There is no doubt that this country is short of doctors. The shortage is so chronic that some country towns are without the services of a general practitioner - and even in the larger centres some doctors are so overworked that they have closed their books to new patients.
The only places that this does not apply is in affluent suburbs of the major cities, where doctors tend to congregate because the living is good and they command high salaries.
A solution to the problem has appeared, but as usual the medical profession is closing ranks and gearing up for a turf fight. The idea is to relegate some of the duties performed by general practitioners to clinical nurses working side by side with the doctor.
Many doctors are opposed because they believe that the only source of medical advice and treatment should come from a doctor, but common sense delivers a very different story.
How often does a patient attend a doctor simply to get scripts renewed ? How many times does a patient only need a referral renewal to the specialist they are attending ?
How many times is the visit to get the annual flu jab ?
None of these are either brain surgery or rocket science - and yet many doctors insist that they - and they alone - will attend to these patients.
If doctors would only come down off their high horse and work with a clinical nurse their practice would be more efficient and could handle a greater number of patients.
Nurses have the skill to recognise instances when a patient making a routine call needs to see the doctor - and insist on this happening.
The amazing thing is that nurses perform more of a doctor's function in public hospitals simple because the doctor numbers are not there, but use of their skills in general practice is being resisted.
The suggestion is that there should be one clinical nurse for each general practitioner - and if that was to happen doctor's would be relieved of nearly seventy percent of their work load.
Anything that improves the present chronic doctor shortage is worth serious consideration !
Sunday, 7 October 2007
Saturday, 6 October 2007
Name and shame !
A spirited debate is inevitable over a proposal to remove the suppression on naming offenders under eighteen when they appear before a court.
The civil liberties people are aghast and suggest that naming young offenders subject them to perpetual vilification that removes any chance of rehabilitation.
The victims of crime counter that with the nonchalance young offenders exhibit when they walk away from court - masked from any form of identification - with a mere slap on the wrist.
There is no doubt that punishment handed out to those under eighteen is mild compared to older offenders. Supposedly, under eighteens are not fully developed emotionally and are prone to actions that the more mature would resist. Despite this, the result of their crimes inflicts the same financial, property and trauma damage to their victims despite the age difference.
There is also the unfair situation that when a group is involved and one of that group is under eighteen the suppression order covers all - in case publishing the names of the over eighteen offenders would also identify the juvenile. As a result, wise gang members tend to keep a juvenile in their ranks as safety measure.
There are legal measures in place which allows the judiciary to waive the suppression order in some instances. The problem is that use of this is capricious. The odds are in favour of a juvenile and the suppression creates a public impression that justice is not being done - and that young people are immune from the punishment of crime.
The answer is probably a compromise. It would be reasonable to allow a first offence to be subject to suppression because anyone can make a mistake - and most people would think it reasonable to offer an opportunity to learn from that mistake.
What is unreasonable is to allow a hardened criminal - who has a rap sheet that would take an hour to read in court - to hide behind the protection of age.
We have young criminals under the age of eighteen who use the court as a revolving door and thumb their nose at the bail system.
Fairness requires that if such a person has rejected the opportunities of rehabilitation then the public has a right to know - and to be able to identify by way of pictures published in the media - those people who are likely to cause them harm and who represent a threat to their person and property.
Protection - is a two way street !
The civil liberties people are aghast and suggest that naming young offenders subject them to perpetual vilification that removes any chance of rehabilitation.
The victims of crime counter that with the nonchalance young offenders exhibit when they walk away from court - masked from any form of identification - with a mere slap on the wrist.
There is no doubt that punishment handed out to those under eighteen is mild compared to older offenders. Supposedly, under eighteens are not fully developed emotionally and are prone to actions that the more mature would resist. Despite this, the result of their crimes inflicts the same financial, property and trauma damage to their victims despite the age difference.
There is also the unfair situation that when a group is involved and one of that group is under eighteen the suppression order covers all - in case publishing the names of the over eighteen offenders would also identify the juvenile. As a result, wise gang members tend to keep a juvenile in their ranks as safety measure.
There are legal measures in place which allows the judiciary to waive the suppression order in some instances. The problem is that use of this is capricious. The odds are in favour of a juvenile and the suppression creates a public impression that justice is not being done - and that young people are immune from the punishment of crime.
The answer is probably a compromise. It would be reasonable to allow a first offence to be subject to suppression because anyone can make a mistake - and most people would think it reasonable to offer an opportunity to learn from that mistake.
What is unreasonable is to allow a hardened criminal - who has a rap sheet that would take an hour to read in court - to hide behind the protection of age.
We have young criminals under the age of eighteen who use the court as a revolving door and thumb their nose at the bail system.
Fairness requires that if such a person has rejected the opportunities of rehabilitation then the public has a right to know - and to be able to identify by way of pictures published in the media - those people who are likely to cause them harm and who represent a threat to their person and property.
Protection - is a two way street !
Friday, 5 October 2007
The road to Hell !
Yesterday two great ships sailed into Port Kembla harbour, the first of many that will deliver this state's car imports to the newly refurbished $ 167 million port facility.
The Tarago - of 67,000 tonnes - and the Taipan of 57,000 tonnes are much larger than the usual shipping using this port. They are welcome because they will rejuvenate an ageing port and bring many new jobs to the region - but they will also deliver an overload to this city's road system.
There are predictions that Port Kembla will handle somewhere near half a million new cars a year. Very few will be moved by rail because the rail system is presently overloaded moving coal and commuter traffic.
The new cars will be moved by road and that means a huge increase in car transporter trucks.
To exit Wollongong these vehicles will have to navigate the long, hard slog up Mt Ousley road and merge with the existing heavy commercial traffic. Many will continue along the F-6 and either use the Heathcote road to western Sydney or fight their way through the congestion by way of General Holmes drive.
There is another option that seems to have been overlooked. Many of these new cars will be destined for towns south of Sydney and even more will be headed to Sydney's west - and to achieve that will be routed along Appin road.
Appin road has an appalling death toll because it simply is not designed for the volume of traffic it presently moves. It services several major coal mines and hence carries a mix of coal miners driving to work and coal trucks moving the results of their labour. The addition of new fleets of car transporters will be a toxic increase to an already grossly overloaded and dangerous road.
Unfortunately there is no chance of any relief any time soon. The state government has initiated an enquiry into completing the abandoned Maldon-Dombarton rail link to western Sydney, but this will be years in the planning and construction stage if it is approved - and there are absolutely no plans for a road upgrade to relieve this additional traffic.
Once again the state government has solved one of it's problems by creating a major headache for the citizens of this area - and then walked away without offering any funds to resolve the problem !
The Tarago - of 67,000 tonnes - and the Taipan of 57,000 tonnes are much larger than the usual shipping using this port. They are welcome because they will rejuvenate an ageing port and bring many new jobs to the region - but they will also deliver an overload to this city's road system.
There are predictions that Port Kembla will handle somewhere near half a million new cars a year. Very few will be moved by rail because the rail system is presently overloaded moving coal and commuter traffic.
The new cars will be moved by road and that means a huge increase in car transporter trucks.
To exit Wollongong these vehicles will have to navigate the long, hard slog up Mt Ousley road and merge with the existing heavy commercial traffic. Many will continue along the F-6 and either use the Heathcote road to western Sydney or fight their way through the congestion by way of General Holmes drive.
There is another option that seems to have been overlooked. Many of these new cars will be destined for towns south of Sydney and even more will be headed to Sydney's west - and to achieve that will be routed along Appin road.
Appin road has an appalling death toll because it simply is not designed for the volume of traffic it presently moves. It services several major coal mines and hence carries a mix of coal miners driving to work and coal trucks moving the results of their labour. The addition of new fleets of car transporters will be a toxic increase to an already grossly overloaded and dangerous road.
Unfortunately there is no chance of any relief any time soon. The state government has initiated an enquiry into completing the abandoned Maldon-Dombarton rail link to western Sydney, but this will be years in the planning and construction stage if it is approved - and there are absolutely no plans for a road upgrade to relieve this additional traffic.
Once again the state government has solved one of it's problems by creating a major headache for the citizens of this area - and then walked away without offering any funds to resolve the problem !
Thursday, 4 October 2007
Our failing hospitals !
A recent emergency department disaster - and the plethora of unpaid bills that have caused local product suppliers to cease supply to Wollongong hospital has raised the question of what form of administration would resolve these crises.
There have been suggestions of a return to the past when a local hospital board was in charge. This had the advantage of bringing the decision making process to a local level, but the disadvantage was that such boards were stuffed with stooges by whatever political persuasion was in office at that time.
The problem comes down to one simple basic. All our hospitals are grossly underfunded - and they will continue to suffer logistic and staff problems until that problem is rectified.
The cause of the problem is simple. There are two distinctly different sources of funds that sustain our hospitals. Money comes from the state government - who own and run the hospitals - and from the Federal government who provide tax money to support the health system.
As a result, we see a classical example of buck passing. Both levels of government blame the other for lack of adequate money to run the health system.
There will never be a solution to this problem until a single entity has the responsibility of both running and financing our hospital system, and for that to happen - one of two choices will have to be made.
One option would be for the Federal government to take full responsibility for the Australian hospital system, removing it from state control and therefore achieving uniformity rather than differing state standards of care.
This would be a divisive approach that would split public opinion, but it is an option that should be widely debated - and possibly decided by a referendum.
The other option would be to return personal income taxing power to the states. At present, taxation is solely administered by the Federal government, giving rise to state claims that each state is short funded. The Goods and Services tax ( GST ) was an attempt to reimburse the states by a new tax imposed on a national basis and distributed in it's entirety to the states - and this has done nothing to reduce their claim of still being short funded.
More than a century ago the states and the Federal government both levied an income tax. The re-imposition of a state income tax would allow the Federal tax to be lowered and applied to Federal functions - while the states would have to accept responsibility for hospitals and schools as purely state functions - and face their taxpayers when setting the level at which that tax would be applied.
Services like hospitals are a need that should not be provided by way of a joint responsibility. If they are under the control - and financing - of a single entity then there is no excuse for failure - and the taxation level to provide that service is open to public scrutiny - and either acceptance or rejection by the voting public !
There have been suggestions of a return to the past when a local hospital board was in charge. This had the advantage of bringing the decision making process to a local level, but the disadvantage was that such boards were stuffed with stooges by whatever political persuasion was in office at that time.
The problem comes down to one simple basic. All our hospitals are grossly underfunded - and they will continue to suffer logistic and staff problems until that problem is rectified.
The cause of the problem is simple. There are two distinctly different sources of funds that sustain our hospitals. Money comes from the state government - who own and run the hospitals - and from the Federal government who provide tax money to support the health system.
As a result, we see a classical example of buck passing. Both levels of government blame the other for lack of adequate money to run the health system.
There will never be a solution to this problem until a single entity has the responsibility of both running and financing our hospital system, and for that to happen - one of two choices will have to be made.
One option would be for the Federal government to take full responsibility for the Australian hospital system, removing it from state control and therefore achieving uniformity rather than differing state standards of care.
This would be a divisive approach that would split public opinion, but it is an option that should be widely debated - and possibly decided by a referendum.
The other option would be to return personal income taxing power to the states. At present, taxation is solely administered by the Federal government, giving rise to state claims that each state is short funded. The Goods and Services tax ( GST ) was an attempt to reimburse the states by a new tax imposed on a national basis and distributed in it's entirety to the states - and this has done nothing to reduce their claim of still being short funded.
More than a century ago the states and the Federal government both levied an income tax. The re-imposition of a state income tax would allow the Federal tax to be lowered and applied to Federal functions - while the states would have to accept responsibility for hospitals and schools as purely state functions - and face their taxpayers when setting the level at which that tax would be applied.
Services like hospitals are a need that should not be provided by way of a joint responsibility. If they are under the control - and financing - of a single entity then there is no excuse for failure - and the taxation level to provide that service is open to public scrutiny - and either acceptance or rejection by the voting public !
Wednesday, 3 October 2007
The battle for Burma.
Once again armed troops are beating monks and ordinary citizens to contain unrest in Burma. This deeply religious Buddhist country has suffered forty five years of iron rule by it's military.
The generals applied the classical formulae for suppression when they gained power from a coup. They enlarged the army and made sure it and their supporters were well paid and had access to the best consumer goods to ensure loyalty. The rest of the citizenry faced deteriorating conditions as misrule saw prices rise and incomes dwindle.
The junta surprised the world some years ago when they allowed a vote to elect a parliament. Legendary leader Suu Kyi's NLD party won in a landslide. The generals simply ignored the result and Suu Kyi has remained under house arrest ever since.
In 1988 things boiled over and there was an uprising, suppressed by the military with brutality that led to the deaths of thousands.
And so we have Burma today. Simmering and on the edge of revolt with the nation's Buddhist monks leading the movement for change. This time the military are more cautious. They can no longer seal off the country from the rest of the world, thanks to mobile camera phones and the Internet - and so far they have avoided mass confrontations that would result in the massacre of thousands of people.
This is the very situation the United Nations was formed to settle peacefully - and as usual the UN has failed dismally.
The key in this instance is China - which shares a border with Burma - and is it's biggest ally and trading partner.
Burma is blessed with two major assets - gem stones - and oil !
China covets Burma's potential oil reserves and will do nothing to dislodge the junta from power while ever it grants China access to that bounty.
The fly in the ointment is the coming 08 Olympic games in Beijing. The last thing China wants is unrest on it's border during this opportunity to showcase itself to the world - and that brings with it the best opportunity for the world to press China to use it's influence to moderate the Burmese military.
As usual the UN will divide into two camps. Those that support China - and those on the other side of the political divide. Hopefully, world anger at the brutality and suppression in Burma may be enough to move the Chinese to pressure the junta into reform - but it is unlikely that democracy will come to that unfortunate country anytime soon !
The generals applied the classical formulae for suppression when they gained power from a coup. They enlarged the army and made sure it and their supporters were well paid and had access to the best consumer goods to ensure loyalty. The rest of the citizenry faced deteriorating conditions as misrule saw prices rise and incomes dwindle.
The junta surprised the world some years ago when they allowed a vote to elect a parliament. Legendary leader Suu Kyi's NLD party won in a landslide. The generals simply ignored the result and Suu Kyi has remained under house arrest ever since.
In 1988 things boiled over and there was an uprising, suppressed by the military with brutality that led to the deaths of thousands.
And so we have Burma today. Simmering and on the edge of revolt with the nation's Buddhist monks leading the movement for change. This time the military are more cautious. They can no longer seal off the country from the rest of the world, thanks to mobile camera phones and the Internet - and so far they have avoided mass confrontations that would result in the massacre of thousands of people.
This is the very situation the United Nations was formed to settle peacefully - and as usual the UN has failed dismally.
The key in this instance is China - which shares a border with Burma - and is it's biggest ally and trading partner.
Burma is blessed with two major assets - gem stones - and oil !
China covets Burma's potential oil reserves and will do nothing to dislodge the junta from power while ever it grants China access to that bounty.
The fly in the ointment is the coming 08 Olympic games in Beijing. The last thing China wants is unrest on it's border during this opportunity to showcase itself to the world - and that brings with it the best opportunity for the world to press China to use it's influence to moderate the Burmese military.
As usual the UN will divide into two camps. Those that support China - and those on the other side of the political divide. Hopefully, world anger at the brutality and suppression in Burma may be enough to move the Chinese to pressure the junta into reform - but it is unlikely that democracy will come to that unfortunate country anytime soon !
Tuesday, 2 October 2007
The arsonist danger.
The combination of the start of the fire season on the Australian east coast and a long weekend saw three major outbreaks in New South Wales.
Two homes were destroyed north of Newcastle and there were fires in the national parks north and south of Sydney - and the cause of all three fires is highly suspicious.
One natural cause of bush fires is lightning strikes, but in the preceding forty-eight hours there were no dry lightning storms - and in the case of the fire that destroyed homes there were numerous ignition points. The overwhelming verdict from the fire fighters is that this was arson.
Our fire fighting defences have been strengthened in recent years. Fire bombing helicopters have been added to the arsenal and money has been spent on upgrading vehicles and equipment, but the biggest asset is the army of volunteers who give up their time to save lives and property - and their employers who willingly accept their absence from work to provide this valuable service.
The big question is how do we stop people deliberately lighting fires in the bush ?
Penalties have been increased - and if there is a death from a deliberately lit fire the offender could face a murder charge.
There is no obvious remedy that will stop teenagers looking for excitement or the mentally ill with a grievance against society from dropping a match and starting a fire. Unfortunately, many of these people are cunning and have devised instruments that will lay dormant and only ignite long after they have left the scene..
The only defence is to be able to react quickly and extinguish the fire before it becomes a major event - and to do that we need adequate fire trails to get fire crews to the scene quickly.
That seems to run contrary to the policies of the Greens. For some reason their philosophy is to obstruct any action that entails cutting back the bush to make a fire trail navigable - despite the fact that fires damage and destroy the very vegetation they are dedicated to protect.
It is impossible to have a logical argument with people of that persuasion. They have closed minds - and logic does not prevail.
What is needed is for government to be strong minded and ensure that legislation is in place to allow fire trails to be maintained without hindrance by Greenies who set up blockades or resort to delaying legal action.
Just as the strong arm of the law should descend on any arsonists caught, so it should be equally strong on anyone obstructing the fire services from protecting lives and property !
Two homes were destroyed north of Newcastle and there were fires in the national parks north and south of Sydney - and the cause of all three fires is highly suspicious.
One natural cause of bush fires is lightning strikes, but in the preceding forty-eight hours there were no dry lightning storms - and in the case of the fire that destroyed homes there were numerous ignition points. The overwhelming verdict from the fire fighters is that this was arson.
Our fire fighting defences have been strengthened in recent years. Fire bombing helicopters have been added to the arsenal and money has been spent on upgrading vehicles and equipment, but the biggest asset is the army of volunteers who give up their time to save lives and property - and their employers who willingly accept their absence from work to provide this valuable service.
The big question is how do we stop people deliberately lighting fires in the bush ?
Penalties have been increased - and if there is a death from a deliberately lit fire the offender could face a murder charge.
There is no obvious remedy that will stop teenagers looking for excitement or the mentally ill with a grievance against society from dropping a match and starting a fire. Unfortunately, many of these people are cunning and have devised instruments that will lay dormant and only ignite long after they have left the scene..
The only defence is to be able to react quickly and extinguish the fire before it becomes a major event - and to do that we need adequate fire trails to get fire crews to the scene quickly.
That seems to run contrary to the policies of the Greens. For some reason their philosophy is to obstruct any action that entails cutting back the bush to make a fire trail navigable - despite the fact that fires damage and destroy the very vegetation they are dedicated to protect.
It is impossible to have a logical argument with people of that persuasion. They have closed minds - and logic does not prevail.
What is needed is for government to be strong minded and ensure that legislation is in place to allow fire trails to be maintained without hindrance by Greenies who set up blockades or resort to delaying legal action.
Just as the strong arm of the law should descend on any arsonists caught, so it should be equally strong on anyone obstructing the fire services from protecting lives and property !
Monday, 1 October 2007
Fooling the public.
The New South Wales government is indulging in a smoke and mirrors attempt to fool the public that it has implemented a " get tough on crime " policy. A new law is passing through parliament that is supposed to introduce " mandatory minimum " sentences for an array of crimes.
To most people, " mandatory minimum " means an automatic prison sentence for the crimes listed. That is not the case. The new sentencing will apply to those who plead " not guilty " , but are found guilty at trial. For those who plead guilty the sentence will still be decided by the judge.
The list of proscribed crimes is an interesting mix that range from twenty five years prison for murder of a child, to civil offences such as malicious wounding, malicious grievous bodily harm - down to car rebirthing, cultivating prohibited plants and finally illegal possession of a firearm. These latter offences are supposed to attract a mandatory sentence of between three and ten years.
The legislation draws attention to the " one size fits all " attempt to bypass the wisdom of judges and magistrates to rule on the severity of a particular crime. Few would disagree with a harsh prison sentence for the murder of a child, but then there is the supposedly automatic three
year gaol term for being in posession of an unregistered firearm.
There are hundreds - and perhaps thousands - of farmers and rural folk who have unregistered shot guns and rifles - and have had them for generations - for the purpose of safely killing snakes that threaten their family or for mercifully killing terminal livestock. Do we seriously want to lockup such people who have committed no crime other than not having got around to complying with a law designed to remove guns from the cities ?
Wouldn't it be reasonable for a judge to vary the sentence between such a farmer - and a city criminal who used such a gun to holdup a TAB ?
The problem with passing harsh laws is that they usually bring unintended consequences. Knee jerk reactions intended to create brownie points with the public are virtually assured of creating a negative response somewhere down the track. They should be approached - with caution !
To most people, " mandatory minimum " means an automatic prison sentence for the crimes listed. That is not the case. The new sentencing will apply to those who plead " not guilty " , but are found guilty at trial. For those who plead guilty the sentence will still be decided by the judge.
The list of proscribed crimes is an interesting mix that range from twenty five years prison for murder of a child, to civil offences such as malicious wounding, malicious grievous bodily harm - down to car rebirthing, cultivating prohibited plants and finally illegal possession of a firearm. These latter offences are supposed to attract a mandatory sentence of between three and ten years.
The legislation draws attention to the " one size fits all " attempt to bypass the wisdom of judges and magistrates to rule on the severity of a particular crime. Few would disagree with a harsh prison sentence for the murder of a child, but then there is the supposedly automatic three
year gaol term for being in posession of an unregistered firearm.
There are hundreds - and perhaps thousands - of farmers and rural folk who have unregistered shot guns and rifles - and have had them for generations - for the purpose of safely killing snakes that threaten their family or for mercifully killing terminal livestock. Do we seriously want to lockup such people who have committed no crime other than not having got around to complying with a law designed to remove guns from the cities ?
Wouldn't it be reasonable for a judge to vary the sentence between such a farmer - and a city criminal who used such a gun to holdup a TAB ?
The problem with passing harsh laws is that they usually bring unintended consequences. Knee jerk reactions intended to create brownie points with the public are virtually assured of creating a negative response somewhere down the track. They should be approached - with caution !
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