Tuesday, August 02, 2011

Brilliant new hospital reform: Add an extra layer of bureaucracy

That seems to be all that's left of Gillard's proposed new Federal/State arrangements. The Feds will also provide more funding but it's the same pool of taxpayer's money, however you divide it up

LABOR has caved in to premiers on national health reforms, junking a plan to guarantee public hospital elective surgery patients private hospital treatment if they are forced to wait beyond recommended periods.

Federal Health Minister Nicola Roxon has also watered down the previous blanket guarantee of a maximum wait of four hours for treatment in hospital emergency departments, agreeing that the target will now be rolled out on a hospital-by-hospital basis and will apply to only 90 per cent of patients.

Ms Roxon announced the backdowns yesterday just hours after Julia Gillard postponed a Council of Australian Governments meeting that had been scheduled for next week to thrash out the disputes with the states over the health reform package.

The reason given - that most of the disputes had been ironed out in informal talks - came into clearer focus with Ms Roxon's announcements, which the opposition then attacked as clear backdowns on election promises.

But as the opposition described Ms Roxon as a failure, the minister said the elective surgery changes would let more patients be treated within clinically recommended times because 100 per cent of patients would have to be treated on time by 2015, up from 95 per cent under the previous health reform deal.

And each year 10 per cent of the patients who had waited the longest beyond the clinically recommended time for their surgery must have their procedure done.

Labor was elected in 2007 with then leader Kevin Rudd promising to "end the blame game" between the commonwealth and the states.

Mr Rudd failed in a bid to take over majority control of funding of hospitals but promised a range of reforms, including minimum hospital emergency room waiting periods and greater use of private hospitals for elective surgery.

After Ms Gillard ousted Mr Rudd, she agreed to a deal with the states to boost commonwealth funding by $16 billion in exchange for greater transparency of hospital performance through the creation of a new hospital performance authority.

In subsequent negotiations, the states won concessions on the operation of the authority, including requirements that it must consult with the states before making conclusions about poor performances by particular hospitals.

Ms Roxon said the latest concessions were made on the recommendation of an expert panel of clinicians set up after February's COAG meeting. "I think it's a change, I am not pretending to anyone that this is not a change," she said. "If this is properly implemented more patients will be seen in the appropriate times and more of the backlog will be cleared than would have been achieved, particularly when we had advice from clinical experts that the previous structure would not have worked."

However, the changes strip away a key selling point of the health reform program initiated by Mr Rudd - a guarantee that patients not treated on time in a public hospital could get their surgery in another public hospital or in a private hospital within a specified period.

"The government considers that Australia's private hospitals will have an important role to play in the delivery of this guarantee," Mr Rudd pledged in his April 2010 health reform blueprint.

Yesterday Ms Roxon said this private hospital guarantee had been removed. "The major change is that instead of just saying as soon as you tip over the timeframe . . . you aren't meeting your target and there was a guarantee about purchasing that service from a private hospital," she said. "Instead they've built in a target to clear people on the waiting lists."

The reason for this change is understood to be the reluctance of private hospitals to take public patients on an ad hoc basis, because they preferred longer-term contracts.

The federal government was still encouraging states to use private hospitals, Ms Roxon's spokesman said.

Australian Private Hospitals Association chief Michael Roff said this meant there was now not much chance of people in a public hospital being seen in the recommended time. "The only way that was ever going to be achieved was through some innovative arrangements with the private sector adding capacity to the system," he said,

Catholic Health Australia chief Martin Laverty said the private sector wanted to help, "and more importantly the Productivity Commission has found that private hospitals on national averages are able to deliver a service cheaper than in a government-run public hospital".

Opposition health spokesman Peter Dutton said the four-hour target and the use of private hospitals to relieve public hospitals had been held out by Labor as answers to problems within the health system.


The Australian Leftist government's latest bright idea has not stopped the illegals from coming

PEOPLE-SMUGGLERS in Indonesia are understood to be preparing at least two more asylum boats as Immigration Minister Chris Bowen conceded some of the 800 boatpeople transferred to Malaysia may end up back in Australia.

As authorities on Christmas Island readied themselves for the arrival of 54 asylum-seekers whose boat was intercepted yesterday, and who will be among the first transferred as part of the government's Malaysia Solution, Tony Abbott predicted the new arrangements would fail.

"The ink is scarcely dry on that deal, yet another boat arrives," the Opposition Leader said yesterday. "I'm very doubtful this is really going to stop the boats."

Mr Bowen told the Sky News Australian Agenda program the 54 would be sent to Malaysia within "weeks" once they had been identified and screened.

Vulnerable asylum-seekers, such as unaccompanied minors, will almost certainly avoid transfer to Malaysia, although Mr Bowen was careful to insist there would be no blanket exemptions for fear smugglers would exploit loopholes in the regime.

"We've got appropriate staff now on Christmas Island," Mr Bowen said of the arrangements being made to effect the first transfer. We've got counsellors, we've got assessment staff, and we also have a Federal Police and security presence to make sure that all the appropriate arrangements are in place, and that's what will apply."

The minister's tough line followed the interception on Sunday morning of the latest asylum boat, which had among its personnel several Afghans and two crew, northwest of Scott Reef off the West Australian coast. It was the first boat to arrive since the Gillard government's Malaysia pact came into effect.

Under the arrangement, which was signed in Kuala Lumpur last Monday, Australia will transfer up to 800 boatpeople, taking in return 4000 declared refugees from Malaysia over four years.

A source close to the South Asian syndicates operating from Jakarta told The Australian yesterday the vessel was organised by a group headed by the jailed Pakistani Haji Sakhi, alias Zamin Ali, one of three people-smugglers being sought for extradition by Australia.

Two more boats are being organised by the Jakarta syndicates, one by an Afghan operator formerly part of the Sajjad group and the other by an Iraqi group.

News coverage of protests against the Malaysian deal in Australia and Kuala Lumpur has raised awareness of the risks among potential passengers and, according to sources in Jakarta, that threatens a slowdown in the traffic in the months ahead

But as the AFP prepared to force asylum-seekers on to planes, the shadow of legal action fell over the government's plan and threatened to delay, or prevent, any pending transfers.

Prominent refugee lawyer David Manne, whose advocacy on behalf of Sri Lankan asylum-seekers is credited by some for effectively ending the system of offshore refugee processing, hinted that he might oppose any attempt to deport the 54 asylum-seekers. "Wherever you have a situation of life or death, matters involving such significant rights and interests, and the government shirking its basic obligations in terms of protect obligations, then you certainly couldn't rule out a challenge," Mr Manne said.

Mr Bowen moved to manage public expectations about the implementation of the plan, saying the initial transfer would not occur within the 72-hour timeframe stated in the agreement. Instead, there would be a "ramp-up" period of a few weeks.

Mr Bowen's office confirmed none of the transit facilities that would hold the asylum-seekers was ready, nor had the government signed leases for any of the buildings, which were likely to be old hotels.

He said that while none of the 800 sent to Malaysia would be included in the quota of 4000 refugees coming back, some could find their way to Australia via normal resettlement channels.

"If the UNHCR makes the decision that somebody in Malaysia who has been transferred by us is a compelling case and it's appropriate to be resettled, then we would consider that in the normal course of events," Mr Bowen said. "But there would be no special treatment for those people."

Opposition immigration spokesman Scott Morrison leapt on the admission, saying it was further evidence of the government's lack of resolve. "They've exposed too many chinks in this thing, in terms of how they've announced it," he said. "I think the deals dying the death of a thousand cuts."

The Greens also condemned the deal, with their immigration spokeswoman, Sarah Hanson-Young, calling on the government to process the 54 asylum-seekers in Australia. "These people are being sent to an unknown fate because despite claims from (Ms) Gillard, there is no guarantee their human rights will be protected because there have been no changes in Malaysian domestic law," she said.

Mr Bowen insisted the transfer sent a "very clear message" to anyone considering the boat journey to Australia. "We're going to take you back to where you started that boat journey," he told Sky News. "You have nothing to gain out of that boat journey."


The "hate speech" emanating from Australian conservatives

Last week, the New York Times ran a headline depicting Breivik as a "Christian extremist" while other media outlets have labelled him a "white extremist". Breivik is certainly white - so much so that he is said to have undergone plastic surgery to look like an Aryan Nazi. But he does not belong to any Christian church and he has condemned both the Catholic and Protestant faiths.

In Australia, some left-wing commentators have focused on the fact that Breivik cited some well-known Australians in his manifesto - Peter Costello, John Howard, Cardinal George Pell, former Liberal MP Ross Cameron and historian Keith Windschuttle. It is easy to score ideological points against political opponents who have been cited with approval by a mass murderer. However, a reading of Breivik's manifesto reveals that the Australians named have nothing to be defensive about.

Costello is quoted as declaring that Australian Muslim leaders should denounce terrorism and Howard is referred to as stating that Islamist migrants to Australia should adapt to Australian ways. Cardinal Pell is cited as expressing concern about invocations to violence in the Koran and about the deeply anti-Christian views held by some secularists. Cameron's citation turns on his view that young men should commit to women and agree to have children. And Windschuttle is mentioned as someone who is disturbed about an anti-Western culture in many of our universities. That is all.

All of these comments are considered. None has provoked acts of violence in Australia.

One problem with the reaction by sections of the left to the Norway murders is that it is intolerant in itself. If the likes of Costello, Howard, Pell, Cameron and Windschuttle cannot say what they said, there would be no free debate at all.


Damages claims to flow from Wivenhoe dam mismanagement

THE Bligh government faces potentially huge damages claims from flooded residents and businesses after a finding by the Queensland floods inquiry that the operator of Wivenhoe Dam "breached" the official manual over the releases of water into the river system.

Premier Anna Bligh, who received the royal commission-style inquiry's interim report yesterday, acknowledged the breach by the flood engineers who were managing the dam's water releases "may well be ultimately tested in the courts".

The inquiry also pinpointed a lack of flood preparedness by the Queensland government, systemic dysfunction and confusion across bureaucracies involved in water management, a failure of the Water Minister, Stephen Robertson, to ensure timely risk-management before the flood, and other problems.

It has recommended a "precautionary approach is best" and a reduction in the Wivenhoe Dam to 75 per cent of its supply level for drinking water if future weather forecasts are as serious as the forecasts that were made late last year.

The inquiry's finding that the manual was breached strips the owner and operator of the dam, the Queensland government and SEQWater, of legal indemnification and paves the way for claims for compensation.

More than 17,000 homes and businesses were partially inundated at an estimated cost of $5 billion in the January floods. Many people are yet to return to their homes.

The inquiry qualified its finding that "there was a failure to comply with the Wivenhoe manual" by observing that the flood engineers "were acting in the honest belief that the Wivenhoe manual did not" compel them to adopt a strategy based on forecast rainfall.

A successful legal action would need to prove that the breach had a direct and adverse impact on the levels of inundation and damage, senior lawyers told The Australian yesterday.

The breach occurred because the flood engineers did not rely on "forecast rainfall" when they were determining the timing and volume of dam releases at critical stages of the flood event.

During periods of very heavy rain and with more forecast by the Bureau of Meteorology, the engineers made relatively low releases based on a "no further rainfall" model instead of the manual's requirement to be using "the best forecast rainfall".

A spokesman for SEQWater said yesterday the agency was continuing to review the interim report. The limited releases of water early in the flood event meant the dam was holding on to water unnecessarily and would more rapidly run out of capacity as its inflow increased.

As the dam's lake rose to worrying levels, the operators dramatically increased the releases to a peak flow of 7500 cubic metres a second - twice the volume known to cause damage to low-lying properties - and this started what hydrologists described as a "flood wave".

The inquiry's expert witness, hydrologist Mark Babister, has separately found that while the dam's releases comprised more than half of the total flood in the Brisbane River, the flood engineers achieved as good a result as could be expected. Ms Bligh vowed to implement all the recommendations of what she described as "a blueprint for us to manage future disasters better".

"We owe it to those people who suffered in this disaster to learn the lessons and act on them," she said.

After 31 days of public hearings that traversed central and southern Queensland, Justice Holmes released 175 detailed recommendations ranging from an overhaul of the dam's manual to standardised training for police officers in call centres, a single point of tasking for emergency rescue helicopters "as a priority", better liaison with the army and Red Cross and mandatory disaster plans for councils.

The interim report strongly criticised the actions of Toowoomba senior constable Jason Wheeler, who "wasted time" admonishing a woman trapped in rapidly rising flash flooding at a busy CBD intersection in the hilltop city. The woman, Donna Rice, 43, and her 13-year-old son Jordan later died after being swept away from their car.

The interim report said although Constable Wheeler assumed the caller was not in danger, he had "failed to ask obvious and relevant questions" to determine the potential danger.

The inquiry heard the number of trained swift-water rescue technicians across Queensland was "manifestly inadequate", leading to rescues being delayed or carried out by the public because there was not enough staff. "The fire service did not have enough firefighters trained as swift-water rescue technicians (Level 2) to meet the demands of the 2010-11 floods," the report said.

It called for the Queensland Fire and Rescue Service to consider providing basic swift-water rescue training to all auxiliary firefighters in flood-prone areas.

The interim report also urged a statewide campaign about the dangers of driving through flooded roads, highlighting nine deaths in such circumstances during the summer. It called for practical training for council-based local disaster management groups before the next wet season and better use of SMS alerts for extreme weather and floods.

The report said that if a task was considered too big for one council area, personnel from other local governments should be deployed.

The Local Government Association of Queensland president Paul Bell said councils were working to increase engagement with local communities.


1 comment:

Paul said...

If you think about it (briefly) you realize there is only one way to stop the boats, and that is to not allow them to land...at all on any Australian territory. Given that none would be provisioned for a return trip we know what would happen, if indeed we chose that path, which I suspect would put us in uncharted international law-of-the-sea..er..waters (even before one got to the moral position of leaving their slow death as their only alternative course). The only other alternative is to prevail on our neighbours to stop them launching, which they clearly aren't interested in doing. ugly sure, but it would be effective, but which side of politics would make it official policy? beyond this we are screwed.