Monday, January 16, 2012

Whaler in Aust waters stand-off

This report is from a couple of days ago but it shows the weak position of the Gillard government. If Gillard expects respect from Japan while she gives safe harbour to ships that attack the Japanese fleet, she is very optimistic indeed. There's probably an international convention against protecting piracy too, which Japan could accuse Australia of breaching.

It would be a great loss of face for Japan to surrender in the face of Greenie attacks so the Greenies by their actions ensure that Japan will continue whaling.

Whale meat is not popular in Japan and the trade would die out of its own accord without Greenie meddling. As it is, Japan has resorted to handing out free whale meat in schools in order to reduce their unused stocks of it

A Japanese whaling ship has defied high level Australian complaints and has stayed in the waters of World Heritage-listed Macquarie Island. The harpoon-equipped whale hunter, Yushin Maru No3, was still there late yesterday, hours after Prime Minister Julia Gillard said the ship was leaving.

"I'm aware that there has been one vessel which I'm advised has been in Australian territorial waters and I'll advise that it will leave Australian territorial waters," Ms Gillard said.

The Australian embassy told the Japanese Government on Tuesday that whaling vessels were not welcome in the country's waters, repeating earlier complaints. But the Japanese ship was photographed yesterday within a few miles of the coast of Macquarie, which is part of the state of Tasmania.

The Sea Shepherd anti-whaling group said the harpoon ship continued trailing the vessel Bob Barker inside the 12 nautical mile territorial limit all day. The Bob Barker's first mate, Peter Hammarstedt, said, "Things seem to be reaching a boiling point here. "It has followed us on circuits of the island, keeping right inside the 12-mile zone."

The Bob Barker sought refuge at Macquarie in an attempt to shake the harpoon ship off its stern. As long as some vessels of the Japanese fleet are able to keep tabs on Sea Shepherd activists, the others can keep clear and continue whaling.

Meanwhile, Sea Shepherd leader Paul Watson said from far south of Western Australia last night that the Japanese security ship Shonan Maru No2 had left the tail of his vessel, Steve Irwin, to be replaced by the harpoon ship Yushin Maru No2.


'Perverse' incentives cost Medicare up to $3bn a year, claims GP

A SYSTEM of "perverse" financial incentives under Medicare is causing the Australian health care system to haemorrhage billions of dollars each year, a medical expert says.

In a scathing article for the Medical Journal of Australia published today, GP Dr Tony Webber has described the Medicare scheme as a "monster". "I estimate that $2 billion to $3 billion are spent inappropriately each year," Dr Webber writes.

As former chief of the Professional Services Review - set up to police Medicare - he said he gained insight into how dysfunctional the system had become.

Two items listed on the Medicare Benefits Schedule which are subsidised by the Government and create "opportunities for a bonanza" are General Practice Management Plans (GPMPs) and Team Care Arrangements (TCAs), Dr Webber said.

They aim to allow doctors to spend time with complex patients, such as those who have diabetes, kidney failure and hypertension. But "perverse incentives" and a badly drawn-up scheme had created opportunities for abuse, he said.

Under Medicare a normal consultation of at least 20 minutes carries a benefit of $69. If a GP wants to refer a patient to a Medicare allied health service, a GPMP and TCA need to be drawn up. A GPMP attracts a Medicare benefit of $138.75, a TCA has a benefit of $109.95.

"That's created a monster because many of these items are being done for inappropriate reasons for people for whom their medical conditions would ordinarily be managed quite happily in the course of the normal general practice," Dr Webber told AAP.

Items listed on Medicare also needed to be re-evaluated to reflect their true cost, he argues. While once cataract surgery was a "big deal", with patients staying for a week, it now takes around 20 minutes. Despite this, private patients are sometimes charged more than $4000 for this procedure, with top providers performing more than 20 procedures in one day, he wrote. "Not bad work if you can get it but very poor public policy," he said.

A spokesperson for the acting minister for health, Nicola Roxon, said "a broad compliance regime" monitored the MBS and the PBS. "Items listed on the Medicare Benefits Schedule are placed there because they are clinically necessary."

The spokesperson also said Dr Webber, who was responsible for running a peer review arrangement on around 270 doctors, "has no responsibility in the area of health policy or funding". "Accordingly, he is unable to comment with authority on these matters."


Putting a dollar value on having top teachers

GOOD teachers can influence the earning power, teenage pregnancy rates and university enrolments of their students.

These are the findings of a controversial US study, which followed 2.5 million students over 20 years.

The study, by economists from Harvard and Columbia universities, used scores from standardised tests - the US equivalent of Australian NAPLAN testing - to assess teacher quality.
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It has not been peer reviewed but its results have sparked debate between teachers and parents over the benefits of merit-based pay for teachers, one of Prime Minister Julia Gillard's 2010 election promises.

The study found "excellent" teachers can increase a student's lifetime income by about $4600, compared with students of a similar demographic. Across an entire classroom, that could equate to $266,000.

Students who had the best teachers were also least likely to become pregnant in their teens, the study found.

But the majority of Australian teachers argue that using NAPLAN results to measure teacher quality does not take into account other factors such as student backgrounds.

"It is extremely difficult, if not impossible, to isolate teachers in that way," the president of the NSW Teachers Federation, Bob Lipscombe, said. "A typical high school student has seven or eight teachers each year - which teacher takes credit for the results?

"More goes into making an excellent teacher than just test results."

But the president of the NSW Parents and Citizens Association, Helen Walton, said the study's findings could empower parents who are concerned their child's teacher is not performing well.

"You need quality teachers in every classroom, in front of every child," she said. "At the moment, if a parent or a group of parents are concerned that a teacher is not performing, the process required to put that teacher through an improvement program can take up to 12 months. By that time, it's too late."

The Federal Minister for Education, Peter Garrett, said the government was working towards giving schools greater say on recruitment. However, he stopped short of endorsing the study.


Women 'overdiagnosed' with breast cancer

There have been similar reports to this from Britain

WOMEN are being treated unnecessarily for breast cancer due to mammograms "overdiagnosing" cancers which would never cause harm, a study has revealed.

In an article published in the Medical Journal of Australia, Monash University breast cancer researchers Robin Bell and Robert Burton called for women invited to use the publicly-funded BreastScreen program to be presented with a more balanced view about the benefits and harms of breast screening.

Their analysis found that improvements in cancer treatments rather than early detection through screening was likely to have caused the 21 to 28 per cent reduction in breast cancer deaths since the program began in 1991.

A 2010 study found that for every 2000 women invited for screening throughout 10 years, one would have her life prolonged but 10 healthy women would be diagnosed as breast cancer patients and treated unnecessarily.

The Cancer Council has backed calls for women to be informed about the risks and benefits of screening, including the uncertainty of overdiagnosis but insist that breast screening has contributed substantially to an overall drop in breast cancer deaths. It said three evaluations of mammography screening for women aged 50-69 years had put the reduction in breast cancer mortality at between 30 and 47 per cent.

Associate Professor Robin Bell said the benefits of the BreastScreen program were overblown. "This comes down to the balance of harm versus benefits," Prof Bell said. "My view is that women need to be given more balanced information about the BreastScreen program when invited to be screened.

"Overdiagnosis amounts to women having a small, slow-growing cancer being diagnosed and treated, where in her lifetime that cancer may not have required treatment."

She said the impact of breast screening was diminishing as the outcome of treatment for breast cancer improved and the balance of benefit to harm of breast screening was becoming less favourable. "This has serious implications for health policymakers," she said.

More than 13,000 women in Australia are diagnosed with breast cancer each year.


1 comment:

Paul said...

I recall a study from one of the Scandinavian countries that first posited the idea of "over-diagnosis" of breast cancer. The ethical issues it raised are something of a medical equivalent of a live grenade.