Tuesday, July 03, 2007

A big wait in the public hospital system of Victoria

Crippled woman faces 3-year surgery wait

A PENSIONER who cares for her invalid husband while hobbling around on crutches faces a three-year wait for ankle surgery. Jennifer Haffenden, 65, says she is barely able to care for herself because of an excruciating arthritic ankle. She thought help was in sight, until she looked more closely at her appointment card for the orthopaedic specialist at Maroondah Hospital. "I thought it was for this year and I nearly turned up before I realised it was June 2008," she said. By that time, the Croydon pensioner will have been waiting 14 months. She is then likely to be put on another waiting list for surgery, for up to 18 months.

"It's very short sighted because the longer people have to wait for an operation, the worse the problem gets and the more it's going to cost," she said. Mrs Haffenden said her ankle had degenerated over the past three years and she resorted to crutches six months ago because she "hit the roof" in pain every time she put weight on it. Out of desperation, she went to an orthopaedic specialist as a private patient a few months ago.

The specialist told her she could operate within two weeks. But with the bill expected to hit $4000, Mrs Haffenden was forced to go on the 14-month waiting list to see the same specialist as a public patient. Mrs Haffenden also has Meniere's disease, a disorder of the inner ear that causes vertigo and vomiting, and has heart problems. Husband Roy, 79, is recovering from recent back surgery, is in a back brace and has serious heart problems.

Mrs Haffenden said that as well as caring for her husband, she also helped her 91-year-old mother, who lives in a retirement home. "It is really very difficult," she said. "The Government can find money for non-essential things, like millions of dollars for sport or giving themselves a pat-on-the-back pay rise, and I don't see why they can't give more money to hospitals," she said.

Opposition health spokeswoman Helen Shardey said Mrs Haffenden's case was a typical example of the falling standards of health care. However a Government spokesman said significant commitments had been made to reduce waiting lists and speed up service delivery. This included funding an extra 72,000 outpatient appointments in this year's budget as part of a $324 million promise to provide 200,000 new appointments. A spokesman for Eastern Health, which runs Maroondah Hospital, said he was not aware of Mrs Haffenden's case but urged her to return to her GP if she was unhappy or believed her condition had changed. Her GP could then reassess her case and liaise with the hospital about finding a more suitable appointment. [Translation: You CAN get prompt treatment but it takes publicity]


XDRs: Deadly bugs hit Australian public hospitals

A NEW breed of killer bacteria is invading Australian hospitals, endangering patients and forcing staff to revert to old-fashioned infection control measures. [About time! Proper aseptic procedures should never have been abandoned. Neglect of them has created the present problem] The mutant infections - dubbed XDR for "extreme drug resistance" - cannot be treated with available medicines. Experts say it will take at least 10 years to develop new drugs to kill the virulent bugs, which can result in blood poisoning and death. In the meantime, Australian hospitals have no option but to "return to the pre-antibiotic era" in an attempt to stem the infections' spread.

Professor David Paterson, consultant infectious diseases physician and microbiologist at the Royal Brisbane and Women's Hospital, revealed the extent of the XDR crisis in the latest edition of the journal Critical Care Medicine. "The XDR problem is here," he said. "We are returning to the pre-antibiotic era where some infections are untreatable. "Strict infection control practices must now be routinely enforced and antibiotics that are still helpful should be prudently and optimally used."

He told The Sunday Mail that drug companies had failed to develop new antibiotics [With so much of their time, attention and money devoted to fending off attacks from predatory lawyers, is it any wonder?] to combat XDR infections because it was not profitable enough. It will become a much bigger issue in the future, he warned.

XDR bacteria, which can be passed through human contact, are forecast to be a massive threat to intensive care units. Critically ill patients with weakened immune systems are particularly vulnerable. Staff will be forced to adopt stricter handwashing, disinfection and protective measures. "Prevention is of paramount importance," Prof Paterson said.

E-coli and other common bacteria that cause pneumonia and urinary or respiratory infections are among those that have developed resistance to various modern antibiotics. They would have been treatable in the past, before mutating into their more resilient forms. Prof Jeffrey Lipman, co-author of the study and the hospital's director of intensive care, said the unrestricted use of antibiotics had fuelled the growth of highly resistant bacteria. There had not yet been any confirmed deaths from XDRs "but we are worried about it," he said. Hospitals needed to be more aware of the XDR risk and take preventive action, he said.

Disease specialists are now experimenting with combinations of older types of antibiotics, which were considered too strong to be used in the past. Golden staph, or methicillin-resistant staphylococcus aureus, has become a leading cause of post-surgery infections in hospitals around the world in recent years.


Western Australia clinging grimly to its "postmodern" school assessment system

Thus giving teachers a useless extra workload

The State School Teachers Union says teachers are struggling to meet the conflicting demands of a federally-imposed marking system which requires students to be graded from A to E. The union's President Mike Keely says teachers are being forced to combine conflicting directives from the Federal and State Governments which are simply incompatible. Under the Federal system teachers are forced to award students traditional A to E grades, while the State Government requires levels-based assessment through grading charts.

Mr Keely says in many cases politicians are enforcing systems without any idea of their implications. "We are now coping with the Federal Minister's A-B-C and D system and E system, even for students in year one which is absurd, and we are also coping with a levels system which for many teachers in the state is still problematic," he said.

He says the two systems are simply incompatible and the union is doing all it can to change them, but teachers are working hard to overcome the challenges within the marking system. "I have a great deal of trust in teachers. Teachers have always been able to say to students look you will do well if you pick up this course, this course and this course, in year 11 and on to year 12, we are very good at that, we have been doing it for a long time, we will tell students and parents if necessary that grade doesn't give a good indication."


Carbon trading proposals in Australia: A critique

The Government should consider other options before it burdens our economy with emissions taxes

The Howard Government is keen to show it is serious about the problem of human-induced climate change, although the debate is still raging. To this end, the Prime Minister has announced that he is moving to establish a national carbon-emissions trading system by the end of 2012, as recommended by a taskforce he appointed last December.

Separately, the state and territory Labor governments have set up a national emissions-trading taskforce, which is investigating a scheme for emissions-trading by the end of 2010. The aim of these proposals is to put a price on the emissions of greenhouse gases, particularly CO2, with a view to progressive reductions in the years ahead.

The Federal Government proposal, as set down by the taskforce, envisages the establishment of a "cap and trade" system, in which the government determines limits on greenhouse gas emissions (that is, sets a target or cap) and issues tradable emissions permits up to this limit. Beyond that, they must be bought from the government, i.e., they are a tax. Businesses must hold enough permits to cover the greenhouse gas emissions they produce each year. Under the taskforce recommendations, permits can be bought and sold, with the price determined by the supply of and demand for permits. Similar schemes are in operation in Europe and in parts of the United States. They are also proposed for Canada and New Zealand.

The European Union (EU) describes its Emission Trading Scheme, established in 2005, as the largest multinational greenhouse gas emission scheme in the world. It is the centre of the EU's campaign to cut greenhouse gas emissions. It is also a costly failure. The Climate Action Network, an umbrella group of some 350 environmental organisations, of which 100 are in Europe, issued a report which stated that only two of the 25 EU states (UK and Germany) asked participating industries to reduce emissions below historic levels, and found that in the 15 old EU member states as a whole, allocations were 4.3 per cent higher than the base year. The British reached their target by closing down the domestic coal industry and importing from abroad, while Germany cut greenhouse emissions by closing down dirty old Soviet-era power stations in Eastern Germany.

In May 2006, when several countries revealed that their industries had been allocated more allowances than they could use, trading prices crashed from about 30 euros ($50)/tonne to 10 ($17)/tonne, and have since declined further to 4 ($7) in January 2007, and below 1 ($1.60) in February 2007. Countries like Sweden have committed themselves to cutting CO2 emissions by closing older coal-fired power stations and building nuclear power plants. Most countries in the European Union have failed to meet their Kyoto Protocol commitment to cut CO2 emissions. Those which have "reached" the target have usually done so through what are known as "international credits", that is, by purchasing emission permits from overseas to bring themselves within the Kyoto targets. Another method of purchasing carbon credits is in bankrolling reforestation programs, which are supposed to "lock up" CO2 in trees. In fact, trees' absorption of CO2 is minimal in their early years, and eventually, when the tree dies, the CO2 is returned to the atmosphere.

All of this basically is a manipulation to make it appear that countries are achieving measurable reductions in greenhouse gas emissions when in fact they are not. Reading the report of the Prime Minister's Task Group on emissions-trading, the EU scheme is described in glowing terms. It said, "The European Union has committed to meeting its Kyoto reduction target and has introduced a domestic emissions trading scheme to that end. In March 2007, the European Union adopted a package of new climate change and energy security measures." Its failings were not even mentioned.

There can be little doubt that the taskforce's objective was to solve a political problem rather than an environmental one, and to minimise the potential damage to Australian industry, particularly the export industries. If Australia and other countries wished to preserve fossil fuel resources as well as cutting greenhouse gas emissions, they would be looking at encouraging nuclear power and the use of biofuels, which recycle atmospheric CO2 through plants, into ethanol and biodiesel. This recycling process substantially cuts net CO2 emissions.

A few other countries have already established very large biofuel industries. Brazil, which produced 18 billion litres of ethanol in 2004, was the world leader in ethanol production until it was recently overtaken by the US. Brazil's output is currently being expanded to produce biodiesel. If Australia was serious, it would forget about emissions trading, and invest in biofuel technology instead.


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