A "cure" for public hospital chaos?

A senior doctor at one of Queensland's big hospitals wants the public to be told daily of the number of patients admitted to emergency wards. He said the alarming statistics might make people more careful. The doctor, who has worked for 25 years in public hospitals, revealed a slice of the chaotic life in a typical hospital emergency department in a heartfelt "I will be your doctor" open letter to The Sunday Mail last weekend. His insightful words about sickness, accidents, drunkenness, overdoses, abuse, miracles and death touched hundreds of thousands of Queenslanders and prompted scores of readers to write in with their support for our overworked frontline medicos and nurses.

But the doctor also warned Queenslanders that "things are not good" with the state's health system. In a follow-up letter, the doctor - who must remain anonymous to protect his government job - said there were five things he would like to see happen now to help start rectifying problems at our public hospital emergency wards. He wrote:

* I would like the media to report daily emergency department capacity in the same way as water levels in our dams are regularly reported. This information is on the Queensland Health website but I believe it is in the public interest for the figures to be more widely publicised. If people were aware of the backlogs, they might drive a lot more carefully.

* The financial incentive to access "free" medical care at public hospitals instead of via a GP and community-based facilities needs to be removed. A good first step would be for politicians to bring health together under one umbrella, preferably controlled by the Commonwealth.

* Queensland Health needs to provide alternative access to hospital-based medical services. People will continue to come to emergency wards, either by choice or on the advice of their GP. True emergencies should be seen in a properly equipped emergency department. Hospitals need to provide a practical and timely alternative for non-emergencies.

* We in emergency departments need to reconsider the way we do business. We are about to receive a flood of new medical graduates, part of the solution offered after the Patel affair. New models of care are needed to maximise their learning opportunities, provide adequate supervision and still deal with the increasing number of patients.

* End-of-life issues need to be openly examined. The taboo and secrecy surrounding death has prevented us looking at the way we treat people in the last year of their life. It is a shame the end is so often medicalised beyond dignity.

After last Sunday's hard-hitting open letter, the doctor acknowledged that his words were likely to "ruffle some feathers" with government and health authorities. "I do hope something comes of it," he said. His comments came as the March quarter figures revealed an 11 per cent jump on the same period last year in the number of people attending emergency departments in public hospitals.

Queensland Health Minister Stephen Robertson has called on the Federal Government to fund a scheme allowing GPs to treat people in public hospital emergency departments. Mr Robertson said the primary-care shake-up would cost millions of dollars, but said it was vital to ease pressure in the ER.

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Public hospital closures to stretch waiting lists

QUEENSLAND Health's decision to shutdown one of the state's biggest cardiac surgery units in Townsville and to stop cataract surgery in Hervey Bay has aggravated a waiting list blowout that has worsened in the past three years, doctors said yesterday. The Courier-Mail reported at the weekend that elective surgery waiting lists have blown out by 15 per cent and lists to see specialists by 50 per cent in the past 1000 days since the Government promised to fix the health system.

Don Kane, the president of Salaried Doctors Queensland, said closing the Townsville cardiac surgery unit because of infighting among staff lengthened waiting lists by at least 200 patients a year. Queensland Health estimated the unit was doing 400 procedures a year. "What happened there was a failure of management," Mr Kane said. "The situation could have been fixed up in a short period of time. Closing the unit was totally unnecessary." Since its closure in November, Queensland Health has flown dozens of patients to Brisbane for heart surgery.

A spokesman for Health Minister Stephen Robertson said the unit was closed to protect the public. "Dysfunctional interpersonal relationships between key staff threatened the safe, sustainable operation of the service," he said. "This hard decision followed several ongoing attempts by local hospital management to rectify the situation." The spokesman said Queensland Health was in final stages of negotiations with an experienced surgeon and hoped to reopen the surgery "very soon." However Mr Kane predicted it would take up to a year before the unit reopened.

In Bundaberg, optometrist Ross Fisher criticised Queensland Health for "ditching" 48 elderly patients waiting for cataract surgery at Hervey Bay hospital. The patients, who had been waiting an average of two years for the surgery, faced starting over on new waiting lists. "They certainly ditched them. They were taken off the list and told they would need to get a referral to start again on another," he said.

One of them, John Kennedy, 76, said he was told he would have to wait another 18 months beyond the year he spent waiting for a slot at Hervey Bay. "I don't know whether I'm on a list or not. I'm in limbo. I'm in the dark," he said. Queensland Health categorises cataract surgery as non-urgent elective surgery.

The minister's spokesman said he was unable to provide details about the Hervey Bay cases. "We understand the frustration of some patients who do wait longer than desirable for their surgery," he said. "Ophthalmology in particular is affected by chronic workforce shortages right around the country."

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Climate change will boost farm output in Australia (and elsewhere)

A bit of logic for a change. That CO2 is a potent plant fertiliser and that a warmer climate would mean more rain overall are basic facts that Greenies never mention. And a dry continent like Australia could certainly make good use of more rain!

AUSTRALIAN agricultural output will double over the next 40 years, with climate change predicted to increase, rather than hinder, the level of production.

A recent spate of reports forecasting the decline of Australian agriculture because of climate change have greatly exaggerated, and even completely misreported the threat of global warming, according to senior rural industry figures. In a report published by the Australian Farm Institute, executive director Mick Keogh says agricultural output is projected to improve strongly through to 2050, with a growing global population and increased economic wealth boosting demand for Australian produce. If the sector adapts even modestly, production would increase rather than decrease as a result of climate change, the report says.

Predictions of a 20 per cent drop in farm production by mid-century were cited by Kevin Rudd and Agriculture Minister Tony Burke as justification for Australia's signing of the Kyoto Protocol. In fact, Mr Keogh says, if global warming does occur, some areas such as southeast Queensland will receive more rain, and as a result will greatly benefit. Recent research has shown increased carbon dioxide in the atmosphere lifts plant production by up to 30 per cent in a phenomenon known as carbon fertilisation.

Mr Keogh, a well-respected industry figure, said much of the media reporting on the recent ABARE report Climate Change: Impacts On Australian Agriculture, was so misleading it risked eroding industry confidence in public research agencies. "The reporting claimed that agriculture would be absolutely devastated, when that is not what the research showed at all," he said. "For a start the media consistently misreported the research results as a future reduction in agricultural output, rather than a slowing of future rates of growth in output."

He said the ABARE report chose a series of highly unlikely worst-case climate change scenarios and then projected them over a long period of time. ABARE also used the assumption that climate change would slow economic growth globally, thereby decreasing the demand for food. "With increasing world population this is highly unlikely," Mr Keogh said.

Also unlikely was the assumption that farmers would not adapt. "In many situations it appears as if an increase in temperature, certainly over the next few decades, will increase rather than decrease productivity," he said. "As well, open field studies are returning increases in plant productivity of about 15 per cent with increases in carbon dioxide in the atmosphere. Levels up to 30 per cent have been returned in laboratory studies."

Charles Burke, a fourth-generation cattle farmer at Lake Somerset, north of Brisbane, said most farmers were sceptical of the claims surrounding climate change and believed they were instead dealing with climate variability. After the recent dry, he hoped the Australian Farm Institute was right in its predictions southeast Queensland would benefit from more rainfall. "No one has their head in their sand, but farmers want to move forward armed with the right information," he said. "The experts can't agree. Many farmers aren't convinced. We have to have the right information and the right tools. We need to make sure the information is correct."

Chief executive for the National Farmers Federation Ben Fargher said his members too had been concerned about the negative reporting of the industry's future. "We are very well placed to grow businesses into the future," he said.

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Exporting STONE to China!

One would think that stone would not be hard to find in China but business is business -- and Helidon stone does look good



A HELIDON quarry that produced sandstone for some of Brisbane's oldest buildings is now helping to build a modern China.
Australian Sandstone Industries is shipping container loads of sandstone to Beijing, Shanghai, Guangzhou and Hainan Island for shopping centre and tourist resort projects. Blocks of up to 22 tonnes are sent over each month in 500-tonne consignments and then cut to meet local needs.

And demand is growing, according to the company's general manager Patrick Ng, who said Chinese developers recognised Helidon sandstone as the world's best. "The colours cannot be found anywhere else and because the stone is not as porous it produces the finest surface," Mr Ng said. "There are other good Australian sandstones but none as good as Helidon's." Mr Ng said that while the company was publicly listed, its major shareholders were Chinese. "As a result, 90 per cent of what we quarry is exported with the remainder being offered on the domestic market," he said. "There is increasing Chinese interest and there is a huge market potential there."

Chinese company L'Sea Group had recently placed a $1 million order for 2500 tonnes for its real estate projects and since 2003 ASI had exported product worth more than $13 million.

While Queensland Trade Minister John Mickel recently hailed the quarry as a Smart State business, sandstone has been excavated from the ASI site for more than a century by former owners. The quarry provided sandstone for Queensland's former Treasury building, now the Conrad Treasury Casino, and its material was used in the construction of the University of Queensland at St Lucia, in Brisbane's west.

Sandstone from several quarries in the Helidon hills to the east of Toowoomba on the Darling Downs has also been used in Toowoomba, Ipswich and Warwick. The stone, formed 200 million years ago, is also one of the main materials used in Brisbane's St John's Anglican Cathedral, which is now nearing completion.

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