Queensland ambulance service still endangering patients

Despite greatly increased funding



A woman with a brain aneurism had to wait more than an hour for an ambulance after her plea for help was recorded as a headache complaint. The woman was working out at a suburban gym when she collapsed in agonising pain, holding her head and screaming "I'm going to die". Gym staff immediately dialled triple-0, but it was 80 minutes - with the woman lapsing in and out of consciousness - before paramedics arrived.

An ambulance spokeswoman last night confirmed the incident occurred last Thursday morning at the EnergyXpress gym in the Brisbane suburb of Bellbowrie. The spokeswoman said that, as the call had been recorded as being for a "50-year-old woman with a headache", it was treated as a low priority. "One hour later we got another call to say the lady was experiencing altered consciousness, so an ambulance was dispatched immediately," the spokeswoman said, adding that crews were attending other high-priority cases in the area at the time.

The woman underwent surgery in a Brisbane hospital on Friday night and was last night released from intensive care. But the woman's sister, who asked that family members not be identified, said her sister faced a long road to recovery. "I'm very upset that it happened and that she was waiting such a long time," she said. "It's still very raw for us and very upsetting."

Jessica Williams said she was working out with her mother when she heard a terrible scream. "At first we thought it was a personal trainer pushing someone a bit too hard, then we realised it was a lot worse than that," she said. "She was holding her head and she was screaming: 'My head's going to explode. I'm going to die. There's something wrong'."

Queensland Liberal leader Bruce Flegg, whose electorate takes in Bellbowrie, called for the service to release the full transcript of the initial call. "Clearly it is unacceptable to wait an hour and a half for an ambulance," Dr Flegg said. "Staff are under severe stress (but) there should be adequate resources because of the ambulance levy, but it is not flowing into improved services."

A spokesman for Ambulance Employees Queensland said communications officers were being forced to work up to eight 10-hour shifts in a row causing stress and fatigue that could lead to mistakes.

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Bans on useful shopping bags are wasteful and pointless



In the hairshirt fashion houses of modern environment policy there are many labels but few emblems. In the 1980s it was nuclear disarmament. In the '90s it was recycling. But for true retail environmentalism, these days it's hard to go past the plastic bag. If black is the new black, plastic bags are the new cause celebre. In seemingly Orwellian fashion they are now no longer just a couple of grams of super-convenient plastic, but stand accused of killing marine wildlife in their hundreds of thousands, wreaking havoc across the oceans and choking our rivers, zoos and possibly even troubling our livestock. Apparently they are everywhere in their ubiquitous billions. Plastic bags have become an emergency that must be stopped.

In July the Victorian Government announced just that. Describing them as "a symbol of our inefficient use of resources", the Government banned free plastic bags from 2009, a headline act in its 90-page sustainability action statement. The statement claimed about 10 million of these shopping bags "become litter that endanger the health of marine wildlife, damage property through clogged drains and machinery and detract from the beauty of our environment". "Giving consumers incentives and stronger choices to 'say no to plastic bags' is a way we can all contribute to environmental sustainability - in itself a small action but important in developing a more sustainable culture in Victoria."

The action may indeed be small but the impact of such a ban certainly has not been. What the Victorian statement conveniently excluded was the evidence before the Government before its announcement that such a ban would be every bit as wasteful as the bags themselves. In May, the Productivity Commission released its much anticipated draft report on waste generation and resource efficiency in Australia. In this report it warned that enforcing bans on plastic bags must be based on rigorous cost-benefit analysis. In plainer words, the commission said if a government imposed the largely hidden costs of this kind of blunt regulation, then it needed to demonstrate that such costs were worth it, and that the action taken was the most effective and efficient way of achieving the stated objective.

A year earlier, all environment ministers in Australia - the Environment Protection and Heritage Council - had commissioned just such analysis. Respected economists Allen Consulting reported back to them in June, and the numbers on a ban didn't look good. The report found that even with generous definitions of environmental hazard for plastic bags, the cost of imposing various types of bans and other similar mechanisms was still about four times greater than the environmental benefit. They estimated the cost of a national ban would be as high as $1.4 billion over 10 years through a range of retail costs including slower checkouts and other indirect costs borne by retailers. These are effectively the same as a tax on consumers as retailers pass the costs on in higher prices.

The key point made in the report was not that nothing should be done to address the environmental impacts that plastic bag litter might cause, but that banning all or most bags to target the estimated 0.8 per cent of bags causing the problem was a pretty brutal and indirect way of going about it, like banning all cars to cut air pollution. It is hardly surprising, then, that a number of state governments reportedly fought to block the release of the Allen report, which was finally released to the public in September.

Under increasing pressure from government, retailers eventually introduced a voluntary program to reduce plastic bag use and began selling the lurid green polypropylene reusable bags with considerable success, cutting bag use by 46 per cent in three years. This was only just shy of the agreed 50 per cent target by 2005, but clearly not good enough for the Victorian Government. Victorian Opposition spokesman David Davis estimates the Victorian ban will cost $106 million a year. "Instead of advancing the co-operative approach the state Government has chosen to use a powerful stick that will add costs for consumers," he says. Despite his concerns, the political cachet of being tough on plastic bags was undeniable: "We didn't oppose the bill but we did express great doubt about this aspect."

The Victorian ban had no regulatory impact statement, no supporting evidence that the move was based on anything more than green political opportunism. The scientific evidence of the environmental impact of plastic bags is mostly anecdotal and flagrantly thin. The seminal report in Australia was completed in 2002 and is, by its own admission, based in many parts on nothing more than educated guesses simply because of the vacuum of credible, documented science.

Plastic bags have two environmental impacts: the resources used to make them; and their impact in the litter stream. Each bag weights about 2g, but like an ant can carry more than a thousand times its weight. Because they are so light they make a relatively tiny dent on landfill and resource use: only about 0.2 per cent of solid waste in Australia. A typical car return trip to a supermarket consumes about the same energy as nearly 100 bags.

On the litter side the claims are more outrageous. Environmental branding and marketing company Planet Ark has been one of the primary megaphones of the "plastic bags are evil" message, claiming they kill at least 100,000 birds, whales, seals and turtles every year. This claim, which has been proudly recycled by politicians and activists across Australia, is based on a single study - from Canada, more than 20 years ago. Planet Ark director Jon Dee claims to have countless anecdotes of landfills hiring people to pick up plastic bags, farmers complaining about their livestock dying from plastic bags and negative reports from zoos, wildlife rescuers and litter groups. He has even seen the footage of a Bryde's whale that died on the beach near Cairns in 2000 after reportedly ingesting 6cum of plastic.

"It's nearly impossible to measure how big the problem is," he says. He's right, but without the exclamation mark. The more sober independent study from 2002 had this to say about such reports: "Actual numbers of animals injured or killed annually by plastic bag litter is obviously nearly impossible to determine. Despite this lack of reliable data, the potential for plastic shopping bags to injure marine wildlife is real and of a high concern to Australians. Measures to reduce the littering of bags, other plastic film and other packaging should be a high priority."

Reducing the risk of such a hazard to ocean wildlife and other animals is an agreed and noble idea. That's not the problem. The vacuum of credible data allows a near hysterical debate to rage, which risks distorting policy from problem. There is no reliable data on the total size of the litter stream in Australia. For the purpose of the exercise, the consultants made an educated guess that between 50 and 80million plastic bags end up as litter annually. Truth is they have no idea. The bags come from a variety of sources including bags blown from landfills, bags re-used in public places and then left behind, and bags inadvertently littered from places such as street bins. This is curious because the proposed Victorian ban from 2009 targets bags from supermarkets but proposes exemptions for small retailers. The places where most of the at-litter-risk bags are likely to be coming from will be exempted from the ban, while those at low risk will be targeted.

What this research actually flags is that the trouble with plastic bags is they are a victim of their own success. They are light, strong, versatile be it as a bin liner, temporary storage device or dog's poop scooper. Because the bags are so versatile, households continue to store them rather than discard them. About 60 per cent of bags are estimated to be re-used before disposal. Most councils will not accept them in kerbside recycling systems because they can only be recycled if packed in tight with 100 other plastic bags and not wrapped conveniently around wine bottles and milk cartons. And so they continue to breed in kitchen-sink cupboards across the country. Tim Grant from the Centre for Design at RMIT University thinks most households respond more to the immediate sense of waste in their homes than have some greater awareness of potential risk to marine wildlife. "People are coming from that resource aspect rather than being overly concerned about litter," he says.

Federal Environment Minister Ian Campbell thinks the voluntary approach has been working and believes Australians and their state governments should persist with it. He would also like to see the development of degradable bags to further reduce the littering of plastic bags rather than a mix of populist state taxes, bans and levies. "We should be very proud of what we have achieved with a voluntary approach and just keep the momentum going. The practical way to get plastic bags out of the litter stream is to replace them with a degradable alternative," Campbell says. "If I had a billion dollars to spend over the next 10 years I'd rather spend it on climate change than on a more marginal environmental issue like plastic bags. We have limited resources in this country and we need a rational debate on this sort of issue that considers all the costs and benefits."

Degradable bags sound a great solution, but there are complications. First, the bags are still resource-intense. Second, there are discrete types of degradation - in water, in the earth and in sunlight. If marine wildlife is the primary concern then water-degrading bags may be best suited, while reducing land-born litter would favour light-degrading bags. One size does not fit all.

Clean Up Australia chairman Ian Kiernan also supports a continuation of the existing voluntary approach, which has delivered a significant reduction in plastic bag use through effective community engagement. "To then go and whack a 10c levy on them and punish them is not equitable," he says.

Other state governments, including NSW and South Australia, are looking at similar measures to Victoria's, with the issue to be revisited at the next EPHC meeting in November. A spokesman for NSW Environment Minister Bob Debus says considering the different cost options to reduce plastic bags is "part of the debate we have to have" about plastic bag management. "We know that there is strong feeling in the community for a reduction in plastic bag use," the spokesman says. The Victorian bans are big on political symbolism but dangerously thin on actually addressing the problems at hand. A more considered approach might have looked at more direct strategies that specifically addressed the main environmental threats of plastic bags for a much lower cost. After all, that's what cost-benefit means.

Australia faces a wide range of serious environmental challenges. Climate change, water management and the continued protection of biodiversity are chief among them. The plastic bag problem sits in the shallow end. It remains an issue anchored in symbolism and amplified by its physical tangibility to the public rather than the scale of its environmental impact.

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Priest shortage hits RC church

Given the extraordinary high crime rate among Africans and given the sexual frustrations of the Roman priesthood, what outcome can one expect from a "blacker" priesthood? Vigilant parents, one hopes

The Catholic priest shortage in southeast Queensland has become so acute the Brisbane archdiocese is recruiting in Nigeria. The archdiocese has one parish priest for every 6000 Catholics, double the number to which they were ministering 15 years ago, church figures show. Despite the southeast Queensland population explosion, parish priest numbers in the region have plummeted by about a third from 150 to 103 in a decade. However, the number of parishes has remained the same at 110.

Brisbane archdiocesan moderator Father Peter Meneely said an ageing population of priests and an inability to recruit as many young men to the cloth as had happened in the past had resulted in the shortage. Only seven men are attending the Holy Spirit Seminary at Wavell Heights, in Brisbane's north, in various stages of becoming a priest, which usually takes seven or eight years. By comparison, when Father Meneely was a young seminarian in the 1980s, about 60 men were studying for the priesthood in Brisbane. The seminary serves parishes throughout Queensland - not just the Brisbane archdiocese, which takes in the Gold and Sunshine coasts - and extends west to Gatton and north to Hervey Bay.

To cope with the increasingly acute shortage, Archbishop of Brisbane John Bathersby recently signed an agreement with the Umuahia diocese in Nigeria to receive two priests and four student priests a year for three years from 2007. The English-speaking priests will work in southeast Queensland parishes for six years before returning to Nigeria. "It won't solve our shortage but it'll certainly give us some relief and they've got more priests than they need," said Father Meneely. Without the Nigerian input, church projections showed parish priest numbers could dwindle to as low as 87 by 2011.

Archdiocesan Ministry Development Officer Chris Ehler likened the shortage of priests to the skills crisis in other professions. "It's a little bit similar to our health system in terms of attracting people to take on these quite significant responsibilities in terms of vocation to priesthood," Mr Ehler said

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More on the geography wars

As a former High School geography teacher who was employed to teach geography despite having NO tertiary qualifications in the subject, I can attest to the reality of the "de-skilling" of geograpphy teaching described below

As part of a geography assignment studying the effects of pollution on the environment, a group of primary schoolchildren from Brisbane headed off to photograph the damage to Moreton Bay. But when they arrived, the waters of the bay were relatively pristine and there was no pollution to be seen. Undeterred, the children carefully set about creating their own polluted part of Moreton Bay, photographed it and just as carefully cleaned up the mess they had made. "Those kids knew what answer they were supposed to come up with," says geographer John Lidstone, associate professor at Queensland University of Technology in Brisbane. "And when kids know what answers they're supposed to reach, they stop thinking."

Students in geography classrooms across the nation are being asked to devise strategies to manage scarce water resources, for sustainable use of resources, to minimise the degradation of our coastline or environment from farming, mining or other human activities. Often, the answer is in the politicisation of the topic or with the data they are provided, and time pressure precludes them making their own investigations.

Geographers are concerned that missing in the examination of some of society's most intractable issues is fundamental teaching of the basic processes behind these problems: the rainfall cycle, the theory of longshore drift of sand along the coastline, the formation of physical landforms and resources. Also missing is the breadth of the discipline, the wider look at human society, its relationship with the Earth it inhabits and interaction within itself. "If you look at issues like environmental sustainability, it's essentially about how societies come to terms with managing and living in their environment," says Clive Forster, associate professor at Flinders University school of geography, population and environmental management in Adelaide.

"If you want to understand what we may need to do to live more sustainably in the future, you don't need to know solely about environmental issues. You also need to have an understanding of how societies operate and to be able to put together the economic, social and environmental perspectives. Traditionally, that was the strength of geography; it produced people who had an appreciation of the three perspectives and how they needed to be seen in relation to one."

Geography teacher Sue van Zuylen, from Tara Anglican School for Girls in northwest Sydney, agrees the lack of specialist geography teachers is critical. "The biggest impact in the classroom is the way the curriculum is delivered by the teacher and it's going to be delivered with greater passion and interest and enthusiasm by somebody expert in the subject than someone (for whom) it isn't their first love," she says.

In the first half of the 20th century, school students were taught "capes and bays" geography, with its emphasis on naming the world; being able to draw maps of countries, knowing the names of capital cities, river systems, the highest mountains. During the 1960s came a rise in regional geography, with students writing profiles of countries based on subheadings such as population, climate, land use and vegetation, or writing about the industrialisation of particular countries.

Geography teachers critical of merging the subject into the new-vogue "studies of society and environment" argue that it undermines the integrity of geography and does not serve the interests of social studies, either. SOSE becomes a mish-mash and makes it harder for syllabus consistency between states. The SOSE syllabus encourages state parochialism instead of encouraging understanding of global trends. Underplaying physical geography robs children of interesting inquiry into how volcanoes, mountains, rivers and glaciers are formed.

Teachers lose confidence when teaching SOSE because they studied to specialise. The mish-mash of SOSE is less likely to inspire enthusiasm in teachers, a key to passing on passion to students.

The argument is whether the focus should be on developing a disciplinary understanding or whether it should be an integrated studies approach based on contemporary issues. Eventually, the rise of SOSE in schools will remove teaching expertise in geography. Geography is fundamental to understanding the society in which we live and issues from water usage and environmental sustainability to population trends, migration and Australia's links with the world.

Since the late '80s, geography has been dominated by environmental studies, a trend sparked by the rise in the green movement and entrenched with the move in the '90s to teach geography as part of an integrated social studies course. The model originated in the US and was adopted in school systems across the world, including Australia, predicated on the idea that as no single discipline had all the answers, it was better to teach children skills and knowledge in the integrated way they would need to apply them in the real world.

In Australia, the integrated social studies movement occurred at the beginning of the push for a national curriculum, which created a key learning area called studies of society and environment. Adding to the pressure to integrate geography into one colossal course with history, economics, civics and citizenship and legal studies were timetabling pressures. School curriculums are overcrowded, forced to include an ever-expanding list of topics from sex education to vocational subjects. So teaching a little bit of geography, with a little bit of this and that, seemed a good compromise, as well as providing a way of trying to make the curriculum more relevant to students.

And so the phenomenon of what high school geography teacher Steve Cranby, a member of the Australian Academy of Science's national committee on geography, calls SOSE-ification of geography. Only NSW stood alone, continuing to teach geography and history as separate, compulsory subjects in years 7 to 10. Victoria in recent years reintroduced an identifiable geography course, with a new one taught this year under its humanities umbrella.

Lidstone, who was secretary for 10 years of the International Geographical Union's education commission, points out that while the US started the trend of integrated social studies, it has recently undergone a resurgence in geography with a bill before Congress to make it compulsory in schools. "An American once said that God invented war to teach Americans geography," he says. But Lidstone prefers the vision outlined by the first man to hold the title professor of geography, James Fairgrieve of the University of London, who said in 1926: "The function of geography in schools is to train future citizens to imagine accurately the condition of the great world stage and so to help them to think sanely about political and social problems of the world around."

Says Lidstone: "The two phrases, 'to imagine accurately' and 'to think sanely' still represent for me the essence of the enterprise." But much of what passes for geography in schools today is what Lidstone describes as "naive environmentalism". Phenomena such as global warming are presented as unquestioned facts, with no real examination of the debate. In part, that's a result of not having geography teachers in charge of teaching geography.

The main consequence of the SOSE-ification of geography was a de-skilling of geography teachers. It's pot luck whether the teacher in a SOSE classroom is trained as a history teacher, economics teacher or geography teacher. Obviously, teachers are most comfortable with their own discipline. A history teacher forced to teach geography is going to struggle with the often complex science behind some geographical ideas, such as climatic cycles.

Before Cranby starts a topic with his students, he spends a couple of weeks teaching the theory underpinning the theme. One of the core topics for his Year 12 class is the Murray-Darling basin and the issues surrounding its use and management. Cranby spends four weeks teaching his students about rivers, their formation and processes, how they work and operate, the definition of a sustainable resource and the theory behind it before embarking on the specific issues of the Murray-Darling.

The problem is that not enough new geographers are being trained. SOSE students don't study anything called geography and the minority who do take on geography into their final years of school, or even university, come out with generalist training or specialising in an environmental study rather than disciplinary skills in geography. "We are not producing our kind," Forster says. "There's not that degree of breadth that people had 25 years ago. They'll go on to become the new generation of academics but they won't be teaching as geographers, they'll be teaching as someone who has done an environmental management degree."

Alaric Maude, secretary of the Institute of Australian Geographers, who was involved in writing the South Australian school syllabus 20 years ago, says the environmental thrust of geography has also splintered the subject. Not only is geography forced to compete with the plethora of subjects offered in schools today, it also has to compete against specialisations of itself: environmental studies, natural resource management, sustainable futures. "Geography seems to have become narrowed down," he says. "It's become very heavily environmental geography with not much emphasis on the core topics of human geography, such as people and cultures, regional development, divisions between regions such as who's wealthy and who's poor or why Western Australia is growing. Somehow the environment has become a major part of what teachers seem to see geography as, but it's only part of our inheritance."

Maude imagines a geography curriculum that sets out questions students can investigate, including indigenous knowledge and use of the environment; land clearing and its consequences; water sources and their management; the coast and its place in Australian life; Australia as a highly urbanised country; and migration, settlement and identity.

Lidstone would like to see students acquainted with some of the "awe and wonder" of the natural environment, how mountains are formed, the population and settlement patterns of communities who live on mountains. "Geography is the study of patterns," he says. "You can have patterns of homosexuality, there's a cultural geography of things like food and wine or the geography of bird flu. "There's a geography of the internet. It's fascinating when you sit on the internet and suddenly notice different countries coming on line. It's connected to the Earth's rotation and as people come to work or go home, the people on chat sites change. "At 8pm in Australia you get a whole different group of people than early in the morning in the US. Internet providers employ geographers to work these things out on the time zones because they target advertising according to who's going to be online at any particular time. "Yet I don't know that many schools teach time zones, despite more of us travelling than ever before. I learned about time zones when I was at school and I didn't expect I would ever be able to go on an aeroplane. Everyone can fly around the world today and we don't teach time zones."

Lidstone says the focus of geography curriculum on issues, to make it relevant and more exciting, is counterproductive. Students can find it depressing to focus on problems so big that adults and governments cannot fix them, and instead of appreciating the wonder of the world are taught only about the Earth's problems. "There's not much room for the geography of laughter, the geography of fun," he says. "Where are people happiest on the Earth? What does it look like? Is it to do with a pristine environment, workloads? "If you want to live a happy life, where would you go to live? These are very nice geography questions."

Taught a discipline and the skills of geographical thinking, Lidstone believes students will find the relevance for themselves. He tells the story of students at a girls school where the "very feminist geography teacher" was appalled to find her students were using computers to identify where in Australia was the greatest concentration of young professional men with high incomes who owned their own home. "That's where they wanted to go to university, so they could find wealthy husbands. The teacher was so appalled that she banned them from the computer room. We might not agree with the topic but these girls were using geography and geographical skills to find the answer to a question that was important to them."

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