Sunday, September 23, 2007

Labor pledges support for Medicare safety net

Another move towards the status quo from Australia's Left. Opposing protection from unusually high medical bills was always pretty wacky for socialists. The great "offence" of the scheme was that it helped "rich" people as well as the poor. But there are many so-called "rich" and their votes cannot be risked

The Federal Opposition has announced it will maintain the Medicare safety net if it wins the imminent federal election. In the 2004 election campaign Labor said it would cut the scheme, saying it subsidised the wealthy. But Labor's health spokeswoman Nicola Roxon says soaring health costs means the safety net now provides some cost relief to families and the party will make no changes to the scheme.

"Nearly 1 million people each year get some benefit from the safety net," she said. "Labor supports the relief that that provides. "And we're going to make sure that in areas where the safety net is not used as heavily, we get services like doctors and specialists into those areas, so they can get the healthcare they need, and they'll get more benefit then from the safety net as well."


Surgeons say NSW public hospital unsafe

THE head of surgery at Mount Druitt Hospital says the hospital is unsafe and has accused the Health Department of covering up the death of a patient who waited 14 hours to be moved to another hospital because Mount Druitt has no intensive care unit. In a letter obtained by the Herald, Mac Wyllie said the department's claim in an internal report that the delay "did not affect the outcome" of the patient's condition was "'inappropriate" and "deliberately misleading". The 68-year-old man died of acute pancreatitis the day after arriving at Westmead Hospital's intensive care unit from Mount Druitt on March 3. "Our [surgeons'] alternative conclusion is that this delay did affect the final outcome of this patient who eventually died," Dr Wyllie said in his letter to the Sydney West Area Health Service, dated September 5.

Surgeons have been warning for the past three years that Mount Druitt Hospital's emergency department is unsafe because it has had no intensive care unit since early 2004, when it was closed due to staff shortages, and the high dependency unit, where the man waited for the transfer, has no full-time medical staff. They say even "remotely unwell" patients must be transferred to Blacktown or Westmead hospitals. They are concerned that local people, among Sydney's most disadvantaged, wrongly believe the "emergency" sign at the front of the hospital gives the impression it can admit acutely ill patients, which it has not done since October 2004.

The Premier, Morris Iemma, who was then the health minister, promised that patients would not wait for transfers as a result of the intensive care unit closing and that the high dependency unit would have consultant supervision. Apart from cardiology, rehabilitation and pediatric services, Mount Druitt has no acute medical beds and no full-time general staff physician, or even an on-call general visiting physician.

A patient presenting with conditions such as a diabetic complications, breathing problems, chronic arthritis or a stroke must be transferred. Accident and emergency specialists are confined to that department, which is also understaffed. A senior doctor at the hospital, who did not want to be named, told the Herald: "Since 2004 there has pretty much been a whitewashing at Mount Druitt Hospital." He said the man who died "had deteriorated quite significantly" while waiting for the transfer.

Critical cases were not brought to Mount Druitt, but for the "isolated cases" that do end up there, "there is no question that they are in danger - quite considerably - which has been shown by this case and others".

However, local residents are staunchly opposed to closing the emergency department and it would be a political nightmare for the State Government. The Government has ignored its own, independent General Metropolitan Clinical Taskforce, which recommended in a February 2005 report that the department be closed and noted that the community's "perception" that it was a 24-hour, comprehensive service "needs to be addressed". "Mount Druitt Hospital still remains unsafe and the clinicians find it increasingly difficult to fully exercise their duty of care to the patients of Mt Druitt," Dr Wyllie said in his letter, which he addressed to the deputy director of clinical governance at the Health Department, Dr Andrew Baker. Dr Wyllie did not supply the Herald with the letter.

He said the Sydney West Area Health Service Root Cause Analysis (RCA) report on the man's death had "fundamental flaws and omissions". It was more than 15 hours before the man saw an intensive care doctor, Dr Wyllie said. "To say that this delay did not affect the final outcome of the patient is not only inappropriate on the evidence put forward, but could be construed as deliberately misleading," he said. The report failed to take into account that the high dependency unit "has no dedicated residents and it has no direct supervision from either Blacktown or the Westmead intensivists". "I am advised that no intensivist has had a physical presence in the unit to supervise the treatment of patients for over three years."

The RCA report, seen by the Herald, said the man arrived at Mount Druitt Hospital emergency department at 7.30am on March 3, was diagnosed with acute pancreatitis and was to be sent to Westmead Hospital's intensive care unit. However, there were no beds available and he was moved instead to Mount Druitt's high dependency unit and did not arrive at Westmead until 9.45pm. He died early the next morning.

"It is unlikely that this delay altered the course of his illness." the RCA report said. Although the report said there were no intensive care beds at Westmead when nurses checked at 3pm and 5pm, when the man "began to deteriorate", it blamed the delay on "poor communication" within the emergency department.

Another senior doctor at Mount Druitt Hospital, who did not want to be named, said transfer delays were "inevitable" and "unnecessary". "The point is that you can't keep anyone who's even remotely unwell for monitoring at Mount Druitt," he said. "Politically, it's the right thing to say that you've got an emergency department but the fact of the matter is that this hospital has been so downscaled that if a person is really unwell, we can't keep them here.

But one of the authors of the General Metropolitan Clinical Taskforce report, Professor Kerry Goulston, said yesterday that the problem was not a lack of an intensive care unit but understaffing of the emergency department. "We said it was wrong 2« years ago to have a sign saying 'emergency department' and it wasn't functioning as a proper emergency department," Professor Goulston said.

Questions put to the Sydney West Area Health Service on Tuesday - including how it justifies keeping the emergency department open, whether patient transfers have been improved, what it was doing to increase consultant staffing levels, and what were the results of an audit on patient transfers - remained unanswered yesterday.


Rent law revamp to lure investors

Reality strikes at last -- faintly. Existing tenancy laws are so anti-landlord that only high rents can justify the risk of letting properties out. So the NSW government is finally beginning to recognize that the high rents that the poor have to pay are to a considerable extent the government's own doing

TENANTS face swift eviction if they fall behind in their rent and many will have to pay water charges currently borne by landlords, under the first big overhaul of NSW's tenancy laws in 20 years. But tenants' rights will also be boosted. If landlords default on their mortgages and their properties are repossessed, tenants will be guaranteed at least 30 days' notice to move out. And for the first time, renters who need to move out of a share house or a relationship will be able to be apply to have liability on their part of the lease waived.

The changes are partly about "encouraging investment and people back into the property market", the Fair Trading Minister, Linda Burney, told the Herald. "At the moment it can take three months to [evict tenants] and that's a long time." That will be about halved under the new legislation to cut the "red tape". "Encouraging investors back into the market should help to reduce Sydney's rental squeeze," Ms Burney said. The rental vacancy rate in Sydney is just 1.5 per cent, and this adds to the housing affordability crisis.

The State Government will release its plans for public comment today - after several years of reviews - before introducing legislation early next year. The tenancy tribunal now confronts more than 20,000 cases involving rent arrears every year, and the Government wants to cut its workload. Under the changes, tenants who fall behind in rent would have "the onus placed on them to apply to the tribunal" if they wished to contest their eviction - rather than landlords having to justify their case. The tribunal could make a decision on the application swiftly without need for a hearing.

But the laws will also protect tenants who become victims when landlords default on their mortgages. The planned 30-day eviction warning follows horror stories of tenants arriving home to find the locks changed. On the rights of renters leaving a shared tenancy, Ms Burney said: "The issues of co-tenancy are really important - particularly where you might have a domestic violence situation." Other planned changes include:

* A right to a reduced rent if a landlord puts the property up for sale and prospective buyers traipse through;

* Greater rights for tenants to put up pictures or paint properties;

* Water charges to be levied on all tenants in properties with separate meters to provide "uniformity". A similar move in public housing resulted in a 29 per cent cut in water use;

* Powers for the tenancy tribunal to remove tenants from databases that real estate agents use to reject applicants;

* Cancelling eviction notices if a tenant can pay their rent arrears before the eviction date.

The Government plans to stop the payment of interest to tenants on their bond money. Currently the rental bond board returns the money after tenants move out of a property, with an interest payment of 0.01 per cent. That is just $80,000 a year on the $650 million in bonds that it holds.

The principal solicitor for the tenants' union, Grant Arbruthnot, said it was "retrograde" to put the onus on tenants when they fall behind in rent. It would hurt people with low literacy and of non-English speaking background the most. The Government says those people would receive special consideration. Ms Burney, a former chairwoman of the Council for Aboriginal Reconciliation, said it was about achieving a "balance" and she stood on her record of "protecting the rights of the vulnerable". The Real Estate Institute of NSW welcomed the quicker dispute resolution but said it needed a closer look at the detail.


Some history of the Chinese in Australia

It is certainly true that the Chinese adapt very well to Western society -- something clearly attributable to large areas of cultural compatibility between the two groups -- plus the high Chinese IQ. I have reproduced below just the history -- ignoring some rather silly political point-scoring

At the age of about seven, I have to confess, I took part in one of the earliest and smallest race riots in Sutherland Shire. Our gang at Jannali Public School somehow thought it would be a good idea to line up outside the local Chinese greengrocer's shop and chant "Ching-chong, Chinaman". Duly reported to our parents by an outraged neighbour, some of us were sent to make a formal apology, the first but not the last embarrassing encounter in a lifetime largely focused on Asia.

At that point, in the 1950s, the identifiable community of Chinese descent in Australia had dwindled to about 10,000 from about 50,000 at the time of Federation, thanks to steady application of immigration laws enforcing the White Australia ideology. Subject to this kind of cheap taunt, you must wonder why any stayed at all.

The answer is supplied in a powerful new book by John Fitzgerald of La Trobe University that combines the skills of an excellent China specialist, Australian historian and fine writer. The Chinese were as "Australian" as the rest of us, and despite all the rejection - which started immediately after the Federation parades they joined with dragon and lion dances - they held keenly to what are now called Australian values. While our early statesmen were fulminating about the subservience, cruelty and depravity of "John Chinaman", John was punting on the Melbourne Cup, as a frayed Chinese SP bookie's ledger in the Launceston Museum attests.....

Fitzgerald shows us that right from the 1850s gold rushes, Chinese immigrants to Australia were caught up in the revolutionary fervour starting to sweep their homeland. Indeed, some arrived fresh from the millenarian Taiping rebellion against the Manchus. They quickly appreciated the benefits of the British rule of law and the labour movement beginning to form in the colonies, and were early supporters of the imperial reform movement, then Sun Yat-sen's republicanism.

Far from seeking to stay outside the emerging Australian society - running the opium and gambling dens of popular perception - the Chinese sought respectability and participation, with the biggest secret society, Yee Hing, going public as the Chinese Masonic Association of NSW in 1911. If Australian Chinese travelled more frequently back to their homeland than British migrants, it was because China was that much closer, and because of the White Australia laws blocking entry of wives and family.

The republican period also saw Australian Chinese tycoons marshalling share capital in Australia for some of the biggest overseas investments in the modern Chinese economy, with the four biggest department stores on Nanking Road in Shanghai modelled on the Australian retailer Anthony Hordern's formula of impressive display, reasonable fixed prices, and polite uniformed staff.

Other Chinese Australians went back consciously trying to plant Australian and Christian values in the new China, with the journalist Vivian Chow drawing on the "Anzac spirit" in his writings (there were many diggers of Chinese descent in World War I). But partly this offshore business move reflected the restricted opportunities in Australia (in 1921, Queensland even applied the infamous dictation test, whereby port officials could test anyone arriving in any European language, for entry to its banana industry).

Even so, some who remained found ways to flourish. In 1925, Leslie Joseph Tingyou changed his father's name for that of his old profession, a "hooker" on the railways, and went on to set up the real estate agent L.J. Hooker, with most of his big business peers unaware he was a "Chinaman". This background was hardly known in the 1980s when the Malaysian share raider Lee Ming Tee was mounting a hostile takeover of L.J. Hooker, frequently complaining of racism when his manoeuvres were queried. Maybe the irony was on all of us.

It was not just in business. As a baby, John Yu, son of a Kuomintang minister, was smuggled out of Japanese-occupied China in a wicker basket and raised in Sydney, becoming a pediatrician and chancellor of the University of NSW.


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