No ambulance: Woman in agony forced to take taxi

Only tears saved her life -- and that was with the taxicab company. Nothing worked on the government ambulance service

MELBOURNE'S overloaded ambulance service has been forced to apologise to a woman it refused to help. Michelle Couling had her appendix removed in an emergency operation in hospital. But the 29-year-old almost didn't get there after being refused an ambulance when she called 000 for help. "I consider myself pretty lucky," she said. "It's difficult to think that they wouldn't believe me and they were going to try and diagnose me over the phone. "(My appendix) could have ruptured and I would have been here by myself without help."

Opposition health spokeswoman Helen Shardey said the health system's failings were now being exposed daily. "For this young woman, it put her life at risk," she said. "If we had enough ambulances on the road, paramedics wouldn't need to make medical assessments by phone."

Metropolitan Ambulance Service general manager operations Keith Young admitted an ambulance should have been sent. "The preliminary information is that it was human error," he said. Mr Young said it appeared checks built into the secondary triage system, which diverts about 26,000 low-priority calls a year to alternative services, had failed.

Mr Young said MAS had called Ms Couling to apologise and explain after being contacted by the Herald Sun. He said the matter was being investigated to ensure similar mistakes did not occur again. [So they always say]

Ms Couling was home alone when she fell ill about noon on Saturday, December 15. By 2am, she knew she was in trouble with sharp abdominal pain. She called her parents in Traralgon for advice. "They told me I needed to call an ambulance," she said.

Ms Couling rang 000 and was told an ambulance would be sent, but there would be a delay as ambulances were busy. She was told to call back if her pain got worse. "I hung up thinking someone was on the way so I rang my parents to reassure them that it was going to be OK." But 25 minutes later Ms Couling was in extreme pain and rang 000 back. After being put on hold for about four minutes, Ms Couling's call was transferred to a paramedic. "After a three or four minute conversation he said: 'We're actually not sending anyone out - it doesn't sound like it's an emergency to me, it sounds like you might have gastro'." The paramedic said Ms Couling should still see a doctor and suggested she get a lift or call a cab.

Not wanting to wake friends at 3am, she called a cab. "The lady said: 'Look, we're not an ambulance service - there's a delay here, too'." When Ms Couling broke down in tears, the call-taker relented. A taxi arrived about 10 minutes later and took her to the nearby Austin Hospital. Ms Couling needed three morphine doses and anti-nausea drugs to dull her pain. She was operated on at 12.30pm and is now recovering.

Ms Couling's father said the response to his daughter's call for help was "pretty ordinary". "It could have been life-threatening - they didn't know that at the time. "A system where you can ring up and get a diagnosis over the phone - I just think that's a joke." Health Minister Daniel Andrews said a doubling of MAS funding since 1999 had put 489 more paramedics and 56 extra ambulances on the road.

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How we were

By Professor Geoffrey Blainey, Australia's pre-eminent historian

THE woman on the mobile phone explained - to everybody in earshot - that she was off to Rosebud on New Year's Day. "Camping!" She said that in an excited voice that we all heard.

Camping around the bayside used to be a hallmark of Christmas and New Year, in the era when few families travelled far for their holidays. The bayside tent-towns were so prominent in the summers of the 1930s - just before World War II - that newspapers often sent a reporter and photographer down to see what was happening. One family had camped in the same spot at Dromana for 21 years, they reported. And the girl from Northcote was engaged to marry the Hawthorn boy, from just two tents away. They had first met at this very camping ground!

There were no portable fridges, but an ice man did call. Campers who did not even own an ice chest kept their fresh meat in what was called a safe. Firewood was widely used for cooking meals and boiling water. There were no days of Total Fire Ban. It didn't exist.

At that time most Victorians who went away for a summer vacation stayed with relatives. Most went by train. My first memory of the Christmas holidays is of a train coming in. We were standing on the crowded Leongatha railway station and waiting for our grandfather to arrive. The little station was packed. The excitement was overpowering. More people seemed to be waiting on the platform than coming in the train.

Few Victorians owned a holiday house, at the sea or in the country. If they wanted to holiday at the sea they either camped, or they stayed at what was called a guest house. Victorians then lived in the shadow of the Great Depression of the early 1930s, and most were wary of spending extravagantly. It was cheaper to kill your own Christmas chook and pluck its feathers. Poultry was a luxury, and eaten at only one meal of the year.

Alcohol was not yet essential for New Year's Day. Victoria had just staged a referendum on alcohol, and more than 30 per cent of the voters wanted to close every single hotel and drink-outlet in the State. Many other Victorians tolerated alcohol but did not let it pass their lips, to quote the popular pledge.

Christmas was then more Christian. Even New Year's Eve was seen by many as a time for reflection rather than roistering. In Melbourne in 1938 arose that remarkable festival, Carols by Candlelight. It was the bright idea of the 3KZ radio announcer and football broadcaster Norman Banks, who had once intended to be an Anglican clergyman. The Myer Music Bowl did not exist, and on Christmas Eve in the descending darkness the crowds gathered on the lawns of the Alexandra Gardens, close to the river. Most who came knew the Christmas carols and hymns by heart: the candles supplied the magic and atmosphere.

Community singing was still a favourite pastime, and the enthusiastic singing by the crowd rather than by individual performers appealed to a radio audience. On Christmas Eve, all over Victoria, and eventually in other states, people twiddled the dial on their radio until they picked up Norman's voice or the sound of Away in a Manger.

The way in which people celebrated Christmas and the New Year was about to change. World War II came, and unemployment virtually ceased. By the mid-1950s the country was prosperous as never before. Christmas became expensive. Families added ham to their roast poultry, which by now was rechristened as chicken. A few tried a turkey. The leftover food lasted for days. The feasting was becoming lavish. Alcohol - perhaps Quelltaler Hock or Barossa Pearl or even Ballarat Bitter - was seen on tens of thousands of dinner tables where strong drink had once been banned.

Even in the 1960s, Christmas Day was still like an old time Sunday, and hotel bars were mostly closed, as were picture theatres. Restaurants and coffee shops were few and were mostly closed.

People who did not dream of sending Christmas cards before the war now bought two or three dozen. The postmen carried heavy sacks of mail and worked long hours in the week before Christmas. Some were still delivering mail after 7pm. It was the period when the postie, like the garbageman, was seen by many householders as being entitled to a tip of at least 10 shillings, or a glass of cold beer or Tarax or Marchants lemonade - if December 24 proved to be blazing hot.

By 1960 most families, for the first time, owned a car. The great day for motoring was Boxing Day. The roads to the beach were jammed. On the way home they probably saw at least one traffic accident. There were no blood-alcohol tests in those days. At the beach a tanned skin and complexion was craved, as never before. Whereas holiday-makers on Boxing Day in the 1930s wore a hat to the beach and favoured a shirt with a collar and long sleeves, and usually sat on the sand beneath a beach umbrella - if they could afford one - their children now wore skimpy shorts and sleeveless shirts and no hat. They revelled in their brown faces.

While this was the era of the family car, it was not yet the era for long-distance motoring. Motorists who decided to venture along the Great Ocean Rd reached the end of the bitumen soon after passing Lorne. Cars that pressed on, past the Wye River, were coated with fine dust before they reached Apollo Bay. Those post-war motorists who set out for Sydney in their secondhand Jowett Javelin or their new Holden, and had no wish to camp beside the highway for the night, were wise if they booked accommodation in advance. There was hardly a motel along the Hume Highway. To go interstate - unless by train - was a luxury.

In the mid-1950s the Gold Coast was still in its infancy, and the Sunshine Coast was not yet in the property developers' diary. North Queensland was too far away, except for the family who was reasonably well-off. In any case Cairns was not yet a tourist town and Port Douglas was a sleepy spot in the mangroves.

A young Victorian family whose relatives lived in WA was lucky to see them once in every five Christmases. Unless they were amateur motor-mechanics they did not yet think seriously of driving across the Nullarbor. The train, day after day of it, was their only option.

As for air travel, whether on TAA or Ansett-ANA, it was simply too expensive for most Australians. When I worked as a luggage loader at Essendon airport at Christmas 1948, there were not many suitcases to load. Air travel initially displayed a style, a sense of spaciousness. Air hostesses were glamorous and much admired. It was much later, in 1975, that Reginald Ansett in a moment of exasperation described some of them as a batch of old broilers. By then air travel was becoming cheap.

At Christmas and New Year the unbelievable was happening. Many people who in their youth had camped at Rosebud or Anglesea were now taking their holiday in Thailand or London, and not even marvelling that such a momentous change had occurred in the space of their own life time.

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Another influential Australian Leftist who is keen on the navy

Sub fleet should be doubled says Kim Beazley -- even though new ones are already planned. Tony Blair recently ordered two big new aircraft carriers for Britain so maybe the moderate Left is going back to a Theodore Roosevelt mentality. But big Kim always did like military hardware

AUSTRALIA may need to double the size of its submarine fleet tocounter the growing and deadly threat posed by rival submarines in the region, former defence minister Kim Beazley said yesterday. His comments come after The Australian this week revealed that Defence Minister Joel Fitzgibbon had ordered planning to begin on the next generation of submarines to replace the six Collins-class boats when they are retired in 2025.

Mr Beazley also called on the Rudd Government to urgently tackle what he said was a "glaring weakness" in Australia's anti-submarine warfare capabilities. "This weakness comes at a time when (the navy) will soon be producing the best submarine targets in the region with the new air warfare destroyers and amphibious landing ships," Mr Beazley told The Weekend Australian.

Mr Beazley, who ordered the Collins-class submarines when he was defence minister in the 1980s, said the strategic scenario facing Australia had changed and that a larger submarine fleet was needed. "I think we need to have up to 12 submarines because of the numbers of submarines being developed elsewhere," he said. "This project will be of vital significance to Australia at a time when submarines are increasingly becoming multi-purpose platforms (for warfare)."

The 17-year submarine replacement plan will be the longest and most expensive defence project undertaken in Australia, potentially costing up to $25billion. It comes at a time when rival navies in the region are acquiring submarine capabilities or expanding them. China, India, Malaysia, Pakistan, Indonesia, Singapore, Bangladesh and South Korea are planning to acquire modern, conventional submarines.

In September, Russian leader Vladimir Putin visited Indonesia to sign a deal to sell two advanced Russian Kilo-class submarines to Jakarta, with the possibility of selling eight more in the future.

Mr Beazley said six submarines would no longer be sufficient to combat this regional growth or protect the navy's new surface ships from enemy torpedos. "The Russians and the Chinese are going for big numbers of submarines," he said. "We are a bit boutique at the moment and we will have to give serious consideration to the numbers which we acquire. We will certainly need more than six submarines. "If I look back on mistakes I made as defence minister, one was that I should have signed up to another two Collins-class (boats)."

Mr Fitzgibbon has said the new submarines will be built in Adelaide and all options remain open in relation to the design and the capabilities of the boats and the weapons they will carry. Studies will begin immediately within Defence, with the aim of winning "first pass" approval for the design phase from cabinet's National Security Committee in 2011. Although Defence will examine the option of nuclear submarines, Mr Beazley said Australia should opt for deisel-powered vessels. "I think we should go conventional because the main advantage of a nuclear submarine is speed, and the manner in which we use our submarines, closer to shore, means this (advantage) is not applicable," he said. "You also need a substantial nuclear industry to support nuclear submarines and there is no way Australia is going to have such an industry."

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Tax cut opportunity

FORMER Treasury secretary John Stone said the Rudd Government could slash taxes without harming the economy. Mr Stone said the economy could handle a cut in income tax scales from four rates to two - 15 and 30 per cent - and could even go further once those rates were achieved. And Mr Stone said the federal budget had the capacity for the capital gains tax to be eliminated altogether.

Most economists are urging the new Government to be cautious about fuelling inflation with tax cuts. But Mr Stone, who ran the Treasury during the early 1980s, said an overhaul of the tax system was necessary, because government continued to be awash with cash. And he has dismissed fears of the "interest rates bogeyman", arguing that the Reserve Bank should have been tougher in its interest rates policy.

In a paper in the latest National Observer, Mr Stone criticised his former Treasury colleagues for getting budget numbers wrong. "The once-in-a-generation opportunities for genuine tax reform have simply gone begging," Mr Stone said. He called for a tax review and for major changes to personal income tax structures in the next budget on a staged basis, starting from next July 1. "This review should take as a basic assumption that the federal budget should continue to be balanced," Mr Stone said. "However, it should also take as a basic assumption that, commencing with the 2008-09 financial year, there is no longer any basis for continuing to run significant budget surpluses."

Mr Stone said that warnings about interest rate rises from tax cuts were exaggerated because overall economic policy was askew. The Federal Government's fiscal policy had been too restrictive while the Reserve Bank's interest rate policies had been too soft, leading to speculation. "As a general principle, there is no virtue in taxing people too heavily so that other people may enjoy lower interest rates than would otherwise be appropriate," Mr Stone said. "That is particularly true when a high proportion of those enjoying those lower interest rates are speculators, either in the stock market or the housing investment market."

During the election the Labor Party promised tax cuts and a "tax goal" over the coming six years, which would flatten Australia's income tax system by reducing the number of personal income tax rates from four to three - of 15, 30 and 40 per cent. But Mr Stone called for a 15 and 30 per cent personal income tax structure, which he said would deliver more cuts so that the two scales would become over time 14 and 28 per cent, then 13 and 26 per cent and eventually 12.5 and 25 per cent.

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