Monday, March 22, 2010

Libs back from the dead and in with a chance

The state elections show momentum and maths moving Abbott's way

THERE are two federal messages out of the Tasmanian and South Australian state elections at the weekend: momentum and mathematics. And both are moving Tony Abbott's way.

First to momentum. Anybody who tries to tell you that voters in either state cast their ballots on the basis of Abbott or Kevin Rudd's policies, or on the basis of their respective plans for health care and hospitals, or their approach to climate change, is talking tosh.

What they did vote on was the issue of unity; that after years of corrosive in-fighting over leadership, both state Liberal parties finally got their acts together and voters rewarded them for it. The fact that the swing back to the Liberals in both states was just over 7 per cent reinforces this fact. The swing away from them when they lost at the last election was so bad that had they recovered by half as much, they would have been returned decisively in both states.

The result shows the high-water mark of the Labor brand in Australian politics, and this includes federally. Many people have been wondering why Rudd's fall from grace, as measured by the polls, has been so speedy. My analysis for what it's worth: Rudd's misfortune has been to come at the end of the Blair era. The electorate has watched for more than 10 years now as do-nothing state Labor premiers have dominated the evening news in fluoro jackets, framed by bulldozers. The same goes for milling about hospital beds with television cameras, harassing patients who are just trying to get better. All in the name of a health policy that doesn't start until 2014.

That sort of Hawker Britton news management may have worked at a state level but voters have now seen so much of it that they have also seen through it. They also expect more of their federal leaders.

So that's the Labor brand. What of the Liberals? Here the theory is that with Howard gone the Coalition drifted, first under Brendan Nelson, then under Malcolm Turnbull. The ascension of Tony Abbott has changed all that. He now offers a real point of difference to Rudd and, critically, he has reunited the party. They're no longer the rust bucket full of leaking holes they once were. And as in Tasmania and South Australia, voters are beginning to reward them in the polls.

This was most evident in South Australia, where the Liberal base returned in large numbers in traditional seats such as Norwood, Bright, Morialta, Hartley and Adelaide. The Mike Rann v Isobel Redmond contest was also redolent of the Rudd-Abbott square-off. Rann was your classic spin merchant, the last of the Labor state premiers in the mould of Bob Carr and Peter Beattie.

Rudd is the first federally to be cast in the state mould. Abbott, like Redmond, is judged to have been the real deal by the electorate; straight talking and authentic, somebody with whose views you might not necessarily agree, but who you respected nevertheless because they simply held them.

Which brings us to the federal election. There's a perception abroad that with Rudd so far ahead, Abbott has no chance. The maths of the Tasmanian and South Australian elections, both with swings of just over 7 per cent, speaks of another equation. As we speak the Coalition needs 17 seats to hold government in its own right. Sounds daunting.

But if there were a sizeable swing to the Coalition, the independents, Tony Windsor, Bob Katter and Rob Oakeshott, all holding conservative seats, could be expected to sit with the conservatives. That reduces the task to 14 seats.

Under the most recent redistribution there are five seats which have become notionally Labor but are actually represented in the parliament by Liberals: Dickson, Macarthur, Gilmore, Greenway, and Swan. They're expected to come back to the Coalition. If you doubt that, Peter Dutton recently paid for some polling in his seat; Rudd's popularity rating was net 22. Dutton was on net 20.

The redistribution has put Greenway within reach. So that reduces the 14 seats the Coalition needs to win to 10.

Then there are the other winnable marginals in Queensland where voters have gone sour on Rudd: Leichhardt, where local Liberal favourite Warren Entsch is standing again; Dawson, where the local Labor MP is resigning due to ill health; Flynn, a coalmining seat where the local member has already declared he's "gone" on the issue of climate change; and Brisbane, which is now ultra-marginal and is being contested for the Liberals by former MP and seasoned campaigner Teresa Gambaro. In Bonner, former member Ross Vasta is going around again. Forde is regarded as a possibility. The redistribution also abolished a seat on each side.

In Robertson, NSW, the most marginal Labor seat in the country, the Liberals look like a shoo-in, thanks to the antics of sitting member Belinda Neal. The same for nearby Dobell. The Nationals are looking to pick up Page again. Bennelong is, in the words of one shadow minister, the white whale; the seat will be pursued obsessively by the party as Captain Ahab. But in the end it will be uncertain who has captured whom .

Lindsay will be gettable for the Liberals because, unlike either Nelson or Turnbull, Abbott appeals to the Howard battlers. Eden-Monaro could well change hands based on its status as the nation's bellwether seat. Abbott's stand on climate change will be vital there.

In Victoria, Corangamite should come back to the Liberals based on the fact Stewart McArthur went round one too many times. And in Tasmania, looking at the weekend's numbers, Bass and Braddon are definite chances. In SA, Hindmarsh is dominated by the elderly, whom Abbott may well appeal to. Kingston swings with cost of living and interests rates, neither of which look to be coming down. In the Northern Territory, as in Hasluck in the west, boatpeople are a big concern. And that leaves Wentworth and Turnbull's intentions. Of which we know nothing. But you see where I'm going here. In the end there may only be four to five seats in this.

In February Rudd addressed his party caucus after another bad Newspoll. He warned it needed to be mindful of the perils of first-term governments and that this year's election campaign was likely to be very tight.

"Remember, the government's majority is what, eight seats?" he said. "Two or three percentage points? It doesn't take much to move that. Two or three people in a hundred change their votes, then Mr Abbott's prime minister."


Paying nurses to play doctor will make system sick

The Medicare reforms will only exacerbate the problems facing public hospitals

CRITICISING the nursing profession is like killing Bambi. Nurses who devote their lives to the care of the sick rightly deserve our honour and respect. But the problems with the Rudd government's changes to Medicare, which fundamentally change the role of nurses in the health system, cannot pass without comment.

Under the legislation passed by the Senate last week, nurse practitioners will for the first time be allowed to bill the Medical Benefits Scheme for treating patients with minor illnesses and prescribe certain medications on the Pharmaceutical Benefits Scheme.

These changes are not only an egregious waste of health dollars. They will also encourage nurses not to work where they are most needed: in public hospitals, feeding, washing and medicating the sickest patients in the nation.

To understand what the problems are you have to appreciate the structural defects with the health system. Since free fee-for-service general practice visits were introduced in 1984, increasing amounts of taxpayers' dollars have been spent at the least severe end of the health spectrum. To try to contain the cost of bulk-billed services that were immediately overused and quickly became a political sacred cow, the number of medical training places was capped in the mid-1990s. Today's GP shortage and longer waits for appointments is the result.

As the cost of Medicare spiralled, health spending was controlled at the one point in the system where real savings could be made. Public hospital budgets were tightly capped and bed numbers hugely culled (by 60 per cent since 1984) to limit the number of patients who could be treated. Today's ever longer waits for elective surgery and emergency admission are the result.

Rationing of services by waiting based on relative need is an unavoidable feature of all government-run, taxpayer-funded health systems. But what Medicare has produced is an irrational and immoral rationing in the form of an inverse care law.

People with no or relatively minor health problems can see the doctor free of charge and virtually on demand an unlimited number of times at taxpayers' expense, while people with serious illnesses are denied timely access to care and are forced to wait and suffer in the long queues for essential treatment in overcrowded hospitals.

Paying nurses to substitute for doctors so the "worried well" don't have to wait is the wrong priority. This will simply pour more money into the part of the system that will do the least to improve health.

Creating an alternative, lucrative career path for practice nurses will also worsen the shortage of nurses willing to work in hospitals and therefore make it even more difficult to increase the number of hospital beds. It will exacerbate the problems in the nursing profession that have stemmed from the shift from in-hospital training to university-based education in the 80s.

According to many nurses trained under the old vocational system, university training has been a disaster. The three years spent in the classroom has left many nurses unprepared for life in the wards, leading to premature permanent retirement.

This is backed up by the failure of the federal government's greatly undersubscribed back-to-work program. Last year, just 541 returning nurses took up the offer of $6000 cash bonuses, half the number expected and only 7 per cent of the five-year target.

The changes to Medicare aren't a victory against the doctors club, they're a win for interest group politics. The nurses union has flexed its considerable political muscle and convinced the government to use taxpayers' money to pay nurses to do the kind of community-based clinical work that many university-trained nurses now prefer to do.

This is one of the reasons many frontline hospital staff support a return to the traditional system. On-the-job nurse training would enable trainees to discover whether they are actually cut out for nursing. This would also open up nursing careers to students who are unable to gain university admission. And it would enable many hospital beds to be immediately reopened. While we clearly need more ward-based nurses, this does not diminish the need for specialist nurses who will require higher education.

Practice nurses have an important role to play in modern health care. But to ensure safety and quality, practice nurses should work in the same clinics in partnership with doctors who have full clinical responsibility for the care of patients.

When the MBS was introduced the M was said to stand for the all the Mercedes that GPs would now be able to afford. It's the same story this time round. Paying nurses to play doctor will see taxpayers money subsidise a new class of health entrepreneurs. It will not do what all good health reform should promote: the efficient use of scarce resources to ensure the truly sick receive better care.

Any government serious about health reform should end this rort before it has even begun.


Australians living in prosperous times, says CommSec

AUSTRALIANS have never had it so good, to coin a phrase. Commonwealth Securities chief economist Craig James says a new measurement tool launched today shows that Australians are indeed living in prosperous times. The CommSec National Performance Gauge stood at a record high at the end of 2009, rising four per cent over the past year when other countries were trying to cope with global financial crisis.

While the recent Australian Bureau of Statistics national accounts data showed Australia outperformed the rest of the world in 2009, the data indicates how the broader economy fared rather than individuals.

"The CommSec National Performance Gauge attempts to fill the void by focusing on issues that matter to ordinary Aussies," Mr James said. "That is, financial decisions like buying a car or house, filling up the car with petrol, the state of the job market, wages and confidence levels." The CommSec gauge has seven measures:

- Income per head

- Retailing spending per head

- Unemployment

- Consumer confidence

- Number of weeks to buy a car

- Number of weeks to pay the average monthly mortgage repayment

- Litres of petrol that can be purchased on the average wage.

The starting point for the gauge is 1987.

Over the past decade, the CommSec gauge has increased by just over 10 per cent. "While the standard of living of ordinary Australians has lifted over time, those who have done best have been those holding assets such as shares and houses," Mr James said. Adding shares and house prices to the index - the CommSec National Performance Gauge Plus - this shows a 42 per cent jump over the past 10 years.

The gauge shows that car affordability is the strongest in 35 years, taking a person on the average wage just under 30 weeks to buy a new Ford Falcon, down from 36 weeks five years ago.

You can also buy just over 1,000 litres of petrol per week on the average wage, a gain of seven per cent over the same five-year period. During that time, income per head has increased by six per cent and retail spending has risen seven per cent. And while there are gripes about rising home lending rates, the gauge shows it takes a worker on the average wage 1.58 weeks to make the monthly repayment on an average mortgage, similar to levels of five years ago.

Among the states and territories, the ACT tops the gauge's ranking, followed by Western Australia and Tasmania. The country's two most populous states, NSW and Victoria, came seventh and eighth, respectively.

Mr James admits it is difficult to accurately compare different periods of time. "Many, perhaps fondly, remember the simpler times of the 1950s and 1960s. And some people would prefer that interest rates were lower or perhaps jobs were more plentiful. "But in terms of general economic well-being, you would be hard pressed to fault the current times."


Is the national curriculum overdue, or spoiled by political correctness?

By BRETT MASON (Senator Brett Mason is a former university lecturer and Shadow Parliamentary Secretary for Education and School Curriculum Standards)

A necessary and long overdue step in education reform in Australia or the further entrenchment of a politically correct agenda in our primary and secondary schools? Or, indeed, both?

These will be some of the questions that parents and others interested in the education of our children will be asking when considering the draft National Curriculum in English, Mathematics, History and Science, recently released for public consultation by the Australian Curriculum Assessment and Reporting Authority.

The idea that all Australian primary and secondary students, regardless of which state or territory they attend school in, should be studying the same things, at the same time in their academic progression, and according to the same standards, has been bandied around for years. It is no longer seen as controversial, and now enjoys broad public support. The devil, as is so often the case with Rudd government initiatives, will be in the detail – of both the finished Curriculum and its implementation.

With the draft National Curriculum now publicly available we can start forming an opinion on the former; and with the Rudd government’s past track record in implementing its lofty programs we are inclined to fear the latter.

While some aspects of the Curriculum, such as the greater emphasis on achieving practical literacy and numeracy, are welcome improvements, there are serious concerns about the direction the Curriculum drafters chose to take in a number of other areas, such as history and science. Perhaps the root problem with the draft Curriculum is ACARA’s decision to weave through all the subject areas three “cross-curriculum perspectives”, no matter how relevant these over-arching themes are to each subject. They are the “Indigenous perspective”, “a commitment to sustainable patterns of living”, and an emphasis on Asia and Australia’s engagement with the region.

There is, of course, nothing wrong with our primary and secondary students learning more about Aboriginal culture, the environment or the history of our region. It is, however, a question of weight, priorities and perspective as to how much, when and in what context students are required to absorb these themes. And the picture presented in the draft Curriculum does not look promising.

Thus, for example, in the Science curriculum, year 9s are to study traditional Chinese medicine, before being given their first opportunity a year later to look at the periodic table of elements, arguably the most important document of modern chemistry, which systemises and informs our understanding of the physical world around us.

Or take 4 year olds in preschool being taught the significance of ANZAC Day and Sorry Day at the same time, while having to wait until Grade 3 to learn about Australia Day and its meaning and place in our nation’s history.

Indeed, the Curriculum contains 118 references to Aboriginal and Torres Strait Islander people, culture and history (with Grade 5s studying “White Australia” and Grade 9s Aboriginal massacres and displacement). But there is only one reference to Parliament, and none to Westminster or the Magna Carta, the aspects of our political and cultural heritage that have made Australia perhaps the most peaceful, successful and prosperous democracy in the history of humanity.

If the new National Curriculum sounds like the return and the entrenchment of the “black armband” view of our history, you can be forgiven for being confused. Unlike its drafters, the Coalition – as well as a large majority of Australians - believe that, on balance and for all its faults, Australia’s history is a cause for celebration rather than constant breast-beating.

Here again we have all the ingredients of another Rudd government disaster in the making: a grand but not unattractive idea (the National Curriculum), a tight schedule (2011 is to be a pilot year involving a number of schools around the country), and little thought given to the practicalities of making it all work. There are no resources coming from the Federal government for all the additional teacher training and development required, while extra burdens will be imposed on those who have to deliver the initiative.

Primary school principals in particular are already worried about their capacity to deliver the science, history and math components according to the detail prescribed. We are already experiencing teacher shortages, particularly in areas like science, and the demands of the new Curriculum will merely exacerbate the problems while leaving others to pick up the pieces. For instance, it has been highlighted that only 16 universities in Australia train history teachers and 10 of these are in NSW. It will be necessary for universities to significantly adjust to meet this new demand, particularly given that the Curriculum mandates as many as 80 hours of history a year. Bear in mind that NSW, the only state that currently teaches history as a stand-alone subject, only sets aside 50 hours per year for teaching this subject in years 7 to 10.

Quite apart from the technicalities, the Australian Education Union and legions of individual teachers will in the end have a considerable influence on how the final product is translated for consumption in the classrooms. In the past this has proven to be a game of Chinese whispers where Australia’s mainstream often misses out in favour of elite preoccupations. In its 2007 Curriculum Policy Document, the AEU states, for example, that the first task of schooling should be to "assist in overcoming inequalities between social groups".

To that end, a curriculum entails "recognising that Australia is a multicultural society and that therefore students come to school with a variety of backgrounds, cultures, histories and values, all of which are equally valid" – a statement of cultural relativism that not many outside of the AEU head office would actually agree with.

Or that through a curriculum “students should gain an understanding of the role that the construction of gender has played and continues to play in society”, another exposition of political correctness of little obvious benefit to making our children better educated and productive citizens.

With a die-hard commitment to these sorts of values, parents could be forgiven for fearing that no matter how balanced the National Curriculum will be the ideologues in our education system will always find a way to teach what they want and how they want it.

Parents and other interested parties have just under three months to provide feedback on the draft; that is if they manage to access the information and navigate the rather user-unfriendly feedback website. Perhaps the "digital education revolution" should have started with the government. All we can do at this stage is make our voices heard and hope that a more balanced and mainstream vision of a National Curriculum will prevail.



Paul said...

There is a place for Practitioner Nurses as Medicare enabled practitioners in some settings, particularly in the ares of chronic disease such as diabetes or kidney failure s part of a treatment team approach. Health assessments, repeat prescriptions etc. do not always require the eyes of a Medical Practitioner. I think this guy is way over-estimating the impact of Practitioner Nurses and is seeing them in the thousands where it'll be a long time before their numbers even reach the hundreds. I guess time and Government meddling will tell. I'm with him on his views of Nurse training though. The quality of Grads is inversly proportional to the intensity of the work. The arrogance and sudied neglect of the Unis toward their students is a story for another day.

Paul said...

Further to that, we have the situation at my hospital where Nurse shortages are now so dire that they are compounding. New nurses start, see just how bad the understaffing is and are gone within weeks. And here in Cairns many breadwinners are out of work due to the collapse in tourism. Normally economic weakness brings nurses back into the workforce (as it did in 1991), but now it isn't happening. Part of our problem here was that the clever people made the hopsital smaller about ten years back to try and engineer medical practice in favour of sending people home early or just not admitting them at all. The services needed to make this idea work were never put in place and the population just kept on growing. The end result now is our service is close to crippled and belated redevelopment has barely started.