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Category: Government

20/08/2021

Attitudes to Anti-Vaxxers- a parallel with smokers?

20 August 2021

I spent over 20 years of my life with my principal task to fight the tobacco industry. I saw how harmful smoking was in my patients, and tried to tell them. But smoking was common, allowed everywhere and, after food, the most advertised product in the country. Shops were so covered with ads that when you drove into a town, you looked for the cigarette ads to find the food shop. It was normalised. One of my patients, whose leg I had just amputated said, ‘All the doctors say that smoking is harmful, but if it was the government would do something about it’.

There were almost no smoke-free restaurants anywhere, because the non-smokers had been trained to put up with it, and restaurateurs were worried that smokers might leave them. They knew that the non-smokers had no choice. The tobacco industry told the pub owners that smokers drank more and gambled more, so they had better not offend them, so the Australian Hotels Association were the major lobby, with the Registered Clubs and Restaurant Association tagging along. The tobacco industry disputed the science long after it was proved to any reasonable analysis, and smokers clung onto this. The tobacco industry PR followed what was called the ‘tightrope policy’. They did not know if smoking was harmful because they were not doctors, so they were not responsible for selling a lethal product, but because everyone had heard it was harmful, smokers were taking their own risks.

Smokers therefore said, encouraged by the Industry that it was their ‘right to smoke’, and then they denied that it harmed everyone else. So instead of the tobacco industry having to prove that passive smoking was harmless, the medical profession then had to prove it was harmful and then get legislation implemented, a process that took about another 45 years at about 43 deaths a day in Australia. Since non-smokers also got heart attacks etc, the Industry argued that they could not blame them on the second hand smoke.

Now we have the ‘right not to be vaccinated’ and the ‘right not to be excluded because we are unvaccinated’. Instead of spreading second hand smoke, unvaccinated people are spreading COVID virus. And they are saying that vaccinated people also spread the virus and can also catch it. Perhaps. But vaccinated people spread less virus, and the right not to be exposed to a virus trumps the right to spread it.

China unashamedly goes for the greatest good for the greatest number and puts little store on individual rights. Our tradition of Greek thought is all about the individual reaching his or her full potential, even if this means we tend to overlook the exploitation of others. This is becoming increasingly relevant as unregulated markets, like a Monopoly game, move money upwards and increase inequality.

I saw a meme yesterday that the CDC (Centre for Disease Control) does not mandate masks. This was in the context of the conclusion that ‘neither should we’. No doubt CDC does not need to mandate masks (assuming that the meme was correct)- the people who work there will have the vaccine ASAP.

The answer in civil rights terms if that anti-vaxxers have the right to be unvaccinated as consenting adults in private, but they do not have the right to go into public spaces where they may spread the virus. That is the individual rights answer and also the greatest good for the greatest number. We had a tobacco epidemic for 100 years, when it should have lasted 50 years if there had been science-based policy. This must not happen with this epidemic. We must have a lockdown until probably 90% of the whole population is vaccinated. We should vaccinate people who want it as fast as we can. Then we should have vaccine passports so we can open up again. Florida in the US is showing us what happens when silly policies are followed.

04/08/2021

The 2021 Census- Why you should put ‘No Religion’

4 August 2021

I thought that Australia was one of the least religious countries in the world in terms of church attendance. When I was in Uruguay a tour guide claimed that his was the least religious country, and I said that Australia was. Looking at church attendance statistics we were both wrong.

Here are some figures from Pew Research in 2018: China 1%, Sweden 6%, Russia 7%, Norway 7%, UK 8%, Germany 10%, France 12%, Uruguay 14%, Spain 15%, Greece 16%, Australia 17%, Chile 19%, Canada 20%, Israel 30%, the US 36%, Bangladesh 58%, Indonesia 73% (From comparecamp.com)

Church attendance is declining everywhere in the developed world, but their influence here is rising due to their systematic entry into politics. Scott Morrison is fond of saying ‘God helps those that help themselves’ and seems to live by this, getting Pentecostals into Parliament and into Cabinet, (not to mention helping himself with sports rorts and car parks).

The religious agenda of subsidies to religious schools to the detriment of State schools, the huge subsidy by tax exemptions for Church-owned land and businesses, the continuation of religious education in supposedly secular schools to the exclusion of secular ethics classes, the exemptions to the Equal Opportunity laws that allow churches not to hire gays, the right to continue to smack children, and even demands to have special rights with the 2019 Religious Discrimination Bill which may have unintended consequences are examples enough.

The subsidies to religion through tax exemptions are principally a historic legacy of when secular law replaced church law. No government has been brave enough to repeal them and in the 1960s ‘State Aid for Church schools’ was a catch cry that allowed governments to win elections as the Church claimed that parents who went to Church schools were paying twice in school fees and in taxes. When I was in Parliament I asked the then Treasurer, Michael Egan, what the cost of the Church tax exemptions were and he replied that it would be too expensive to cost these so he was not going to answer the question!

Another little gem that turned up during the NSW Upper House inquiry into Social Housing (Report No 7/53 2006) was that the NSW government was building houses on Church land. I asked who would own the houses? The answer was that it was a ‘joint ownership’ in which the State owned them at first but over a decade the ownership transferred to the Church, so that in 10 years the Church fully owned them. From Day 1 the Church managed them. How were the tenants selected? Anyone who was on the Housing waiting list could apply. We visited one of the houses, a 3 bedroom one with a retired couple in it. ‘Please notice the garden, they are very proud of it ‘, we were told. The lady of the house was also very proud of her Royal Doulton tea set from which we drank. We asked how she got the house. She said, ‘We heard the Church was going to build some houses so we started going to Church and we were on the list so we got one’. The children and grandchildren come and stay occasionally.

I asked the Church facility manager if he ever had tenant problems. ‘Not often’ he said, ‘As we usually choose the tenants’. ‘But we had one tenant, a blind lady with a little girl, who had a boyfriend and they used to have huge fights and disturb the neighbours’. ‘She had to go’. He showed us a round hole in the plaster where the boyfriend had opened a door roughly and the door handle had punched through. The house was vacant. Blind single Mums with boyfriend troubles get the boot.

This level of detail is not in the final report. No doubt the Church managed properties have fewer tenant problems than the government managed ones, as this why the Housing Dept with limited stock ends up with ghettos of social problems.

The assumptions are that the Church is basically a charity, which does work that no one else would do, and that its right to prosthetise is tolerated as the majority agree with its teachings. We have not reached the stage of the USA where school boards try to stop science teachers teaching evolution, but the religious influence is strong in education. I recall happily singing, ‘All things bright and beautiful, All creatures great and small, All things wise and wonderful, The Lord God made them all’ and several similar verses to follow. It was many years later before I wondered if it was good that this was how it was.

The Church has tried actively in Australia to get people to fill in the census form by how they were brought up, which naturally creates a massive lag in the statistics. I find the church attendance figures above hard to believe and wonder if new migrants of non-Christian faith have swelled the number of church goers. In our area the Presbyterian Church, with a congregation of 2 or 3 closed and was sold a couple of decades ago.

The Christian Churches’ prestige has declined massively all over the developed world, with the paedophile scandals, and now most recently with the scandals at the Vatican Bank, which were alluded to in David Yallop’s 1983 book ‘In God’s Name’ which alleges that Pope John Paul 1 was murdered at least in part because he tried to reform the Vatican Bank.

So it is important that those who do not believe write ‘No Religion’ on the Census form, which is to be filled out for the night of Tuesday 10 August. We need to demonstrate how many non-believers there are, and to work towards the secular state that is supposedly guaranteed in the Constitution.

www.smh.com.au/national/lapsed-catholics-need-to-reflect-their-beliefs-in-the-census-20210730-p58edo.html?fbclid=IwAR3i2ewer_sI58oFyfjHztjKIuNJOQmLFFjeufKFhJGEAWaoSJFn1MGQOf8

21/07/2021

Privatised Job Services- Guess who benefits?

21 July 2021

Privatisation of job services was based on the concept that competition improves performances; hey we all run faster in a race than on a jog.

It takes the simple model and assumes that public servants do not work as hard as the lean, mean private sector workers.

I have worked in the public service here and the UK for some years. I defy anyone to say that salaried doctors do not work hard. How does a basic 60 hours a week, with a few hours of unpaid overtime a day and on call one night in two for ICU or ED sound?

I was at Sydney Water for 13 years. The clerical staff worked their 35 hours, but the professional staff were mainly there until 6pm, despite only being paid to 3.30pm. The clerks knew their jobs and did their jobs. They thought about their work, prioritised the important things and did them. Their jobs were safe, they were honest, and criticism of them was frankly misplaced. So was the idea that a ‘blow-in’ manager could do their jobs better than they could.

The assumption of privatisation of job seeking is that contractors would do better than the CES. The Key Performance Indicators were set up so that they go paid less for people who were easier to place and more for those who were hard to place. So it was presumably staffed as cheaply as possible, and the business model concentrated effort where the most money could be had for the least work. People who would have got a job without the providers help at all were money for jam. People who were very difficult to place were not worth spending time on. So instead of an ongoing effort to help people in whatever way possible there were distorting priorities- what do you expect? In this case you get what you pay for.

There was a similar nonsense when there was a privatised effort to lower unemployment, which was in the mid-1990s. This drive did not come with any more jobs, so the best hope was reclassification of people who were not working. Many people were sent to me as a doctor to fill in their Disability Pension forms, as the private sector were given bonuses to get people off the dole and putting them disability pension qualified as this. And they think that the public service does paper shuffling- they are amateurs!

After they had expanded the Disability Pension numbers a few years went by and Morrison decided that there were too may people on this, so he would make it tougher to get. He boasted that only a third as many people were put on the disability pension in one year than had been the case the year before. I knew some of the people who could not get the disability pension. There were not enough jobs for healthy people, let alone unhealthy ones. They were demeaned and humiliated, with supposed ‘mutual obligations’. They had to waste their time writing job applications for jobs that they had no chance of getting, and presumably the bosses wasted time either reading them, or just binning then without bothering.

When NSW passed legislation that Workers Compensation would only be for 5 years and then they would have to apply for a disability pension the object was to transfer the costs of injured workers from the State insurers’ premiums to the federal taxpayer. Centrelink was having none of that. Of the people kicked off Workers Comp, only about a third managed to get a disability pension; the rest were on ‘Newstart’ applying for jobs that they had no chance of getting and on far less money than before. Patients came to me asking for ever more elaborate reports to try to get disability pensions when they needed them.

One man, a 61 year old Middle Eastern man who had been on compo for 13 years and was carer for his disabled wife could not get a disability pension. He had chronic back pain and a limp. His English was poor, he was illiterate in English (and possibly Arabic) with a file two inches thick. I spent a lot of time writing a report for him. Centrelink thanked me but said they could only pay a small amount for such reports. So I will not do such reports again, and presumably neither will any of the other doctors- we cannot afford to work for free to fight a system with a different agenda.

Meanwhile the private providers are cream-skimming, adding another layer of costs. Because a market system transfers money upwards to those with more economic power who can control their pieces and costs, a government and a welfare system needs to transfer wealth both to everyone in society equally by building facilities everyone can use or by direct payments to those who are unable to get jobs or who are otherwise disadvantaged.

The problem is that jobs are being offshored to low wage countries or replaced by technology. This is national problem for high income countries. It is a problem for the whole country, but it affects some people directly. We are all lucky that our dollar is high and our goods cheaper because low wage countries make things cheaper. So we all should contribute to make our own country more equal.

Until we demand a fair system we will not get one. Stopping rip offs, and paying CES people a fair wage to do a fair job is a start.

https://theconversation.com/the-problem-with-employment-services-providers-profit-more-than-job-seekers-162421?utm_medium=email&utm_campaign=Latest%20from%20The%20Conversation%20for%20July%2021%202021%20-%202008419727&utm_content=Latest%20from%20The%20Conversation%20for%20July%2021%202021%20-%202008419727+CID_fbb8f126a3150e0c593a044f9ebff43b&utm_source=campaign_monitor&utm_term=The%20problem%20with%20employment%20services%20providers%20profit%20more%20than%20job%20seekers

17/07/2021

Giving out Jobs to Perpetuate the Status Quo

17 July 2021

The composition of the US High Court, especially on the issue of abortion has had more publicity in Australia than our own stacking of the judiciary and major government bodies. Where are the records of all this? Has it just continued quietly under the radar with George Brandis and Christian Porter?

The Liberals have been masters of putting conservative people and ?mates in the judiciary and on bodies such as Clean Energy, which they did not manage to abolish. This will naturally make it very hard for the country to move on when they are voted out. The judiciary are appointed for life- about the only people in the country left in that position, and these major Government bodies have appointments with quite long tenure, so that change will be both hard and delayed. Years ago these problems would have been in the hands of relatively unsackable career public servants.

We presume that Matthias Cormann had a miraculous change toward clean energy once he got to the OECD and did not have to toe the Morrison government line. But people who have spent their working life in an industry are unlikely to do the same. Once again it is the Liberals standing in the way of progress for as long as they can.

Taylor appoints another fossil fuel executive to a key clean energy body

16/07/2021

Chomsky- the 10 Strategies of Media Manipulation

16 July 2021

Chomsky is one of the most important intellectuals alive. He has charted the ability of the State to control people without force, which is the key difference between us and the totalitarian states.

He has drawn up the list of the 10 strategies of manipulation through mass media.

1-The strategy of distraction

The primordial element of social control is the distraction strategy that consists of diverting the public’s attention from major problems and the changes decided by political and economic elites, through flooding by continuous distractions and insignificant information.

Distraction strategy is also essential to prevent the public from becoming interested in essential knowledge in the area of science, economics, psychology, neurobiology and cybernetics. Keeping the audience’s attention deviated from real social problems, imprisoned by themes without real importance.

Keeping the public busy, busy, busy, with no time to think, back to the farm like other animals (quoted in the text ′′ Silent weapons for quiet wars ′′).

2-Creating problems and then offering the solutions.

This method is also called the ′′ problem-reaction-solution “. It creates a problem, a ′′ situation ′′ planned to cause a certain reaction from the public, with the aim that this is the mandate of the measures they want to accept. For example: letting urban violence intensify or spread, or organize bloody attacks, with the aim of the public then requiring security laws and policies to the detriment of freedom. Also: creating an economic crisis to make social rights demotion and dismantling of public services accepted as a necessary evil.

3-The Strategy of Graduation.

To make an unacceptable measure accepted, you only need to apply it gradually, by dropper, for consecutive years. This is how radically new socioeconomic conditions (neoliberism) were imposed during the decades of the 80 s and 90 s: minimum state, privatisation, precariousness, flexibility, mass unemployment, wages that no longer guarantee dignified incomes , so many changes that would have brought about a revolution if they were implemented at once.

4-The Strategy of Deferring.

Another way to get an unpopular decision to accept is to present it as ′′ painful and necessary “, gaining public acceptance, in the moment, for future application. It is easier to accept a future sacrifice than an immediate sacrifice. First, because effort isn’t that taken immediately. Second, because the public, the mass, always tends to naively hope that ′′ everything will be better tomorrow ′′ and that the required sacrifice could be avoided. This gives the audience more time to get used to the idea of change and accept it resigned when the time comes.

5-Reach to the public like children.

Most publicity advertising uses speeches, topics, characters and a particularly childish intonation, many times close to weakness, as if the viewer was a few years old creature or a mental moron. When you try to deceive the viewer the more you tend to use a childish tone. Why? Why? ′′ If someone addresses a person as if they are 12 or under, then based on suggestionability, they will probably tend to a response or reaction even without a critical sense like that of a 12 person. years or less ′′ (see ′′ Silent Weapons for quiet wars ′′).

6-Using emotional aspect much more than reflection.

Take advantage of emotion it’s a classic technique to provoke a short circuit on a rational analysis and, finally, the critical sense of the individual. Additionally, the use of emotional register allows the unconscious access door to implant or inject ideas, desires, fears and fears, compulsions, or induce behaviors.

7-Keeping the public in ignorance and mediocrity.

Making the public incapable of understanding the technologies and methods used for their control and slavery.

′′ The quality of education given to lower social classes must be as poor and mediocre as possible, so that the distance of ignorance that plans between lower classes and upper classes is and remains impossible to fill from the lower classes “.

8-Stimulating the public to be complacent with mediocrity.

Pushing the audience to think it’s fashionable to be stupid, vulgar and ignorant…

9-Strengthening self-guilt.

Making the individual believe that he is only the culprit of his disgrace, because of his insufficient intelligence, skills or efforts. So, instead of rebelling against the economic system, the individual devalues himself and blames himself, which in turn creates a depressive state, one of whose effects is the inhibition of his action. And without action there is no revolution!

10-Knowing individuals better than they know themselves.

Over the past 50 years, science’s rapid progress has generated a growing gap between public knowledge and those possessed and used by dominant elites. Thanks to biology, neurobiology, and applied psychology, the ′′ system ′′ has enjoyed advanced knowledge of the human being, both in its physical and psychological form. The system has managed to learn better about the common individual than he knows himself. This means that, in most cases, the system exercises greater control and greater power over individuals, greater than that which the same individual exercises over himself.

14/07/2021

The Broken Bargain- Australia Institute Webinar

14 July 2021

Sally McManus, ACTU Secretary looked at Australia’s growing wages crisis in a 1 hr webinar at 11am today.

She told of how the Australian system of award wages had been world-leading with its concept of a ‘fair go’, and it had an outcome similar to the Nordic countries. This has, however been in retreat since 1975 with the rise of neo-liberalism and trickle-down economics as the dominant political philosophies.

Perhaps the most amazing fact in the webinar was that the workers share of GDP in 1975 was a record high of 54%, but has declined by 10.4%, and this has gone to the corporate sector. The amount in dollars is $200 billion a year. While wages growth in Australia has been generally below the CPI, wages recently actually overtook the CPI briefly. However, as McManus points out the CPI is composed of discretionary goods, which tend to be imported and more luxury items, and necessities. The discretionary component has not risen as fast as wages, but the necessities component has risen faster. So the lower paid, who mainly spend on necessities have gone backwards relative to the most important component of their spending. McManus estimates this at $20,000 per waged worker.

She identifies poor bargaining power as the cause of the change in the distribution of Australia’s wealth. According to the RBA (Reserve Bank) temporary workers have kept wages down. This is partly, but not wholly, workers on visas who are a group likely to be a whole sector vulnerable to wage theft. But Labour Hire companies have also lowered wages and conditions as workers can simply not be offered any shifts.

Visas have also been used to avoid training people. TAFEs have been run down and overseas workers’ skills have been used to save money on training. This has improved short-term profits but deskilled the country- a bad strategy. It has relied on foreign training.

COVID has been used as excuse for the economy not doing well, but it has not led to a revival. 60% of new jobs since the last lockdown have been casual, and 57% are part-time.

Another Australia Institute IR expert, Jim Stanford, commented that Australia’s IR system was unique, but the changes since 2013 had severely limited the ability of workers to bargain. Only restricted aspects could be discussed, and conditions could easily be traded away. Even the ILO (International Labour Organisation) has commented on this. The casualisation of the workforce has been facilitated and most recently this has been a significant factor in the spread of COVID.

The webinar will shortly be available at https://australiainstitute.org.au

10/07/2021

Is There a Role for the Military in Vaccination?

10 July 2021

I felt that something was wrong when a Soldier started advising me about vaccinations.

Here is a good summary from Crikey of what seems to be happening.

www.crikey.com.au/2021/07/07/administration-with-authority-how-putting-the-vaccine-rollout-in-military-hands-is-corrosive-for-the-country/?utm_campaign=Weekender&utm_medium=email&utm_source=newsletter&wkndr=RFdETTg0am9ucG5qc2dpcVpTeTU2QT09&success=krsmvj

10/07/2021

NDIS Individual Assessments; A Symptom of a Wider Problem

10 July 2021

The current issue in the NDIS (National Disability Insurance Scheme) is the government’s efforts to introduce ‘independent assessments’ of people on the scheme and those who want to get on the scheme. The idea has been abandoned for the present, but that is not the end of the story. It is the beginning.

Some context is needed here. I was on a State Parliamentary inquiry into disability funding during which we heard evidence of inefficiencies within the disability sector where often there were shortages of appropriate services, and in some areas there were none at all. The real crunch time was when parents with children with disabilities realised that they were going to die eventually and wanted to make a plan for the rest of their child’s life. People would apply at various facilities, and be turned away as there were no places. They then assumed that they were on a waiting list, but usually no lists were kept. When a vacancy occurred, whoever applied at that time got it. It was mainly luck. Naturally the people trying to help their loved one wanted a guaranteed package that would continue after their death. More articulate parents and carers, who had struggled for years just wanted the money to buy the services that they felt that they needed. Many carers simply wanted more services, and hoped that a national system that guaranteed services for disability.

Given the political context of privatisation and reducing government involvement in everything, the scene was set to have disability services delivered by the private sector as a massive market for services. The private sector naturally wanted to get access to services that had been provided by government as a source of business and profit.

Government also had a real estate agenda. Some large institutions were on valuable land. The large facilities at Peat Island in the Hawkesbury and Stockton Disability Centre was on beachfront land just north of Newcastle. There was a residence for the grossly disabled opposite Wollongong Hospital that had taken years of fundraising for the parents to achieve. These could be sold off as the mental health facilities had been a few decades earlier, with the catchy slogan of putting the residents ‘back in the community’. The idea that the residents were better off isolated in a suburban homes with few facilities rather than in a community of people with the same problem and a well-structured programme of activities seemed a dubious proposition to me. Resident groups such as the relatives of long-term psychiatric facilities at Bloomfield in Orange were very scared of the suggested changes. There had been problems with the old system and some inappropriate facilities, but an overall lack of facilities was the major problem. It was not even throwing the baby out with the bathwater; it seemed more like smoke and mirrors.

The key question in dealing with any problem is how big a task is it? When the Committee asked how many people with disabilities there were, there was no answer. No register was kept. The two ways of calculating it were:

To add up all the people on all the types of possible benefits and get to a total.
To look at the AIHW (Aust. Institute of Health and Welfare) figures of what percentage of the population was disabled, then multiply this by the total population.

The latter method gave figures about ten times greater. So clearly if help or services were made more available, the numbers involved were going to blow out hugely from what was currently funded.

John Howard passed the Aged Care Act in 1998, which was the blueprint for the privatisation of the sector. Old people are very vulnerable. They have often sold the family home, so they are temporarily cashed up, looking for accommodation and long term care with mental and physical facilities failing, or they would not be there. Carers faced with responsibilities that they were not used to and uncertain of what care was needed were easy pickings also. The whole sector is more like a dysfunctional real estate market; a market failure due to insufficient ‘consumer information’, but also distorted incentives and priorities.

The NDIS was similar. Private operators with slick marketing made promises which would not be tested for some time, but people were signed up now. The not-for profit sector had never paid staff well, but most had a ‘care ethos’. Some of the private providers did not, and regulatory supervision was minimal. The government was pro-business and trying to give away responsibility.

But an absolute shortage of services was still a big factor. A neighbour who was a 95 year old retired academic widower wanted 2 hours a week of home help. For some reason he could not get a community nurse. The best deal he could get was 2 sessions of 2 hours at $65 an hour. The lady delivering the service was paid $21/hr. So much for private services; the ‘overheads’ are huge. I had suggested to Kevin Rudd’s 2020 Vision in 2000 that the Government needed to licence service providers as individuals if they wanted a market model, and our neighbour could have selected a person on a one to one basis. (I never even got an acknowledgement).

Now the government wants ‘independent assessors’ to evaluate cases, presumably to lessen costs. A number of points can be made about this. It assumes that the assessors will learn more about the patient in an interview than the people who work with them already know. The new management philosophy since the 1980s always assumes that a manager at the top will know more than the person actually doing the job. Naturally if the object is to save money and have the person at the bottom paid minimally, requiring no skills and interchangeable in staffing, this may be true. But if the people at the bottom were respected, trained and empowered, the need for the middle level experts might be much less.

‘Independent Medical expert’ assessors are used in the Workers Compensation and CTP systems. They work for agencies hired by insurance companies. Often they find the patients either have nothing wrong with them, or it is degenerative and not related to their injury. These experts are even flown from interstate and save insurers money by denying treatments. Presumably if they find in favour of the patients, their agency gives them less work. The agency takes its cut and has to please the insurer. So the systems are more complicated and an ever higher percentage of the money is spent in trying not to give services. The NZ National Accident Compensation scheme, though it was government owned, went to a private insurance model and the same thing happened. Doctors who had a track record of denying liability were flown around the country to do their medicals.

The assumption may still be that well intentioned assessors still can do better. My widowed mother lived alone in the family home and had a stroke. A neighbour noticed her confused, walking on the balcony. She recovered, but seemed to have lost some judgement. She was assessed by an ACAT (Aged Care Assessment Team) who said that she could live alone in supported accommodation. So we got her into a unit in the grounds of an old house, where she could book a dinner at a days’ notice in the communal dining room, have a nurse onsite during the day, and had a right to a nursing home bed if she ever needed one. Seemed perfect. She said that she could look after herself. Can you microwave a dinner? Yes. OK. Do it. It got done. No problem. Dinners in the frig. Sweets in the jar on the mantelpiece; see you in 2 days. Arrive in 2 days. Dinners still in the frig. Lolly jar empty. Very hungry- can we go to lunch? She could do anything when asked, but could not initiate a process. She could not think to get a dinner from the frig, or book lunch tomorrow in the communal dining room, nor ask for help. The one-off team could not pick this. Neither did the family. But it emerged when the situation at home was known. This is just a story, but a carer who is savvy and properly trained will know more than a university-qualified assessor who has only a short knowledge of the patient. And naturally the person on the job actually delivers the service and is not an extra cost. They can also judge relative needs of people on a run or in an area if resources are limited.

So the scheme to bring in assessors is the tip of an iceberg.

Private insurance models have huge problems at many levels. The overheads of Medicare are a bit under 5%. The overheads of Private Health Insurers are about 12%, and they cannot refuse to pay doctors. The overheads of US Health insurers are about 12-36%, as the best way to improve profits is to cut costs (payments to patients) rather than increase services and then try to prove you have and sell on that basis. At the bottom of the efficiency barrel is our own NSW CTP system with overheads of almost 50%. The question has to be what is the focus of the system? Delivering services, or saving money? The US health insurers, like our CTP scheme are very good at making money. What they make their money from just happens to be people rather than widgets. The main cost savings of privatisation seems to be destroying award conditions and lowering ‘staff costs’. The immense administrative savings from universal systems, where determining entitlement and paying for profits are eliminated cannot be matched by any private system, despite what the ideologues might pretend.

The NDIS is currently a fund supposedly to help people with disabilities. These people apply to get ‘packages’ of money and services. Businesses persuade people to spend their packages with them. It is a market. But there are more people with disabilities than was expected, for the reasons discussed above. So a new level of assessors, were to be rolled in, but a huge outcry has prevented this temporarily. But the problems that led to the need for the assessors remain implicit in the design of the NDIS, which is fatally flawed. The government, particularly this one, is not going to take this very large bag of lollies from the private sector. The totally inefficient Private Health Insurers (PHI) give money to political parties and advance by stealth, letting Medicare become irrelevant for health care. Disability is now also privatised, and a new private lobby is in there. It has not yet generated a Royal Commission into its rip-offs, but it will, not that the Aged Care Royal Commission has stopped the privatisation of aged care. The political forces are too great. It is ironic that as Medicare is starved and pays less and less of the doctors’ fees its levy was increased, using a wave of sympathy for people with disabilities to make a bigger pool of money for increasingly private disability providers.

How to fix the problem?

I do not pretend to have all wisdom on this, but in dealing with difficult political problems I think it is wise to set a direction, take some basic steps and consult widely, looking for advice particularly from those who do not get an immediate financial benefit.

Here is a start:

Recognise that disability is not a sickness. Some disabilities are inherited; others are acquired due to accident, illness or aging. The sector is quite diverse, often divided up by the type of disability or how it was acquired. Sickness has an ‘episode’ model, based on traditional infectious diseases or surgical treatment models. Disability tends to be long-term and may improve or be worked around, or may degenerate gradually. As such it needs long-term solutions like welfare, but using the term ‘welfare’ now implies charity. Disability funding is funding to enable those less fortunate to have as normal a life as possible. From our common wealth, we give more to those who need more so that our society has equal opportunity for all. We are being taught that tax must be minimised and if we are getting less than we pay we are being ripped off. A better model is to consider the statement by Rhonda Galbally, ex-CEO of VicHealth, ‘There are two populations, the disabled and the not-yet disabled; if you are lucky enough to be in the second group, you should be happy to help pay for the first’.

The idea of a universal service obligation is the cornerstone. We should start with the assumption that people with disabilities should live in our society with as normal a life as possible and we should adapt to support them in as cost-effective way as possible.

My suggestion is that the Community Nursing service is the basic structural framework. We assume that people with disabilities will be living in society, and need varied and integrated support. If they are born with a disability or acquire one, they will come in contact with the acute hospital system, which will hopefully document their situation and alert the community support system. People on the ground will then liaise with family to see what support there is for independent living, and organise resources, calling in specialists of required. The cost of home support may be part of a package or allowance. Individuals may register to offer services for everything from shopping, cleaning and lawn mowing to medical or paraplegic support services. The government will register and insure both practitioners and those who use their services and may put training requirements on those who wish to register for some skills. A market with consumer feedback as exists for restaurants or other practitioners will allow people to hire help directly without big corporations adding massive overheads.

Whether the monies are paid separately of via Centrelink is an administrative question, but Centrelink has to have a major makeover so that it is not the niggardly decider of the ‘worthy poor’ with its chief function being to avoid paying anyone, or paying as little as possible. If society cannot find everyone employment, we must share what we have to those who are disadvantaged by disability or circumstance. This will collide head on with the problem of increased numbers of those with disabilities, but the extra load must be seen as part of having a decent society.

The way we are going seems to be privatising, allowing huge profits, then running out of money and shutting the gate on those who do not yet have packages. The independent assessors were merely the instruments of Managers who were not able to make their own assessments and did not trust the people who actually deliver the services. The assessor problem was the tip of the iceberg of a system that has all its underlying assumptions wrong, but sadly has a lot of political power that having been created, may not be able to be undone. The first step is to understand what is happening. Hence this lengthy post.

www.abc.net.au/news/2021-07-09/ndis-disability-independent-assessments-model-dead-after-meeting/100277324

04/07/2021

Christian Porter Rape Allegations

25 June 2021

The much publicised rape allegations against Christian Porter have been released.

People can judge their veracity for themselves. Click on the link in The Saturday Paper:

www.thesaturdaypaper.com.au/post/max-opray/2021/06/25/porter-dossier-released

04/07/2021

Collapsing Buildings

4 July 2021

The collapse of the front wing of a 12 storey Florida beach residential tower block on 24 June has sent shivers around the world. The rest of the building, more than three quarters of it, is now to be demolished before a tropical storm comes in (ABC News today). Another similar condominium 8km away has been evacuated (SMH- Unsafe Florida Condo evacuated 4/7/21).

It has always been assumed that tall buildings do not fall down in first world countries unless earthquakes are very bad. We need to look again.

I did a locum in Sydney’s Eastern Suburbs in the early 1980s and found that a number of quite famous and prestigious buildings were being treated for concrete cancer, which is what happens when the steel reinforcing rods rust, expand and the overlying concrete flakes and falls off. Presumably the treatment of the Eastern Suburbs buildings was successful as they are still there. When I was at Sydney Water head office, it had a 7 storey old part from 1927 (which is still there repurposed as a hotel) and a ‘new’ building, which was 26 floors in concrete. Though not at all pretty, (the word brutalist comes to mind), the new building had won an architectural award. A fortune was then spent removing the asbestos. Some years later a nice big front overhang was built over the footpath outside. I discovered that this was because the concrete cancer was so bad that bits of it were falling off and might be dangerous to the citizens on the footpath outside. None of that was mentioned at the time of course; that building was demolished some years later.

When I visited Cuba in 2007 the buildings along the foreshore in Havana were all 1930s reinforced concrete two or three storeys high with concrete balconies with concrete balustrades and handrails and the sort of scrolls holding up the verandahs and around the doors. Art deco if I am not mistaken. But they had concrete cancer bigtime and the balconies were literally falling off. As you walked down the footpath, some areas were roped off in case there were more falls. Some houses were condemned, which seemed just to mean that they were full of squatters rather than owners.

It is not clear whether the building falling in Florida was poorly constructed, whether it got concrete cancer, or whether the sand shifted under it. Presumably we will know eventually.

Back here in Australia the wave of deregulation in the early 1990s led to the privatisation of building certifiers, and the distorting effect of real estate money, surely the biggest problem in Australian governance, has hugely affected building standards. We have seen the fiasco of the Opal Towers building at Olympic Park in December 2018 (SMH 24/12/18), and Mascot Towers (SMH 15/5/19). We now have a new building inspectorate and the new NSW Building Commissioner seems aware of the problems. But Body Corporates do not want to report their defects. No doubt they are fully aware that if they do their property values may be totally destroyed, or at best they will be up for a fortune in repair costs if the problem is fixable. So the answer is to hide the defect if you think the place will not fall down.

The Building Commissioner says that there are 200 apartments on the lower North Shore with ‘scandalous’ defects.

When I was in Parliament it was drawn to my attenti0on that air-conditioning ducts often went through supposedly fire-proof walls, as did plumbing that was not sealed off around the pipes. One of Sydney’s major apartment builders and generous political donor was named, and I asked a question as to how many building were there in the Sydney CBD that the Fire Dept. had declined to certify as safe for occupation? I never got a quantitative response, but the company in question sued the Sydney City Council for being slow in issuing certificate of occupancy. I guess that they thought attack was the best form of defence.

A little known fact is that insurers will not insure buildings over 3 storeys.

The system of private certifiers is a farce and the chickens are likely to come home to roost. How do you buy an apartment now?

Inspectors have to have the power to refuse and guaranteed employment, so that they cannot be bullied or blackmailed. Then there have to be protections against corruption. A head of a planning dept. that I knew banned meetings in a certain coffee shop that was known as a place where developers spoke to public servants, banned meetings on a one to one basis and insisted that there be minutes of every meeting and that only what was written down was to be considered as binding. He had lessons on ethics and acceptable behaviour, but admitted, ‘I cannot check on everything’.

www.smh.com.au/national/nsw/construction-watchdog-body-corporates-are-not-reporting-known-defects-20210630-p585hh.html