hospital admissions.
The figures, from 2007-08, represent a significant deterioration from a year earlier, when NSW was one of the best states, recording only 32 events.
A spokesman for the NSW Health Minister, Carmel Tebbutt, said the state's performance reflected the fact the state had better systems for collecting and reporting incident data than other parts of Australia.
"NSW takes patient safety seriously,'' the spokesman said, pointing to the Government's clinical excellence commission, which provides analysis of incident data twice a year.
The data showed 18 NSW procedures involving the wrong patient or body part (out of 29 nationally), 19 cases of medical instruments being left in patients after surgery (out of 37) and medication errors killing 17 patients (out of 29).
Sentinel events are independent of a patient's condition, meaning most are the result of hospital mishap. The Productivity Commission notes that while sentinel events occur relatively infrequently, they ''have the potential to seriously undermine public confidence in the healthcare system''.
All public hospitals are required to provide information on sentinel events, which include suicide of a patient, blood transfusions that involve blood group incompatibility, deaths in labour and newborns being presented to the wrong family.
Professor Rick Iedema, of the University of Technology, Sydney, said the sharp increase was likely to be a result of both more incidents and more rigorous reporting.
Professor Iedema said policy-makers were faced with a dilemma in confronting sentinel events, because efforts to push them towards zero would be costly and take funds from other health functions.
''We already know that health care is costing an absolute fortune,'' he said. ''If we are going to look at making that system totally fail-safe … we'd have to spend a prohibitive amount.''
While only figures from public hospitals were collated, he expected private hospitals to perform better because they took in patients for lower-risk procedures.
The Productivity Commission said the data was collected and released in an effort to reduce the risk of recurrence.
''The programs are not punitive, and are designed to facilitate self reporting of errors,'' it said.
ARI SHARP, smh
January 29, 2010
PUBLIC hospitals in NSW are the worst performing in the country when it comes to causing death and serious injuries to patients.
New Productivity Commission figures on ''sentinel events'' - severely harmful incidents that occur due to a failure of hospital systems - showed 59 cases in NSW, compared with 28 in Victoria, the next worst-performing state, and 147 nationwide.
Even accounting for NSW having the largest population and the largest number of hospital admissions, the figures still show the state performing worse than the rest of the country, with 40 per cent of sentinel events but only 30 per cent of public hospital admissions.
The figures, from 2007-08, represent a significant deterioration from a year earlier, when NSW was one of the best states, recording only 32 events.
A spokesman for the NSW Health Minister, Carmel Tebbutt, said the state's performance reflected the fact the state had better systems for collecting and reporting incident data than other parts of Australia.
"NSW takes patient safety seriously,'' the spokesman said, pointing to the Government's clinical excellence commission, which provides analysis of incident data twice a year.
The data showed 18 NSW procedures involving the wrong patient or body part (out of 29 nationally), 19 cases of medical instruments being left in patients after surgery (out of 37) and medication errors killing 17 patients (out of 29).
Sentinel events are independent of a patient's condition, meaning most are the result of hospital mishap. The Productivity Commission notes that while sentinel events occur relatively infrequently, they ''have the potential to seriously undermine public confidence in the healthcare system''.
All public hospitals are required to provide information on sentinel events, which include suicide of a patient, blood transfusions that involve blood group incompatibility, deaths in labour and newborns being presented to the wrong family.
Professor Rick Iedema, of the University of Technology, Sydney, said the sharp increase was likely to be a result of both more incidents and more rigorous reporting.
Professor Iedema said policy-makers were faced with a dilemma in confronting sentinel events, because efforts to push them towards zero would be costly and take funds from other health functions.
''We already know that health care is costing an absolute fortune,'' he said. ''If we are going to look at making that system totally fail-safe … we'd have to spend a prohibitive amount.''
While only figures from public hospitals were collated, he expected private hospitals to perform better because they took in patients for lower-risk procedures.
The Productivity Commission said the data was collected and released in an effort to reduce the risk of recurrence.
''The programs are not punitive, and are designed to facilitate self reporting of errors,'' it said.
Monday, January 25, 2010
CHANGES TO CHILD WELFARE SYSTEM
Greater front-line roles on child welfare watch at school
DEBORAH SMITH, SMH
January 25, 2010
TEACHERS, police and doctors will have more responsibility for child welfare decisions under changes to the state's child protection system that came into operation yesterday.
In preparation for the start of school on Thursday, most government school principals have been trained in new guidelines aimed at reducing calls to the overwhelmed Department of Community Services' Child Protection Helpline, which received 309,000 reports about suspected cases of child abuse or neglect last year.
Teachers and other professionals will have to decide whether or not a child is at risk of significant harm, and refer those they believe fall below the threshold to four new child wellbeing units in government departments rather than to DOCS case workers, who will concentrate on serious cases.
The Premier, Kristina Keneally, said the new system was about sharing responsibility for child safety and would provide better support for vulnerable families before they reached a crisis point.
''We want to prevent abuse and neglect,'' she said. ''Children's care is the responsibility of families, friends, neighbours, government - because it really does take a community to raise a child.''
The Minister for Community Services, Linda Burney, said more than 23,000 teachers, doctors, nurses, police and other mandatory reporters of suspected child abuse had attended information sessions about the new system, and training packages had been provided to more than 200,000 people who work with children.
She said an example of a child who was above the significant harm threshold, and should be referred to DOCS for immediate action, was one who came to school with bruises or other injuries and was fearful of returning home.
If a teacher noticed a child was consistently unwashed and had no warm clothes or lunch, the case should be referred to the wellbeing unit in the Department of Education and Training.
Its staff of 28 social workers would co-ordinate family assistance from a range of government agencies and non-government organisations.
The system's $750 million overhaul follows the recommendations of the Wood inquiry, which was sparked by the death of Dean Shillingsworth, whose body was put in a suitcase and dumped in a pond, and of a girl known as Ebony, who starved to death.
Ms Burney acknowledged the Government had failed children with some ''very, very real tragedies''.
Three other child wellbeing units have been established in NSW Health, NSW Police, and Human Services departments.
The acting NSW Police Commissioner, Dave Owens, said police made about 98,000 reports to DOCS last year. He expected about 60,000 would go to its new child wellbeing unit.
The director-general of Education and Training, Michael Coutts-Trotter, said teachers would discuss the system at a development day on Wednesday. ''The vast majority of principals have been trained or will be trained come Thursday.''
Teachers at non-government schools will still have to use the DOCS helpline.
DEBORAH SMITH, SMH
January 25, 2010
TEACHERS, police and doctors will have more responsibility for child welfare decisions under changes to the state's child protection system that came into operation yesterday.
In preparation for the start of school on Thursday, most government school principals have been trained in new guidelines aimed at reducing calls to the overwhelmed Department of Community Services' Child Protection Helpline, which received 309,000 reports about suspected cases of child abuse or neglect last year.
Teachers and other professionals will have to decide whether or not a child is at risk of significant harm, and refer those they believe fall below the threshold to four new child wellbeing units in government departments rather than to DOCS case workers, who will concentrate on serious cases.
The Premier, Kristina Keneally, said the new system was about sharing responsibility for child safety and would provide better support for vulnerable families before they reached a crisis point.
''We want to prevent abuse and neglect,'' she said. ''Children's care is the responsibility of families, friends, neighbours, government - because it really does take a community to raise a child.''
The Minister for Community Services, Linda Burney, said more than 23,000 teachers, doctors, nurses, police and other mandatory reporters of suspected child abuse had attended information sessions about the new system, and training packages had been provided to more than 200,000 people who work with children.
She said an example of a child who was above the significant harm threshold, and should be referred to DOCS for immediate action, was one who came to school with bruises or other injuries and was fearful of returning home.
If a teacher noticed a child was consistently unwashed and had no warm clothes or lunch, the case should be referred to the wellbeing unit in the Department of Education and Training.
Its staff of 28 social workers would co-ordinate family assistance from a range of government agencies and non-government organisations.
The system's $750 million overhaul follows the recommendations of the Wood inquiry, which was sparked by the death of Dean Shillingsworth, whose body was put in a suitcase and dumped in a pond, and of a girl known as Ebony, who starved to death.
Ms Burney acknowledged the Government had failed children with some ''very, very real tragedies''.
Three other child wellbeing units have been established in NSW Health, NSW Police, and Human Services departments.
The acting NSW Police Commissioner, Dave Owens, said police made about 98,000 reports to DOCS last year. He expected about 60,000 would go to its new child wellbeing unit.
The director-general of Education and Training, Michael Coutts-Trotter, said teachers would discuss the system at a development day on Wednesday. ''The vast majority of principals have been trained or will be trained come Thursday.''
Teachers at non-government schools will still have to use the DOCS helpline.
HEALTH SPENDING TO SWAMP STATE BUDGETS
Health spending to swamp budgets
JONATHAN PEARLMAN AND LINTON BESSER SMH
January 25, 2010
KEVIN RUDD has warned that the states are being ''overwhelmed'' by rising health costs as he gears up for an election fight over an overhaul of hospital funding.
Citing figures from the coming third intergenerational report, the Prime Minister said yesterday health spending was set to swamp the public purse and he sought to pave the way for a battle with the states over control of funding.
He singled out NSW, where the Treasury estimates spending will more than double over 22 years to 55 per cent of the budget.
''Rapidly rising health costs create a real risk - absent [of] major policy change - state governments will be overwhelmed by their rising health spending obligations,'' he said in a speech in Sydney. ''Without reform, states' ability to provide the services they currently provide will be significantly strained. That is why 2010 must be and will be a year of major health reform.''
Mr Rudd is under pressure to fulfil his election pledge to seek a mandate for a federal takeover of hospital funding if states fail to meet healthcare benchmarks.
In July he put off his announcement for six months when an expert panel urged the Government not to rush into a takeover and recommended sweeping changes. The proposals, by the National Health and Hospitals Reform Commission, included a voucher system for patients to use private clinics. It suggested national access targets, under which patients would wait no more than two days to see a GP or three months for planned surgery.
The intergenerational report, expected to be released within weeks, says health spending will rise from 4 per cent of gross domestic product to 7.1 per cent by 2050, equivalent to $200 billion, or an increase from $2290 a person to $7210. Treasury modelling for the report found that by 2045 health spending would exceed the states' non-GST tax revenues - a result that Mr Rudd said would occur possibly earlier in some states. By 2050, health spending on those aged 65 plus is expected to rise seven-fold and spending on those aged 85 plus will increase by 12 times.
In NSW, health dominates the state's budget. In 2009-10, it was set to soak up $15.1 billion - more than double the $7 billion for transport - and has been growing faster than inflation.
In 2007, NSW health department spending increased 7 per cent but last year it grew more than twice as fast. In all, between 2005-06 and 2009-10, health expenditure has ballooned by more than $3 billion. If the present rate of growth continues, health will eat into all other portfolios.
Mr Rudd had promised to release his plans after consulting with the states and receiving the intergenerational report. He consulted them last month and the report will be released soon.
''We will put a proposal to the states and territories,'' Mr Rudd said last week. ''What we have said consistently is that if they accept that well and good. If they don't then we'd seek a mandate from the people in terms of the Commonwealth moving to take over the system.''
The Opposition Leader, Tony Abbott, yesterday labelled Mr Rudd a ''fraud'' and challenged him to deliver on his election promise. ''Mr Rudd promised if there had not been any improvements in health he would move to a federal takeover,'' Mr Abbott said. ''Most people say that if anything, things have gotten worse … Mr Rudd is a fraud. He shouldn't make commitments he doesn't intend to keep.''
Mr Abbott, who as health minister signalled a federal takeover, has indicated he will push for a referendum on reform but would like to retain local boards to administer funding. ''We will announce a comprehensive policy in due course,'' he said.
JONATHAN PEARLMAN AND LINTON BESSER SMH
January 25, 2010
KEVIN RUDD has warned that the states are being ''overwhelmed'' by rising health costs as he gears up for an election fight over an overhaul of hospital funding.
Citing figures from the coming third intergenerational report, the Prime Minister said yesterday health spending was set to swamp the public purse and he sought to pave the way for a battle with the states over control of funding.
He singled out NSW, where the Treasury estimates spending will more than double over 22 years to 55 per cent of the budget.
''Rapidly rising health costs create a real risk - absent [of] major policy change - state governments will be overwhelmed by their rising health spending obligations,'' he said in a speech in Sydney. ''Without reform, states' ability to provide the services they currently provide will be significantly strained. That is why 2010 must be and will be a year of major health reform.''
Mr Rudd is under pressure to fulfil his election pledge to seek a mandate for a federal takeover of hospital funding if states fail to meet healthcare benchmarks.
In July he put off his announcement for six months when an expert panel urged the Government not to rush into a takeover and recommended sweeping changes. The proposals, by the National Health and Hospitals Reform Commission, included a voucher system for patients to use private clinics. It suggested national access targets, under which patients would wait no more than two days to see a GP or three months for planned surgery.
The intergenerational report, expected to be released within weeks, says health spending will rise from 4 per cent of gross domestic product to 7.1 per cent by 2050, equivalent to $200 billion, or an increase from $2290 a person to $7210. Treasury modelling for the report found that by 2045 health spending would exceed the states' non-GST tax revenues - a result that Mr Rudd said would occur possibly earlier in some states. By 2050, health spending on those aged 65 plus is expected to rise seven-fold and spending on those aged 85 plus will increase by 12 times.
In NSW, health dominates the state's budget. In 2009-10, it was set to soak up $15.1 billion - more than double the $7 billion for transport - and has been growing faster than inflation.
In 2007, NSW health department spending increased 7 per cent but last year it grew more than twice as fast. In all, between 2005-06 and 2009-10, health expenditure has ballooned by more than $3 billion. If the present rate of growth continues, health will eat into all other portfolios.
Mr Rudd had promised to release his plans after consulting with the states and receiving the intergenerational report. He consulted them last month and the report will be released soon.
''We will put a proposal to the states and territories,'' Mr Rudd said last week. ''What we have said consistently is that if they accept that well and good. If they don't then we'd seek a mandate from the people in terms of the Commonwealth moving to take over the system.''
The Opposition Leader, Tony Abbott, yesterday labelled Mr Rudd a ''fraud'' and challenged him to deliver on his election promise. ''Mr Rudd promised if there had not been any improvements in health he would move to a federal takeover,'' Mr Abbott said. ''Most people say that if anything, things have gotten worse … Mr Rudd is a fraud. He shouldn't make commitments he doesn't intend to keep.''
Mr Abbott, who as health minister signalled a federal takeover, has indicated he will push for a referendum on reform but would like to retain local boards to administer funding. ''We will announce a comprehensive policy in due course,'' he said.
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