More stupid medical bureaucracy

If you are a Pakistani doctor killing people regularly that is fine but if you just take a break for once you are negligent! And a bureaucracy that fails to consider the impact of its decisions is CLEARLY negligent. These dummies wouldn't know malpractice if they fell over it

Eight Kingaroy doctors have labelled the Medical Board of Queensland's suspension of a colleague as "absolutely disgusting". Patrick Lip, who has practised in the nearby South Burnett town of Wondai for 36 years, was suspended last month after allegations that his response to an emergency had contributed to a patient's death from a drug overdose.

A letter to Dr Lip, signed by the eight general practitioners and faxed to Health Minister Stephen Robertson, said other doctors in the region were finding it hard to cope with the extra workload resulting from his suspension. "For this to happen three days before Christmas was badly timed and is absolutely disgusting," the letter said. "There must be thousands of patients dependent on the very devoted medical services you have offered over the past 30-odd years. "Our real concern is for these patients now having to find another GP in an area that is totally short of doctors in any case."

The doctors said their Kingaroy surgeries had been swamped by requests from Dr Lip's patients to join their practices. "Unfortunately, most are already very busy working 12 hours on a daily basis, and many of your patients are turned away," they wrote. "The situation is intolerable and the future looks dismal."

Wondai Mayor David Carter said he knew of at least one patient who had travelled 90 minutes to Gympie to see a GP since Dr Lip's suspension. He said the suspension had created great angst in the town. Cr Carter said Dr Lip was the type of doctor who still made house calls. "I've been that ill myself, my wife has called and he came straight round," Cr Carter said.

Dr Lip, who has appealed his suspension, has declined to comment on legal advice. A Queensland Health spokeswoman said the department was very committed to maintaining GP services in rural and remote areas. But she said it also had a duty of care to ensure patient safety. The Medical Board of Queensland said it was working hard to resolve the matter as quickly as possible.

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False economy in governmental failure to plan ahead -- but the Greenies love it

The article below notes that it is a delusionary saving when spending on development needed for future growth is cut but does not mention that water-supply planning and provision was routinely effective while it was left in the hands of the engineers. Once Greenies started their hysteria about dams, however, the engineers found themselves talking to the air

Keeping the water running and the lights on are such basic requirements of modern society that people are entitled to take them for granted. But the mismanagement of these core responsibilities by state governments over the past 20 years is letting the public down.

True, governments could not predict the drought, at least not its severity, and it was not so many years ago that concern about climate change seemed to be confined to Al Gore and fellow zealots. We could even be generous and say that few predicted that air-conditioning would spread so rapidly that the peaks in electricity demand suddenly became much steeper, requiring larger overall capacity and putting strains on existing systems.

But prudent planning suggests that developing just one new water source in the past 20 years for Australia's major cities the desalination plant in Perth is inadequate. During that time, Australia's population has increased by four million or 25 per cent. Moreover, the assumptions about how much can be drawn from existing capacity have changed. A further 25 per cent increase in population by 2032 could be accompanied by a 15 per cent reduction in available water in the eastern states and South Australia, according to the CSIRO.

Squeezing more out of existing resources has been public policy not only in water and power generation but on other infrastructure such as public transport. Capital spending in these areas has been running down for most of the past two decades, with only recent years seeing some increases. The states have had other priorities: putting money into the running of high-profile public services such as health services, education and police and giving pay rises to public-sector employees.

Nor were they reluctant to use their utilities as cash cows. In the private sector, dividend payments of 60-70per cent of after-tax income are normal. But during the latter stages of the Carr government in NSW, the Hunter Water Corporation was routinely paying dividends and taxes to the government of more than 100per cent of its operating profit and as high as 184per cent. The Beattie Government in Queensland demanded special dividends of $150 million in 2001-02 and $30million in each of the next three years from its electricity company Energex, money it had to obtain from borrowings.

As well, the states reacted to the economic mismanagement of Labor governments in Victoria, South Australia and Western Australia during the 1980s by adopting conservative economic benchmarks, such as completely eliminating debt. This made about as much sense as a family living in a tent until they saved enough money to buy a house. The first target for savings to support this policy was capital spending.

Only in recent years have the states moved back to the practice of borrowing to develop long-lived assets, spreading some of the costs to future generations who will benefit from the facilities. The irony is that, by opting for what they thought was sound economic management, governments have been caught mismanaging the nation's assets.

A breakdown of figures supplied to The Australian by the Australian Bureau of Statistics show that in the '60s state and local governments regularly allocated 2per cent or more of gross domestic product to capital spending for electricity, gas and water supply. Twenty years ago, the figure was down to 1.4 per cent but it was after that the fall became precipitous. By 1994, capital spending in this area had halved to 0.7per cent, including 0.2per cent from the private sector. The '90s were the decade that private investment started contributing to the development of these sectors on a significant scale. But it did little more than replace falling government spending, keeping the overall ratio at the same low level. Only in recent years, as the consequences of 20 years of neglect have stared governments in the face, has the figure started rising, running at 1.1per cent during the past three years. But this is still barely half the proportions of 40 years ago.

There is no hard and fast rule saying that spending on the nation's infrastructure should be maintained at a particular level. The years following World War II was an era of nation-building projects, including the Snowy Mountains Scheme and large dams. Dams started falling out of fashion a few decades ago. The Goss government in Queensland (which included a senior adviser named Kevin Rudd) decided shortly after its election in 1989 not to proceed with a new dam at Wolffdene. The Carr government cancelled plans drawn up decades earlier for a new dam on the Shoalhaven River and decided against raising the height of Warragamba Dam. But whether or not dams were the answer, letting capital spending in these areas halve or more suggests neglect.

"The criticism is not so much that they should have built a dam but that they did nothing else," says federal Parliamentary Secretary for Water Malcolm Turnbull. "The critical thing is to make a decision. The problem now is that you have a lot of infrastructure being built in a great panic and when you do that you end up paying a lot more than you otherwise would." The honourable exception is Western Australia, which reached the conclusion earlier that it was not good enough to rely on historical rainfall averages to plan for the future and which, in the five years to 2005, spent two to three times as much per capita on water infrastructure in Perth as the levels in Sydney, Melbourne, Brisbane and Adelaide.

Contrary to the impression created by the states, water is not scarce. In a study last September, the Business Council called this "one of Australia's greatest myths". It explains: "The perceived shortages are due to artificial limits on supply to our cities and an inability to allocate water to its highest value use in rural areas. If we allocated water for environmental purposes for example, to restore river health and allowed market pricing and the laws of demand and supply to operate as they do in every other market, there would be no talk of shortages or the need to curb economic growth."

Nor should a shortage of money be a factor, according to a recent report to the Howard Government by Marsden Jacob Associates. "Virtually all water businesses supplying the capital cities have significant financial capacity to fund both increased levels of capital expenditure and the dividends to state governments," it says. "The strong balance sheets and ability to raise additional revenue demonstrate that none of the major water businesses is under any immediate cash constraint."

The political hurdle is higher prices. Despite being the driest inhabited continent in the world, Australia has some of the lowest prices for urban water: below $1 per kilolitre (1000 litres), compared with $2 in Britain and approaching $3 in Germany and Denmark. The Australian price works out at 1c for every 10 litres of water of drinking quality. The BCA study points out that the average Australian's electricity bill is four times that for water. Marsden Jacob says if the same approach to cost recovery was adopted for water as for other services such as electricity, gas and telecommunications, revenue levels for the capital city water authorities could rise by 33 per cent or up to $600million a year.

Former Kennett government minister Mark Birrell, who chairs Infrastructure Partnerships Australia, the peak industry organisation, is an optimist. He believes water restrictions in capital cities can be removed within five years. "Policy makers know the changes that are necessary," he says. "Rural areas need a private market for water and in metropolitan areas we need to look at the trifecta of recycling, desalination and new catchments. But you have to bring communities with you that have often been fed a diet of parochial geographic arguments along the lines that 'this is our water and you can't use it over there'."

As to the best way to supply water in future, there is no shortage of options. "I am neither ideologically nor hydrologically opposed to dams," Turnbull says. "I am agnostic, it depends on the circumstances. The only thing I would say - and this is speaking with a high level of generality - if you are talking about the big Australian cities, you should be giving a higher priority to expanding your non-climate-dependent water sources, which means things like desalination and recycling."

The economics suggests the same. The Marsden Jacob study calculated that for Sydney, Adelaide, Perth and Newcastle sourcing new water supplies from dams would cost up to $3 a kilolitre - the same maximum price as desalination - although the cost for both can be lower depending on location and other circumstances. Recycling water to drinking standard and putting it back into the water supply would cost up to $2.61 per kilolitre, accessing groundwater up to $1.58 and re-using stormwater up to $1.50. There also are more expensive ways of obtaining water, such as rainwater tanks, calculated to cost up to $5.60 per kilolitre, and long distance pipelines, at up to $9.30. The report argues that for most big cities the best sites for dams already have been taken and environmental considerations could stretch the planning and approval processes out to 10 years.

Governments are running the risk of being caught short on electricity supply in the same way as they have on water. Sudden spikes in demand, such as during a heatwave, mean that in most states the top 10 per cent of generating capacity is needed for 1 per cent or less of the time. The spread of air-conditioning means that these fluctuations are getting bigger, with each rise in temperature requiring increasing amounts of capacity. The blackouts in Melbourne this week were caused by transmission rather than generation failures but maintenance and other problems meant alternative supplies were not readily available.

Some forecasts of demand show potential shortages in Victoria, South Australia and NSW over coming years. While peaking plants are being installed, there are few plans to expand baseload capacity. The Carr government, which failed to win party and trade union support to privatise the electricity industry, ruled out further substantial government investment in electricity generation in 2004. Nine years since the much heralded announcement of a national electricity market, the ability for states to buy power from each other remains limited.

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Hate beyond reason

Another day, another outrageous series of comments by an Australian sheik. Sydney-born Sheik Feiz Mohamed calls Jews pigs and urges Muslim children to find fulfillment as jihad martyrs. Though the group with which he is associated commands the patronage of hundreds of young people, we are assured that his extremist views appeal only to a tiny minority.

Let's be quite clear. The overwhelming majority of Australian Muslims clearly do not support this kind of extremism. They should not have to bear the burden of the bad name that such comments create. However, it is entirely reasonable to ask just what proportion of Muslims do hold views similar to the sheik's, or which might otherwise be seen as genuinely extremist. The US Middle East scholar, Daniel Pipes, argued in a book a few years ago that about 10 per cent to 15 per cent of the world's Muslim population held radically extreme views, including support for jihad.

In a fascinating piece in this week's Financial Times, Turkey's foreign minister, Abdullah Gul, often seen as one of the most Islamist-inclined foreign ministers Turkey has had, called on the peoples of his region to recognise that their most serious problems were home grown. He wanted them to stop blaming outsiders and get on with the business of reforming their own societies. He said it had been impossible for a mainstream to develop and wrote: "We now find that only extreme voices from the region are being heard, misrepresenting their cultures and societies ..."

Turkey is a successful society and a functioning democracy. Gul's contribution is forthright, brave and praiseworthy. And yet here is a question. Do the extremists really represent a tiny fringe or is there some much bigger mainstream part of Middle East society that supports extremism? More particularly, is there an element inherent to Islam itself that lends support to extremism?

It is right to treat religion with respect. Islam has produced magnificent cultural artifacts, much profound human culture and a generally good moral code. It contains great spiritual depth and associated intellectual discipline. But given how much violence and extremism are generated in the name of Islam it is now just not satisfactory to dismiss all this as merely a perversion of Islam.

Perhaps two elements make it more liable to extremist misappropriation than other religions. First is its high militant content. Second is the failure to distinguish between the political and the religious order. Most religions contain an injunction to improve the world, but Islam, in the view of many of its followers, requires a strictly and directly Islamic world, in which civil matters are ruled by explicitly Islamic precepts and institutions.

It is difficult to get a guide to Islamic public opinion anywhere. One of the best is a joint Asia-Europe Institute and University of Malaya survey of Malay Muslim opinion in Malaysia. I have referred to this survey before, but not previously given its results in any detail. It was exhaustive in its methodology. About 65 per cent of Malaysia's population is Muslim, and only Malay Muslims were surveyed. Malaysia is a moderate and generally tolerant country. It does not persecute its religious minorities, and it has developed successfully economically so that it can just about be considered a middle-class society. Certainly it is vastly more successful and wealthy than it was 20 years ago. If there's a Muslim population anywhere that should feel happy and content it is in Malaysia. Successful, increasingly rich, Islam afforded a special status in the constitution, Malays given substantial financial, educational, housing and other preferences, persecuted by no one, they should be among the least paranoid people in the Muslim world. If they are, then that is disturbing, for the results of the poll are unsettling to say the least. Here are highlights:

* 73 per cent of Malays, if they could choose only one identity, would choose Muslim first, only 14 per cent would choose Malaysian while 13 per cent would choose Malay. So Islam trumps citizenship, which only just edges out ethnicity.

* 77 per cent believe Malaysians should be allowed to choose their own religion but this is contradicted by a massive 98 per cent believing that Malaysian Muslims should not be allowed to change their religion. Freedom of religion means you don't have to convert to Islam, but if you are a Muslim you should have no right under the law to change your religion under any circumstances. This belief is very widespread throughout the Muslim world.

* 73 per cent said their parents had had the greatest influence on their development as Muslims, an encouraging sign of the strength of indigenous Malay traditions as opposed to contemporary Middle East influences.

* 49 per cent thought the Malaysian Government sufficiently Islamic, but almost as many, 47 per cent, thought it was not sufficiently Islamic.

* 77 per cent do not want Malaysia to become an Islamic state like Iran, but 18 per cent do want Malaysia to become an Islamic state like Iran.

* 57 per cent say Islam and politics should be separate but a substantial 40 per cent say they should be mixed.

* 57 per cent do not want strict hudud laws (stoning for adultery, and so on) implemented in Malaysia but 32 per cent do want hudud laws.

* 60 per cent say non-Muslims should not be subject to hudud laws but nearly a third, 28 per cent, actually want hudud laws to apply to non-Muslims. Similarly, some 31 per cent want sharia (Islamic law) to replace the Malaysian constitution.

* 77 per cent, a staggering figure, believe that Malaysia's existing sharia laws (which govern family matters for Muslims) are not strict enough.

* 76 per cent believe men and women in Islam have equal rights.

* 57 per cent believe wives could disobey husbands to work, but 47 per cent say if the husband forbids work, the wife should obey.

* 97 per cent, encouragingly, believe it is acceptable to live alongside non-Muslims and 79 per cent believe Malays should learn about other religions.

* 62 per cent believe suicide bombings are wrong but a disturbing 12 per cent (the exact mid-point of Pipes's estimated range) support it.

* 1 per cent like the US, 45 per cent dislike it and 39 per cent hate the US.

* 3 per cent like Europe, 38 per cent dislike it and 19 per cent hate Europe.

* 4 per cent like Australia, 37 per cent dislike it and 18 per cent hate Australia.

Overall, these results are staggering. They show a substantial residual moderation, but a degree of genuine intolerance among even the majority and authentic extremism among a substantial minority. It's hard to believe Islamic opinion is not substantially more extreme in the Middle East. The task of reforming the extremism in Islamic cultures remains vast.

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Australian advertisement too sexy for prudish New Zealand



New Zealand airport officials deny they lack a sense of humour, despite banning a billboard with a lacy bra-clad Jennifer Hawkins clutching a stuffed rhino with the caption: "Feeling horny?" The lingerie ad featuring Australia's former Miss Universe was declined by Auckland International Airport, which felt it was a "step too far".

"The bottom line is the airport has a vast array of people of different nationalities, different ages, and our view was that it was just not in keeping with general airport image and brand," the airport's general manager retail Nick Forbes told NZPA.

But Forbes, an Australian, felt it was unfair to say airport management lacked a sense of humour. "If you straw-polled most of the people around our office they just had a good laugh and think it's great," he said. "On a personal level I don't really have an issue and not many people probably do but we've got to try and be sensitive." Forbes said the airport had had billboards in the past that some found inappropriate and wanted to tread carefully. The airport had declined "very little" advertising. "That one was maybe just one step too far."

The lingerie billboard is not the first airport billboard in New Zealand to raise eyebrows. In December, the Advertising Standards Complaints Board upheld a complaint about a Christchurch billboard for cars which showed a late-model car beside a partial image of a "long legged woman in a brief pair of shorts" who appeared to be hitching a ride. The heading of the billboard read, "Drive Bling Bling, Get Bang Bang!"

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