Sunday, September 16, 2007

Bipartisan recommendation: Degrees first -- before teacher training

ASPIRING high school teachers should have to complete arts or science degrees before undertaking specific studies in education, an inquiry into teaching standards has recommended. The inquiry's report, tabled in Federal Parliament yesterday, also called for more rigorous teaching of literacy and numeracy to trainee teachers at university. It backed offering "incentives" to teachers as part of a broader push to improve their pay and raise entry standards. Education Minister Julie Bishop has been promoting performance-based pay to improve teaching standards in schools.

Teaching education as a compulsory postgraduate course for aspiring secondary-school teachers would be a significant departure from current practice, where many students simply complete a straight bachelor of education.

The bipartisan inquiry by the Senate's employment, education and workplace relations committee was chaired by Victorian Liberal senator Judith Troeth. The committee said many new teachers had "insufficient grounding in the actual subject content they are teaching". "That is, they do not know enough history, have limited appreciation of literature through not reading enough of it, and are ignorant of, and frightened of, mathematics and science," it said. "This has a direct effect on the quality of educational outcomes because it can impede student intellectual growth." [Surprise!]

Senator Troeth, a former teacher, said she had studied history and geography as majors in an arts degree at Melbourne University, as well as a sub-major in English, before going on to complete a specialised diploma in education. She then went to teach Year 11 and 12 English and history and middle school (junior high school) geography. "So often these days, teachers have the general experience of the bachelor of education degree which teaches them the skills of pedagogy but it does not instil the subject disciplines into them," she said. "We feel there should be a movement back to that."

In its report, the committee expressed concerns about weaknesses in the training of teachers. "Some of these may be the consequence of factors outside the control of universities, namely the academic quality of school-leavers wanting to become teachers, although it might be argued that entry levels should be raised to keep out those whose literacy and numeracy are of doubtful standard," it said. Too many students were reaching Year 6 yet remained "functionally illiterate".


More propaganda from "Lancet"

Fight climate change, cut down on red meat? If you make dozens of unproven and wrong assumptions, what they say is correct

PEOPLE should limit their meat-eating to just one hamburger per person per day to help stave off global warming, according to Australian scientists. That would be their contribution to a proposed 10 per cent cut in global meat consumption by 2050, a goal that would brake greenhouse-gas emissions from agriculture yet also improve health for rich and poor nations alike, it says. The paper has been released online as part of a seminar by the Lancet British medical weekly into the impacts of climate change on global health.

Its authors point out that 22 per cent of the planet's total emissions of greenhouse gases come from agriculture, a tally similar to that of industry and more than that of transport. Livestock production, including transport of livestock and feed, account for nearly 80 per cent of agricultural emissions, mainly in the form of methane, a potent heat-trapping gas.

At present, the global average meat consumption is 100g per person per day, which varies from 200-250g in rich countries to 20-25g in poor countries. The global average should be cut to 90g per day by 2050, with rich nations working to progressively scale down their meat consumption to that level while poor nations would do more to boost their consumption, the authors propose. Not more than 50g per day should come from red meat provided by cattle, sheep, goats and other ruminants.

The authors were led by Anthony McMichael, professor at the National Centre for Epidemiology and Population Health at the Australian National University, Canberra.

"Assuming a 40 per cent increase in global population by 2050 and no advance in livestock-related greenhouse gas reduction practices, global meat consumption would have to fall to an average of 90 grammes per day just to stabilise emissions in this sector,'' the paper said.

"A substantial contract in meat consumption in high-income countries should benefit health, mainly by reducing the risk of ... heart disease... obesity, colorectal cancer and, perhaps some other cancers. An increase in the consumption of animal products in low-intake populations, towards the proposed global mean figure, should also benefit health.''

According to a study published in July by Japanese scientists, a kg of beef generates the equivalent of 36.4kg of carbon dioxide, more than the equivalent of driving for three hours while leaving all the lights on back home.


Doctors for auction in Australia

Yet more of that wonderful government "planning". There are plenty of would be doctors but a very limited number of places in medical schools (Which are all run by Leftist State governments). The result: Much more dangerous circumstances for patients

A CRISIS in public hospital emergency departments has reached the point where they are forced to bid against each other for casual doctors who are already paid as much as triple the award rate. Doctors say patient care is at risk because emergency departments are forced to rely on often inexperienced locums with a "nine-to-five mentality" to plug gaps in the system. The Herald has obtained an email from one large NSW locum agency that describes 26 NSW hospitals as being at crisis point, 21 of them public hospitals, with some unable to fill shifts for senior emergency doctors the next day.

NSW Health estimates it costs $35.2 million more a year for locums than it would for permanent staff, but refuses to fund more permanent senior specialists. Rates for locums generally vary from $90 to $180 an hour depending on experience and type of shift, but can reach $250 for a senior doctor required at the last minute in a regional area or on a public holiday, or when the hospitals bidding against each other push up the price.

The vice-president of the Australasian College for Emergency Medicine, Sally McCarthy, said the use of locums was at "phenomenally high levels" and NSW Health did not support more permanent positions. "But the health service is happy to compete against other hospitals for locums, bidding up the price," Dr McCarthy said.

When the Herald contacted heads of emergency departments, they were highly emotional - one even tearful - and some called out of hours or while on holiday to express their frustration and desperation. They all refused to go on the record, fearing repercussions from NSW Health.

On Tuesday, vacancies emailed by Australia Wide Locum Placement included 41 shifts in the emergency department at Nepean Hospital from now to September 25, and 70 shifts at Blue Mountains Hospital to November 30 - 16 of which are in emergency just for this month. Camden Hospital had 85 emergency shifts to fill over the past month, all for senior doctors.

Royal North Shore Hospital needed 20 shifts filled in emergency up to October 14 and Fairfield needed 25 up to the end of next month, 13 of which were for senior emergency doctors to work overnight this month to fill vacancies every few days. Other public hospitals listed as in "crisis" - with shifts needing to be filled within 48 hours - included Concord, Mona Vale, Fairfield, Sutherland, Campbelltown and several regional hospitals.

Locums are often junior doctors, lured by the pay and far less stressful working conditions.

The emergency departments at Camden and Campbelltown hospitals are among the busiest in the state but are understood to have the heaviest use of locums. Of all doctors in Camden's emergency department, about 70 per cent are locums.

The director of Australia Wide Placements, Terry Keenan, said his company would fill "less than half" of the crisis shifts at public hospitals. His agency sought to fill 800 shifts in Sydney public hospitals on any given day. "The demand is enormous," he said. Hospitals are so desperate that they even offer a higher rate than is necessary, he said. "We sometimes get hospitals saying 'we can give up to $140 an hour', and we say we think we can fill it for less." He also said some doctors did not commit to a shift until the last minute, "thinking that if you don't the price might go up".

The use of locums in public hospitals has "increased alarmingly" in recent years, said a NSW Health report published in The Medical Journal of Australia last year. The head of a big Sydney metropolitan emergency department said it spent $1 million on locums last financial year. "It's virtually impossible to check how well they're going to perform, whether they're really as senior as they say they are and whether they can do all they say they can do and . you never have the organisational knowledge or the commitment," he said. "You end up with the more inexperienced, lower-quality employees . we regard it as a bit of a crisis."

A medical registrar at a Sydney public hospital emergency department said the use of locums could be "life-threatening for a patient". "You've got the people who are the least skilled, the least loyal and the least oriented who are the ones that are making more money than even the directors of the department. And you're sending them off to life and death situations." The head of emergency at a big regional hospital said he had to "fight tooth and nail for every doctor" employed there. "They just say no, no money. When you talk about safety they don't want to know about it."

The State Government blamed the doctor shortage on the Federal Government, saying it was not funding enough university places [But the universities are run by STATE governments!]. A spokeswoman for NSW Health said: "Clearly it is better to have full-time medical staff than to rely solely on the use of locums to backfill vacancies," she said.


The medicalization of misery

By Tanveer Ahmed

As a doctor working in mental health and within the public hospital system, I am a regular witness to those living on the bottom rungs of our society. They are the homeless, the drug addicts and those suffering from severe mental illness. More often than not, they are all three at once. I am struck by their amazing uptake of mental health language. They skilfully weave technical psychiatric language into their reporting of symptoms. As a result, comments such as "I'm pretty sure I'm coming down with a depressive disorder" or "I think I'm developing a personality defect" are not uncommon, even from people with minimal education.

This is in part a reflection of wider society and how the language of human distress has been overtaken by psychological terminology. I hear very few people tell me they are unhappy. They are almost always depressed, even if their life choices or circumstances would be perfectly consistent with them being miserable.

Increasingly they no longer suggest they feel depressed, but that they are getting depression, in the same way we may catch a cold. The consultation then moves to the awkward dance modern therapists play. I become the healer attempting to cure their condition, pretending somehow their malaise is one of biology and not of meaning. The result is that it can blind them to the possibility their actions may have played a role in their problems.

Barely a week goes by when we don't hear of the crisis in mental health. Rising depression, worsening drug and alcohol problems and a strained social sector make us think that despite our stupendous prosperity, we remain in some kind of existential abyss. It is a symptom of the market society and individualism that our grievances must be turned on to the self.

This is in spite of psychiatry remaining a hazy field, an arena where diagnosis and treatment are poorly correlated and where clinical energies focus on symptom relief. It is reflected further in the tremendous amount written about happiness studies. If being dissatisfied with life is pathological and health is a right, the implication is that happiness is also our birthright.

The use of psychiatric terminology is also more and more colloquial. During the Andrew Johns saga and his eventual secular confession, bipolar disorder was used widely in the press as a synonym for erratic behaviour. The former Victorian premier Jeff Kennett, a tireless campaigner in raising awareness for depression, openly admits he uses the term not in its medical context, but as a synonym for emotional distress.

But just like fashion and baby names, language eventually filters down the social ladder. The dominance of mental health language in projecting our distress is of dubious value when applied to the most disadvantaged groups. Indeed, it may be complicit in helping them to maintain lives of dependence and misery, the sick role curing them only of their autonomy and personal responsibility.

Bureau of Statistics figures from 2005 show about a third of the 700,000 people receiving the disability pension have been diagnosed with a mental illness. This is a critical group because the vast majority are young and otherwise physically able. Many could be in the prime of their lives. Forty years ago, fewer than in one in 30 working-age adults relied on welfare payments as the main source of income. The figure today is one in six. In particular, the proportion of the population on the disability support pension has doubled since 1981.

An important player in this debate is the doctor, for they determine if someone meets the criteria for disability. Patients who are on the margin of receiving the pension or Newstart will often ask to receive the pension. The disability pension is more generous than the unemployment benefit and there is little mutual obligation.

The sick role, however, comes with an obligation to seek and comply with treatment. The patient's compliance with treatment is the priority for a doctor. There are many times when giving in to a patient's wishes elsewhere can ensure their compliance with medication. The pension is often one such compromise. The flipside is that 90 per cent of those receiving disability pensions never return to the workforce. This is not a fact well known to professionals determining disability. Colleagues working in mental health were flabbergasted when they heard the figure.

For many on the margins of eligibility, there is an incentive to remain sick. The welfare market operates like any other - a better price will increase demand. This lack of incentive to take a more active role in society can strip them of meaning in their lives and perpetuate what may have started as mild mental illness. A feedback loop of disability, welfare and worsening mental health is created. This is a hidden factor straining both Australia's mental health and welfare systems. They are operating in a kind of pathological symbiosis.

This cycle describes many people who are said to be in a state of deep poverty. They are hardly poor in a historical sense, for they have enough money to eat and are housed, educated and medically treated by the state. In formulating their situation, poverty in this sense is more like a psychological condition than one determined by socioeconomics.

While the middle classes debate their happiness and psychiatry acquires a cultural prestige well beyond its powers, the poor inherit the new straitjacket of psychological language. It not only costs the taxpayer billions of dollars, but encourages recipients to wallow as victims of passive circumstance, stripping their lives of meaning and purpose.


No comments: