Selwyn Johnston… Independent Advocate

Reading this weeks press is a depressing exercise as far as confidence building in our health services is concerned. We learn that “hundreds of patients have had their diagnoses for deadly afflictions such as cancer and strokes delayed because of acute staff shortages at one of Queensland’s biggest hospitals”, in this case the Royal Brisbane.

We read of yet another stuff up case whereas a relatively young heart patient died while being shuffled between the Tweed Hospital and the Southport Hospital due to communications breakdowns, and recently, the Townsville hospital went “off-line” due to what appears to be error by a backhoe operator.

Now certainly it would be quite unfair, on the surface at least to put the Townsville episode down exclusively to health management, but the question still has to be asked how to hell could the backhoe be there, at that critical and apparently unidentified spot, in the first place without the benefit of adequate supervision.

And this of course is only in the last week. This litany of sad events has now been going on for years. If there was a bright spot last week it was in the publication of the “Sentinel Events Report” which enumerated, but did not identify other than generally, those accidental events that occur in medicine which result either in the death of, or to the serious detriment of a patient.

The medical staff that co-operated in this study is to be congratulated and hopefully by incremental improvement in procedures the number of events will drop. It was once stated that the end result was to achieve the same procedural rigour in the operating theatre as happens in the cockpit. That of course was said when airlines were engineering companies rather than marketing operations, but the concept holds true.

Clearly the present problems are of our own administrator’s making and they are now so busy applying band aids, and saving political backsides, that they have no time, or apparent ability to step back, take a macro view of the situation and work to correct it. As this weeks articles have mentioned professional staff levels are critical and that is simply because for the previous 20 years we have failed to invest in education and training of these professionals.

Why did we do that? Well there are a number of reasons and probably the biggest one was that some “bean counter” worked out that every doctor trained and who was issued with a “provider number” cost the Government through Medicare about $250,000 a year. Solution was simple, no more doctors… no more cost. Hence today’s predicament.

The nursing situation was the same. An efficient and dedicated nursing “profession” serviced our hospitals. Nurses were hospital trained and at an early stage of their training they could op out if they didn’t like it. They had no serious investment of either money or time in their training in the early stages and if they didn’t like nursing, or if nursing didn’t like them it could all be ended as a matter of course. No ill feeling, no regrets.

Then of course the “academic profession” took the show over and the only real beneficiaries were the academics. Nurses were required to do a full time three-year University course at the end of which they had an enormous tuition bill, and no real appreciation as to whether or not they were suited to the daily grind of the job.

Apart from that the TE score, or whatever it’s called today, that was the requirement for a nursing degree, it was not up there with the other professions requirements so the students were encouraged to take up nursing with the sole view of improving their TE score. Consequently, of the say 250 places annually allocated to nursing starts, in the initial years less that 10% of starters finished up as practicing nurses. The following nursing shortage was fully predictable. This problem was partially solved by creating a class of enrolled nurse who is now required to do a short technical course and, hey presto, they now are filling the gap, and doing it well.

The disappointing thing about the nursing situation was that its “professionalisation” had already been tried in the States and failed. Ultimately hospitals are about making money and while on the way they offer patients the best care possible. Expensive graduate nurses were not required as part of that system and let’s be honest if you spend three years of your life studying you are entitled to expect some additional reward. The whole exercise was, and remains an industry incompatible system. Nor were these graduates required as managers. The managers needed management skills and an understanding of nursing, not the other way around.

Finally medicine was centralised. The local input was effectively removed and where it was allowed to remain professional [and more often than not political] managers had no trouble pulling the wool over the eyes of the “local representatives”. This was particularly the case where funds could be temporarily transferred between “operating” and “capital” expenditures so as to give the appearance that the hospital was operating both within budget and efficiently. In fact it would have been doing neither. The scam in the long run worked against the hospitals future funding.

So it is for all these reasons that I have made serious submissions to the Government in relation to the updating of the Cairns Hospital system. I have suggested a three-site hospital system with the services at each site strategically located at not only the least cost, but also the most logical locating. It remains to be seen now just what it is that both levels of government will do to implement my suggested system or otherwise make the system keep up to date with current demand, forgetting of course increasing demand.

People throughout the country don’t need political rhetoric, which seems to be the major ingredient of health management today. What they need is independent and practical ideas that will be put forward without fear or favour, and frankly that cannot be done from within the ranks of a disciplined party political system.

What everyone wants is a national and local Health system that works, and the Australian people couldn’t give a ‘tinkers cuss’ who paid for it, whether out of State or Federal taxes!

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Recently the Sunday Mail published a Glenn Milne article headed “MP enjoys $7000 a day spree” which was referring to the retiring member for Leichhardt who took a trip, with an adviser, to a space launch in the USA in July 2005. Our local member it seems was not alone in the “big spending traveller” category also being mentioned was recently resigned Liberal Senator Santo Santoro.

The reasons given by both politicians for their trips while reading well on paper really fool no one. We all know that the matters referred to are deals done either in back rooms or as set offs at a higher level. The Labor Party is apparently auditing MP’s travel expenses with a view to causing embarrassment in key Queensland seats, a highly productive public pursuit.

But it’s all just major party political point scoring over a far more serious question. “Just what should the public is paying for its politicians”?

The matter was last addressed when the Parliamentarians awarded themselves a 6.7% pay rise while the Fair Pay Commission could only see its way clear to grant low wage earners a little over $10 a week wage rise, nowhere near 6.7%. The issue was last addressed seriously when the parliamentary pension scheme was forcibly put on the agenda by Independents with the result that Government contributions to politicians superannuation were reduced drastically to that paid by employers generally. That has of course since been watered down and no doubt will receive more attention in the future.

One of the aspects that came up in the initial parliamentary debate over superannuation was that parliamentarian’s remuneration came in a number of ways and if there was any control it was not just to be applied to one area but to the remuneration package as a whole. The major sources of income for the politicians came from three major sources, their salary, their super and their “perks” which of course includes a multitude of sins including travel allowances and committee sitting fees and the like.

It is really quite untenable that captains of commerce and industry should be paid in the millions of dollars and the Prime Minister paid nowhere near that figure, in fact merely a fraction of it. It is undignified when politicians have to pull unbelievable travel “stunts”, particularly at the end of their service to try to, I expect in their eyes, get some relativity into the pay equation.

The answer is simple if not palatable. Like everyone else in the community there is a contract between employer and employee whatever the particular arrangement happens to be called. So what should happen with politicians should be no different. Their salary, superannuation and other official income sources, should be capped to what is adjudged to be a reasonable figure generally and with a set and known electorate payment. Within certain parameters the individual member would have some flexibility to move funds but the limit would be the limit and after that funding would be stopped for the individual politician.

So then, if a retiring member wanted to go to a rocket launch he could do so. He would pay for it out of his all-up allocation. Then none of this grubby point scoring, which only serves to depreciate the public confidence would be necessary.

The question is, just what is the politician worth, and, maybe that’s a job for the Fair Pay Commission!

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It was big news last weekend when no less a prominent News Corp journalist than Glenn Milne, in an exclusive story exposed Kevin Rudd’s foray into a New York down-town Club “Scores” variously described as a gentleman’s club, a strip joint and apparently anything else that came to mind. The name itself is quite intriguing.

Mr Rudd came clean on the event making differing statements about his state of intoxication, and level of comprehension on the night but, by and large, did the right thing with the appropriate level of forthrightness and mia culpa. Mr. Rudd can take some consolation from the fact he is not the only visiting dignitary that has found himself compromised in America.

He attended the club in the company of fellow Labor MP Warren Snowden and News Corp’s editor of the New York Post, a Mr. Col Allan. Neither of these gentlemen can recall any misbehaviour on the part of Mr. Rudd.

All this happened in September of 2003, so it’s becoming public by way of an obscure source in Canberra a few months before the Federal election, is something of a surprise. According to Mr. Milne the matter was a subject of discussion in diplomatic and political circles for some time but was only confirmed last week by the “Canberra” source.

There is no doubt that this type of story gains momentum by association with some other factors, in this case the Federal election. If it was a matter of discussion for “some time” surely some investigative journalist from a multitude of Australian newspapers, eager to get the scoop, would have picked up the phone and made a call to New York. That would seem to be the line of action that would be taken by any respected investigative journalist.

But that didn’t happen until Mr. Milne came along, and, why Mr. Milne failed to make inquiry of his New York ’sister’ paper at the first opportunity is something that, to date, he hasn’t explained.

The concern for Kevin Rudd here is not so much the question of propriety, morality or even hypocrisy, but rather compromise. If, as all parties to date have claimed, that any perceived indiscretion was minor, if at all, then the affair is over and the question of its release hype and prominence should be called to account.

If on the other hand the event at Scores was a little more colourful than has been presented, then the question has to be asked can it held over Mr. Rudd’s head in the future. That is the serious question and the one that Mr. Rudd and Mr. Snowden should now be challenging their alleged foggy memories on.

And that’s the rub. A night out with the boys is manifestly understandable and forgivable but at this time the public needs to know of any, as yet, untold indiscretions so as they can then decide whether it’s a storm in a teacup, or something else!

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Presented by Selwyn Johnston, Independent Candidate for Leichhardt 2007 on Wednesday 8 August 2007

Let me start off by saying that probably one of the greatest factors facing our so-called egalitarian society is the growing disparity in the distribution of income…and consequently wealth.

Our society believes that every person should have adequate food and shelter as a minimum and sadly that minimum is increasingly not being met.

Thirty years ago it was possible for a family to have a one-income earner, be able to pay off a house and raise a family at the same time, and, have what I would describe as a high happiness level.

Jobs were generally permanent, wage rises were gauged to maintain this position and education for the family was not only free but also compulsory and beneficial.

Something has happened.

With progress many people are worse off, not marginally but, considerably worse off. We have now reached the point where, for vast numbers of Australians, the choice is between a house and a family, and, for just as many, the daily food simply cannot be taken for granted.

What is even more alarming is that people’s “margin of safety” has decreased, which means that you can be going well today but with just one bad event… you are in trouble.

Just ask anyone who works with any of the charities and they will tell you that not only are the numbers seeking help on the rise but the kind of people turning up is also changing.  More and more previously self-sufficient people have now fallen on harder times and are seeking help.

Unfortunately the situation can only deteriorate, as we all know following today’s .25% interest rates increase, will bring more grief to those in debt. In addition, there is a real possibility of another .25% increase in November.

Australia [with 12.9%] presently has the record of being second only to the United States of America for the percentage of people below the income poverty line [US at 19.1%] with Canada a close third at 11.7%.  Lowest is Norway at 6.6% and Sweden 6.7%.

The question is what do we do about it or more importantly what can we do about it. Given that the situation is worsening, not improving, things need to be done to minimise the immediate harm.

CLICK HERE TO: READ THE FULL ARTICLE

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