Wednesday, October 19, 2022

$8.8bn blowout in NDIS budget

This Julia Gillard invention is an absurdity. "Disability" is a very loose term. I am in some ways disabled by my degree of autism. Do I qualify for government support of some kind?

At the very least, eligibility to the scheme should be based on visible physical disability only. Others should be expected to cope with the aid of the payments that all unemployed people get

Bill Shorten sees the problem, which is good coming from him, but his solution -- to pass the buck to other levels of government -- has zero chance of being taken up

Australia’s “disability safety net” has blown out by $8.8bn and needs a reset to remain sustainable for future generations of people with disability, NDIS Minister Bill Shorten says.

Mr Shorten has brought forward by a year a planned review of the National Disability Insurance Scheme, saying the scheme, now forecast to cost taxpayers $50bn a year by 2025-26, needs “to be better than it is”.

“For too many people the scheme has developed into a source of stress and anxiety,” he said.

“We want it to do what it’s meant to do – to provide choice and control for people with disability. (We) want to make sure that our national disability safety net is strong and responsive, generous and reasonable.”

Mr Shorten said next week’s federal budget would reveal “an increase in projected costs over the next four years of $8.8bn” compared to the Coalition’s budget handed down just seven months ago, blaming poor management by the previous government.

The first Chalmers budget will show the cost of the NDIS is forecast to be $50.3bn in 2025-26, compared with $44.5bn in the last Frydenberg budget.

Mr Shorten called out waste, inefficiency and fraud as driving up NDIS costs, but also noted other levels of government had retreated from offering support and services to people with disability, leaving them to try to scramble their way on to the scheme.

“What we need is to have more support for people with disabilities outside the scheme. We need to make sure our school system is more responsive to kids with learning needs,” he said.

“We need to make sure that (in) community mental health … there are supports for people who wouldn‘t be eligible for the scheme.”

But he didn’t accept the NDIS’s own financial sustainability report, which forecast costs to reach almost $60bn by 2030.

“I’m sceptical about some of the out-year forecasts,” Mr Shorten said. “I don’t necessarily sign up to every 10-year number. I think that is more science-fiction and art than it is science and evidence.”

He said it was important to restore community trust in the NDIS, and the new review would investigate its design, operation, workforce and overall sustainability, including costs.

“I absolutely want to see this scheme be sustainable, I absolutely want to see what we can do to moderate the growth cost trajectory.

“(And) I absolutely want to minimise rent-seeking by people who are seeking to take money from the NDIS, which the taxpayer wants to get to people with disability.”

The NDIS currently provides support to 530,000 people with a permanent disability, ranging from physical to neurological and psychosocial.

The NDIS projects there could be more than 850,000 participants by 2030.

The independent review will be co-chaired by longtime disability advocate Bruce Bonyhady, the inaugural NDIS chair, and Lisa Paul, a distinguished bureaucrat. Professor Bonyhady said there were “important issues to address in order to ensure the scheme can be … the best disability system in the world”.

He said the review was taking place at a critical juncture, and warned about the focus on costs.

“There’s far too much talk about the costs of the scheme,” Professor Bonyhady said. “It needs to be balanced with a discussion about the benefits, and there’s no doubt there are many examples of the scheme transforming peoples’ lives.

“It’s essential this review is owned by the disability community and in particular people with disability and their families.”

Disability groups and unions welcomed the review being brought forward, but the federal opposition said Mr Shorten was now caught in a difficult position on scheme sustainability.

“Bill Shorten promised plans would not go backwards under his watch, but questions are now being raised over the NDIS’s future funding, so let’s see if Labor’s actions meet its promises around the scheme’s framework and viability,” opposition NDIS spokesman Michael Sukkar said.

People With Disability Australia president Samantha Connor said the disability community was “looking forward to seeing the application of a rights-based lens to the NDIS, an increased focus on choice and control for people with disability, and renewed efforts to make sure that people with disability are truly the authors of our own lives”.

Australian Services Union NSW secretary Angus McFarland said the review “should mean frontline workers are now that much closer to being properly valued”.

“Right now we just don’t have the conditions, the job security or the salaries to attract – or retain – a sufficient number of disability workers to the sector.”

A final report will be delivered by the end of October next year.


Let’s get uni students face-to-face again – for their mental health

A couple of weeks ago, I asked a university colleague if she had an unusual number of students experiencing psychological distress. “Yes,” she replied. “I have lots of students like that.” I told her that I had never had so many students dealing with mental health issues. We looked at each other in silence not knowing what to say.

I already knew that Australian university students suffered significant rates of anxiety and depression. When I wrote a column on higher education for The Age, I’d report on research about students’ mental health. One study that stood out, published in Australian Psychologist, showed university students had higher levels of psychological distress than the general population.

I also knew from studies that financial stress and working long hours affected students’ mental health. I can reel off other predicators for psychological distress, too. At the moment, none of these predicators seem to worry my colleagues and I more than the enduring effects of COVID-19 lockdowns on students.

Now it seems that our hunch that the COVID pandemic has had a negative psychological impact on students is correct. A new Monash University study, led by PhD candidate David Tuck, concludes that more tertiary education students experienced higher levels of psychological distress during the pandemic.

“More tertiary education students experienced severe distress during the COVID-19 pandemic than adults in the general population, as well as before the pandemic,” the Monash researchers say in their study published in the Journal of Clinical Psychology.

It is one of the first Australian studies to investigate the level of psychological distress among tertiary students during the COVID pandemic. The research shows almost 71 per cent of the more than 1000 students surveyed displayed elevated levels of psychological distress during the pandemic between September 2020 and February 2021. Twenty-three per cent of the sample reported extreme levels of distress.

Another worrying finding is that students who had already been diagnosed with anxiety, depression, PTSD or other mental disorders before COVID had significantly higher levels of distress than students who did not have a previous diagnosis of a mental health disorder.

And it is the younger students and those studying undergraduate degrees that have higher levels of distress than older and postgraduate students. It’s understandable why this would be the case. It can be tricky for students to make the leap from high school to university, and this year’s first-years have done much of their final years of high school online at home during COVID lockdowns. The students had to readjust to being in classrooms and then acclimatise to university life.

So, what can universities do to help students?

They certainly can do more to help students feel they belong to their campus. One way to achieve this is to make more classes face-to-face. I have been shocked at how many undergraduate subjects, particularly in the humanities, are still being taught online. This semester students told me they chose my unit because it has a face-to-face tutorial. One student said that she “just wanted to see other students”.

Imagine, for a moment, the pressure placed on my first-year students last semester when they had a mix of online and face-to-face classes and had to try to navigate them on one day. I had students doing online classes in the morning and then racing to university to attend their face-to-face tutorial. Or some would try to do their online classes in the library whispering their answers during a Zoom discussion.

Universities justify the increase in the number of online classes by saying they are giving students a choice. But what about the pedagogical reasoning, particularly after students have spent so much time isolated at home during lockdowns? Previous Australian studies have suggested that online learning is not always appropriate for undergraduates because they are unaccustomed to the university style of learning. Besides university is more than the academic work. Campuses are where students can make lifelong friends.

I’m also unsure what the pedagogical reasons are for having pre-recorded lectures, which began during the lockdowns. Yes, students can listen to them any time, but from what academics tell me, many don’t watch them because the lectures are not engaging. You can’t ask questions in real time and hear the student responses.

University bosses need to think less about how to make cuts to teaching resources and examine the evidence about the best teaching methods for students in this COVID age. They could also speak to David Tuck and his colleagues, who have published material on how tertiary students can be helped during this period of COVID. They emphasise that positive social interactions in tertiary settings are vital to helping students.

In the International Journal of Stress Management, the researchers concluded that “engaging in enjoyable and personally meaningful activities, focusing attention on the present moment, exercise, positive social interactions, humour, and acceptance in difficult circumstances have the largest effects on improving resilience in tertiary education students”.

I’m sensitive to what my students are going through. But that’s not enough. Universities need to step up more to support and reduce stress among students. Then my colleague and I may not be staring at each other in silence wondering what will happen to our students going through psychological distress in this age of COVID.


Chilling warning that Australian aged care sector at risk after huge losses

Government mandates and their attendant bureaucracy are probably a large part of the costs involved. Regulations always grow. They never recede. And they are rarely imposed together with any cost-benefit analysis of them

The industry in Australia is at serious risk of financial collapse after a new report revealed that two out of three nursing homes operated at a serious loss in 2020-21, with warnings an emergency injection of funds from the federal government is needed.

Analysis of more than 1300 residential aged care homes across Australia showed the desperate situation the sector is facing with each home suffering a loss of $14.67 a bed a day, a huge jump compared to the previous financial year where losses sat at $8.43.

The figures were even more alarming considering the former government paid an extra $10 a bed a day last year in a package worth around $800 million for the sector.

But the report from specialist accounting firm StewartBrown said the financial situation had “deteriorated” due to a number of reasons including staff pay jumping by an extra 1.75 per cent to 3.5 per cent, inflation skyrocketing to 6.1 per cent and an increase in superannuation payments to employees.

It also revealed that 67 per cent of nursing homes made an operating loss in the year to June 2022, a significant jump on the 58 per cent in 2020-21.

“The residential aged-care segment has sustained significant aggregate operating losses for the last five years totalling an estimated $3.8 billion, with $1.4 billion being the FY22 forecast,” it noted.

“These losses have eroded equity and capital growth, which has caused a considerable ­decline in investment into the sector.”

Its a stark downfall for the industry where providers were making $2.11 a bed a day in 2018-19, only for losses to rack up to $14.67 a bed a day.

“It is the opinion of StewartBrown that after five years of significant aggregate operating losses in the residential aged care sector, structural funding reforms including increased and appropriate care recipient co-contribution are essential, the report said.

“However, to avoid closure of homes and reduced service delivery, especially in regional locations, an emergency funding package also needs to be considered in the short term to ensure current viability and allow for the necessary funding reforms to be properly implemented.”

This would include the aged not only paying for the accommodation, but for living essentials as well such as such as food, utilities, cleaning and laundry.

However, it added where the consumer did not have the financial means to further contribute this must not in any respect disadvantage them.

“A safety net must be enshrined within aged care, as with other areas of health care and social services,” the report urged.

With the Labor government set to deliver its first budget next week, Treasurer Jim Chalmers had already flagged that aged care was one of the biggest cost pressures for it.

Funding for the sector will increase from $29.8 billion in 2022-23 to $52.5 billion in 2032-33.

There are around 245,000 Australians who live in an aged-care facility annually but with an ageing population this is expected to rise dramatically in coming years


Informed consent and vaccine side-effects in Australia

Australia’s medical Code of Conduct, the statutory rules for medical practitioners, defines informed consent as ‘a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved’.

In addition, the Australian Immunisation Handbook states: ‘For consent to be legally valid … it must be given voluntarily in the absence of undue pressure, coercion, or manipulation … and it can only be given after the potential risks and benefits of the relevant vaccine, the risks of not having it, and any alternative options have been explained to the person.’

Think back to the last time you gave consent for a medical procedure or, dare I say it, a vaccination. Were you taken through this process?

There’s more. What happens to consent if you’re involved in a clinical trial?

Former barrister, Julian Gillespie, explains:

‘There is a portion towards the end of the medical Code of Conduct, which … clearly addresses if you are a medical practitioner and you are involved in a clinical or experimental trial … then there’s all these further procedures and protocols that must be satisfied.’

Surely that would only apply in the circumstances of an experimental trial, wouldn’t it?

As it happens, that’s what we’ve been doing for the past couple of years. ‘We heard it out of former health minister, Greg Hunt’s lips, and several others,’ Gillespie says. ‘It’s well acknowledged that these Covid vaccines have only been provisionally approved and are still subject to clinical trials.’

Julian Gillespie LLB, BJuris, is co-author, with Peter Fam LLB, of a recently published bombshell legal opinion casting doubt on the legal basis of AHPRA’s March 9, 2021 ‘gag order’.

The opinion was issued with a letter stating:

‘Contingent to a joint statement received from AHPRA and the National Boards on 9 March 2021, Australian Health Professionals … were essentially forbidden from publicly questioning the science underlying the emerging Covid injectables, let alone questioning any government messaging urging Australians to be vaccinated, because these products were deemed “safe and effective”.

‘The effect of this unilateral action … inserted AHPRA and the National Boards between the Clinician and their Patient, which resulted in a serious failure of evidenced-based information being shared by Health Professionals with patients … for the purpose of their providing legally acceptable Informed Consent to receiving Covid injectables.

‘This failure in Informed Consent has likely resulted in hundreds of thousands, if not millions of Australians agreeing to the administration of Covid injectables, where they would not have so agreed or consented had they been provided with all the available evidenced-based information… including that they expose a recipient to a real and significant risk of death, injury, or illness.’

What does this mean?

Essentially, the legal opinion posits that it was illegal for AHPRA and the National Boards to even produce the position statement. Health Professionals were always required to first observe their Codes of Conduct irrespective of the various coercive and threatening statements made in the March statement.

But wait, there’s more.

It also appears the public officers responsible for that statement are now legally exposed:

‘As the harm to Covid vaccine victims was foreseeable, in terms of these still remaining experimental gene-based therapies, these vaccine victims … can sue the public offices of AHPRA and the National Boards in their personal capacity,’ says Gillespie.

It doesn’t stop there. There may be further liability available to health practitioners who administered the vaccines in breach of their Codes of Conduct. Gillespie adds, ‘Should those health practitioners subsequently be sued by their patients … then those health practitioners may, in turn, be able to sue the public officers of AHPRA and the National Boards for coercing and threatening them to ignore their Codes of Conduct. Such illegal action would be the tort of misfeasance in public office.’

I’ll just let that all sink in.

The legal opinion was sent to all medical associations and colleges, nearly 70 of them, all Australia’s politicians, state, federal, and territory, and medical professional insurers.

Oh, and it was also sent to over 300 of Australia’s top personal injury and medical negligence lawyers.

No one’s missing out on this one.

The legal opinion was helpfully accompanied by a 107-page report reviewing the evidence and adverse event data for Covid vaccines. It’s an alarming read.

But wait – there’s (even) more.

Proposed changes to Health Practitioner National Law, due to be debated in the Queensland Parliament on October 11, 2022, are set to give AHPRA even more power to interfere with the doctor/patient relationship.

These proposed amendments have medical organisations extremely concerned including the Royal Australian College of General Practitioners, the Australian Medical Association, the Australian Medical Network (AMN), and the Australian Medical Professionals Society.

If passed, ‘Doctors will no longer be able to express their opinion or use their experience, training, and education if their opinion goes against what the health bureaucrats say is in the best interests of public confidence in safety,’ says AMN.

And the changes won’t stop in Queensland. The amended National Law will then be rolled out to other jurisdictions. All Australians should be concerned.

The Australian Medical Professional Society says, ‘Health regulation is not being used to protect the public from legitimate professional misconduct but is being used to silence Health Professionals from questioning government policy as a matter of routine.’

If the legislation comes to pass, it begs the question: when a patient goes to visit their doctor how will they know if they are receiving the doctor’s professional opinion or the government’s latest edict?

The March 9, 2021 joint position statement has given Australia a taste of what might come if we don’t stand up to this obscene imposition by regulators in the consultation room.

In the words of ‘Dr Frank Mercy’ – an Australian doctor who writes under a pseudonym for fear of reprisal – ‘This is our Stalingrad. Defeat here will open the field to unlimited human resources for oppressive forces that can never be turned back. We must oppose this with all our resolve.’


Floods to push up food prices and worsen deficit, says Jim Chalmers

Imagine if we had built dams instead of desalination plants, we could have mitigated impacts of flooding (a land of flooding rains after all) and had more water resources to assist in food production

Australians have been warned to brace for another hit to the cost of living as the floods devastating parts of Victoria and NSW drive up food prices, and require billions of dollars to be spent on assistance to those affected, Treasurer Jim Chalmers has warned.

Due to the floods that have hit some of the east coast’s major food production regions, and caused extensive property damage, the forecast deficit for this year is likely to be worse and inflation possibly higher, Dr Chalmers suggested.

“We need to brace ourselves for the impact of these natural disasters on the cost of living,” he said.

“We’re talking here about some of the best growing and producing country in Australia, and it has been seriously impacted – whether it’s the destruction of crops, or the inability to access some of these farmlands, whether it’s livestock and other consequences.

“Australians do need to brace for a cost-of-living impact from these floods. These are likely to push up the cost of living when Australians are already under the pump. It will also have obvious consequences for the budget.”

The treasurer’s office said it was too early to estimate the inflationary and budgetary impact of the floods.




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