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Category: Health

08/06/2020

Domestic Violence Becomes a Workers Comp Issue 8/6/20

The NSW Supreme Court has held that the children of a worker killed at home by her mentally ill partner in a domestic violence incident can have compensation.

It is good that the issue of domestic violence gets publicity and that the children get compensation. But it raises the issue of whether employers are seriously able to assess the domestic situation of all employees and then whether they can ever hope to intervene in them. Employers ran a long campaign not to have to pay for journey accidents, people injured on the way to work, on the basis that it was not a risk that they could control, yet which potentially might cause a big change in their insurance premiums and thus costs. If we want our employers to be concentrating on making their businesses efficient and looking for hazards in the workplaces that they do control, it is slightly dubious public policy to have them sniffing around about employees’ home life. This case is slightly unusual in that the employer was effectively a partnership bet ween the couple rather than having a distant employer, and the company had been deregistered which suggests some dysfunction But the money accessed was Workers Compensation insurance and this will affect premiums and potentially other work situations.

It is true that a lot needs to be done about the discovery and action on domestic violence. It is also true that mentally ill people need to live somewhere and that their carers are at risk. Judges faced with people in dire need of help such as the children in this situation search for answers, and the Workers Compensation insurance scheme is a source of such funds. But the precedent set is not a good one.

The same principle applies when a baby gets into trouble at birth and has long-term adverse effects. If the obstetrician is found to have erred, there is a lot of money to give the unfortunate infant. If he or she is not found to have erred, there is no money for the infant. So now the premiums for obstetricians are very high and some retire in consequence. 4 Corners ran a show on this issue some time ago and it turned out that one doctor was responsible for about 60% of the problem births in Western Australia and had declined to speak to the show. Wow- go after him! Who was he? The Professor at the biggest teaching hospital of course. Most of the difficult cases in the State were admitted under his name, and the staff of the hospital did their best with these cases.

What is needed is a compensation system that is no fault. Sometimes bad things happen. Sometimes people make mistakes. Sometimes big mistakes have small consequences and sometimes little mistakes have big consequences. With systems, it is not usually one person who makes a mistake, there are miscommunications, lack of clarity who was responsible, lack of availability of something or someone. Accident causation theory is now an academic discipline, but the legal profession has not really caught up, let alone the political system.

A lot needs to be done about domestic violence, but I am not sure that making it a workers compensation issue will do anything more than push it into the public eye and help these children. Employers and insurers will run a successful political campaign to change the law to exclude it. I am not often on the side of Workers Compensation insurers, but a better solution has to be found.

www.smh.com.au/business/workplace/no-longer-a-private-matter-employer-held-responsible-for-family-violence-20200605-p54zy1.html

06/06/2020

The ‘Black Lives Matter’ Protest in Sydney 6/6/20

Prime Minister Scott Morrison was smugly distancing Australia from the riots in the USA over the George Floyd public murder, but voices were quick to point out that there had been 432 deaths in custody in Australia since 1991, despite Royal Commissions and their findings, which were not implemented.

The demonstration was planned as everyone here knows the COVID19 lockdown is gradually being eased as there are now few community-acquired cases in Australia.

But the Police applied to the Supreme Court and got them to declare the rally and march illegal under the COVID19 restrictions. I had been going to miss the march on health grounds, but the Police rather than the public health authorities wanting it declared illegal made me want to attend.

As I have written before, Police intolerance of any sort of dissent was clearly brought home to me when I wore a sign that said, ‘Respect the Dead by working for Peace’ at the ANZAC service in Hyde Park in 2019, where the police sergeant said that he would arrest me if I did not move 50 metres away.

John Howard initiated the needless Australian invasion of the Middle East against the wishes of 74% of the population who marched in 2004. The creation of a terror threat due to that folly, the handling of that threat by increasing surveillance, decreasing civil liberties and increasing Police power without supervision is a trend of our time. The other trend, the increase in social inequality has put pressure on Police, as the enforcers of the norms of a social system that excludes an increasing percentage of the population.

But the Police inability to handle mental illness or drunkenness and conflict has not been sufficient. There are too many deaths in custody, which principally affect Aboriginal people and too many Police shootings, which principally affect the mentally ill.

So I was not willing to sit at home because the Police did not want a demonstration that asked that they be called to account and change their ways.

Interestingly some of my son’s friends who are overseas students did not dare to go lest their visas be cancelled.

The Supreme Court’s ban on the rally and march was overturned on appeal in the morning, but my opinion was that most people going to the 3pm event were unaware of this and, like myself had decided to go anyway.

The city had prepared for the event by stopping the trams from Circular Quay, (could they have run from Central to Randwick?), and by the trains not stopping at Town Hall. So we walked from Circular Quay and the demonstration went back almost the full length of the Queen Victoria building in George St. It later went back further than this. Protesters were socially distancing and about two thirds were wearing masks. People were walking among the protesters issuing masks and hand sanitiser, and soon more than 90% were wearing masks. There was a wide spread of ages and racial origins.

The protest speakers were on the Town Hall steps, but could not be heard at all for a fair percentage of the crowd as the PA system which is on the traffic lights was not in use by the speakers. After about half an hour, at about 3.30pm the speeches stopped, and everyone assumed that the March would start. It did not. It was not clear what was happening, whether the rally was allowed and the march not. There was quite a lot of chanting of ‘Black Lives Matter’ and also activist shouting, ‘Too Many Coppers’ with the reply ‘Not enough Justice’.

There were Police amongst the protesters. They did not look comfortable, and I noted Glock pistols in their holsters. Glock pistols have no safety catches, so the only thing stopping them or someone else grabbing them was the flap and press stud on the top of the holsters.

We kept thinking that we were about to march, as we went forward in little bursts. But looking a long way ahead we could see that the placards were not moving. All that was happening was that the social distancing was being taken up. This and the chanting would have increased the infection danger somewhat, so one could only wonder at the reason for the delay. The rally and march had been scheduled from 3pm to 5pm with a break at 4.32pm when we were all to kneel for 1 minute to remember the 432 people who had died.

The March started a bit before 4pm and wound to Belmore Park near Central station with the stop and kneeling at 4.32pm an impressive moment. Belmore Park was totally packed, with social distancing quite undermined, so we took a photo and left. Apparently there were some minor scuffles between Police and people who stayed after 5pm.

It was interesting that the public, who have been very compliant and responsible throughout the COVID19 epidemic, were willing to defy the Supreme Court ban on the rally and march. The large Police presence suggested that they were willing to suppress the event, but there were a very large number of protesters, 17,000 seems a reasonable estimate. I do not think that the crowd would have tolerated not having the rally and not marching, so it might have escalated with lines of Police, riot shields, water cannon and tear gas. Fortunately sense prevailed.

It was a victory for the people in the sense that they stated in large numbers their attitude to Black Deaths in custody, and the limits to which they are willing to tolerate the Police, the government and the Supreme Court telling them what they may and may not do. The relatively poor uptake of the COVID19 tracking app is a similar indicator of the trust of government. No, we do not want COVID19, but we do not trust the government either.

As I get older, I trust people more and government and institutions less, and work for the power to go to those who legitimately own it, the people. This was a good day. Hopefully no COVID19 cases will result.

05/06/2020

Housing Stimulus: More Middle Class Welfare 5/6/20

Successive governments have used the building industry to pump up the economy on credit. How so? For decades the tax deduction on negatively geared real estate has made housing a favoured investment. It has been the no-brainer way to make money. You borrow to own a property, and as long as it is your, all the capital gain is yours. So the lesser fraction that you own, the greater the percentage rise in your total assets. And since you save on tax and gain rent, it is far better than shares or other assets. If you ask to borrow 90% to buy shares, no bank would lend you 90%. They would fall about laughing, and you would be taking a big risk. If you wanted to borrow 90% of real estate, no problem- all perceived as low risk. How come? Because Australia’s private debt is rising and is now the highest in the world. This little Ponzi scheme has a cost. We have the best houses, which are the most expensive relative to our incomes, and we have a huge national private debt, which means that we pay interest to foreign banks and have no money to develop and own our own country. Like all Ponzi schemes, it is OK as long as you sell out before the bubble pops. The older generation are doing this, cashing out as the younger generation takes up the huge loans that are now necessary.

The tax department got less money to create this mess, so public housing was not built, and there is a huge shortage of public housing. Because prices are so high there is also a problem in affordable housing as wages in the real world have stagnated as globalisation allows jobs to go offshore to be done more cheaply by third world people. The negative gearing thing amounts to middle class welfare, where those who had one house were able to buy more, and those that did not merely saw rents and prices rise. Labor tried to address this and lost the election.

Now we have a recession, worsened by the COVID-19 crisis and the taxpayer has to step in, making more debt for the future. So what projects to spend the money on? More middle class welfare! Those who already have $150,000 to improve their house get another $25,000 from the future taxpayer, the young people of today.

It is merely another example of the Morrison government’s lack of commitment to a fair go for all. This could be a huge opportunity to build social housing to help those who have been left behind. Is the excuse that the projects are not ‘shovel-ready’? The government could pay for the huge outstanding renovations and repair bill on the public housing, which has been neglected for 30 years. Surely these repair lists on yellowed paper could be found and actioned.

Morrison governs for his voters, not for the country as a whole. His policies increase inequality, which stores discord for the future. This last effort will further the Matthew Effect, named after the biblical quote, ‘For to every one who has will more be given, and he will have abundance; but from him who has not, even what he has will be taken away’.

— Matthew 25:29, RSV.

www.theguardian.com/australia-news/2020/jun/03/morrison-government-to-offer-25000-grants-to-help-build-and-renovate-homes

03/06/2020

Mental Illness and Stupidity 3/6/20

Quite early in my Parliamentary career I was approached and discovered 4 problems with mental health in NSW. A fellow medical student, now psychiatrist approached me and said that the system was far worse than formerly.

I had worked as an after hours call doctor in 1977 and 1983 and found that mental hospitals did not want patients sent to them, and would try to talk referring doctors out of sending them. At first they would say it was not in their catchment area, then that the patients were not really mentally ill and I did not actually know what I was talking about. Eventually I tired of this game, so I would call and tell them a brief history, my diagnosis and that the ambulance with or without police escort was on its way.

So when my psychiatrist friend said it was a lot worse I was surprised. She explained that Nick Greiner closed all the long-stay mental hospitals for a supposedly community-based service with supported accommodation, but the alternative was never funded, and the system had staggered on ever since.

Then I was in an inquiry into the rise in the NSW prison population and a government prison psychiatrist had found large numbers of mentally ill and developmentally delayed people falling foul of the law. He explained that if they became dysfunctional they could not pay for the electricity and rent so became homeless. They had no chance of getting through the complexities of Centrelink and getting money, so eventually they were caught shoplifting in order to eat and ended up in the Magistrate’s court, where, if he did not divert them, they went off to gaol. He had a pilot scheme in Sydney and ?Port Macquarie to divert them to supported accommodation at hugely reduced cost.

I went for a long weekend near Port Macquarie and met an older lady on the beach, who, hearing I was a politician said that this made me a cad and a bounder who was of no use in the major social problem which was mental health. Accustomed to this assumption about politicians, I remonstrated mildly, and she told me her story of her schizophrenic son, who had gone in and out of supported accommodation and prison for 30 years without getting much help.

Finally I want to a conference on homelessness where I met a community mental health nurse who described how after long weekends she would go to the parks and under the bridges to look for her homeless patients, to see if they were alive to take their medication. I asked that she write a summary in point form of the problems of NSW mental health. She did so, and her excellent report formed the terms of reference of the NSW Mental Health inquiry which I initiated. I asked Brian Pezutti to chair it. He was a Liberal, and had the credibility of having been an Assistant Health Minister. He was also a very thorough and meticulous anaesthetist, retiring at the next election, and keen to do something useful before he went.

The Labor government agreed to the Inquiry because I had the numbers in the upper house. The Inquiry came out in 2002 (NSW Health System Worst in Aust SMH 10/12/2002).

It resulted in a number of things. The budget the following year in NSW rose by $320 million, but mental health money was also quarantined so that it could not be siphoned off to fund Emergency Depts or ICUs further down the budget allocation tree. Most significantly it triggered a Democrat-initiated Federal Mental Health inquiry which put psychologists on Medicare and hugely increased the mental health workforce.

Needless to say, diversionary schemes were part of the recommendations, as without support, mentally ill and developmentally delayed people cannot do the functions that are needed to manage a life in society. There appeared to be some progress and the complaints from mental health workers for some time changed from, ‘we cannot afford staff’ to ‘we cannot fill our positions’.

As the time has passed, it seems that the situation has slipped back. The history of these inquiries is that there is a fuss, things improve for a while, then go back until another inquiry finds the same problems.

So I was discouraged to read that a program to divert mentally ill people from Gaol is to be axed, because some bean counter thinks it is too expensive. According to the Dept of Corrective Services it cost $181.85 per day to keep a prisoner in NSW gaols, which is $1,273 a week, or $66,375 a year. It is dubious that a support scheme could not be organised for less than this, but the idea that the only thing that matters is whether it saves money seems an appalling way to run society. Surely we should figure out what we want to do, workshop how to do it efficiently, and then work out how to fund it.

If a diversion plan is to be axed, let the NSW government tell us that there are good diversion schemes already working and prove it by having an independent body affirm that there is not an excess of mentally ill or developmentally delayed people in prisons. If such schemes existed, why was there this new one set up? There is a long history of ‘pilot schemes’ being set up to deal with a political problem, and then quietly dying when the political heat goes off.

www.smh.com.au/national/program-diverting-intellectually-impaired-people-from-nsw-prisons-faces-axe-20200527-p54wve.html

28/05/2020

Truth in the COVID-19 Era: Australia

Prime Minister, Scott Morrison is perceived to have done well in managing the COVID-19 crisis as, smarting from his bushfire debacle, he took expert advice. He has used the crisis to shut down Parliament and with his use of State Premiers as a sort of wartime Cabinet he has bypassed the Labor opposition. Now he […]

28/05/2020

Truth in the COVID-19 Era: The USA

Some of us watch the COVID-19 statistics with fascination try to work out which policies will stop the march of the virus. This has become all the more urgent as countries try to break the lockdown to restart their economies. The US has overtaken Western Europe (29 countries) in the number of cases by about […]

27/05/2020

Privatised Job Seeking- just another opportunity for rorts.

27 May 2020 Call me old fashioned but I really believe in lifetime public servants paid a reasonable wage to do an honest job. They do not need ‘incentives’, ‘bonuses’, ‘commissions’ or other gimmicks. Salesmen have always rather revolted me when they judge everyone by how much commission they made on their sales, as some […]

27/05/2020

Charity, Government and Institutions

27 May 2020 The comedian Celeste Barbour set out to raise $30,000 for fire relief and people gave $51 million. She was going to give it to the Rural Fire Service. It turns out that the. RFS is basically a government-funded body which buys fire equipment, and had received rather less than recommended in the […]

27/05/2020

COVID-19: A large range of Pathological Processes

It seems that COVID-19 affects not only the lungs, but the heart, kidney, brain, gut, clotting and blood vessels, and that a lot of facts are still not clear.Here is an article from ScienceMag from the Australian Association for the Advancement of Science.www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes

27/05/2020

COVID-19: The Swedish Response. Is it OK?

27 May 2020

Sweden likes to present itself as a highly sophisticated welfare society where a caring State looks after all its citizens. But conservative governments have been quietly undermining its welfare system for some time, and this opening up of the country and talk of ‘herd immunity’ may be both hypocritical and very poor public policy.

The assumption that healthy people will not die, and the rest do not matter is a very callous moral judgement. The assumption that without normal commerce the economy will not function and thus it is the economy versus a few oldies welfare is a morally appalling position, which is creeping in by default.

When I was a NZ sheep and beef farmer standard practice was that the breeding females had a performance criterion. If they did not get pregnant before winter, they went to the abattoirs as they were too expensive to feed over winter.

Managers love performance criteria, and as Management now dictates political actions people now have to perform also. Not strong enough to survive a COVID19 infection? Funeral for you! It is assumed that the rest will be infected once and then be immune. And when most people have been infected so that the virus cannot propagate in the society, we (hopefully) have ‘herd immunity’.

Politics being what it is, things have to dressed up a bit. Less tests, fewer masks, omit certain types of hospitals, change the death certification. Do not state the policy bluntly, and give no mandatory orders from the top, but make it vague enough with scope for non-implementation of best practice and plausible deniability. Make concerned statements of good intent, select some good figures to quote, and praise the people for their fortitude. If the odd whistleblower says something and manages to get publicity, be surprised, deny, promise to investigate and call it a ‘one off’ case or situation.

Brave New World is here. The only surprise is that it has started in Sweden.

COVID-19: How Trustworthy and Humane is Sweden’s Pandemic Strategy?