Monday, March 28, 2011

Hospitals pay $6000 for Kiwi weekend warriors

A CHRONIC doctor shortage in NSW has led to the rise of fly-in, fly-out locums from New Zealand and interstate who are increasingly covering shifts that cannot be filled with locals.

Some weekend warriors, as they are called, will fly in from New Zealand on a Friday, work two days and fly home on Monday, pocketing $6000 or more for their efforts.

Recruitment agencies that specialise in locum placements say business is booming – with most of the demand coming from emergency departments in regional NSW. The NSW government spent $59 million on locums for regional areas in the 2009-10 financial year.

Local doctors have expressed concern about the spiralling cost, saying they are willing to do locum work but are effectively stopped by NSW Health policy. Sally McCarthy, president of the Australasian College for Emergency Medicine, said increased regulation now required doctors working in public hospitals to seek permission from NSW Health before undertaking locum work.

"Often that permission is not forthcoming or it's extremely slow and there is a lot of paperwork involved," Dr McCarthy said. "That means for doctors who may be available to work one or two shifts, it's not worth the effort for them to ask for that permission."

New regulations on locums were introduced three years ago to prevent doctors working dangerously long hours, to exercise greater control over pay rates and to ensure they were qualified to do the work they were given.

"Effectively all it has done is make it impossible to employ locums in certain hospitals," Dr McCarthy said. "Doctors will fly interstate and work for another state if they want to do extra work. Similarly, you'll have doctors flying into NSW from other states to do locum work here. It's crazy."

The greater regulation of the locum market was introduced after a 2005 study found it was costing NSW Health $35 million more to employ locums than hire permanent staff. While there have had been benefits, Dr McCarthy said the increased paperwork required had proved to be an impediment.

"One of the constant laments of doctors and nurses working with NSW Health is the incredible and increasing bureaucracy," she said. "It is completely obstructive to providing a service."

Australian Medical Association president Andrew Pesce said the increased regulation ensured locums were qualified for the work they performed and were not working dangerously long hours. However, he agreed it would be better to use locals.

"Obviously it costs a bit more to fly people in from other states or from New Zealand," Dr Pesce said. "In general you would think if you have a local workforce that's willing to provide a service, it would be better to use them. It really fails the commonsense test."

NSW Health defends its use of interstate and overseas locums, saying they are essential to keeping services running.

'2018;There is a worldwide shortage of medical staff that is affecting NSW as it is everywhere else in the world," a spokeswoman said. "Our priority is to provide the best possible care for patients in need and it is sometimes necessary to provide locum medical officers both from within and outside the state to maintain services, particularly in rural and remote areas and busy emergency departments."

Locums working at remote hospitals in NSW were generally paid more than twice as much as those in metropolitan hospitals. Rates for specialists were higher and hospitals were willing to cover flights and accommodation, said Kerrie Dudley, the director of a NSW recruitment agency, Antipodean Medical Recruitment.

"There are plenty of New Zealand doctors who are happy to do it," she said. "Especially consultants, they'll come over for a long weekend, no problem.

"They can leave New Zealand at 6 that morning and start a shift in Sydney or just outside in an area like the Blue Mountains, Gosford or Wyong – they can start at 10am. It's become quite a common thing."

Sam Hazledine, managing director of New Zealand agency MedRecruit, said caps on locum pay rates introduced in New Zealand last year had encouraged the flow to Australia.

"Since then, our doctors on average can earn twice as much in Australia," Dr Hazledine said. "If you take the exchange rate into account it's even more. We have seen a big net migration of locum doctors to Australia."

He said: "There is the weekend warrior phenomenon. You would have people heading over to Australia to work for the weekend, make $5000 or $10,000, and then fly back."

But now the trend was for New Zealanders to seek longer-term locum positions.

"It works out well for the doctor because they are in a place they love earning great money; it works out well for the hospital because they are securing the doctor for a long time."

New Zealander Jason Pascoe took a locum position in Port Macquarie last year and has since taken another as an emergency doctor in Bega.

"The money is better here," Dr Pascoe said. "I had plenty of friends from New Zealand who had come over here and had positive things to say, so I came over and so far it's been really good."


Anglicans lose the plot

Next thing they'll be ditching that fusty old-fashioned Bible

THE inscription on June Cameron's family prayer book commemorates her aunt's confirmation at St Clement's Anglican Church in Marrickville in 1910.

Mrs Cameron was married in the Gothic Revival-style church. So was her daughter. But most of her children and grandchildren have since left the area. And now, at 81 years old, she has finally been moved along as well.

"It's sort of devastating, all of a sudden. To have them do this," she said. "It isn't just the church's history - it's blooming well mine. And that's what I object to."

Mrs Cameron was part of the congregation at St Clement's moved out of the historic building last month, when its Sunday prayer book service was replaced with an "informal" service held in a shopfront next door.

For many among the congregation it was yet another sign that church leaders viewed them as incompatible with the future envisioned for St Clement's, which would aim to increase attendance by restyling the parish to suit a modern congregation.

Other groups, including a flourishing Chinese congregation and a "church plant", or introduced congregation that joined the parish in 2009, hold their services in the church.

"We were excluded because we didn't fit in. And our idea of a service didn't fit in," Mrs Cameron said.

The organist of 35 years was told in January her services were no longer required; the parish recently added a new jazz group.

Long-time parishioner Ken Turner said the group had shrunk from about 45 to 15, as many opted to leave rather than fight the changes - which increased following the election of last year's parish council, under its part-time rector, Reverend Campbell King.

At the annual vestry meeting yesterday, the traditional congregation did not have the numbers to get any members elected to the new parish council.

Last month the parish submitted a development application to Marrickville Council - with the approval of the diocese - to remove the pews to increase space "for standing, dancing and singing-style congregations". The application suggested the baptismal font could be moved to accommodate a cafe.

The Heritage Council of NSW this week advised council the application was "lacking in its assessment of the heritage significance of the site".

Mr Turner said he complained about the removal of the pews, and the Archdeacon of Liverpool, Ian Cox, asked him to let the matter rest.

Mr Cox said the parish was seeking new ways to connect with the community and its decisions were no different to those being made in other "rapidly changing suburbs". [Marrickville is an old suburb but it has had a lot of Southern Europeans for years. How come it is "rapidly changing"?]


Power generator tells academic climate adviser to get real

ELECTRICITY producers have called on the Gillard government's chief climate change adviser to drop "undergraduate rhetorical devices" and develop "real world" policy about power generation that doesn't damage the economy.

One of Australia's biggest electricity generators, InterGen, has challenged Ross Garnaut to change his position on not compensating power companies for asset value destruction under a carbon tax. Brent Gunther, managing director of InterGen, which produces 16 per cent of Queensland's electricity, has declared that Professor Garnaut's arguments have "missed the point" about financial damage to companies under a carbon price.

He joins several senior business figures in speaking out against the carbon tax proposed to start on July 1 next year.

Mr Gunther says, in an article published in The Australian today, that Professor Garnaut's position on compensating power companies under the Rudd government's carbon pollution reduction scheme would have resulted in "major damage to the national electricity market" and was a "prescription that will end up damaging the Australian economy".

Professor Garnaut "needs to deliver real-world solutions, not high-level principles that assume away problems", Mr Gunther writes.

Professor Garnaut will release another major discussion paper on electricity generation and the carbon tax tomorrow, but signalled last week he had not changed his position from 2008, when he argued there were no grounds for compensation for electricity generators.

He said that, although assistance to emissions-intensive, trade-exposed industries was needed to avoid unfair competition between Australian emitters and those in countries without a carbon price, this should not be confused with providing support for loss of profits or asset value.

"Any fall in asset value stemming from the internalisation of the carbon externality (through pricing carbon) creates no greater case for compensation than other government reforms to reduce other externalities, such as the introduction of measures to discourage smoking, control the use of asbestos or phase out lead in petrol" Professor Garnaut said.

Mr Gunther says the comments suggest Professor Garnaut's discussion paper tomorrow will be a "prescription based on a simplistic and superficial understanding of the power sector - a prescription that will end up damaging the Australian economy".

The InterGen chief also says that asset value losses for electricity companies raise the prospect of state governments having to direct "a power station to keep operating if things ever got bad".

In 2009, as a result of Professor Garnaut's recommendations, the Rudd government indicated it would provide $7.3 billion over 10 years to the power sector for the impact of an emissions trading scheme.

This was after commissioning a report from investment bank Morgan Stanley that highlighted generators would be unable to pass on to consumers the impact of a carbon price on their asset losses.

"At a time when the economic debate in Australia is starting to refocus on how to enhance productivity, the importance of the national electricity market should never be underestimated," Mr Gunther says.

He says the energy sector wants to "develop a solution", as did Climate Change Minister Greg Combet and Energy Minister Martin Ferguson.

Last week in parliament, Mr Ferguson, said: "A highly efficient energy-driven system has been the key to the Australian economy.

"The Australian energy market is actually held up as the most efficient in the OECD world.

"It is estimated that over $17bn of capital is required for powerhouse generation assets - that is, refinancing, capital expenditure and new build over the next five years."


Straddling black fella and white fella law

Sara Hudson

Bess Nungarrayi Price, an activist against violence and chairwoman of the Northern Territory’s Indigenous Affairs Advisory Council, gave a moving talk at CIS this week about the problems faced by Central Australian Indigenous communities.

Price described a typical week in her life. How every day, a member of her family was either the victim of violence or the perpetrator of crime. How a young relative committed suicide because the boy she liked was from the wrong skin group and she was forbidden to see him. How another young woman was gang raped but no one in the community did anything about it. The perpetrators were from the right skin group, and the young woman could not report the crime to police for fear of retribution.

Women in traditional aboriginal culture are subordinate to men and Price herself has had her life threatened for speaking out about these injustices.

Too many people romanticise Aboriginal culture. The ‘Disneyland’ idea of culture is holding Aboriginal people back. It fosters the belief that Aboriginal people do not need to adapt, to learn English, and become educated. While there is much about traditional Aboriginal culture that is worth continuing and maintaining, Price feels that Aboriginal law needs to be adapted to fit with ‘white fella’ laws.

When Aboriginal people follow their own law, they break ‘white fella’ law; when they follow ‘white fella’ law, they break their own laws. Price explained how only Aboriginal people have the power to change their laws, but they need white people to help them by really talking about these issues with them.

Lawyers are using traditional culture as an excuse to get their clients off charges or to receive more lenient sentences. Recognition of traditional culture was introduced to counteract institutional racism in the criminal justice system. But it is rewarding the perpetrators of crime, not the victims.

Most of the crimes committed by Aboriginal people are intra-racial – and it is Aboriginal women who bear the brunt of men’s violence. Human rights groups protest against honour killings in other countries but turn a blind eye to the injustices taking place in their own backyard for fear of being labelled a racist.

Price’s plea was that we need to stop being afraid to speak up and to stop using culture as an excuse for crimes.

The above is a press release from the Centre for Independent Studies, dated 25 March. Enquiries to Snail mail: PO Box 92, St Leonards, NSW, Australia 1590.

No comments: