Red News Readers,
It should be no surprise to anyone that complaints are rising what with mandatory reporting of elder abuse and the and minimum cost care provided by aged care providers. Many nursing homes are now run largely by non nursing trained carers who may have minimal training the care of the aged and their needs and medications. Working for a phone triage company we get plenty of calls from aged care workers in aged care facilites that range from what would be a simple problem for a trained nurse to solve eg how to stop a patient bleeding from a skin tear, medication errors, and emergencies where the aged care workers are instructed to call Heatlh Direct first before calling other agencies. There is no nurse on site that they can call for assistance. Lord knows what goes on in the facilities where the aged care workers do not call for assistance,
Jenny Haines
Our nursing homes in turmoil
Rachel Browne, Sun Herald.
May 31, 2009
COMPLAINTS about nursing homes have tripled in a year, with authorities investigating serious cases of physical and sexual abuse as well as referring more than 30 deaths to the coroner.
The Department of Health and Ageing's Complaints Investigation Scheme (CIS) looked at almost 7500 complaints in 2007-08.
Of these, 1770 matters were referred to the Aged Care Standards and Accreditation Agency for further investigation, 62 to nurses registration boards, 53 to the police, 33 to the coroner, 27 to the Health Care Complaints Commission and 13 to the Medical Practitioners Board.
Of the referrals to the coroner, seven occurred in NSW, 22 in Victoria, one in Queensland and three in South Australia.
This marks a significant increase from 2006-07, when the CIS and its predecessor, the Aged Care Complaints Resolution Scheme, examined 2399 complaints. In 2005-06, the scheme received 1260 complaints.
However, aged care lobby groups say the complaints handling system for Australia's 2830 nursing homes is seriously flawed and the public is denied information about the outcomes of investigations.
The Department of Health and Ageing will identify nursing homes that have been the subject of an official sanction or a notice of non-compliance.
The name-and-shame list will appear on a Department of Health and Ageing website from July 1.
But Aged Care Crisis Team spokeswoman Lynda Saltarelli said the information would be more than a year old and would relate only to a small number of homes subject to complaints.
"We would like to see a transparent system where a consumer can look at a nursing home and find out the type of ownership and structure; whether it has been the subject of failing standards as well as a complaint; the nature of the complaint; and what the provider did to address that complaint," Ms Saltarelli said.
There are 175,000 people in aged care facilities across the nation, a figure growing by 5000 a year.
Taxpayers subsidise the care of residents by an average of $45,000 a year, with residents contributing an average of $20,000 a year for care.
Over the next four years, the Government will invest more than $41.6 billion into aged and community care. During 2007-08 the Aged Care Standards and Accreditation Agency conducted 5244 visits to homes, with 3105 visits unannounced. In this same period the Department of Health and Ageing undertook 3127 visits to homes, of which 1145 were unannounced.
The policy co-ordinator of the Combined Pensioners and Superannuants Association of NSW, Charmaine Crowe, said the increase in complaints revealed that people were more likely to come forward, but many complainants found their cases were not investigated thoroughly. "I know of one case which went to the department and was referred back to the nursing home. That complaint was very serious in nature. It should not have been referred back to the nursing home. That is simply unacceptable."
Elder Abuse Prevention Association founder Lillian Jeter said many cases of abuse or neglect were still going unreported.
Under changes to the law in 2007, it is mandatory for nursing home staff to report serious cases of physical or sexual abuse.
In 2007-08, there were 725 notifications of alleged unreasonable use of force and 200 allegations of alleged unlawful sexual contact.
However, nursing home staff are not obliged to report matters such as neglect, financial exploitation or psychological abuse.
"I think those three categories should come under mandatory reporting," Ms Jeter said.
"If you catch these so-called lesser types of incidents early, if you catch the neglect, the pyschological abuse or the financial exploitation, you are more likely to prevent the more serious types of incidents from happening. There needs to be a zero-tolerance policy."
The Aged Care Crisis Team is also calling for mandatory staff-to-resident ratios. "Hospitals, schools and child-care centres must adhere to set staffing levels. Why are facilities which provide end-of-life care exempt?" Ms Saltarelli said.
"We have heard of multiple instances of under-staffing. For example, one staff member to 80 residents at night."
Up to half aged care residents suffer from malnutrition, a senior dietitian said at a conference in Darwin yesterday.
Dr Merrilyn Banks from the Royal Brisbane and Women's Hospital said that while nursing home residents were usually given nutritious food, many of them were unable to eat it if they were on heavy pain medication, which can reduce their appetite or make them drowsy.
Aged Care Association Australia chief executive Rod Young, whose organisation represents private sector and not-for-profit nursing homes, said providers were doing the best with limited resources.
"We provide approximately 80 million days of care by nearly 240,000 staff ranging from personal care workers to registered nurses. So a very complex service is being offered by a great range of staff in a variety of settings and often to the most frail, vulnerable and complex-care recipients in the country."
He said the number of complaints were small in comparison to the number of people either in aged care or with a friend or relative in aged care. "Throw into the mix a further 500,000 people who are the family, friends, legal representatives, volunteers and visitors, many of whom will have their own views on how care should be delivered and many of whom have to struggle with the declining health of a loved one … and it is a volatile mix of emotions," he said.
A spokeswoman for the Minister for Ageing, Justine Elliot, said the increase in complaints was due to increased compliance measures and increased awareness of the Complaints Investigation Scheme.
Sunday, May 31, 2009
Wednesday, May 27, 2009
NEWSAGENTS BID TO BUY LOTTERIES
Newsagents bid to buy NSW Lotteries
Alex Mitchell writes in Crikey 27.5.09:
Newsagencies in NSW have been complaining loudly about the forthcoming privatization of NSW Lotteries because of the impact on their revenue streams and the value of their businesses.
So they’ve decided to put in a bid themselves.
On Friday the Newsagents’ Association of NSW and ACT Ltd has a meeting with Treasurer Eric Roozendaal, former general secretary of the NSW Labor Party, who is leading the privatization push.
Under the bank-backed newsagents’ proposal, the government would retain a majority 51 per cent shareholding and the association the other 49 per cent.
With a section of the Labor Caucus, the unions and the party-at-large up in arms over the sell-off of the lotteries, Parklea prison and other state-owned assets, Roozendaal may see electoral merit in a partial sale.
On the other hand, as a rabid privateer he is more likely to go with one of the players from the Big End of Town.
The front-runner to win the lotteries jackpot is the Victorian Tattersalls group which has already taken over Queensland’s Golden Casket.
Tattersalls has an inside run because it has strategically placed urgers in and around the NSW Government who are doing their best to dismiss the rival bidders -- Tabcorp, which owns Sydney’s Star City Casino at Pyrmont, and G-Tech, a subsidiary of the world's biggest lottery firm, Lottomatica.
For newsagents, the outcome of the auction is critical. Lottery ticket sales are a nice little earner at their 1200 online outlets and they also bring customers into newsagencies acting as a drawcard for selling other items off the shelves.
NSW newsagents argue there is no guarantee that they will continue to have exclusive retail rights if one of the big private operators buys the lotteries licence and there is a genuine fear that the percentage they receive from Lotto and Scratchies sales will eventually be reduced.
The big gaming enterprises are also seeking support from Roozendaal for an agreement to allow the sale of lottery products to be broadened to include registered clubs, supermarkets and service stations.
The club industry, one of the major donors to the NSW ALP, already sells Lotto and Scratchie products at the giant Twin Towns RSL Club at Tweed Heads and the neighbouring Banora Point RSL Club, both owned by the heavy-hitting Twin Towns empire.
Under Roozendaal’s timetable, the sale of the 30-year exclusive licence will be completed by the end of the year and the sale price will be reflected in the 2010-11 budget i.e. election year.
The government is hoping to raise more than half a billion dollars for the lottery concession which, ironically, was started by Premier Jack Lang at the start of the Great Depression in 1931 to fund public hospitals.
When the government first investigated the sale of NSW Lotteries a few years ago the market price was more than $900 million, but the worldwide credit and lending crisis, and its impact on the tinhorn Australian economy, has put paid to that sort of return. The new owner is purchasing a gold-plated bargain.
Alex Mitchell writes in Crikey 27.5.09:
Newsagencies in NSW have been complaining loudly about the forthcoming privatization of NSW Lotteries because of the impact on their revenue streams and the value of their businesses.
So they’ve decided to put in a bid themselves.
On Friday the Newsagents’ Association of NSW and ACT Ltd has a meeting with Treasurer Eric Roozendaal, former general secretary of the NSW Labor Party, who is leading the privatization push.
Under the bank-backed newsagents’ proposal, the government would retain a majority 51 per cent shareholding and the association the other 49 per cent.
With a section of the Labor Caucus, the unions and the party-at-large up in arms over the sell-off of the lotteries, Parklea prison and other state-owned assets, Roozendaal may see electoral merit in a partial sale.
On the other hand, as a rabid privateer he is more likely to go with one of the players from the Big End of Town.
The front-runner to win the lotteries jackpot is the Victorian Tattersalls group which has already taken over Queensland’s Golden Casket.
Tattersalls has an inside run because it has strategically placed urgers in and around the NSW Government who are doing their best to dismiss the rival bidders -- Tabcorp, which owns Sydney’s Star City Casino at Pyrmont, and G-Tech, a subsidiary of the world's biggest lottery firm, Lottomatica.
For newsagents, the outcome of the auction is critical. Lottery ticket sales are a nice little earner at their 1200 online outlets and they also bring customers into newsagencies acting as a drawcard for selling other items off the shelves.
NSW newsagents argue there is no guarantee that they will continue to have exclusive retail rights if one of the big private operators buys the lotteries licence and there is a genuine fear that the percentage they receive from Lotto and Scratchies sales will eventually be reduced.
The big gaming enterprises are also seeking support from Roozendaal for an agreement to allow the sale of lottery products to be broadened to include registered clubs, supermarkets and service stations.
The club industry, one of the major donors to the NSW ALP, already sells Lotto and Scratchie products at the giant Twin Towns RSL Club at Tweed Heads and the neighbouring Banora Point RSL Club, both owned by the heavy-hitting Twin Towns empire.
Under Roozendaal’s timetable, the sale of the 30-year exclusive licence will be completed by the end of the year and the sale price will be reflected in the 2010-11 budget i.e. election year.
The government is hoping to raise more than half a billion dollars for the lottery concession which, ironically, was started by Premier Jack Lang at the start of the Great Depression in 1931 to fund public hospitals.
When the government first investigated the sale of NSW Lotteries a few years ago the market price was more than $900 million, but the worldwide credit and lending crisis, and its impact on the tinhorn Australian economy, has put paid to that sort of return. The new owner is purchasing a gold-plated bargain.
Monday, May 25, 2009
GOVT COOL ON HOSPITAL TAKEOVER
Government cool on hospital takeover
Mark Metherell, smh
May 25, 2009
THE Rudd Government is expected to stop short of a financial takeover of public hospitals and instead seek control of other health areas including outpatient care and community health services.
In the strongest sign yet that the Government will abandon moves to take over hospitals unless they came up to scratch, the Health Minister, Nicola Roxon, said yesterday there were "positive signs" of improvement in public hospitals. Despite continued signs of long waiting lists and hospital strains, Ms Roxon said there had been "significant developments" in hospitals, and state governments had agreed to sign on to "improved outcomes".
The National Health and Hospitals Reform Commission is being tipped in government circles to sidestep a total federal takeover and instead recommend in its final report next month that the Commonwealth assume financial say over outpatient care and all health services outside hospitals. This would enable better co-ordination of primary health care by doctors, nurses and community services.
The commission said in its interim report this year that while it would involve a significant shift in responsibility to the Commonwealth, it would involve less disruption to existing responsibilities than other more radical schemes.
The Commonwealth could secure a greater say over in-hospital care by introducing a payment system tied more closely to actual caseload, rather than untargeted payments.
Asked on Channel Nine about the Government's stance given that no one believed public hospitals were up to scratch, Ms Roxon said there had been significant developments since Labor took office. "I think there are some positive signs, but that does not mean everything is fixed," she said.
But the Opposition's health spokesman, Peter Dutton, said Kevin Rudd was deserting his promise to end the "blame game" over funding between federal and state governments.
The Government had watered down its pledge and was walking away from its promise to take over public hospital funding, Mr Dutton said on Channel Ten.
On a related issue, the Government plans to introduce legislation to means test the health insurance rebate in the next two weeks to intensify pressure on the Opposition over blocking a budget measure that would generate $1.9 billion in savings over four years.
Mark Metherell, smh
May 25, 2009
THE Rudd Government is expected to stop short of a financial takeover of public hospitals and instead seek control of other health areas including outpatient care and community health services.
In the strongest sign yet that the Government will abandon moves to take over hospitals unless they came up to scratch, the Health Minister, Nicola Roxon, said yesterday there were "positive signs" of improvement in public hospitals. Despite continued signs of long waiting lists and hospital strains, Ms Roxon said there had been "significant developments" in hospitals, and state governments had agreed to sign on to "improved outcomes".
The National Health and Hospitals Reform Commission is being tipped in government circles to sidestep a total federal takeover and instead recommend in its final report next month that the Commonwealth assume financial say over outpatient care and all health services outside hospitals. This would enable better co-ordination of primary health care by doctors, nurses and community services.
The commission said in its interim report this year that while it would involve a significant shift in responsibility to the Commonwealth, it would involve less disruption to existing responsibilities than other more radical schemes.
The Commonwealth could secure a greater say over in-hospital care by introducing a payment system tied more closely to actual caseload, rather than untargeted payments.
Asked on Channel Nine about the Government's stance given that no one believed public hospitals were up to scratch, Ms Roxon said there had been significant developments since Labor took office. "I think there are some positive signs, but that does not mean everything is fixed," she said.
But the Opposition's health spokesman, Peter Dutton, said Kevin Rudd was deserting his promise to end the "blame game" over funding between federal and state governments.
The Government had watered down its pledge and was walking away from its promise to take over public hospital funding, Mr Dutton said on Channel Ten.
On a related issue, the Government plans to introduce legislation to means test the health insurance rebate in the next two weeks to intensify pressure on the Opposition over blocking a budget measure that would generate $1.9 billion in savings over four years.
Friday, May 22, 2009
OUTSTATIONS POLICY - ASSIMILATION
Outstations policy a fresh attempt at assimilation.
Dr Thalia Anthony, Sydney University. Circulated by Women for Wik.
May 21, 2009
Evidence shows that indigenous wellbeing declines in townships.
ON THE eve of the Northern Territory Government announcing plans to, in effect, close down indigenous outstations, a report was released that showed indigenous people in Arnhem Land outstations and homelands had the most sustainable lives and communities.
The Healthy Country, Healthy People report shows the physical, emotional, social and cultural health benefits experienced by these people. It is therefore incongruous that while the Federal Government espouses a "closing the gap" agenda, the Northern Territory Government is undermining these health outcomes.
The Arnhem Land study finds that Aboriginal people participating in customary and contemporary land and sea management practices, particularly those living in traditional homelands, are much healthier than those in townships.
The report's authors note that "pressure to centralise remote indigenous populations and services into townships has increased, despite evidence suggesting this would lead to worse health outcomes". Townships promote inactivity, malnutrition, social dysfunction and other social disadvantages.
The researchers from Charles Darwin University reveal that health outcomes associated with living on and managing traditional country include major reductions in risk of cardiovascular disease, diabetes and other chronic diseases. These diseases not only severely disrupt indigenous society, they also require large public expenditure for treatment.Participants in natural and cultural resource management practices report a more nutritious diet and a greater degree of physical activity. Cultural management also provides potential markets for environmental investment.
Rather than foster and support these homeland communities and outstations, both the federal and Northern Territory governments have sought to undermine their existence. Under federal policy, there is a ban on expenditure for housing on Aboriginal outstations and homelands, apart from some repairs and maintenance.
This policy was entrenched in the memorandum of understanding between the Australian and Northern Territory governments on indigenous housing, accommodation and related services, which was signed in the dying days of the Howard government in September 2007.
The Northern Territory Government's announcement this week furthers this understanding.
The plan to consolidate services into 20 large communities will threaten up to 580 remote outstations. This will force indigenous people into townships, which will undermine their traditional, healthier lives and provoke social dysfunction in the townships.The attempts to oust outstations also run against the Australian Government's recent endorsement of the United Nations Declaration on the Rights of Indigenous Peoples, which supports self-determination.Outstations resonate with aspirations of indigenous self-determination. According to Gregory Marks, who has been an adviser on Northern Territory policy for the past four decades, the outstations emerged in the 1970s in response to the assimilation policy and changes in pastoralism that pushed indigenous people into settlements and onto urban fringes.Many of the outstations are a reaction to the confinement that settlement life imposed on indigenous people. Outstations allow indigenous people to nurture their economies and culture.The only basis for the outstation policy is ideological: to push indigenous people into the mainstream and engender assimilation. It operates hand in hand with the Northern Territory intervention that focuses funding priorities on a limited number of prescribed communities.
The Northern Territory and federal governments are reimposing colonial forms of containment that prevent indigenous survival beyond government-regulated boundaries.The policy of undermining outstations is a threat to indigenous wellbeing and is against evidence-based research that recommends the preservation of outstations.
Marks notes that the ideological campaign against outstations has provided an unproductive distraction from constructive policy development. Government investment needs to be measured in terms of health, cultural and natural resource management outcomes.
The outstation policy exposes the "closing the gap" policy as mere rhetoric, with dangerous political prejudices.
Dr Thalia Anthony is a lecturer and a Northern Territory indigenous law researcher at the Sydney Law School.
Dr Thalia Anthony, Sydney University. Circulated by Women for Wik.
May 21, 2009
Evidence shows that indigenous wellbeing declines in townships.
ON THE eve of the Northern Territory Government announcing plans to, in effect, close down indigenous outstations, a report was released that showed indigenous people in Arnhem Land outstations and homelands had the most sustainable lives and communities.
The Healthy Country, Healthy People report shows the physical, emotional, social and cultural health benefits experienced by these people. It is therefore incongruous that while the Federal Government espouses a "closing the gap" agenda, the Northern Territory Government is undermining these health outcomes.
The Arnhem Land study finds that Aboriginal people participating in customary and contemporary land and sea management practices, particularly those living in traditional homelands, are much healthier than those in townships.
The report's authors note that "pressure to centralise remote indigenous populations and services into townships has increased, despite evidence suggesting this would lead to worse health outcomes". Townships promote inactivity, malnutrition, social dysfunction and other social disadvantages.
The researchers from Charles Darwin University reveal that health outcomes associated with living on and managing traditional country include major reductions in risk of cardiovascular disease, diabetes and other chronic diseases. These diseases not only severely disrupt indigenous society, they also require large public expenditure for treatment.Participants in natural and cultural resource management practices report a more nutritious diet and a greater degree of physical activity. Cultural management also provides potential markets for environmental investment.
Rather than foster and support these homeland communities and outstations, both the federal and Northern Territory governments have sought to undermine their existence. Under federal policy, there is a ban on expenditure for housing on Aboriginal outstations and homelands, apart from some repairs and maintenance.
This policy was entrenched in the memorandum of understanding between the Australian and Northern Territory governments on indigenous housing, accommodation and related services, which was signed in the dying days of the Howard government in September 2007.
The Northern Territory Government's announcement this week furthers this understanding.
The plan to consolidate services into 20 large communities will threaten up to 580 remote outstations. This will force indigenous people into townships, which will undermine their traditional, healthier lives and provoke social dysfunction in the townships.The attempts to oust outstations also run against the Australian Government's recent endorsement of the United Nations Declaration on the Rights of Indigenous Peoples, which supports self-determination.Outstations resonate with aspirations of indigenous self-determination. According to Gregory Marks, who has been an adviser on Northern Territory policy for the past four decades, the outstations emerged in the 1970s in response to the assimilation policy and changes in pastoralism that pushed indigenous people into settlements and onto urban fringes.Many of the outstations are a reaction to the confinement that settlement life imposed on indigenous people. Outstations allow indigenous people to nurture their economies and culture.The only basis for the outstation policy is ideological: to push indigenous people into the mainstream and engender assimilation. It operates hand in hand with the Northern Territory intervention that focuses funding priorities on a limited number of prescribed communities.
The Northern Territory and federal governments are reimposing colonial forms of containment that prevent indigenous survival beyond government-regulated boundaries.The policy of undermining outstations is a threat to indigenous wellbeing and is against evidence-based research that recommends the preservation of outstations.
Marks notes that the ideological campaign against outstations has provided an unproductive distraction from constructive policy development. Government investment needs to be measured in terms of health, cultural and natural resource management outcomes.
The outstation policy exposes the "closing the gap" policy as mere rhetoric, with dangerous political prejudices.
Dr Thalia Anthony is a lecturer and a Northern Territory indigenous law researcher at the Sydney Law School.
Tuesday, May 19, 2009
IS HEALTH CARE SAFER??
Red News Readers,
The Safety Study that was done in 1995 has not been repeated. Its results caused controversy at the time and since. I remember evidence being given at the Campbelltown Camden Enquiry about this study, and efforts were made then to discredit the study and its authors. Interestingly Crikey, the link to the study doesn’t open?
Certainly politicians are a group in our community who are not interested in seeing such a study repeated but it should be if we are to know whether the system has improved or not since 1995. The safety processes that were put in place in NSW after 2003 should have made the system more safe and NSW Health should show confidence in their process. But with health being the political football it is these days, I can’t see it happening any time soon!!
Jenny Haines
Millions of dollars and 14 years later: is Australian health care any safer than before?
Australian Healthcare and Hospitals Association Vice-President Dr Patrick Bolton writes in Crikey 19.05.09:
Almost 14 years after the Quality in Australian Healthcare Study showed many patients are harmed as a result of their health care, we still do not know whether Australian hospitals are safer today than when the study was conducted.
Nor do we know if the millions invested in improving patient safety since its November 1995 publication has been money well spent.
The study was a landmark in Australian health service evaluation. It comprised a review of the medical records of over 14 000 admissions to 28 hospitals in New South Wales and South Australia and revealed that 16.6% of these admissions were associated with an "adverse event", which resulted in disability or a longer hospital stay for the patient and was caused by health care management; 51% of the adverse events were considered preventable.
In 77.1% the disability had resolved within 12 months, but in 13.7% the disability was permanent and in 4.9% the patient died.
This study was the catalyst for investment in quality improvement in Australian healthcare.
Unfortunately, the benefit from this investment is unmeasured and questionable.
Nor do we know much about the safety of Australian primary care because no comparable study has been published in that setting.
The overall death rate in Australian public hospitals in 2006-7 was 1.3%. Assuming that the 1995 study’s figures remain applicable, nearly two-thirds (63%) of deaths in Australian hospitals are associated with an adverse event. Half of these -- one third of all hospital deaths -- are preventable. Australia is not alone: The results of the 1995 study are similar to those of other developed nations.
All Australian jurisdictions have invested in quality improvement programs to improve patient safety. Most have introduced self-reporting of safety incidents by hospital staff. This may be useful in identifying opportunities for improvement, but is a poor performance measure. It is unclear whether an increase in the reported rate of error reflects an increase in errors or reporting.
More empirical measures that reflect major causes of morbidity and mortality in areas known to be at high risk of error include drug errors, healthcare acquired infection, mortality after surgery and in-hospital mortality. Successful use of these measures has been demonstrated in limited settings in Australia and overseas. University hospitals in the US have used this approach to reduced in-hospital mortality.
Quality improvement focuses on improving processes, potentially at the cost of improved outcomes. The bureaucratised nature of the Australian healthcare system can combine with the focus on process to produce a ritualised response to adverse events in healthcare. This is illustrated by the root cause analysis process.
Root cause analysis is used internationally and recommended by all state health departments as a tool to investigate and improve from clinical incidents. Most Australian states have in place legislation to facilitate or mandate root cause analysis, at least in public hospitals.
Recent international reviews have questioned the appropriateness and effectiveness of root cause analysis as a tool for improving patient safety, and noted the costs that it imposes.
Root cause analysis involves retrospective analysis of a critical incident by an independent team clinically similar to, and familiar with the kind of work done by, the team involved in the incident. The team identify the causes of the incident and make recommendations about how recurrences might be prevented.
It is not uncommon for recommendations to include the development of tools such as a new policy, form, or further education. Tools such as these can only prevent an error if the risk of error is recognised in advance so that they can be applied. If the risk is not recognised in a timely manner then the tools are not useful. If the risk is recognised in advance then the tools are often of marginal benefit. The requirement to employ these tools increases the overhead on the health system. The recommendations of the root cause analysis team are not subject to any cost-benefit analysis, so additional demands are made without resources or analysis of benefit.
Effectiveness data are urgently required to assess the directions chosen in quality improvement in Australian healthcare.
Healthcare workers sometimes suggest that the 1995 study has not been repeated because the results would be unpalatable to politicians. If this is the case it needs to be recognised that here, as elsewhere in quality improvement, blame is inappropriate because it obscures the interests of patients.
Careful thought is required to ensure the efficient collection of useful data about the safety of the Australian healthcare system, but there is no question that ongoing collection of these data is required.
Australia must build on the foundation laid by the Quality in Australian Healthcare Study so that we have robust contemporary national data about the quality and safety of our healthcare system.
The Safety Study that was done in 1995 has not been repeated. Its results caused controversy at the time and since. I remember evidence being given at the Campbelltown Camden Enquiry about this study, and efforts were made then to discredit the study and its authors. Interestingly Crikey, the link to the study doesn’t open?
Certainly politicians are a group in our community who are not interested in seeing such a study repeated but it should be if we are to know whether the system has improved or not since 1995. The safety processes that were put in place in NSW after 2003 should have made the system more safe and NSW Health should show confidence in their process. But with health being the political football it is these days, I can’t see it happening any time soon!!
Jenny Haines
Millions of dollars and 14 years later: is Australian health care any safer than before?
Australian Healthcare and Hospitals Association Vice-President Dr Patrick Bolton writes in Crikey 19.05.09:
Almost 14 years after the Quality in Australian Healthcare Study showed many patients are harmed as a result of their health care, we still do not know whether Australian hospitals are safer today than when the study was conducted.
Nor do we know if the millions invested in improving patient safety since its November 1995 publication has been money well spent.
The study was a landmark in Australian health service evaluation. It comprised a review of the medical records of over 14 000 admissions to 28 hospitals in New South Wales and South Australia and revealed that 16.6% of these admissions were associated with an "adverse event", which resulted in disability or a longer hospital stay for the patient and was caused by health care management; 51% of the adverse events were considered preventable.
In 77.1% the disability had resolved within 12 months, but in 13.7% the disability was permanent and in 4.9% the patient died.
This study was the catalyst for investment in quality improvement in Australian healthcare.
Unfortunately, the benefit from this investment is unmeasured and questionable.
Nor do we know much about the safety of Australian primary care because no comparable study has been published in that setting.
The overall death rate in Australian public hospitals in 2006-7 was 1.3%. Assuming that the 1995 study’s figures remain applicable, nearly two-thirds (63%) of deaths in Australian hospitals are associated with an adverse event. Half of these -- one third of all hospital deaths -- are preventable. Australia is not alone: The results of the 1995 study are similar to those of other developed nations.
All Australian jurisdictions have invested in quality improvement programs to improve patient safety. Most have introduced self-reporting of safety incidents by hospital staff. This may be useful in identifying opportunities for improvement, but is a poor performance measure. It is unclear whether an increase in the reported rate of error reflects an increase in errors or reporting.
More empirical measures that reflect major causes of morbidity and mortality in areas known to be at high risk of error include drug errors, healthcare acquired infection, mortality after surgery and in-hospital mortality. Successful use of these measures has been demonstrated in limited settings in Australia and overseas. University hospitals in the US have used this approach to reduced in-hospital mortality.
Quality improvement focuses on improving processes, potentially at the cost of improved outcomes. The bureaucratised nature of the Australian healthcare system can combine with the focus on process to produce a ritualised response to adverse events in healthcare. This is illustrated by the root cause analysis process.
Root cause analysis is used internationally and recommended by all state health departments as a tool to investigate and improve from clinical incidents. Most Australian states have in place legislation to facilitate or mandate root cause analysis, at least in public hospitals.
Recent international reviews have questioned the appropriateness and effectiveness of root cause analysis as a tool for improving patient safety, and noted the costs that it imposes.
Root cause analysis involves retrospective analysis of a critical incident by an independent team clinically similar to, and familiar with the kind of work done by, the team involved in the incident. The team identify the causes of the incident and make recommendations about how recurrences might be prevented.
It is not uncommon for recommendations to include the development of tools such as a new policy, form, or further education. Tools such as these can only prevent an error if the risk of error is recognised in advance so that they can be applied. If the risk is not recognised in a timely manner then the tools are not useful. If the risk is recognised in advance then the tools are often of marginal benefit. The requirement to employ these tools increases the overhead on the health system. The recommendations of the root cause analysis team are not subject to any cost-benefit analysis, so additional demands are made without resources or analysis of benefit.
Effectiveness data are urgently required to assess the directions chosen in quality improvement in Australian healthcare.
Healthcare workers sometimes suggest that the 1995 study has not been repeated because the results would be unpalatable to politicians. If this is the case it needs to be recognised that here, as elsewhere in quality improvement, blame is inappropriate because it obscures the interests of patients.
Careful thought is required to ensure the efficient collection of useful data about the safety of the Australian healthcare system, but there is no question that ongoing collection of these data is required.
Australia must build on the foundation laid by the Quality in Australian Healthcare Study so that we have robust contemporary national data about the quality and safety of our healthcare system.
Sunday, May 17, 2009
THOUSANDS FLOCK TO HEALTH FUNDS
Red News Readers,
No wonder politicans don't believe lobby groups when they predict disasters from government changes! No doubt people are taking out private insurance as insurance against having to go to the now disgraced public system. But what citizens have to understand that if they are injured in a trauma, say a motor vehicle accident, they will go to a public hospital ED and be treated by the doctors on duty. There is no choice of doctor in this situation. They then will go to a public hospital bed in a ward. Single rooms in public hospitals are not for private patients. They are for the very sick, the dying and the infectious. If someone with private insurance wants one of these rooms, they're welcome to it, so long as it is not needed for one of these patients, and that would be rare in a public system pressed for beds. If you have private cover you can be sure that you will get the full attention and the bills of your chosen doctor in a public hospital. Private insurance only covers the cost of elective treament in a private hospital. That is the circumstance where you get your choice of doctor.
In a public hospital a clerk will come around as ask if you wish to pay by private insurance or Medicare, and patients have that choice, but there is very little difference in the care given by the health system staff, doctors, nurses etc to a public patient or a private patient. In my 30 year nursing career I never looked at the patient's health insurance status, as I gave the same care to all, rich or poor. Long may it stay that way!! Although I hear now that hospitals are returning to the 30s , 40s ,50s and 60s and setting up private wards in public hospitals where there will be single rooms and private level care, with choice of doctor. Medicare swept all this away. How sad and stupid we are going back to it!!
Jenny Haines
Thousands flock to health funds
Josh Gordon, smh
May 17, 2009
AUSTRALIANS have been pouring into private health cover at a rate of more than 4000 a week, with new figures set to undermine claims that the private health system is about to be king-hit by changes announced in last week's budget.
A leaked report reveals an extra 225,000 people took up private cover during the 12 months to March this year.
The surge came despite warnings from insurers and the Opposition that changes announced in the 2008 budget would pressure the public system by forcing people to abandon private cover.
Some private health funds last year claimed they were heading for a "shock loss" of 6 to 8 per cent of their policy holders, following changes in the 2008 budget that increased the income threshold for the Medicare levy surcharge, applied to people with no private cover, from $50,000 to $70,000 for singles and from $100,000 to $140,000 for families. But the figures suggest the feared exodus did not occur.
Last week's federal budget confirmed plans to means test the 30 per cent private health insurance rebate for singles earning more than $75,000 and for families earning above $150,000. The rebate will cease for couples earning more than $240,000.
The Medicare levy surcharge rate will also be lifted for singles earning more than $90,000 and families above $180,000.
The figures, from the independent but publicly funded Private Health Insurance Administration Council, show more than 9.7 million Australians are now covered for private hospital insurance, equivalent to 44.6 per cent of the population.
In the first three months of 2009, an extra 45,000 people took up private cover, after an increase of 55,000 during the final three months of 2008. Since March 2007 the number of people with private cover has swelled by 634,000.
Treasury estimated the changes will have a minuscule impact on private cover, with modelling suggesting 99.7 per cent of people will remain in private health insurance.
But Opposition Leader Malcolm Turnbull has pledged his party will vote against the plan to means test the 30 per cent rebate. Family First Senator Steve Fielding and Independent Nick Xenophon have also expressed concern.
The Health Insurance Association has argued that the decision to means test the rebate will place increased pressure on the public hospital system and force up premiums.
Health Minister Nicola Roxon yesterday accused Mr Turnbull of plotting to force people on low incomes to pay private health insurance.
No wonder politicans don't believe lobby groups when they predict disasters from government changes! No doubt people are taking out private insurance as insurance against having to go to the now disgraced public system. But what citizens have to understand that if they are injured in a trauma, say a motor vehicle accident, they will go to a public hospital ED and be treated by the doctors on duty. There is no choice of doctor in this situation. They then will go to a public hospital bed in a ward. Single rooms in public hospitals are not for private patients. They are for the very sick, the dying and the infectious. If someone with private insurance wants one of these rooms, they're welcome to it, so long as it is not needed for one of these patients, and that would be rare in a public system pressed for beds. If you have private cover you can be sure that you will get the full attention and the bills of your chosen doctor in a public hospital. Private insurance only covers the cost of elective treament in a private hospital. That is the circumstance where you get your choice of doctor.
In a public hospital a clerk will come around as ask if you wish to pay by private insurance or Medicare, and patients have that choice, but there is very little difference in the care given by the health system staff, doctors, nurses etc to a public patient or a private patient. In my 30 year nursing career I never looked at the patient's health insurance status, as I gave the same care to all, rich or poor. Long may it stay that way!! Although I hear now that hospitals are returning to the 30s , 40s ,50s and 60s and setting up private wards in public hospitals where there will be single rooms and private level care, with choice of doctor. Medicare swept all this away. How sad and stupid we are going back to it!!
Jenny Haines
Thousands flock to health funds
Josh Gordon, smh
May 17, 2009
AUSTRALIANS have been pouring into private health cover at a rate of more than 4000 a week, with new figures set to undermine claims that the private health system is about to be king-hit by changes announced in last week's budget.
A leaked report reveals an extra 225,000 people took up private cover during the 12 months to March this year.
The surge came despite warnings from insurers and the Opposition that changes announced in the 2008 budget would pressure the public system by forcing people to abandon private cover.
Some private health funds last year claimed they were heading for a "shock loss" of 6 to 8 per cent of their policy holders, following changes in the 2008 budget that increased the income threshold for the Medicare levy surcharge, applied to people with no private cover, from $50,000 to $70,000 for singles and from $100,000 to $140,000 for families. But the figures suggest the feared exodus did not occur.
Last week's federal budget confirmed plans to means test the 30 per cent private health insurance rebate for singles earning more than $75,000 and for families earning above $150,000. The rebate will cease for couples earning more than $240,000.
The Medicare levy surcharge rate will also be lifted for singles earning more than $90,000 and families above $180,000.
The figures, from the independent but publicly funded Private Health Insurance Administration Council, show more than 9.7 million Australians are now covered for private hospital insurance, equivalent to 44.6 per cent of the population.
In the first three months of 2009, an extra 45,000 people took up private cover, after an increase of 55,000 during the final three months of 2008. Since March 2007 the number of people with private cover has swelled by 634,000.
Treasury estimated the changes will have a minuscule impact on private cover, with modelling suggesting 99.7 per cent of people will remain in private health insurance.
But Opposition Leader Malcolm Turnbull has pledged his party will vote against the plan to means test the 30 per cent rebate. Family First Senator Steve Fielding and Independent Nick Xenophon have also expressed concern.
The Health Insurance Association has argued that the decision to means test the rebate will place increased pressure on the public hospital system and force up premiums.
Health Minister Nicola Roxon yesterday accused Mr Turnbull of plotting to force people on low incomes to pay private health insurance.
Sunday, May 03, 2009
NSWNA FIGHTS FOR NIGHT SHIFT PENALTIES AT LAST
Red News Readers,
NSW Nurses, including myself, have been calling for this since the 1980s. Better late than never!!
Jenny Haines
NSW Nurses fight for night shift pay
Article from: AAP
May 03, 2009 04:38pm, Sunday Telegraph
PUBLIC hospital nurses will seek their first night shift allowance increase in more than 30 years at a NSW Industrial Relations Commission hearing this week.
The NSW Nurses Association (NSWNA) wants night shift penalty rates increased from 15 per cent to 25 per cent and for the penalties to apply on weekends.
This would mean an extra $130 a week for nurses or midwives who do an entire week of night shifts.
Witnesses from the union, NSW Health and nurses from hospitals around the state will give evidence in Sydney from Monday.
Nurses are expected to tell the commission about the difficulties of working night shifts including poor sleep, health problems and disruption of family and social life.
Union president Brett Holmes said night duty penalty rates hadn't increased for public hospital nurses since 1975.
"The NSWNA does not believe the current rate of 15 per cent fairly and adequately compensates nurses for the social, domestic and health disadvantages experienced when they work night shift,'' he said in a statement on Sunday.
NSW Nurses, including myself, have been calling for this since the 1980s. Better late than never!!
Jenny Haines
NSW Nurses fight for night shift pay
Article from: AAP
May 03, 2009 04:38pm, Sunday Telegraph
PUBLIC hospital nurses will seek their first night shift allowance increase in more than 30 years at a NSW Industrial Relations Commission hearing this week.
The NSW Nurses Association (NSWNA) wants night shift penalty rates increased from 15 per cent to 25 per cent and for the penalties to apply on weekends.
This would mean an extra $130 a week for nurses or midwives who do an entire week of night shifts.
Witnesses from the union, NSW Health and nurses from hospitals around the state will give evidence in Sydney from Monday.
Nurses are expected to tell the commission about the difficulties of working night shifts including poor sleep, health problems and disruption of family and social life.
Union president Brett Holmes said night duty penalty rates hadn't increased for public hospital nurses since 1975.
"The NSWNA does not believe the current rate of 15 per cent fairly and adequately compensates nurses for the social, domestic and health disadvantages experienced when they work night shift,'' he said in a statement on Sunday.
NURSES TO TREAT COMMON AILMENTS
Nurses ready to fill prescription void
EXCLUSIVE by Steve Lewis and Sue Dunlevy
April 29, 2009 12:00am, Daily Telegraph.
NURSES will be able to prescribe cheap medicines to patients under plans to boost their role in frontline health services.
The bold reform will expand health services in the bush, nursing homes and other areas struggling to cope with a shortage of 1300 GPs.
But it will place the Federal Government on a collision course with the powerful Australian Medical Association, which has campaigned to retain a monopoly on prescribing subsidised medicines.
Under the shake-up, the Government will allow experienced nurses - known as "nurse practitioners" - to prescribe medicines listed on the Pharmaceutical Benefits Scheme, saving their patients hundreds of dollars on prescription drugs.
It will allow nursing practitioners to treat nursing home patients with minor ailments, prescribing vaccinations and antibiotics for tonsillitis, urinary tract infections - and even contraceptives.
The Budget measure will be promoted as making health services more affordable, particularly in the bush. The cost of common antibiotics would fall from $17 to $5 for pensioners if nurse prescriptions were subsidised.
It comes as Prime Minister Kevin Rudd and senior ministers yesterday signed off on the thrust of the May 12 Budget. With the recession slashing billions of dollars from revenues, the Budget will target wealthier families in order to fund a pension increase.
The reform had earlier received a tick from the Budget razor gang, even though it is expected to cost millions of dollars in additional health outlays.
Health Minister Nicola Roxon has championed a broader role for nurses, claiming they are "under-utilised and undervalued" in the health system.
There are around 350 nurse practitioners in Australia who have 10 years of nursing experience and a masters degree in nursing.
They have the legal right to write prescriptions for up to 200 medicines but their patients have to pay full price, which can cost hundreds of dollars because the PBS does not cover medicines they prescribe.
Nurse practitioners are qualified to treat a range of common ailments including simple broken bones that don't need surgery, burns, urinary infections, sore ears, kidney stones, rashes and tonsillitis.
Australian Nursing Federation president Ged Kearney said nurse practitioners had been pushing hard to get subsidies for prescriptions.
She said a breakthrough in this area would provide a major encouragement for experienced nurses to increase their qualifications.
EXCLUSIVE by Steve Lewis and Sue Dunlevy
April 29, 2009 12:00am, Daily Telegraph.
NURSES will be able to prescribe cheap medicines to patients under plans to boost their role in frontline health services.
The bold reform will expand health services in the bush, nursing homes and other areas struggling to cope with a shortage of 1300 GPs.
But it will place the Federal Government on a collision course with the powerful Australian Medical Association, which has campaigned to retain a monopoly on prescribing subsidised medicines.
Under the shake-up, the Government will allow experienced nurses - known as "nurse practitioners" - to prescribe medicines listed on the Pharmaceutical Benefits Scheme, saving their patients hundreds of dollars on prescription drugs.
It will allow nursing practitioners to treat nursing home patients with minor ailments, prescribing vaccinations and antibiotics for tonsillitis, urinary tract infections - and even contraceptives.
The Budget measure will be promoted as making health services more affordable, particularly in the bush. The cost of common antibiotics would fall from $17 to $5 for pensioners if nurse prescriptions were subsidised.
It comes as Prime Minister Kevin Rudd and senior ministers yesterday signed off on the thrust of the May 12 Budget. With the recession slashing billions of dollars from revenues, the Budget will target wealthier families in order to fund a pension increase.
The reform had earlier received a tick from the Budget razor gang, even though it is expected to cost millions of dollars in additional health outlays.
Health Minister Nicola Roxon has championed a broader role for nurses, claiming they are "under-utilised and undervalued" in the health system.
There are around 350 nurse practitioners in Australia who have 10 years of nursing experience and a masters degree in nursing.
They have the legal right to write prescriptions for up to 200 medicines but their patients have to pay full price, which can cost hundreds of dollars because the PBS does not cover medicines they prescribe.
Nurse practitioners are qualified to treat a range of common ailments including simple broken bones that don't need surgery, burns, urinary infections, sore ears, kidney stones, rashes and tonsillitis.
Australian Nursing Federation president Ged Kearney said nurse practitioners had been pushing hard to get subsidies for prescriptions.
She said a breakthrough in this area would provide a major encouragement for experienced nurses to increase their qualifications.
UNIONS WIN ON CESSNOCK, PARKLEA TO BE STOPPED TOO!
Unions win private prison row after Rees capitulates
May 02, 2009 12:00am, smh
PREMIER Nathan Rees has capitulated to unions - dropping the State Government's plan to privatise Cessnock jail - to avoid a repeat of the showdown which unseated his predecessor.
In a deal to avoid an all-out war with unions and yet another policy U-turn for the Government, he has agreed to drop at least part of the privatisation plans.
The Government will proceed with the privatisation of Parklea prison but took the extraordinary step of blaming its capitulation on the global financial crisis.
Union leaders yesterday crowed about their victory.
"This is a great day for the Cessnock community and a good result for all those in the community who do not believe that prisons should be run for profit by big corporations," Public Service Association general secretary John Cahill said.
May 02, 2009 12:00am, smh
PREMIER Nathan Rees has capitulated to unions - dropping the State Government's plan to privatise Cessnock jail - to avoid a repeat of the showdown which unseated his predecessor.
In a deal to avoid an all-out war with unions and yet another policy U-turn for the Government, he has agreed to drop at least part of the privatisation plans.
The Government will proceed with the privatisation of Parklea prison but took the extraordinary step of blaming its capitulation on the global financial crisis.
Union leaders yesterday crowed about their victory.
"This is a great day for the Cessnock community and a good result for all those in the community who do not believe that prisons should be run for profit by big corporations," Public Service Association general secretary John Cahill said.
NOT FOOL PROOF!!
Future-proof, theft-proof, not foolproof
Chris Henning, SMH
May 2, 2009
SCENE: A shopping centre in Sydney's north-west, with single-storey shops surrounding a large car park. It is 3am. Rain has just stopped, and light from street lamps is reflected off the wet asphalt, but there is no moon and it is hard to make out anything in the deep shadows.
Owl: More pork!
Suddenly we hear the sound of a powerful car approaching. A huge black four-wheel-drive ute pulls up, and two men get out, rushing to pull equipment - gas bottles, cutting equipment, tubes and a powerful drill - out of the tray. They are dressed entirely in black, and their faces are masked in balaclavas. They look quickly round.
1st man: Here. It's over here. (Points.)
2nd man: Are you sure? Ken's briefing note said it'd be next to Baker's Delight.
1st man: This is Baker's Delight.
2nd man: No, it isn't. It's the Flower of Da Nang hot bread shop.
1st man: Same friggin' difference. Bring us the drill.
2nd man: (Hands over drill) You certain you know what to do?
1st man: Course. I looked it up on Wikipedia. (Takes paper out of back pocket and reads, tongue between lips. Mutters.) OK … OK. About here, I reckon.
He places the point of the drill bit low on the shop wall, and starts drilling. There is a screaming whine, and masonry and dust fly. The bit finally breaks through and 1st man pulls the howling drill out of the hole. He moves a metre or so to the left and repeats the procedure.
1st man: OK. Hoses!
2nd man: Check.
Both feed lengths of hose into the two holes. With one metre inside, they move away, unrolling hoses as they go.
1st man: Wire.
2nd man: Check. (He moves back to one hole, inserts two raw ends of wire, and moves away, unrolling wires behind him.)
1st man: Gas.
2nd man: Check. (He attaches a hose end to each gas bottle, and opens their valves. Muted hissing is heard as gas is pumped into the wall cavity.)
1st man: (Reads.) Let gas flow for 60 seconds.
2nd man: Hey, Wayne, how much you reckon this'll get us?
1st man (Wayne): Dunno. But a lot. Ken reckons the average ATM contains about 250 grand.
2nd man: So, like, we do four. That's a million bucks.
Wayne: (We see his teeth grinning in the low light.) Yeah. We do that a thousand times, that's a billion bucks.
2nd man: And if we do that 40 times, that's 40 billion bucks. (Low whistle.) Big bickies, mate.
Wayne: Yeah, so if we can pull this off just 160,000 times (cocky, lopsided grin), you know what that means?
Both together: We can bring the federal budget back to surplus and secure the future of the Rudd Government. (They high-five.)
Wayne: (Businesslike again.) OK, that's enough gas. (2nd man tightens valves. Both men hide behind their car.) Batteries.
2nd man: Check. (He pulls a nine-volt battery from his pocket and touches the ends of each wire to the terminals. A huge explosion where they have been drilling demolishes the wall, and showers the men and their ute with rubble, fizzing brown fluid and dented aluminium cans.)
Wayne: Shit.
2nd man: Told you he said Baker's Delight, mate.
Wayne: Shut up, Lindsay, will ya? (Gets into the ute.)
2nd man (Lindsay): (Getting in beside him.) We've blown up the hot bread shop Coke machine, mate. (They drive off, bickering.)
Chris Henning, SMH
May 2, 2009
SCENE: A shopping centre in Sydney's north-west, with single-storey shops surrounding a large car park. It is 3am. Rain has just stopped, and light from street lamps is reflected off the wet asphalt, but there is no moon and it is hard to make out anything in the deep shadows.
Owl: More pork!
Suddenly we hear the sound of a powerful car approaching. A huge black four-wheel-drive ute pulls up, and two men get out, rushing to pull equipment - gas bottles, cutting equipment, tubes and a powerful drill - out of the tray. They are dressed entirely in black, and their faces are masked in balaclavas. They look quickly round.
1st man: Here. It's over here. (Points.)
2nd man: Are you sure? Ken's briefing note said it'd be next to Baker's Delight.
1st man: This is Baker's Delight.
2nd man: No, it isn't. It's the Flower of Da Nang hot bread shop.
1st man: Same friggin' difference. Bring us the drill.
2nd man: (Hands over drill) You certain you know what to do?
1st man: Course. I looked it up on Wikipedia. (Takes paper out of back pocket and reads, tongue between lips. Mutters.) OK … OK. About here, I reckon.
He places the point of the drill bit low on the shop wall, and starts drilling. There is a screaming whine, and masonry and dust fly. The bit finally breaks through and 1st man pulls the howling drill out of the hole. He moves a metre or so to the left and repeats the procedure.
1st man: OK. Hoses!
2nd man: Check.
Both feed lengths of hose into the two holes. With one metre inside, they move away, unrolling hoses as they go.
1st man: Wire.
2nd man: Check. (He moves back to one hole, inserts two raw ends of wire, and moves away, unrolling wires behind him.)
1st man: Gas.
2nd man: Check. (He attaches a hose end to each gas bottle, and opens their valves. Muted hissing is heard as gas is pumped into the wall cavity.)
1st man: (Reads.) Let gas flow for 60 seconds.
2nd man: Hey, Wayne, how much you reckon this'll get us?
1st man (Wayne): Dunno. But a lot. Ken reckons the average ATM contains about 250 grand.
2nd man: So, like, we do four. That's a million bucks.
Wayne: (We see his teeth grinning in the low light.) Yeah. We do that a thousand times, that's a billion bucks.
2nd man: And if we do that 40 times, that's 40 billion bucks. (Low whistle.) Big bickies, mate.
Wayne: Yeah, so if we can pull this off just 160,000 times (cocky, lopsided grin), you know what that means?
Both together: We can bring the federal budget back to surplus and secure the future of the Rudd Government. (They high-five.)
Wayne: (Businesslike again.) OK, that's enough gas. (2nd man tightens valves. Both men hide behind their car.) Batteries.
2nd man: Check. (He pulls a nine-volt battery from his pocket and touches the ends of each wire to the terminals. A huge explosion where they have been drilling demolishes the wall, and showers the men and their ute with rubble, fizzing brown fluid and dented aluminium cans.)
Wayne: Shit.
2nd man: Told you he said Baker's Delight, mate.
Wayne: Shut up, Lindsay, will ya? (Gets into the ute.)
2nd man (Lindsay): (Getting in beside him.) We've blown up the hot bread shop Coke machine, mate. (They drive off, bickering.)
Saturday, May 02, 2009
DON'T ASK ME, I'M LOST!
Don't Ask Me, I'm Lost
By Scott Mitchell, New Matilda, 29.4.09
Why are Fairfax journalists — and our Treasurer — treating the IMF's forecasts like fact and using them to peddle false economic optimism?
After only a couple of days in lockdown with the eggheads at meetings of the G20 Finance Ministers and the International Monetary Fund, Wayne Swan last week became aware that the economic crisis was worse than he'd thought.
On Ten's Meet the Press, Swan told the assembled financial journalists that after talking to the finance ministers of the world, it had become "pretty clear that this recession is deep and it will probably go for longer than many had anticipated only a short time ago".
The question is, why does our Treasurer have to travel to the other side of the world to get a reality check? And why are Australian broadsheets playing catch up on the economic crisis?
Until he left our shores, Swan was trumpeting the same delusions to which we've all been subjected recently. Swan's impression of the global financial crisis might well have been based on the same IMF reports given uncritical coverage by the Sydney Morning Herald last week.
Quoting the IMF as an oracle, Jacob Saulwick and Phillip Coorey's front page article read as follows:
"Australia's economy is set to contract by 1.4 per cent in 2009, the IMF said, before growing just 0.6 per cent next year. The IMF's forecast is markedly worse than the 1 per cent growth for 2008-09 predicted by the Government in February, and is likely to be matched when revised figures are released in next month's budget."
That 0.6 per cent over the hill is an important figure. We just need to be patient, we all need to wait just a little longer and everything will work out nice as pie.
Me, I very much doubt this twitch of growth is coming at all. Why? Because the IMF has no idea what's going to happen next. Their analyses and outlooks are consistently wrong — which is to say that they are perpetually upgraded, revised, downgraded and overhauled.
Phillip Coorey certainly knows the IMF's track record on economic forecasting — he reported it on 20 April. Except according to Coorey the IMF weren't wrong, they were just "revising" again.
In fact, Coorey has reported every revision since 20 October 2008 when the IMF predicted our economy would continue to grow through 2009, albeit at only 2 per cent. Those were good times. Since then they've revised the forecast three times. Now, the IMF is calling a 1.4 per cent contraction in the economy for 2009, a figure which indicates we'll have a very serious recession.
A depression, even? And yet Coorey has again handed us the latest round of projections as if they were facts.
Last month when Kevin Rudd was in Washington en route to the G20 in London, Coorey's economic reporting grabbed my attention. "Rudd Reveals Plan To Save World From New Depression", screamed the headline. Breaths had been bated the world over in anticipation of the long rumoured plan and finally, the Prime Minister had chosen to reveal it.
Back in Sydney, whoever thought that title was appropriate for the emptiness that followed should've been dismissed as a lunatic out of hand. Or was it one of the outsourced sub-editors in Brisbane who came up with it? At any rate, the SMH apparently believes that repetitive platitudes constitute not only a "plan" but one that is going to save the world economy. Kevin's first proposition: "No nation can deal with this crisis on its own." And the second? Nations must instead work together. Brilliant!
Coorey went on to relate that, "earlier this week Mr Rudd described protectionism as an insidious evil and he rallied against it in his speech", and that nations must work with the World Bank and IMF to solve their problems. Coorey himself loves to quote important sounding economic reports, so it was odd that he didn't pick Rudd up on the fact that the very same day, the WTO had named and shamed Australia as one of the countries which had turned to protectionism to rescue its economy.
Not only that, but didn't this whole anti-protectionism, pro-unremitting capitalism stance contradict the essay that Rudd's least imaginative advisors had written for The Monthly? It seemed like Rudd hadn't even read the piece, but rather was reciting lines from cue cards written in Washington: IMF funds should be tripled, and every other tired goal that the real leaders of the world had already decided on.
But according to the SMH, Rudd was not only the saviour of the world economy, he was important globally — a myth every Australian prime minister has attempted to perpetuate since Billy Hughes.
What's so bad about all that, you may ask?
Banks have been overrun with mortgage applications in the last couple of weeks, encouraged by falling interest rates and the rosy promises of a recovering economy that have been concocted out of thin air by incompetent hack economists. What happens if, as Access Economics predicts, more than one million Australians find themselves out of work next year?
House repossession rates are already rising steeply in NSW according to the NSW Attorney-General's Department. There are fathers and mothers who don't have enough money to feed their children anymore. We aren't yet in the maw of the recession: the real job losses will hit in the next three to nine months. People will lose their homes, their families, their possessions and their health because they thought this was all going to get better.
Sharp-eyed readers will note that I've just quoted two sets of financial statistics, sourced, no less, from the SMH. Having just lambasted Coorey for treating IMF predictions like gospel, isn't it a bit rich casually to drop in numbers from another "reputable source"? The thing is, financial journalists, like any other breed, must rely on expert opinion and information to put together their stories. Without as much, reporting becomes less a matter of investigation and more one of surmise. What's important is that this information is treated critically, scrutinised carefully and situated in its proper context.
Writers like Coorey who puff false economic optimism have their hands soaked in the red ink of bank statements arriving at more and more homes all over Australia. They continue to peddle total bollocks, creating a vision of prosperity over the hill which will not come — not in time, anyway.
Phil, every time you've told us all it's getting better, it's gotten worse. Every month the losses get bigger, the economy is going to keep contracting, and more of us are going to lose our jobs. Do the honourable thing and be the first of your kind to admit that you're wrong, that the lenses through which you view politics and the economy do not work anymore, that you're as helpless in this storm as the rest of us. At the very least tell us the experts and pollies you're quoting don't know what they're talking about, or, for Christ's sake, find someone else to ask. There are hundreds of economists who've actually been right when the government and IMF have been wrong that no one seems to be consulting.
I don't want to pick on Phillip Coorey, because there are many others doing the same thing. The overwhelmingly positive responses to Jon Stewart's roasting of Jim Cramer, stock market pundit and host of CNBC's Mad Money, in the last month suggests that there is more rage in store for these false prophets of optimism.
As Cramer is to CNBC, so too is Coorey a cog in the wheel of the Fairfax machine, a media organisation that now seems preoccupied with the creation of a fantasy world — one that must constantly be revised — which it thinks makes better product. Is Fairfax selling positivity over reality to chase its fleeing readership?
If they are, it isn't working.
By Scott Mitchell, New Matilda, 29.4.09
Why are Fairfax journalists — and our Treasurer — treating the IMF's forecasts like fact and using them to peddle false economic optimism?
After only a couple of days in lockdown with the eggheads at meetings of the G20 Finance Ministers and the International Monetary Fund, Wayne Swan last week became aware that the economic crisis was worse than he'd thought.
On Ten's Meet the Press, Swan told the assembled financial journalists that after talking to the finance ministers of the world, it had become "pretty clear that this recession is deep and it will probably go for longer than many had anticipated only a short time ago".
The question is, why does our Treasurer have to travel to the other side of the world to get a reality check? And why are Australian broadsheets playing catch up on the economic crisis?
Until he left our shores, Swan was trumpeting the same delusions to which we've all been subjected recently. Swan's impression of the global financial crisis might well have been based on the same IMF reports given uncritical coverage by the Sydney Morning Herald last week.
Quoting the IMF as an oracle, Jacob Saulwick and Phillip Coorey's front page article read as follows:
"Australia's economy is set to contract by 1.4 per cent in 2009, the IMF said, before growing just 0.6 per cent next year. The IMF's forecast is markedly worse than the 1 per cent growth for 2008-09 predicted by the Government in February, and is likely to be matched when revised figures are released in next month's budget."
That 0.6 per cent over the hill is an important figure. We just need to be patient, we all need to wait just a little longer and everything will work out nice as pie.
Me, I very much doubt this twitch of growth is coming at all. Why? Because the IMF has no idea what's going to happen next. Their analyses and outlooks are consistently wrong — which is to say that they are perpetually upgraded, revised, downgraded and overhauled.
Phillip Coorey certainly knows the IMF's track record on economic forecasting — he reported it on 20 April. Except according to Coorey the IMF weren't wrong, they were just "revising" again.
In fact, Coorey has reported every revision since 20 October 2008 when the IMF predicted our economy would continue to grow through 2009, albeit at only 2 per cent. Those were good times. Since then they've revised the forecast three times. Now, the IMF is calling a 1.4 per cent contraction in the economy for 2009, a figure which indicates we'll have a very serious recession.
A depression, even? And yet Coorey has again handed us the latest round of projections as if they were facts.
Last month when Kevin Rudd was in Washington en route to the G20 in London, Coorey's economic reporting grabbed my attention. "Rudd Reveals Plan To Save World From New Depression", screamed the headline. Breaths had been bated the world over in anticipation of the long rumoured plan and finally, the Prime Minister had chosen to reveal it.
Back in Sydney, whoever thought that title was appropriate for the emptiness that followed should've been dismissed as a lunatic out of hand. Or was it one of the outsourced sub-editors in Brisbane who came up with it? At any rate, the SMH apparently believes that repetitive platitudes constitute not only a "plan" but one that is going to save the world economy. Kevin's first proposition: "No nation can deal with this crisis on its own." And the second? Nations must instead work together. Brilliant!
Coorey went on to relate that, "earlier this week Mr Rudd described protectionism as an insidious evil and he rallied against it in his speech", and that nations must work with the World Bank and IMF to solve their problems. Coorey himself loves to quote important sounding economic reports, so it was odd that he didn't pick Rudd up on the fact that the very same day, the WTO had named and shamed Australia as one of the countries which had turned to protectionism to rescue its economy.
Not only that, but didn't this whole anti-protectionism, pro-unremitting capitalism stance contradict the essay that Rudd's least imaginative advisors had written for The Monthly? It seemed like Rudd hadn't even read the piece, but rather was reciting lines from cue cards written in Washington: IMF funds should be tripled, and every other tired goal that the real leaders of the world had already decided on.
But according to the SMH, Rudd was not only the saviour of the world economy, he was important globally — a myth every Australian prime minister has attempted to perpetuate since Billy Hughes.
What's so bad about all that, you may ask?
Banks have been overrun with mortgage applications in the last couple of weeks, encouraged by falling interest rates and the rosy promises of a recovering economy that have been concocted out of thin air by incompetent hack economists. What happens if, as Access Economics predicts, more than one million Australians find themselves out of work next year?
House repossession rates are already rising steeply in NSW according to the NSW Attorney-General's Department. There are fathers and mothers who don't have enough money to feed their children anymore. We aren't yet in the maw of the recession: the real job losses will hit in the next three to nine months. People will lose their homes, their families, their possessions and their health because they thought this was all going to get better.
Sharp-eyed readers will note that I've just quoted two sets of financial statistics, sourced, no less, from the SMH. Having just lambasted Coorey for treating IMF predictions like gospel, isn't it a bit rich casually to drop in numbers from another "reputable source"? The thing is, financial journalists, like any other breed, must rely on expert opinion and information to put together their stories. Without as much, reporting becomes less a matter of investigation and more one of surmise. What's important is that this information is treated critically, scrutinised carefully and situated in its proper context.
Writers like Coorey who puff false economic optimism have their hands soaked in the red ink of bank statements arriving at more and more homes all over Australia. They continue to peddle total bollocks, creating a vision of prosperity over the hill which will not come — not in time, anyway.
Phil, every time you've told us all it's getting better, it's gotten worse. Every month the losses get bigger, the economy is going to keep contracting, and more of us are going to lose our jobs. Do the honourable thing and be the first of your kind to admit that you're wrong, that the lenses through which you view politics and the economy do not work anymore, that you're as helpless in this storm as the rest of us. At the very least tell us the experts and pollies you're quoting don't know what they're talking about, or, for Christ's sake, find someone else to ask. There are hundreds of economists who've actually been right when the government and IMF have been wrong that no one seems to be consulting.
I don't want to pick on Phillip Coorey, because there are many others doing the same thing. The overwhelmingly positive responses to Jon Stewart's roasting of Jim Cramer, stock market pundit and host of CNBC's Mad Money, in the last month suggests that there is more rage in store for these false prophets of optimism.
As Cramer is to CNBC, so too is Coorey a cog in the wheel of the Fairfax machine, a media organisation that now seems preoccupied with the creation of a fantasy world — one that must constantly be revised — which it thinks makes better product. Is Fairfax selling positivity over reality to chase its fleeing readership?
If they are, it isn't working.
Friday, May 01, 2009
AN HISTORIC DAY FOR IRAQ?
A historic day for Iraq – but not in the way the British want to believe
Robert Fisk, The Independent, 1.5.09
One hundred and seventy-nine dead soldiers. For what? 179,000 dead Iraqis? Or is the real figure closer to a million? We don't know. And we don't care. We never cared about the Iraqis. That's why we don't know the figure. That's why we left Basra yesterday.
I remember going to the famous Basra air base to ask how a poor Iraqi boy, a hotel receptionist called Bahr Moussa, had died. He was kicked to death in British military custody. His father was an Iraqi policeman. I talked to him in the company of a young Muslim woman. The British public relations man at the airport was laughing. "I don't believe this," my Muslim companion said. "He doesn't care." She did. So did I. I had reported from Northern Ireland. I had heard this laughter before. Which is why yesterday's departure should have been called the Day of Bahr Moussa.
Yesterday, his country was set free from his murderer. At last.History is a hard taskmaster. In my library, I have an original copy of General Angus Maude's statement to the people of Baghdad – $2,000, it cost me, at a telephone auction a few days before we invaded Iraq in 2003, but it is worth every cent. "Our military operations have as their object," Maude announced, "the defeat of the enemy... our armies do not come into your cities and lands as conquerors or enemies, but as liberators." And so it goes on. Maude, I should add, expired shortly afterwards because he declined to boil his milk in Baghdad and died of cholera.
Related articles * After six years, one month and 11 days, Britain ends its military mission in Iraq. There followed a familiar story.
The British occupation force was opposed by an Iraqi resistance – "terrorists", of course – and the British destroyed a town called Fallujah and demanded the surrender of a Shiite cleric and British intelligence in Baghdad claimed that "terrorists" were crossing the border from Syria, and Lloyd George – the Blair-Brown of his age – then stood up in the House of Commons and said that there would be "anarchy" in Iraq if British troops left. Oh dear.Even repeating these words is deeply embarrassing.
Here, for example, is a letter written by Nijris ibn Qu'ud to a British intelligence agent in 1920: "You cannot treat us like sheep... it is we Iraqi who are the brains of the Arab nation... You are given a short time to clear out of Mesopotamia. If you don't go you will be driven out."
So let us turn at last to T E Lawrence. Yes, Lawrence of Arabia. In The Sunday Times on 22 August 1920, he wrote of Iraq that the people of England "had been led in Mesopotamia into a trap from which it will be hard to escape with dignity and honour. They have been tricked into it by a steady withholding of information... Things have been far worse than we have been told, our administration more bloody and inefficient than the public knows." Even more presciently, Lawrence had written that the Iraqis had not risked their lives in battle to become British subjects. "Whether they are fit for independence or not remains to be tried. Merit is no justification for freedom."Alas not.
Iraq, begging around Europe now that its oil wealth has run out, is a pitiful figure. But it is a little bit freer than it was. We have destroyed its master and our friend (a certain Saddam) and now, with our own dead clanking around our heels, we are getting out yet again. Till next time...* *
Robert Fisk, The Independent, 1.5.09
One hundred and seventy-nine dead soldiers. For what? 179,000 dead Iraqis? Or is the real figure closer to a million? We don't know. And we don't care. We never cared about the Iraqis. That's why we don't know the figure. That's why we left Basra yesterday.
I remember going to the famous Basra air base to ask how a poor Iraqi boy, a hotel receptionist called Bahr Moussa, had died. He was kicked to death in British military custody. His father was an Iraqi policeman. I talked to him in the company of a young Muslim woman. The British public relations man at the airport was laughing. "I don't believe this," my Muslim companion said. "He doesn't care." She did. So did I. I had reported from Northern Ireland. I had heard this laughter before. Which is why yesterday's departure should have been called the Day of Bahr Moussa.
Yesterday, his country was set free from his murderer. At last.History is a hard taskmaster. In my library, I have an original copy of General Angus Maude's statement to the people of Baghdad – $2,000, it cost me, at a telephone auction a few days before we invaded Iraq in 2003, but it is worth every cent. "Our military operations have as their object," Maude announced, "the defeat of the enemy... our armies do not come into your cities and lands as conquerors or enemies, but as liberators." And so it goes on. Maude, I should add, expired shortly afterwards because he declined to boil his milk in Baghdad and died of cholera.
Related articles * After six years, one month and 11 days, Britain ends its military mission in Iraq. There followed a familiar story.
The British occupation force was opposed by an Iraqi resistance – "terrorists", of course – and the British destroyed a town called Fallujah and demanded the surrender of a Shiite cleric and British intelligence in Baghdad claimed that "terrorists" were crossing the border from Syria, and Lloyd George – the Blair-Brown of his age – then stood up in the House of Commons and said that there would be "anarchy" in Iraq if British troops left. Oh dear.Even repeating these words is deeply embarrassing.
Here, for example, is a letter written by Nijris ibn Qu'ud to a British intelligence agent in 1920: "You cannot treat us like sheep... it is we Iraqi who are the brains of the Arab nation... You are given a short time to clear out of Mesopotamia. If you don't go you will be driven out."
So let us turn at last to T E Lawrence. Yes, Lawrence of Arabia. In The Sunday Times on 22 August 1920, he wrote of Iraq that the people of England "had been led in Mesopotamia into a trap from which it will be hard to escape with dignity and honour. They have been tricked into it by a steady withholding of information... Things have been far worse than we have been told, our administration more bloody and inefficient than the public knows." Even more presciently, Lawrence had written that the Iraqis had not risked their lives in battle to become British subjects. "Whether they are fit for independence or not remains to be tried. Merit is no justification for freedom."Alas not.
Iraq, begging around Europe now that its oil wealth has run out, is a pitiful figure. But it is a little bit freer than it was. We have destroyed its master and our friend (a certain Saddam) and now, with our own dead clanking around our heels, we are getting out yet again. Till next time...* *
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