Energy saving light bulbs spark mercury concerns

AUSTRALIA'S switch to low-energy light bulbs is creating a new environmental disaster as tonnes of the mercury-filled fluorescent lamps end up in council landfills.

With 95 per cent of discarded home light bulbs tossed into household rubbish bins, councils say there is an urgent need for a national scheme to recycle globes to ensure the mercury inside them does not find its way into water supply systems.

Mercury is one of the key ingredients of low-energy bulbs, but can cause neurological damage and birth defects if consumed by humans.

The lighting industry says the new bulbs contain just 5mg of mercury fluorescent tubes have three times that much but only 5 per cent of the bulbs are recycled.

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Huge public hospital backlog in W.A.

AMA president David Mountain with his wife Helen and kids Kate and Lara and pet dog Voss. Picture: Matthew Poon Source: PerthNow

THE number of patients waiting for elective surgery in WA, including those waiting to get on to the waiting list, would fill 40,000-seat Patersons Stadium, figures reveal.

Some on the list are waiting up to four years just to see a specialist, according to outgoing Australian Medical Association WA president David Mountain.

The latest published wait list is almost 17,000, but the State Government estimates there are at least 24,000 more patients waiting just to get a specialist appointment.

It means the true elective surgery waiting list is at least 41,000, with patients waiting for serious operations, including hip replacements, cataract and cardiac surgery unable to walk, talk or hear in the meantime.

Dr Mountain said the Government should shed light on the hidden "waiting list to get on the waiting list" because some patients got on to the official list years after their need for surgery was first identified by a GP or other health professional.

Before the last election, the WA Liberal Party promised that from the March 2009 quarter, it would "publish by hospital figures showing the number of patients waiting for a pre-surgical assessment". It has so far failed to do so.

The Liberal commitment read: "This waiting list to go on the waiting list is something that Labor (the then government) wants to keep hidden. But if we want our governments to be truly accountable for their performance then this deceit has to stop By the end of 2009 we also will ensure that the time from original identification of a problem to an outpatient pre-surgery appointment will be no more than six months."

Opposition health spokesman Roger Cook said the Government had broken its election promise to reveal the true number of people waiting for elective surgery and patients were suffering in silence.

Health Minister Kim Hames said WA Health was looking at ways to calculate this data, but it was only possible to provide an estimate, partly because many patients were waiting for private specialists not in the public system.

"I am committed to reporting publicly on the number of patients waiting for a specialist's appointment," Dr Hames said.

Elective surgery often involves serious conditions such as people needing hip replacements, cataract surgery, cardiac surgery and left untreated can prevent people from walking, hearing or seeing.

Dr Mountain said there were several waiting periods patients had to get through before surgery, but only one was recorded.

"First there is a delay in the initial letter from the GP getting through the administrative processes to get to the out-patient clinic, then there's a delay in sending a reply saying how long it will take to get an appointment and organising a date, and then you have to wait for the appointment which is when you get put on the waiting list," Dr Mountain said.

Dr Mountain, 48, will finish the standard two-year stint as head of the AMA in just over two weeks, when another president will be voted in at the organisation's annual general meeting.

``I need a break," Dr Mountain said. ``I've got research and academic things, and I'm a head of department at Sir Charles Gairdner Hospital, and I have two kids who probably feel they've been a bit on the backburner for the last year or so."

His wife Helen, a genetic counsellor, said her husband had worked hard to find time for the couple's two daughters Lara, 9, and Kate, 10, but things would be easier without the demanding AMA role.

Outgoing Australian Medical Association WA president David Mountain explains how to fix the five biggest problems with the health system:

1. Double the Medicare rebate for GPs – “The rebate has been seriously undervalued for 15 years in a row and is well underneath what it should be. The average practice is charging $60 to $70 but the rebate is only half of that. You can’t get a plumber to come to your house for less than $100. It’s amazing to me that some doctors in the outer suburbs are (bulk-billing) because it would be very hard to earn a decent living after paying all the costs of running a practice.”

2. Health bosses and bureaucrats need to butt out and let medical professionals do their job, run hospitals and make decisions – “They need to change their attitude and stop treating clinicians as the enemy. Decisions are routinely made that are centralised, bureaucratic and don’t involve people in their day to day work or allow clinicians to make decisions they need to make. Many of the decision-makers are detached from the reality of providing services to patients. It needs to come from the top, they need to get out of the way and not constantly be a hindrance, slowing everything up.”

3. Increase training positions in hospitals and general practices – “We have triple the number of students that we’ve had in the last few years – an extra 200 doctors that we have to find training positions for. We’ve got new buildings but it takes time to get people into those jobs and to train them so we need to build capacity into the system now.”

4. More resources for elective surgery targets and the Four Hour Rule – “We have major problems with the capacity of the system coming up in the next two to three years. Even with the Fiona Stanley hospital and the others coming online, the demand for beds is much higher than the number of beds. We’re not seeing enough beds, nurses, doctors and other staff coming into the system. There needs to be more major new builds planned in the next 10 years otherwise we’re really going to struggle.”

5. Get rid of the Health Corporate Network – “It’s another nightmare bureaucracy. It is incompetent at paying people properly, appointing people and demoralises people trying to do their job. It’s a terrible experiment that should be cancelled. It rumbles along as a sub-disaster, making life difficult for everyone.”

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Australia is a very gassy place

Mining companies are increasingly taking an interest in shale after it took off in the US, writes Paddy Manning.

Nobody knows the extent of the shale gas resource in Australia but the potential is big, perhaps big enough to reduce coal seam gas to a sideshow.

The federal agency Geoscience Australia set the theme of this week's annual Australian Petroleum Production and Exploration Association conference by estimating shale gas could double Australia's natural gas reserves, from 400 to 800 trillion cubic feet of recoverable gas.

The US shale revolution, spurred by the advent of horizontal drilling and fracture stimulation (or fracking) technology, transformed world energy markets in five years.

Shale gas now accounts for about 23 per cent of the US's annual gas production, according to the US Energy Information Administration. By contrast, coal seam gas (CSG, or coal bed methane as it is known in the US) provides about 7 to 9 per cent, says the managing director of Beach Energy, Reg Nelson.

What has happened in the US is likely to happen here, he says.

Beach, which gets most of its revenue from oil production, has been a pioneer in unconventional gas. Beach sold an early-stage investment in coal seam gas play Arrow Energy to Shell, at a handsome profit.

Beach has some of the best exploration acreage in Australia's most prospective shale gas field, the Cooper Basin in South Australia. Beach shares dived this week after a media report suggested the company had shut down a data room opened to potential co-investors, due to a lack of interest. Nelson says Beach terminated the sale process once it got strong gas flows from one of its wells in the Cooper: "We thought, we've got something big here, we can add value to this. And when we sell it, we're not going to sell it for a small premium. It's going to be a big one."

Certainly there is plenty of jockeying going on, with juniors including Senex, Drillsearch and others seeking to prove up their shale reserves and sell on to a larger company. Big oil producers such as BP, Total and Shell are interested; BHP Billiton's petroleum chief, Mike Yeager, said his team was "studying every square inch of Australia right now" looking for shale gas.

Australia's shale gas reserves are not located under prime agricultural country but in the middle of the desert, and there is a gas pipeline nearby at Moomba. Shale gas wells are deeper - generally well below aquifers - and typically recover more gas per well, meaning fewer wells need to be drilled.

Drew Hutton, the president of the anti-coal seam gas group Lock the Gate, warns shale gas production in the Cooper could have implications for Western Queensland's wild rivers, protected under legislation. "The nomination of the western rivers came about because the traditional owners, local cattleman and local councils got together with the wilderness society and lobbied for it."

He says the US experience shows there are still groundwater concerns associated with shale gas extraction, and there would likely be an environmental campaign - though perhaps not a Lock the Gate campaign - against shale gas in the Cooper.

Nelson, a former South Australian mining regulator who spent much time capping uncontrolled flows from bores in the Great Artesian Basin, says he has "no concerns whatsoever" about groundwater contamination from shale gas.

"The important point is, Cooper Basin gas has been around for 40-50 years. A lot of these reservoirs have been fracked, because the sands are tight. There's been about 700 wells fracked since 1969."

If Cooper Basin shale production was safer, could the entire coal seam gas debate be bypassed? The vice-president for eastern Australia at Santos, James Baulderstone, says at an estimated $6 per gigajoule, shale gas is 20 to 30 per cent more expensive to produce than coal seam gas, and technology and capital constraints mean significant shale production is unlikely to be economic this decade. Santos is concentrating on getting more out of the declining conventional gas reserves in the Cooper Basin, with advanced infill drilling, and on developing its coal seam gas fields in the NSW Gunnedah Basin.

"You need a diversity of supply," he says. "One of the great things about NSW's gas resource is its location to market and where it sits on the cost structure. When you model the cost curve, the coal seam gas will be cheaper than shale to start with, it's easier to develop and we believe that it will fill market demand in the 2015-25 window. Shale would then come on stream towards the end of the 2020 decade, and start to displace coal seam gas as it becomes cheaper over time."

With a majority stake in the Moomba gas plant, and the most acreage in the Cooper Basin, Santos will play a big role in developing Australia's shale resource. It has recently drilled its first vertical shale well, and will drill its first horizontal well later this year.

"We're all very excited about shale but it's not something you can do overnight," Baulderstone says.

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Courts under fire in mental health row

MENTAL illnesses are being exploited by some defence lawyers to reduce sentences for people found guilty of serious offences, despite a lack of evidence linking the ailments to criminal behaviour, mental health experts say.

Groups including the Mental Health Council of Australia and beyondblue have urged more rigorous psychological examinations of people charged with crimes when mental illness is claimed in mitigation. They say those with mental health problems are more likely to be victims of crime than perpetrators.

Several prosecutors from the Office of Public Prosecutions also told The Sunday Age they were frustrated that depression had become a "pro forma defence tactic" used to seek leniency.

One senior prosecutor said defence lawyers were exploiting a Victorian Court of Appeal decision in 2007 that reduced the moral culpability, but not legal responsibility, of those diagnosed with mental disorders.

Mental Health Council of Australia chief executive Frank Quinlan said there were doubts about the diagnosis of some mental illnesses. Distinctions between normal sadness and clinical depression were still widely debated in the mental health profession, he said.

"It seems to me, that on the back of the very poor evidence we have, there is no prima facie case of a link between crime and mental illness."

Mr Quinlan was critical of a recent attempt by a defence lawyer to seek leniency for a client with depression, after the man was found guilty of downloading child pornography.

"Some people who suffer severe psychotic conditions may have an argument about not being able to form intent, but those suffering high-prevalence mood disorders such as acute anxiety and depression have an inability to find motivation and plan, which would obviously impact their ability to commit a crime," he said.

His claims are at odds with a Corrections Victoria report that found almost half of adults in custody had a history of mental illness and 34 per cent of children in detention centres had psychological disorders. Beyondblue estimates major mental illnesses are up to five times more prevalent among prisoners than in the general community.

Law Institute of Victoria president Michael Holcroft said there was a correlation between mental disorders and a range of criminal behaviour. It was "totally appropriate" for a lawyer to raise mental health when entering a pre-sentencing plea, Mr Holcroft said.

"People under the influence of drugs and alcohol or suffering from mental health episodes are far more likely to get themselves into trouble than the standard person in the street. And to avoid re-offending, the courts need to address the underlying source of the problem."

He said lawyers relied on expert medical opinion and had a responsibility not to mislead the courts.

"To say there is no link between crime and mental health is extraordinary. People come before the courts with myriad issues," Mr Holcroft said.

In 2010, the Magistrates Court set up a specialist court and program to provide extra support for the rising number of accused people claiming to have depression and other mental disorders. At the time, magistrate John Lesser said more than a third of those who appeared before Victorian courts had some form of mental illness.

But Superintendent Spiros Kalliakmanis, of the police prosecutions division, raised concerns about the growing number of cases diverted to the specialist court. "It is a matter for the court to determine the legitimacy of a plea. However, any abuse of these jurisdictions and services has an impact on the ability to offer quality services to members of the community who are in real need," he said.

Beyondblue chief Kate Carnell said depression had no bearing on a person's propensity to commit a crime.

"The reality of mental health issues is people don't do things that they wouldn't otherwise do or behave dramatically out of character. Magistrates should listen to the mental health experts and make sure that the information that is being presented in court is evidence based," she said.

Kristen Hilton, director of civil justice at Victoria Legal Aid, said about 20 per cent of its clients had mental health problems. "The research and our practical experience shows that someone with a mental health issue is far more likely to come into contact with the criminal justice system.

"I would hope there's a general community consensus that someone's mental condition should be taken into account during sentencing," she said.

A spokesman for Attorney-General Robert Clark said genuine mental illness was relevant in sentencing. "But claims of mental illness should not be used as an excuse to avoid responsibility for culpable conduct."

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