Wednesday, February 08, 2023

Deficient medical care facilities in remote areas

Decisions about where to live will inevitably have consequences. I live in an inner city area and can get medical appointments very easily and promptly. But to expect that service availability out in the bush is simply unrealistic.

The government tries to provide good medical services to all but doing so has got to be difficult. And the further away from the metropolis you are the more difficult it will be.

If there were infinite funding available no-one would need to be disadvantaged but that is not the case. So priorities have to be looked at. The government is going to be able to deliver care at lower costs in urban areas. So servicing the bush to a high level would reduce care available in the State overall. To do so is obviously not an easy decision

A national crisis has been laid bare in black and white in a report from the Royal Flying Doctor Service, detailing the gross inequity of healthcare for Aussies living in the bush.

A shocking 44,000 people in this country have no access to a doctor within an hour’s drive; almost 120,000 are that far away from a dentist and 134,000 are equally distant from any mental health support.

It’s not just a matter of convenience, or simply how life is out in remote parts of the country.

This is taking years off everyday Australians’ lives. Women are dying 19 years earlier than average in very remote parts of the country, men almost 14 years. First Nations Australians are dying 14 years sooner on average and the gap is even wider in remote areas.

These are the very real consequences of a health system that is sick, and nowhere is it worse off than in our nation’s regions.

In Queensland, there are recent examples of failures in regional health, such as the Gladstone Hospital maternity unit being on bypass since July and sending expecting mothers 100km away to Rockhampton.

Unfortunately, it is just the most recent in a long line of regional maternity services shut down, or put on bypass.

Australia’s healthcare system was once the envy of the world, but now it seems close to being put on life support.

The Strengthen Medicare Taskforce report, touted as providing much-needed reform to make Medicare more sustainable, was released in February 2023, but it was largely found wanting.

At just 12 pages, some of its recommendations were motherhood statements about needing to improve access to after-hours care, or fast-tracking work to increase the supply of doctors and nurses.

Other recommendations were to have blended-model medical practices, with GPs, nurses, physios and more working together in an integrated model, or to develop funding models that are relevant for rural practices.

But these have all been proposed before, and there was little to be said for the specifics on how to do these worthy tasks.

Whatever happens, it will need federal, state and even local governments working together to achieve better outcomes for rural health. This has not always been the case, as has been seen in Queensland recently.

Meanwhile, the commonwealth is seeking ways
to encourage more doctors to bulk-bill, which would increase people’s access to healthcare.

But the Queensland government, as well as those in other states, sought to implement a new interpretation of payroll tax laws, which would have seen doctors slugged.

Medical peak bodies warned that this would hit the regions most, with many GP offices operating on slim profit margins potentially facing closure.

After much pressure, the government backed down and offered an amnesty on the tax until 2025, but only to kick the can down the road past the next election.

Action needs to be taken now; the divide between the regions and the capital cities cannot be allowed to keep widening.

It is no exaggeration to say that lives depend on it.


Interest rate rises may not be enough

Reserve Bank governor Philip Lowe is sticking with his softly-softly approach – he calls it a “narrow path to a soft landing” – to hopefully wind inflation down without sending unemployment shooting up.

If he succeeds he will be a hero: getting inflation sustainably down to the 2-3 per cent target range, without the crippling double-digit jobless rates of the early 1990s or even near double-digit jobless rates.

If he doesn’t, he will go down as the governor who blew near 30 years of RBA low-inflation success, earned and delivered on the back of that early 1990s pain.

He would also then fully deserve to be - in the words of our trainee treasurer with delusions of profundity – ‘renovated’. Let’s bury one – to use a grand old Aussie word – furphy upfront. That’s he delivered really punishing rate hikes.

Lowe’s taken the RBA’s policy rate up 3.25 percentage points in nine months.

The mother – some would unkindly add another word – of central banks, the Fed, has gone up 4.5 percentage points; true over a slightly longer 11 months.

Our neighbour, the RBNZ, has gone up 4 percentage points - again true, over a longer time frame because it, sensibly, got started moving away from the lunacy of near-zero sooner – and with yet another hike all-but certain in two weeks.

So even in nominal terms and despite the inane mantra of ‘nine rate rises in a row’, it’s been softly-softly and slowly-slowly.

In real terms, Lowe has barely increased at all.

Last May when he made his first increase, to just 0.35 per cent, annual inflation was 5.1 per cent. The real interest rate was still a highly stimulatory minus 4.75 per cent.

Now inflation is 7.8 per cent; the 3.35 per cent nominal rate gives a real interest rate of minus 4.45 per cent. It’s barely changed.

Sure, it’s having a big and painful impact on home loan repayments.

But heck, all that means is that borrowers who had two years or so of essentially ‘free money’, now have to pay for it.

And hold your tears for the vast majority of borrowers.

Almost all of them – apart only from first home buyers over the last two years – were either sitting on massive unrealised and tax-free capital gains, or had previously cashed in massive and tax-free capital gains.

On the other side – seemingly invisible to our trainee treasurer, the media and the so-called economists – are the savers who are finally getting some sort of return on their bank deposits.

Even so, still only a negative return in real after-inflation terms.

Yes, 3 per cent is better than zero, but it’s not that great when inflation is eating away at the capital at a near-8 per cent rate a year.

All this goes to Lowe’s attempt – his ‘narrow path -- to engineer a soft landing; taking now another two years to get inflation down only near the top of the mandatory 2-3 per cent RBA’s inflation target.

Bluntly, to me, it is just not acceptable for the RBA to predict inflation only down to “around 3 percent” in mid-2025, fully two years away.

Further, Lowe is playing an extraordinarily dangerous game; ‘hoping’ that unions won’t chase, and win, higher wages into this sustained higher inflation, over-full employment, reality.

Right now, average wages growth is running around 4 per cent. If it breaks higher, inflation will blow up in everyone’s faces and most especially Lowe’s.

That is a future that would force him – or his successor – to deliver exactly the punishing further rate hikes; risking, all-but certainly delivering, exactly the surge in unemployment that he’s desperately trying to avoid.

It would also start to deliver some real pain to home loan borrowers; and, needless to say, property prices.


Pedo precinct breach: Woman visited sex offenders in latest fail

Given my druthers, I would burn pedophiles at the stake. But that's not going to happen. So if we let them survive we need above all to ensure that they do not reoffend. And rehabilitiion should obviously have a role in that. And the first step should surely be to encourage them to develop relationships with adult women -- where consenting women are available. So why was contact with a woman penalized below? The rules would seem in need of changing

One of Queensland’s most notorious pedophiles has been caught with a visitor at the state’s sex offender precinct, despite assurances by the minister and the boss of Corrective Services that security at the facility had been increased.

Violent pedophile Douglas Jackway and another sex offender have been returned to jail after a woman was caught visiting them.

Jackway and the other man had been living in houses under strict Dangerous Prisoner (Sexual Offenders) Act (DPSOA) supervision orders in the sex offender precinct in Wacol.

This latest incident comes just two months after Police Minister Mark Ryan said two reviews had been ordered by Queensland Corrective Services following a Courier-Mail story which revealed another dangerous sex offender living in the facility had allegedly committed offences against a girl, understood to be aged 15.

Last night Mr Ryan said recommendations from the review have been incorporated, while further measures are underway.

“An external body has undertaken a review of the precinct security, resulting in more stringent and more thorough protocols in respect to the DPSOA precinct,” Mr Ryan said.

“I am advised recommendations have already been incorporated into the precinct upgrades, while further protective and preventative measures are still under way to make it more difficult for unauthorised visitors to access the precinct.

“Following the review, I am advised QCS has increased the physical presence of officers on the precinct, with more frequent patrols, while changes to infrastructure has also seen enhancements to fencing, lighting and CCTV.”

The Courier-Mail understands the woman visited the men on the weekend of January 28-29 before the incident came to attention of officers.

Jackway is one of the state’s most notorious sex offenders who was once a suspect in the murder of schoolboy Daniel Morcombe.

It is the second alleged breach at the precinct in months after another sex offender living there allegedly sexually abused a teenage girl there last year. The incidents have prompted a backlash from corrective service officers who want more patrols of the area, including regular use of the dog squad.

Jackway has been charged with contravention of a relevant order.

Jackway, whose matter went before the Supreme Court this week, has been remanded in custody until March 10 when he will face a contravention hearing relating to his order.


Organ transplant patients plead for end to Covid stalemate

When are these mandates going to end? There is plenty of reason for people in poor health to avoid the risks of vaccination

Queensland transplant patients who cannot receive a lifesaving organ until they are fully vaccinated against Covid are calling for the government to compromise and allow them to sign a “no blame waiver” to progress on the transplant list.

The patients say they are not anti-vax but remain unvaccinated as they fear any Covid vaccine side-effects could hamper vital but harsh treatments like dialysis.

The Courier-Mail highlighted the dilemma for the Queenslanders in 2021 when two jabs were mandated for transplant patients and Queensland Health confirmed they would reassess the policy in February 2022.

Ipswich mum Tamara McCarthy told The Courier-Mail families needed to be given a choice.

“We are still waiting (for policy change). My son is 20 years old and needs to have dialysis every day and desperately needs a transplant,” she said.

“He has had his childhood vaccines but was scared to get the Covid jab due to risks of myocarditis, which research shows tends to hit boys of his age. If he had a heart problem it would put an end to his chances of having the lifesaving transplant surgery.

“The years are passing and now the requirement is three Covid vaccines. It’s not an anti-vax matter it is about very ill people needing to be extra careful what medications they take. We would be very happy to sign a waiver taking away any responsibility regarding issues resulting from Covid. We need to be given a choice,” she said.




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