Nurses to replace doctors under Labor Party plan

EVERY doctor's practice in the country will get its own nurse to help treat patients, make home visits, write prescriptions and co-ordinate follow-up care, under a medical revolution in tomorrow's Federal Budget.

Each GP will be eligible for $25,000, worth up to $75,000 a year to a three-doctor practice, enough to hire a full-time nurse.

The nurses will lead a revolution in healthcare, teaching patients with chronic problems like diabetes and heart disease how to manage their conditions, dressing wounds, and carrying out asthma tests and vaccinations.

They will also carry out pap smears, test blood sugar and cholesterol and co-ordinate follow-up care with specialists and health carers.

The care they provide is expected to come at no cost to the patient and it will free up GPs to carry out the more complex medical care.

Currently, government incentives for employing nurses are capped at $40,000 per practice and only apply in rural areas or those with a workforce shortage. About 40 per cent of practices do not employ a nurse.

Medicare also currently provides a rebate to doctors for only three types of services provided by nurses - pap smears, vaccinations and dressings.

The federal Budget will extend the incentives to employ a nurse at more general practices.

The payment will be lower if the practice employs an enrolled nurse with lower qualifications than a registered nurse or an Aboriginal health worker instead.

Medicare rebates for nurses are expected to be scrapped under the reforms with GP clinics instead receiving block government funding to employ nurses instead.

This will free up practice nurses to carry out a much wider range of healthcare duties.

Experts believe there are 441,000 unnecessary admissions to hospitals each year because patients don't manage their chronic conditions or get their follow-up care.

The job of the nurse will be to make sure this happens.

In a speech to the Australian Practice Nurses Association on Friday Health Minister Nicola Roxon promised nurses they would "play a key role" in the Government's reforms to primary health care.

Doctors are also expecting the Budget to contain government grants to the nation's 7000 GP practices so they can add rooms to their surgeries to accommodate the nurses and allied health practitioners like physiotherapists and dieticians.

This would help deliver on the Government's goal of turning every GP clinic into a one-stop shop for health care.

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More people are realizing that Rudd hasn't got a clue

KEVIN Rudd's approval rating has slumped even further, and if an election were held now Labor would lose, a new poll shows. The Prime Minister's approval dropped by 14 percentage points in one month to 45 per cent, while his disapproval rating has risen 13 points to 49 per cent, according to a Nielsen poll published today.

The loss of personal support is the most dramatic for a prime minister in a decade and marks the first time Mr Rudd has had a disapproval rating higher than his approval rating.

The plunge comes in the wake of the Government's announcement last week of its 40 per cent tax on mining profits - a move that appears to have failed to gain popular backing. And it adds pressure on the Government to win support with tomorrow's Federal Budget, although Treasurer Wayne Swan said yesterday he would not use the Budget to try to buy votes.

The approval and disapproval ratings of Opposition Leader Tony Abbott remained steady at 46 per cent and 45 per cent respectively. But Mr Rudd still leads Opposition Leader Tony Abbott as preferred prime mininster 53 to 38.

The poll of 1400 voters comes after a bad month for the Government, in which it scrapped the home insulation scheme and shelved attempts to implement an emissions trading scheme. It follows a similarly dire Newspoll published last week.

The Nielsen poll, which is published in the Sydney Morning Herald and The Age shows that on a two-party-preferred basis, Labor and the Coalition are even at 50 per cent, compared with 51-49 a month ago. This represents a 2.7-point two-party swing against Labor since the election. If the swing were uniform and an election were held now, Labor would lose 19 seats - and government.

Meanwhile, advertising legend John Singleton is being courted to handle Tony Abbott's election campaign. Several sources told The Australian that Mr Singleton, who helped catapult Labor Prime Minister Bob Hawke into The Lodge - has been sounded out about handling the Liberal campaign after the party was advised it had to make a clean break with the campaigns of the Howard era if it hoped to win.

The Opposition Leader last night launched a pre-emptive election advertising campaign using the line "support real action", but it is believed the party could look to Mr Singleton for advice on how it can unseat Labor. It is understood Mr Singleton is considering the invitation, with his newly formed agency, Banjo, expected to take the account if a deal goes through.

Mr Singleton controls 2GB in Sydney, Australia's most influential talkback radio station which features Alan Jones and Ray Hadley as presenters, and recently extended his footprint to Melbourne with the launch of 3MTR, with Steve Price and Steve Vizard.

A source familiar with the situation said: "John has talked about the possibility of doing an election campaign for the Liberal Party. "John has had conversations (with Abbott), but they have been pretty short."

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Huge hike in asylum funding

The good old generous taxpayer again -- paying for illiterate and useless Afghan Muslims to come here -- a choice bunch

THE Immigration Department will receive a multi-million-dollar funding boost in tomorrow's budget in an attempt to meet the rising cost of detaining asylum-seekers.

The funding comes as authorities report fewer boat arrivals as news of the Rudd government's temporary suspension of Afghan and Sri Lankan refugee claims filters through to prospective asylum-seekers.

The Australian has been told overseas-based Australian government agencies have briefed Canberra on the impact of the changes, announced last month.

While emphasising that their assessment was tentative, they said the early indications were that the policy changes were having some deterrent effect.

"The changes have been received with some concern by the community," one source said yesterday. "But the challenge is that people-smugglers are still spruiking the message that it's business as usual."

Last month, the government announced it would suspend all new refugee claims from Sri Lankans and Afghans for three and six months respectively.

Immigration Minister Chris Evans said improved humanitarian situations meant more Sri Lankan and Afghan asylum claims were likely to fail. But the opposition savaged the policy, labelling it an election-year fix.

It is understood the government will boost funding for Christmas Island and onshore detention facilities, strained as a result of the surge in boat arrivals. It is also expected to announce the replacement of eight Customs Bay-class patrol boats as part of a multi-million-dollar border security spend.

It is not clear how much money will be allocated to cover detention outlays, but the figure is likely to be substantial given the sharp rise in boat arrivals last year.

There is also speculation the budget will fund infrastructure upgrades on Christmas Island, which has been groaning under the weight of the asylum trade.

The influx of detention centre workers has placed upward pressures on prices, particularly housing, a source of annoyance to residents of the island.

In order to manage the ballooning number of asylum-seekers, the government announced last month it would transfer detainees to the Australian mainland.

While the move went some way to easing the pressure on the island's beleaguered detention centre, it placed a corresponding burden on mainland facilities.

The government also announced it would reopen the Curtin detention centre in the West Australian Kimberley. The cost of upgrading the facility is sure to be high, given its remote location.

As a result, detention centres in other cities are close to capacity.

According to Immigration Department figures, there were 41 people detained at Perth, just one short of its capacity. And there were 411 people crowded in to Darwin's Northern Detention Centre, which has a normal operating capacity of 382 and a "surge" capacity of a further 164.

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Olympic Dam mining project in doubt, says BHP chief Marius Kloppers

MARIUS Kloppers has warned that a host of multi-billion-dollar projects in Queensland and Western Australia could stall because of uncertainty surrounding the Rudd government's planned resource profit tax.

The BHP Billiton chief executive ratcheted up the pressure on Canberra, saying he could not rule out shelving its biggest Australian project -- the $20 billion expansion of the Olympic Dam copper, uranium and gold mine in South Australia -- because of the impact of the planned tax.

BHP has to make investment decisions this year or next on iron ore and uranium projects in Western Australia and coal projects in Queensland that could be affected by the tax. "While the uncertainty is in place, it would be very difficult to approve any of those projects," Mr Kloppers said yesterday on ABC TV's Inside Business program.

The warning came as Treasurer Wayne Swan hit back at mining executives, escalating the war of words over the tax. Mr Swan called on shareholders to tell company managers to "calm down, get into the process and engage properly", and detailed the benefits of the new tax regime. "Threats and abuse will not alter the government's resolve," he said.

Mr Kloppers said expansion plans at Olympic Dam, where a decision was due by the end of 2011, were also in the firing line. "Our (Olympic Dam) environmental impact statement, I think, will finish in about 18 months' time and this new tax proposal does upset the apple cart there a little bit," he said.

Mr Kloppers said it had only been a week since the government revealed its Resource Super Profits Tax, so it was too early to say whether the project would be shelved. "What I can say, though, is if you move the tax rate from 44 per cent to 57 per cent or possibly more, that doesn't make it any easier."

Mr Kloppers, who is spearheading the mining industry attack on the tax, accused Canberra of a breach of trust because of plans to tax existing projects. "What we have advocated is: don't break the trust or the basis on which past investments have been made," Mr Kloppers said.

Instead, BHP wanted any new tax to apply only to new projects, as was the case in the 1980s when Australia introduced the Petroleum Resource Rent Tax. This would allow investors to make decisions with their eyes open. "That point certainly hasn't got across," Mr Kloppers said.

His concerns were backed up by a survey of some of the nation's biggest fund managers, commissioned by the Minerals Council of Australia. Fifteen of 21 quizzed by research company Radar Group said the decision would have a significant impact on the perception of regulatory or sovereign risk in Australia. "Why bother with new projects if you can't rely on the regulatory framework?" said one of the fund managers surveyed.

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Defence equipment bungles again

Australia's defence equipment buyers are so incompetent that they wouldn't know if you were up them

THE Defence Department has been left red-faced after a public relations exercise to promote its own issued equipment turned pear-shaped.

After a Herald investigation last week revealed troops were spending up to $1000 of their own wages to replace the packs and webbing issued by Defence, the Army newspaper went on the attack. ''Equipment Safe'' was the headline above a photo of three Australian infantry soldiers on patrol, captioned: ''Soldiers deployed to Afghanistan use some of the best equipment available.''

There is one small problem. The troops in the photo may have been using the best gear available, but it wasn't the gear supplied by Defence. Instead, the men are wearing non-issue webbing and pouches, including what appears to be a $110 chest rig made by SORD Australia.

The Herald has revealed soldiers are being put at unnecessary risk because of defective gear issued by a Defence procurement unit riddled with suspect tender practices and incompetence.

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