STATEMENT BY JANELLE SAFFIN MP ON CLOSURE OF BONALBO HOSPITAL 24/7 EMERGENCY DEPARTMENT & NURSING SERVICE

Statement by Janelle Saffin MP on Bonalbo Hospital

I express my dismay at the actions of the Northern New South Wales Local Health District’s administration in closing the 24/7 nursing operation at Bonalbo Hospital, and call upon the Board to immediately reinstate it.

I was at Bonalbo Hospital on Saturday with the nurses and I promised them that in addition to my earlier letter to the Chief Executive Chris Crawford and the Board, that I would make a public call for the immediate reinstatement for the 24/7 nursing operation.

I realise it is a matter of state administration, but I take a very strong interest in health, securing much needed Federal funds locally, so I cannot stay silent when a community is left abandoned, as is the case in Coraki as well.

I question what is going on with our local health services?  

I was at the public meeting in Bonalbo last year, discussing how to handle the departure of the local GP.

With the permanent GP gone, it is important to keep as many of the health services as possible, and give the community a sense of security regarding their health.

This also allows them to keep faith in the health service, while attempts to attract another GP or two GPs to the Bonalbo township and district are continuing.

When the decision was taken to cease the 24/7 nurses’ shifts in Bonalbo, without consultation about how things would work with the 11.00 pm to 7.00 am shift axed, I let Mr Crawford know that I was appalled.

I said in my letter to him, that: “There is fear now in our small communities, both Bonalbo and Coraki, that you and the Board are set on closing their hospitals and neither community believes you when you say that you will restore their health services.”

I have now told the nurses, the SOS Action Committee and locals to go to the Board, as they are our community representatives.

 

The current interim Bonalbo model of operation, with doctors brought in from neighbouring towns, has been lauded by health representatives, including Board members, as a good model for  the residents of Coraki and district, who have not only lost their hospital due to the disrepair of the facility, but have been left without alternative services.

I am waiting to hear the announcement that some emergency services will be reinstated there while a health services plan is done.

.

There have been so many calls for the immediate reinstatement of the 24/7 service from concerned community members and key representative organisations.  These include Kyogle Shire Council, the NSW Nurses Association, the local NSW Nurses Association members, the Aboriginal and Torres Strait Islander Peoples’ representatives and all Bonalbo and district residents.

 

The NSW Nurses Association has said that: “People usually only call on health services during the night when things are serious, so it is important that this community has sufficient capacity to respond during the night.”

The local nurses, through the NSW Nurses Association, have asked a list of some 29 questions which raise serious issues that need to be addressed immediately, including that of nurses’ security.

The list includes critical questions such as:

• Who will carry the hospital and drug cupboard keys and how would they be passed from one nurse to the next; for example, to get keys from evening shift nurse to morning shift nurse where the morning nurse will usually be a different nurse?
• Once the nursing night shifts cease, where does the Local Health District plan to keep the key for the alternative helipad if a helicopter evacuation was required through the night as the usual helipad has been flooded four times in the past 10 years? Is the Health District aware that it takes an average of four hours to mobilize helicopter retrieval?  

It is bad enough to axe the 24/7 nursing operations, but to then not manage the process is negligent.

 

Kyogle Shire Council, in its letter to Mr Crawford, has stated categorically that: “The decision to cease the provision of Emergency Services at Bonalbo Hospital between 11.00 pm and 7.00 am will result in unacceptable risk to the health and well being of our community and is completely at odds with previous guarantees provided to the Bonalbo community at public meetings that there would be no reduction to health services.”

It is clearly up to the Board members to ensure that there are no reduction to health services and I am asking them to continue this service of 24/7 coverage with nurses.

Contact: Janelle Saffin 0418 664 001.   

Gender difference in number of hospital inpatient days 2005- 2010

Australian Institute of Health and Welfare HEALTH SERVICES SERIES Number 40  Australian hospital statistics 2009–10 (April 2011):

Between 2005–06 and 2009–10, patient days in all hospitals increased by 9.8% for males, and by 7.4% for females (Figure 7.3). The relative size and direction of change in patient days varied by sex and age group.

Click on graph to enlarge

Stirrup the bitch! Why the medical experience is still a feminist issue

Because women as a group are constantly being told “You’ve come a long way”  when compared with their grandmothers, it is easy to overlook the fact that misogyny and chauvinism are still slyly woven into much of the female experience in developed countries like Australia.

So it is often only cases such as this which draw any mention in the mainstream media of the fact that the medical experience is frequently one fraught with the risk of physical and/or psychological damage for many females.

The Northern Star Rogue obstetrician faces 15 counts of abuse, malpractice by Natasha Wallace 13 December 2011

She alleged he forcefully put his hand on her vagina

and said, ''Who is the boss now?''

Read the rest here

A win on the board for Labor's Peter Ellem and local nurses regarding O'Farrell Government's health funding offer

It is highly likely that people in the Clarence Valley would still be waiting and, Grafton Base Hospital still be without sufficient staffing levels to open its new orthopaedic beds in 2011-12 if Labor’s candidate in the 19 November Clarence by-election Peter Ellem (with the help of local nurses) had not managed to make it an election issue.

In The Casino Times online on 24 October 2011:

COUNTRY Labor candidate for the Clarence by-election, Peter Ellem today joined Opposition Leader John Robertson and local nurses to demand State funding for orthopaedic surgery and equipment at Grafton Base Hospital.
"The O'Farrell Stoner Government must fund orthopaedic surgery and equipment to complement the new federally-funded operating theatres at Grafton Base Hospital," Mr Ellem said.
"The Commonwealth-funded theatres are a massive boost for Grafton Base, but the O'Farrell-Stoner Government down in Sydney needs to back this up with State-funded orthopaedic surgery and equipment.
"The National Party has been far too timid in their approach to Grafton Base Hospital – I am demanding the immediate funding of orthopaedic surgery for the hospital."

From a NSW Health Minister media release on 14 November 2011:

The NSW Government has allocated $1.7 million of recurrent funding to support the establishment of an Orthopaedic Surgery Service at Grafton Base Hospital, the Minister for Health and Minister for Medical Research, Jillian Skinner, announced today…..

“This funding will allow additional nursing staff, a physiotherapist and an occupational therapist to be recruited to treat orthopaedic surgery patients,” Mrs Skinner said……

This $1.7 million allocation will complement the redevelopment of the Grafton Base Hospital operating theatres and the establishment of dedicated orthopaedic surgery beds, which have been jointly funded by the Federal and State Governments.

Although, given how the O'Farrell Government and its candidate Chris Gulaptis fudged their earlier health announcements, one may have to wait and see if this claimed new funding isn't actually Federal Government money being announced by the NSW Coalition as its own.

The highs and lows of public hospital outpatient care according to NSW consumers

Source: Outpatient care module of the NSW Health Patient Survey 2010
Click on graphs to enlarge

In August 2011 the NSW Bureau of Health Information released Patient Care Experiences (part of the Insight series) a survey of patients using outpatient services in NSW public hospitals during February 2010.

Not surprisingly, consumers on the North Coast had mixed feeling about their experience in the larger regional public hospitals and these scored in both the higher and lower satisfaction bands.

In comparison with all public hospitals in this survey, Murwillumbah and Grafton performed well and Tweed, Lismore and Coffs Harbour performed poorly.

When compared with other non-metropolitan hospitals in the survey most fell in the middle of the rating band with only Tweed Heads in the lowest ranking.

How the emergency department experience in non-metropolitan hospitals is rated by NSW Health can be found in Performance Profiles Emergency department care Major non-metropolitan hospitals Hospital Quarterly: January to March 2011.

Clarence Valley worry that Coalition cronyism is about to bleed health dry has NSW Health Minister throwing counter punch

The Daily Examiner  Health is bled dry  4 July 2011:

TWO members on the North Coast health advisory board have been dumped and replaced by two failed former Coalition political candidates on the re-titled Northern NSW Local Health Board District, leaving the Clarence with only one representative on the 10-member board.

Yamba-based solicitor Bob Thompson and Tweed-based doctor David Hodgson were both dropped from the board appointed under the former Labor government and replaced with former Liberal Party candidate for Page Malcolm Marshall and former National Party candidate for Richmond Dr Sue Page Mitchell.

Former board member and Grafton radio station manager Ron Bell resigned a few weeks ago for personal reasons and has not been replaced by another representative from the Clarence Valley.

It leaves the Clarence area with only one member on a board dominated by members from the Richmond area, and has raised serious concerns the health needs of the Clarence will be swept aside because of the political strength of representation in the Richmond……….

The lack of representation from the Clarence area was a major concern and he cited the recent appointment of an orthopedic surgeon to Grafton as an area of potential problems.

…. that surgeon would treat patients who previously would have been treated at Coffs Harbour or Lismore, but the funding needed for those operations now needed to be transferred from Coffs and Lismore to Grafton.

Taking money from the Coffs and Lismore budgets would be difficult, because of the strong Richmond area representation on the board.

Mayor Richie Williamson, Mr Bell and chairman of the Grafton Base Hospital Medical Staff Council Dr Allan Tyson all expressed similar concerns about the composition of the board and the lack of representation from the Clarence Valley.

The Daily Examiner NSW Health District Board changes 5 July 2011:

“There were people who were not re-appointed.
“In some cases, that was simply due to other applicants being more experienced and skilled in the required areas of governance and finance.
“In other cases, it was because those people were not performing adequately.”

Ouch....

Feeling unwell? Take two aspirin and stay away from NSW hospitals

While bureaucrats are happily busy preparing to collate personal health information (supplied to them by everyone from doctors through to chemists and optometrists) in order to satisfy Federal Health Minister Roxon’s unnatural desire for a great big database on Australian citizens, this is one of the computer systems from which this data will be drawn. It is said to be installed in 59 hospitals having an estimated 80 per cent of all NSW public hospital beds.

The Sydney Morning Herald 7 March 2011:

THE computer system that runs emergency departments in NSW hospitals is compromising patients' care, according to the first systematic review of the troubled project that found it was crippled by design flaws.

The FirstNet system allows treatment details and test results to be assigned inadvertently to the wrong patient, according to the review. It is based on a technical study of the software and interviews with directors of seven Sydney emergency departments.

The system is so compromised it should be scrapped, a specialist doctors' group said yesterday.

Difficulties retrieving patient records could delay treatment, and the system - on which $115 million has been spent - automatically cancelled pathology and radiology requests if the person was transferred from the emergency department without checking whether these were still needed, according to the study by Jon Patrick, the director of the University of Sydney's health information technology research laboratory.

Sally McCarthy, the president of the Australasian College for Emergency Medicine, said Professor Patrick's findings confirmed that the system, loathed by doctors and nurses, was unsuitable for its purpose.........

The project, part of a 10-year electronic medical records plan intended to make patient histories, X-rays and test results accessible from any hospital in the state, had proceeded too fast - apparently because of contractual obligations - for clinicians' feedback to influence it, Dr McCarthy said.

The potential for records to be linked to the wrong patient raised a serious risk they would be given incorrect treatment, she said, and the inability to compile multiple patient records into reports meant doctors could no longer evaluate new treatments or disease epidemics. "Simple audits and research projects are just impossible now," she said.

Really inspires confidence doesn’t it?

These difficulties are not confined to large metropolitan areas as this 2010 quote from the North Coast Area Health Service indicates:

In response to the difficulties our small sites experienced in using FirstNet, NCAHS continues to work with HSS to develop a FirstNet work flow for small rural sites.

Little appears to have changed since the 2009 implementation of this e-health software on the NSW North Coast.

If the reader happens to live in communities covered by the Hunter Urban Division of General Practice this sick software system is probably informing e-discharge summaries etc. forming part of the data collection trial run currently underway in the Newcastle and Hunter Valley region.

Building on these shifting sands, on 1 March 2011 Roxon’s baby, the National E-Health Transition Authority (NEHTA), awarded IBM a $23.6M dollar contract to develop nation-wide authentication system for electronic health records.

Looking for Mr. Good Stork

The Australian Federal Government’s My Hospitals website is up and running and I decided to see what is said about hospitals on the NSW North Coast.

With a bit of nudging the lists from the mid to far North Coast came up here and here. Then the fun began when linking to hospitals in the Clarence Valley.

According to the new website there were no births at Maclean District Hospital in the financial year 2008-09, which was to be expected as its maternity section was closed down years ago despite community protests.

Grafton Base Hospital had 478 births + <10 births in the same financial year. Again something to be expected as it is the only relatively large hospital in the area and it usually records births it the vicinity of four hundred or so.

Wondering how these figures compared with the Australian Bureau of Statistics (ABS) regional profile for the Clarence Valley local government area I went looking.

I found that birth numbers didn’t quite add up when one compares My Hospitals and ABS data, even when the former is operating on financial year dates and the latter on calendar year dates.

The ABS has 278 births recorded in Grafton Statistical Area for year ended 31 December 2008 and no births recorded for the Clarence Valley Local Government Area in the year ending 31 December 2009.

An official 2009 zero birth rate was taking things a bit too far, so who isn’t keeping accurate records? The ABS, local court houses, someone else? Or did bad weather blow The Stork off course?

Well Clarence Valley residents may actually in part be the culprits when it comes to accurate record keeping. Because it appears that Australians don’t always promptly register the births of those little bundles of joy.

Elsewhere on the ABS website it states:

Of the 295,700 births registered in Australia during 2009, 88% occurred in 2009. A further 9% occurred in 2008, and the remainder (3%) occurred in 2007 or earlier. It is expected that some births, particularly those that occur in November and December, may not be registered until the following year.

Now in New South Wales parents are responsible for registering the birth of their newborn within 60 days.
However, somewhere in Australia in 2009 (presumably including NSW) over 8,000 people probably turned up at the court house or registry office with a one and a half to three year-old child in tow and told the clerk that the toddler holding their hands actually existed. Others obviously went in after the Christmas and New Year’s Eve parties were over to inform the world that their family had grown.

Something for New Sou' Welshies to think about as the year ends.....

I’m told that once-upon-a-time in regional New South Wales you could find yourself locked up in a secure mental health facility just on the say so of a family member backed up by the word of a GP who hadn’t actually seen or talked to you.
The only hope you had of getting out from under this form of domestic violence (if the trick cyclist on duty didn’t believe you) was to speak with the visiting magistrate.
Now it seems the bad old days are returning:
“You, or anyone in NSW, could be picked up by the police and held in detention for up to one month without any form of judicial review. This could happen at any time, even though you have committed no crime. These are not the latest draconian anti-terror laws nor are they laws targeting asylum seekers. This is a legal framework that is directed at you and me, or it will be if we are unlucky enough to occasionally suffer a severe mental illness…. The act places restrictions on psychiatrists' power. It says that "as soon as practicable" after someone is admitted involuntarily to hospital, their case must be heard by an independent umpire. Until June, the umpire was a magistrate who came to the hospital every week. The magistrate saw every patient who had been detained and psychiatrists had to justify that deprivation of liberty to the magistrate. In June though, the umpire became a lawyer from the Mental Health Review Tribunal and, instead of visiting the hospital, he or she started appearing by audiovisual link. Whereas patients detained in hospital would previously have an automatic review within a week or so, now that would not happen until they had been locked up three or four weeks. The words "as soon as practicable" were suddenly interpreted to mean "within about a month" and many patients would now be involuntarily admitted and eventually released without ever having their detention independently checked.”
Shame, Premier Keneally, Shame!

NSW Health Minister gets a bi-partisan letter from NSW North Coast MPs

The following is a copy of the bi-partisan letter sent to the NSW Health Minister by NSW North Coast MPs Saffin, Georges, Cansdell and Page:

Friday, December 3, 2010.
REF: PE.03.12.10.

The Honourable Carmel Tebbutt MP
NSW Deputy Premier
NSW Minister for Health
Level 30 Governor Macquarie Tower
1 Farrer Place
SYDNEY NSW 2000.

Dear Carmel,

I am writing, with the support of three North Coast-based State MPs, to express our deep disappointment that the NSW Government has excluded the Lismore Base Hospital Stage 3 Redevelopment from a list of priority projects for funding under the Federal Government’s Health and Hospitals Fund Round 3.

We simply cannot reconcile this decision, particularly as this long overdue, $150-million capital works project is so critical to the future wellbeing of a coastal region with one of the fastest growing and ageing populations in Australia.

Lismore Base is a major referral hospital and its importance as the public health service hub for the entire Northern Rivers cannot be understated.

Federal and State governments, regardless of their political colours, and local community leaders, have long recognised the absolute need for this final stage of the hospital’s redevelopment to cope with an estimated 30-per cent increase in patients over the next decade.

This is reflected in the extensive planning done by the North Coast Area Health Service on a proposed new and expanded Emergency Department; upgraded medical imaging; new operating theatres and wards; a new procedures centre, helipad and additional parking.

In 2005-2006, a capital options study was undertaken as part of the planning process, which signalled that capital funds were imminent and construction would start soon after.

We fail to understand how, on any grounds -- be it clinical services need, population demand or time spent waiting in the queue for funding -- any hospital could have been prioritised higher than the Lismore Base Hospital.

All of these major capital improvements, together with an increase of 90 beds and about 70 full-time clinical staff, are also what the people of the Northern Rivers expect and deserve.

At every public forum held in recent years, including a Big Ideas seminar organised by The Northern Star newspaper in Lismore last Sunday, LBH Stage III has been consistently identified as our region’s No. 1 priority.

While we realise that the Health and Hospitals Fund Round 3 is a highly competitive environment, the NSW Government now has made it that much harder for us to argue our strong case for ‘the forgotten corner’ of this State – north of the Central Coast and Port Macquarie.

As Members of Parliament who cover geographic areas beyond Lismore, we too have other priority health projects, but we know that if Lismore Base is not progressed at State level, it will be virtually impossible to get those ones looked at.

The Northern Star has a petition, which calls on you as NSW Health Minister torethink the decision, and further, calls on Federal Minister for Health and Ageing, The Honourable Nicola Roxon MP, to give priority to LBH Stage III, regardless of the current advice coming from NSW Health.

We come from across the political divide to stand unified in representing the interests of several hundred thousand Australians living in our electorates, and we respectfully ask that you act on our bipartisan approach as a matter of urgency.

Yours sincerely,

Janelle Saffin MP

Federal Member for Page.

Thomas George MP

State Member for Lismore.

Don Page MP

State Member for Ballina.

Steve Cansdell MP

State Member for Clarence.

Cc. Federal Minister for Health and Ageing, The Honourable Nicola Roxon MP.

Another attempt to define protections for Australian mental health service consumers

National standards for mental health services 2010
National standards for mental health services 2010 (PDF 699 KB large file)

"This document outlines a set of mental health service standards which can be applied to all mental health services, including government, non-government and private sectors across Australia."

Standard 6.

Consumers

Consumers have the right to comprehensive and integrated mental health care that meets their individual needs and achieves the best possible outcome in terms of their recovery.
(Note: The consumer standard is not assessable, as it contains criteria that are all assessable within the other standards.)

Criteria

6.1 Consumers have the right to be treated with respect and dignity at all times.

6.2 Consumers have the right to receive service free from abuse, exploitation, discrimination, coercion, harassment and neglect.

6.3 Consumers have the right to receive a written statement, together with a verbal explanation, of their rights and responsibilities in a way that is understandable to them as soon as possible after entering the MHS.

6.4 Consumers are continually educated about their rights and responsibilities.

6.5 Consumers have the right to receive the least restrictive treatment appropriate, considering the consumer’s preference, the demands on carers, and the availability of support and safety of those involved.

6.6 A mental health professional responsible for coordinating clinical care is identified and made known to consumers.

6.7 Consumers are partners in the management of all aspects of their treatment, care and recovery planning.

6.8 Informed consent is actively sought from consumers prior to any service or intervention provided or any changes in care delivery are planned, where it is established that the consumer has capacity to give informed consent.

6.9 Consumers are provided with current and accurate information on the care being delivered.

6.10 Consumers have the right to choose from the available range of treatment and support programs appropriate to their needs.

6.11 The right of consumers to involve or not to involve carers and others is recognised and respected by the MHS.

6.12 Consumers have an individual exit plan with information on how to re-enter the service if needed.

6.13 Consumers are actively involved in follow-up arrangements to maintain continuity of care.

6.14 The right of consumers to have access to their own health records is recognised in accordance with relevant Commonwealth and state / territory legislation / guidelines.

6.15 Information about consumers can be accessed by authorised persons only.

6.16 The right of the consumer to have visitors and maintain close relationships with family and friends is recognised and respected by the MHS.

6.17 Consumers are engaged in development, planning, delivery and evaluation of the MHS.

6.18 Training and support is provided for consumers involved in a formal advocacy and / or support role within the MHS.

The concept of a dysfunctional life and the national e-health database

Ever since medical doctors such as John D'Arcy first began to appear on television screens, be heard on radio and be quoted in print commenting on social, economic and political aspects of Australian life it became apparent that medicalisation of the media and everyday life was well underway in Australia.

All behaviour commonly thought of as unacceptable (and even some behaviours previously falling within 'normal' ranges) quickly became defined as some form of deviance, psychopathology or physical illness. Nevermore so than when applied to those without a large measure of social or political power ie., children and the poor, which had previously only suffered under moral labels such as "lazy" and "bad".

If you are under voting age or come from a socio-economic band found at the bottom of the pecking order then it is highly likely that many aspects of your life are now considered to be so dysfunctional that the state must step in to regulate your behaviour - as instanced by the Australian Government's staged national roll out of a scheme quarantining at least half of the fortnightly cash transfer amount received by certain welfare recipients.

That Australia was not alone in experiencing this domination by the world view of health professionals was obvious when one noticed that internationally this phenomena was being debated, including such issues as the cross-over between moral and medical explanations of criminal behaviour, the medicalisation of sleep and fads in diagnosis which saw some previously rare diagnoses cluster in ways that surprised many epidemiologists.

One only has to look at the increased incidence of multiple personality diagnoses (an estimated 10 per cent of the 1991 North American adult population had a DSM-III-R dissociative disorder of some kind) in the years since The Three Faces of Eve was first picked up by the world-wide media to realise that something may be amiss.

Much of this past discussion was confined to the halls of academia and often only broke free of those constraints via humour, instanced in the late 1980's by an early version of The Etiology and Treatment of Childhood which can now found on the Internet and, more recently by George Monbiot's A Modest Proposal for Tackling Youth.

In the current century this medicalisation of the human condition is so entrenched that some in the principal offending professions became a mite uncomfortable and now posit the theory that we are all to blame for this state of affairs:
Originally, the concept of medicalisation was strongly associated with medical dominance, involving the extension of medicine's jurisdiction over erstwhile 'normal' life events and experiences. More recently, however, this view of a docile lay populace, in thrall to expansionist medicine, has been challenged. Thus, as we enter a post-modern era, with increased concerns over risk and a decline in the trust of expert authority, many sociologists argue that the modern day 'consumer' of healthcare plays an active role in bringing about or resisting medicalisation.
However, this concern has not halted the inexorable march forward of this universal redefinition of life.

In 2010 it seems that children are being further defined by the concept of criminal behaviour and in June this impressively titled study was released by the British Home Office; Experimental statistics on victimisation of children aged 10 to 15: Findings from the British Crime Survey for the year ending December 2009, England and Wales.

This study seeks to define the following scenario as a crime in law:
At home, two siblings are playing and one of them deliberately smashes the other's toy.

Now before you start shaking your head or roaring with laughter (because after all everything is so normal and sane in your particular corner of the national garden) think about the ramifications of this penchant for defining so much of the human condition as deviance, dysfunction, congenital defect or criminal activity.

Think about what the Gillard Labor Government's e-health national database of all Australian citizens (privately endorsed by the Federal Coalition Opposition ) may actually permanently contain by way of label or opinion concerning your own health, lifestyle decisions and family dynamics.

These digital records will not only affect how you are viewed today and tomorrow by officialdom in all its many guises, they might also affect how competent the state deems you to be as you enter frail old-age and whether control of your assets/financial affairs are assumed by another.

Scared yet?

Round the online traps....

Unflattering pic of Tony Abbott alongside ABC News article about his
Budget Reply 13th May 2010

IanLoveridge: Missed the budget reply on purpose. I like my new TV and I didn't want to harm it!
Orcisano: Tony Abbot spent at least 35 minute of his budget reply attacking the government and praising the Howard government.
{Twitter 13th May 2010}

"Accused war criminal "Captain Dragan" Vasiljkovic spent the night in police custody last night in a Coffs Harbour police station after 43 days on the run."
{The Australian 13th May 2010}

"Electronic Frontiers Australia and Australian Privacy Foundation asking the company [Google] to clarify its reasons for collecting personal Wi-Fi network data from Australian homes."
{The Sydney Morning Herald 13th May 2010}

"For Australia's sake, we need to ban the bikini"
{En Passant 11th May 2010}

"Health authorities are warning of the dangers of eating slugs as a Sydney man battles a rare form of meningitis."
{ABC News 13th May 2010}

"Freud signed, but added in his own writing, "I can heartily recommend the Gestapo to anyone."
{Jonathon Glover "Bits and Pieces"}

"THERE is good reason why the North Coast Area Health Service (NCAHS) doesn't want the public to read a report by an emergency medicine expert about the state of the Grafton and Maclean emergency departments (EDs).
Alleged shoddy clinical practices by certain GPs, bullying of nursing staff by senior Visiting Medical Officers (VMOs), bad relations with Coffs Harbour hospital's ED and a culture of overspending on unnecessary pathological tests are just a few of many inflammatory findings of the report."
{The Daily Examiner 7th May 2010}

"Six Things You Need to Know About Facebook Connections"
{Electronic Frontier Foundation 4th May 2010}

Google receives takedown request for multiple Blogspots offering "direct links to files containing soundrecordings for other users to download"
{Internet Anti-Piracy 14th April 2010}

"How Many Bad Assumptions Can You Make In A Single Article About Content Creation And Copyright?"
{Techdirt May 2010}

"A MAN has pleaded guilty over an armed siege at a Port Macquarie McDonald's restaurant last year."
{Port Macquarie News 14th April 2010}

A genetic test will be offered Friday at Walgreens drug stores, but the FDA warns that "consumers are putting themselves at risk if they use a test not approved" by the federal agency. The test, offered by Pathway Genomics, already is offered online. So are similar tests from other companies. The FDA has not previously intervened.
{WebMD 12th May 2010}

"Prominent economist Ross Garnaut says China has shown more leadership in tackling climate change than Australia."

{ABC News 13th May 2010}

Babies!

{Slate 7th May 2010}

Phony Tony just didn't wanna know....

As Australia's Opposition Leader 'Phony Tony' Abbott revs up with manufactured outrage over Kevin Rudd's health funding deal with the states, a neighbour sent me this evidence that he doesn't listen to voters, even very polite ones:
Your message To: Abbott, Tony (MP)
Subject: Forthcoming Leaders' Debate March 2010
Sent: Mon, 22 Mar 2010 13:11:23 +1000
was deleted without being read on Thu, 22 Apr 2010 02:18:49 +1000

BBQ Brumby served on a skewer with sauce piquante

If there was an award for questions from the floor after a National Press Club Address, this one should get first prize:

"Mr Brumby, Sue Dunlevy from the Daily Telegraph. You're saying today —  the title of your address is "putting patients first". But it's not something that you're doing in your own hospital system. Victoria's hospitals see fewer emergency and elective surgery patients within the recommended time than hospitals in New South Wales. You spend $123 less per patient than New South Wales. Your hospital system provides fewer beds per thousand people than New South Wales. And your hospital performance has been going backwards for five years. Why should you be regarded as some kind of authority on health? And why should patients in other states have to put up with a second-rate system because someone who can't run his own health system is behaving like a bully?"

You little bewdy, Sue!

And these are some of the bureaucrats that the Australian Health Minister expects to have access to a national personal health infomation data base

Fifty-two per cent of the agencies

we assessed using capability models had not established

effective controls to manage IT risks, information security

and business continuity. Thirty-one per cent of agencies had

not established effective change controls and 33 per cent

had not established effective controls for management of

physical security [Information Systems Audit Report, March 2010]

On 26 March 2010 Computer World reported on Part Two of a West Australia Government Information Systems Audit Report covering 56 government agencies including the WA Health Department:

Ineffective security measures in Western Australian government agencies are failing to protect sensitive staff and taxpayer information, according to an official security audit....

The audit report found that Royal Perth Hospital and the Department of Commerce do not keep accurate records of laptops. It claimed that Perth hospital "could not provide any assurance on the number of its laptops, where they are or who had them" and possessed two conflicting record lists with a disparity of 277 devices....

"All seven agencies lacked comprehensive management, technical and physical controls over their laptops and portable storage devices to minimise the risk of them being lost or stolen and of sensitive information being accessed," the report states.

Six of the seven agencies failed auditor expectations by not enforcing access controls for laptops or portable devices that would help prevent sensitive data leaving the organisation. The WA Police received praise for encrypting all outgoing sensitive information.

The auditor found critical software vulnerablilities across each of the seven agencies due to a lack of patching. WorkCover was the only agency to enable laptop firewalls to protect computers from introducing potential infections from insecure networks into the corporate environment.

The second part of the report, tabled by acting auditor general Glen Clarke, blasted the agencies for poor application and general computer controls.

Out of the 52 agencies investigated, two had stored unsecured credit card data — one via a network "accessible by any user" and the other within an application — in direct violation of the Payment Card Industry (PCI) Data Security Standard.

Auditors were able to access sensitive information through "highly privileged" accounts that were accessed by simple password guessing. One agency allowed users to access accounts with a single character password that did not expire.

Thousands of sensitive records were cracked with the same basic password guessing in "several agencies".

Auditors were able to manipulate staff and contractor paychecks stored on freely accessible folders before they were processed.

Another unnamed agency sent out names and addresses of clients to external contractors, and many were found to lack basic account access controls that stop users from accessing inappropriate sensitive data, or even creating administration accounts without approval.

Boot passwords were scarcely employed by the agencies, leaving laptop hard disks vulnerable to hacking. Contractor service level agreements were found to be not enforced by another agency.

Weak access controls were found in 41 per cent of agencies, followed by poor network security in 23 per cent, polices and procedures, password control, and physical security.

Third world medicine on the NSW North Coast?

Premier Keneally needs to shift her focus from early electioneering and seriously address funding and service delivery failures in NSW North Coast public hospitals.

This report in The Northern Star last week is yet another pitiful example of how this region is being short-changed by the Keneally Government's management of NSW Health:

AN ELDERLY man suffering from asbestosis had to call Triple-0 from his hospital bed in Lismore Base to get help from a nurse.
Eighty-seven-year old World War II veteran Kevin Park called the emergency number after night shift failed to hear the brass bell he was given as a replacement to the electronic call system at the hospital, which is still not operational.
Yesterday a still angry Mr Park said after ringing the bell for 45 minutes, 'desperate times demanded desperate action'.
"This is like the Third World. We are being treated like dogs."
Patients in Lismore Base's surgical ward were issued with brass bells four weeks ago after both the emergency and nurse call systems failed.
North Coast Area Health last night offered the air force veteran from Iluka an apology 'for any distress that may have been caused to Mr Park and his family'.

Federal Election 2010: so you like the idea of local hospital boards?

The Federal Coalition and their leader, Tony Abbott, may not have revealed much in the way of a national health policy for Australia to date, but the mantra they are all chanting as they move about electorates is local hospital boards.

So how does Opposition Leader Abbott see these boards functioning in a health system he describes (in his latest book Battlelines) as not needing "fundamental restructuring or gargantuan amounts of additional funding"?

Well, he sees these "hospital boards with clout" - apparently run by medical professionals, probably unqualified but prominent local business people and some community representatives - having an ability to vary public hospital staff wages in a two-tiered system if necessary (with newer staff being paid less as a budget-saving measure) and an ability "to contract out hospital management to a private operator" as another budget measure.

Possibilities which would more than likely horrify communities on the North Coast and in other NSW rural and regional areas.

Elsewhere Abbott claims; Boards would appoint hospital CEOs and, with the CEO, manage hospital budgets. Government would appoint boards and set hospitals’ funding levels but wouldn’t be able to cut funding when hospitals raise money from private patients or fundraising.

All in all, this sounds like a recipe for health service delivery disaster in the public sector.

Show me the policy, Mr. Abbott!

It would appear that during the faux federal election campaign Opposition Leader Tony Abbott is not taking the forthcoming Leaders' Debate seriously and expects to use it to mount a series of questions rather than give any genuine outline of the health policy the Coalition intends to take into the formal campaign.

This attittude is not always playing well in the regions if the following emailed letter is any indication:

Hon. Tony Abbott MHR
Leader of the Opposition
Parliament House
Canberra ACT

22 March 2010

Dear Sir,

I have read with interest your reported comments on the forthcoming "Leaders' Debate" this week which is intended to address the subject of health care.

I am concerned that these comments appear to indicate that you have no intention of broadly outlining the Coalition health policy you intend to take to the Australian electorate later this year.

As an ordinary voter I would appreciate less politicking and more respect for the general public, who deserve the longest possible time to compare competing policies before going to the polling booths.

Quite frankly even the most pyrotechnic of debating styles will fail to impress my household if all it turns out to be is flash and no substance.

Sincerely,

[Name and address redacted]

Is this an example of Rudd's future local health service delivery? GP Super Clinic causing stress in Grafton

No-one would deny that the 2007 Federal Labor general practice super clinic election promise was very welcome in the Clarence Valley. However, it has been a rather strange affair as reflected in The Daily Examiner letters to the editor columns over recent months, in light of the fact that this proposed clinic is a taxpayer-funded project though a $5 million federal capital grant for land purchase, building design, construction and equipment purchase.

One has to wonder why Rudd, Roxon and Dept of Health & Aging are allowing a private company Ochre Health (30 percent-owned by global investment bank Lazard through Lazard Carnegie & Wylie which in turn is connected with former Labor PM Keating) to set the agenda in this rather highhanded manner. After all, this clinic is supposed to provide another free health service as an adjunct to the public health/hospital system.

Even if it is apparently a joint venture agreement between Ochre and the Commonwealth, the company appears to outlay next to nothing and it will obviously be well-paid for any ongoing state-level service delivery if past contracts of over $1 million per annum are any indication and, the contracts Ochre usually has with its own doctors are based in part on expectations of the patient volume they attract with practitioners turning over to the company 40% of any Medicare bulk billing payment received.

It is understood that the property eventually reverts to Ochre ownership outright, which would mean that the land and building containing this conveyor-belt medical clinic would be able to be sold on for non-medical purposes in 2031 without penalty.
As the only consolation objecting neighbours have concerning this development is that it would provide a permanent super clinic for the local community, I wonder what they will think if any change of business type came to pass.

A brief history 29 January 2009 to 15 March 2010:

Super clinic site

NO doubt that the Valley is in great need of improved medical services.

Sixty-four people submitted written objection to (Clarence Valley) council regarding the location for the proposed (medical) super clinic (in Grafton).

I objected to the location of the super clinic in a residential area. I was one of many who gave a deputation at the site meeting with council's environment, economic and community committee, and the committee meeting on Tuesday. For three weeks I tried to contact Peter Bailey, of Ochre Health, to discuss my concerns. My calls went unanswered and unreturned. It has been very difficult for residents to get answers to their concerns.

At the site meeting citizens/voters were forbidden to ask any questions. At the site meeting Mr Bailey finally admitted that allied health service includes drug and alcohol treatment at the clinic, to be located in a residential area.

However, when asked by a councillor, Mr Bailey would not reveal why the site was the most suitable out of the other 15 sites allegedly considered.

The committee chair, Des Schroder, advised councillors that the developer's traffic study concluded 'no traffic issues'.

The DA reports an increase of an estimated 300 cars at this location, to begin with.

Ochre Health's report states 30,000 patients in year one, building to 60 by year eight. It is obscured to say the least to suggest such a significant increase in pedestrian and vehicle traffic will have no impact on the area, residential or otherwise.

The DA, and council, does not intend to put basic safety initiatives in place such as a pedestrian crossing or refuges at the site. Despite one councillor's concerns about site selection criteria, including river views for clinic staff, the matter will proceed to council vote this week.

This leaves very little time to exercise our democratic rights and speak out against the location of the super clinic as residents and voters of the Clarence Valley.

K VINCENT, Grafton.

- I WAS present at both the on-site meeting and the meeting of the CVC Environment, Economic and Community Committee meeting relating to DA 2010/0009 on Tuesday.

My strong impression was that I was witnessing a fairly elaborate charade with the issue at stake considered a foregone conclusion. It was deeply disappointing to me, as owner of 5 Fitzroy Street, Grafton, to hear Councillor Ian Tiley moving and Councillor Pat Comben seconding a motion that the DA be recommended for approval at the council meeting of Tuesday, March 16. Both councillors gave 'the greater good' as their justification. Surely 'the greater good' is that Grafton has secured the GP Super Clinic, a good not dependent on site chosen. Please note in this respect that 63 submissions made against the DA were objections to the location only (as compared to one submission of support).

Matters of concern:

(A) It is apparently indisputable that the DA could not be approved under the CVC's own existing 5(a) special uses (school/church) public purposes zoning arrangements. However, we are told that under clause 8 of the infrastructure SEPP if there is an inconsistency between the policy and any other environmental planning instrument, the policy prevails. My reading is that the EEC Committee therefore chose to avail themselves of the opportunity to over-ride their own council policy and the interests of affected ratepayers and residents in order to accommodate a large-scale commercial enterprise, something they concede is not generally referred to as a community purpose. Why? Why not adhere to council's own policy and leave it to the applicant/developer to respond? This would guarantee confidence in transparency and accountability. There are definitely other sites where the clinic could be more appropriately located.

(B) The chairman of the EEC Committee stated at the committee meeting of March 9 that there was only one DA relating to the super clinic for consideration at the meeting and that consideration of other sites was therefore irrelevant. Please consider these points. (i) There was, as far as I know, no community consultation re possible sites for construction of clinic. (ii) There was, as far as I know, no public call for expressions of interest. (iii) There was, according to Peter Bayley of Ochre Health Ltd, an understanding between St Mary's Parish (vendor) and Ochre Health (purchaser of site) that no contact with press or community be made until such time as a joint announcement be agreed. (iv) Well before this announcement was made on January 11, 2010, a DA had been lodged on Christmas Eve 2009. (v) The first communication I received came in a letter from Clarence Valley Council dated January 12, 2010 (received January 14) with an initial deadline for submissions of January 28. It is not surprising therefore that no other DA was before the committee. Further, an examination of the preceding points lends credibility to my impression that I have been participating in a charade.

(C) At both site and committee meeting some vital matters were dealt with cursorily or not at all: (a) The first of these is traffic. In my view, a GP Super Clinic means delay, congestion, frustration, an accident waiting to happen. (b) The second is the disregard for council's own policy re buildings and sites of historic interest. I have been in contact with the National Trust of NSW and the matter was considered by their advocacy unit. At present the Trust prefers not to be involved unless a building listed on their Special Register (there are two in this historic precinct) is threatened with demolition. However, they have asked to be kept informed.

- Edited for length.

KAY ALDEN, Grafton.

Doctors to meet and discuss Grafton GP Super Clinic 26 August 2008

Talks over Grafton super clinic continue 4 December 2008

Super clinic for Grafton 29 January 2009

Provider chosen to run GP super clinic 15 July 2009

Super Clinic site a secret 17 November 2009

Site announced for new GP super clinic 13 January 2010

No methadone for super clinic 23 February 2010

GP says support for local doctors needed 24 February 2010

Sth Grafton calls for medical clinic 11 March 2010