Doctor and activist


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Category: Personal

Farm Update: Bushfire Time Day 3, 2/1/20

The air is better today, with the wind from the north-east, so we spent the day on the roof cleaning out the gutters. 

It terrifies me especially climbing up the slope to do the dormer window gutters, which were the most full of tiny pine needles.  Zincalum (Colorbond) is much more slippery than the old galvanised iron was as you are reminded with every step.  I always resolve that ‘This is the last time I go on a roof’, but it seems resolutions are easier to make than to keep. There is always some circumstance. 

I had always suspected that gutter guards were more trouble than they are worth, but today proved it for me. There was a more material under the gutter guard than on top of it, and it made the gutters much harder to clean.  Jan was cross, and having had the gutter guard installed at great cost ripped it off to make it easier to clean next time.  The object was to have the gutters so clean that no ember can find sustenance there, but obviously a few days of wind before a fire will undermine our efforts.  Gutters are dangerous in that they do allow a point for fires to attack houses and my brother says that in Western Australia, gutters are illegal in fire-prone areas.  This is logical, but the gutters are needed to collect water, and fortunately we still have enough of that at present- it is very expensive to buy it by the tanker load.

I had not realised how much material is blown up under the corrugations of a roof. Even with a 35 degree slope there are quite a lot of pine needles under both the ridge cap and where the roofing iron meets the valleys.  It is hard to get out, so we banged the tin to dislodge them.  I am not sure if it is a way that fire gets into the roof space, but it seems logical to try to remove them.

So that is the rant about roofs. Tomorrow I have to teach Jan how to use the chain saw, as the dead tree is still not removed, and persuade her that the pergola needs a more severe pruning.  We are going to get a real fire pump, which John says manage a higher flow.  Proper fire pumps, give a large volume quickly, so you can turn them off and not waste water. The one we managed to fix yesterday just gives a modest even flow.  John was a Fire Education Officer before his accident and was just a little offended that I raced off to be briefed by the fire team that he used to work with, but I assured him that prophets are never recognised in their own homes, so he took it in good part.

Tomorrow will hopefully be a quiet day and I may return to Sydney. My son, Mike and nephew Nick will come down as the relief team as Saturday expects heat and southerly winds, so the danger will be on again.  The fire is still 35 km away, so hopefully it will still be OK.

Everything is relative.  As we were on the roof a couple drove in with a double horse float. Jan went down and spoke to them.  They run a resort with 14 horses.  Jan has two of theirs already and they had brought 2 more. He said that he had done a google risk analysis and said that we were the safest farm for horses in the Southern Highlands because of the amount of open space between the trees on the road and the house and stables.  He has National Parks on all sides of his resort, which is mainly native eucalypt forest and he has only one access road.  He brought food for his horses seeking asylum.  The Moss Vale showground will take horses, but is very crowded and the rule is that you have to stay with the animals, which of course mostly means abandoning your property.

Time will tell. It is likely to be a long summer.

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Drug Testing and Strip Searching 7/11/19

7 November 2019

I have some experience in this area, though I would not seek to overstate it.

In 1985 I won a public service fellowship to look at workplace absence and I looked at the evidence of whether drug testing in the workplace worked. The main place it was suggested was at pre-employment medicals. The idea was that if you tested them and they were OK, they could have the job. It was a pretty silly idea as only a really serious addict would come to job medical interview with drugs on board so the pick up rate was low, the costs high, and the impression on the workers quite negative.

Later in my OHS job a worker was sent in for a medical as he was said to be using hard drugs in the portable toilet (thunderbox). He was taunting and arrogant, saying that I could not prove anything, and could not do anything as he would not give permission for the test. He was right of course, but he soon proved his accusers right as well by falling out the door of the thunderbox with a needle stuck in his arm.

When I worked in private OHS, the NSW State government saved money by sending people on parole to be drug urine tested on Medicare by local GPs. I was stuck with it in our practice which was one of the few that still agreed to do the testing. A man came in, angry and abusive, demanding immediate service, which he was granted to stop him terrorising the waiting room. He brought in a jar of very cold urine for testing. I said that I wanted a fresh specimen, gave him a jar and pointed to the toilet, ten paces away. He left to ‘get a new specimen’ and came back some time later. I said that I wanted to see him pass it, so he pulled his undies down saying, ‘There it is, are you happy now?’ No I wasn’t, as he had another small vial of urine in his hand as he held his undies. ‘You are a hard bastard’, he said as he eventually passed the urine, which unsurprisingly showed he was still using narcotics. The Parole people were pleased. They said, ‘We knew he was using but could not get a GP to get us a specimen’. I was not surprised that GPs were reluctant. At $15.20 for a Medicare visit that involved a terrified waiting room, half an hour of time, a threat to have your head punched in and the disruption of a whole afternoon for a whole medial practice, I told them that we were not going to continue testing either. Presumably he went back to gaol, and one might wonder how much good that did.

My next encounter was a female friend who had been very traumatised by a previous serious rape attempt that she had fought off. She was going through Central Station on her way to work, when a sniffer dog made the Police insist on searching her bag and ‘patting her down’. She had an empty plastic bag in her handbag that she had had a small amount of marijuana in some weeks before. But she was very traumatised by the experience because of the memories that were stirred and by the idea that she could not even walk around without people assuming that they had the right to touch her body.

The NSW Government will not allow pill testing at concerts, but wants to try to stop the drugs entering. Presumably there is a risk that younger people will bring them in if they are exempt from searches. Where will this end? Body cavity searches? MRIs outside concerts?

Prohibition will generally not work in the workplace, let alone the rock concerts. We need harm minimisation policies. This is not easy and it is not perfect, but it is better than prohibition.

Here is the NSW story in the NY Times, presumably with the unstated subheading, ‘Look what these mad Australians are doing now.’

www.nytimes.com/2019/11/06/world/australia/strip-search-children-drugs.html

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Lest We Remember

4 November 2018

My grandfather was wounded at Passchendaele.  My grandmother was the Army nurse who  looked after him in hospital.  He was one a five brothers all of whom went to the war. Three came back, one a respiratory invalid from chlorine gas.  He did not speak much about the war and rarely went to any of the commemorations.  He had a lot of medals in the drawer when he died.  I pressed him once on what it was like and he said cryptically, ‘You had to shoot them or they would shoot you’.  He did not elaborate.  Perhaps he knew that the stories about the glories were to hide the realities but he could not say so.

Much is written about what it was like in the trenches, but ‘All Quiet on the Western Front[1]’ documents it well, a German description, translated by an Australian.  He describes the misery in the trenches, killing a man with his bare hands and the mental stress that would never go.

The British were ill-led at Gallipoli, landing on the wrong beach.  The ANZACs managed to occupy a hill that they then were ordered off and never managed to take in the next 10 months.  They were ill-led in France, with an anti-Semitic prejudice and personal jealousies hindering the emergence of a more innovative Australian General, John Monash.  The Battle of Passchendaele was hurried up despite the fact that neither the men nor the tanks could move in the muddy conditions because Kitchener, the British general, was in danger of being sacked and needed a battle, at whatever cost, to retain his position.  Prime Minster Billy Hughes was happy for the Australian forces to be used as shock troops as it increased Australia’s prestige, ignoring the excessive casualty rate.

It was not the war to end all wars and as Germany’s industrialisation continued to increase their strength.  A dictator capitalized on the injustice of the peace to start again.

After the blitzkrieg of Poland, Britain declared war on Germany to start the Second World War and our Prime Minister Menzies announced that ‘as a result, Australia is also at war[2]’, following the Brits without question.  Our troops went over to North Africa and when the Japanese landed in Papua the few soldiers on the Kokoda Track with uniforms coloured for the desert fought with minimal resources as the American Commander, General Douglas Macarthur, who had moved from Melbourne to Brisbane to be closer to the action did not think them very important.

Vietnam  showed on our TV screens what war was really like and this was blamed for the loss, but no invader who has come and gone has ever won against the people who live there.  Lives were wasted; the lack of thanks and respect for the Vietnam veterans has caused immense suffering ever since.  ‘If any question why we died, tell them because our fathers lied’ written in WW1[3] was ever true.

The largest protest march since the Vietnam war with 74% of Australians opposing our entry into the Iraq war was not enough.  John Howard followed the US into the war anyway, then on to Afghanistan and the deaths and refugees in their millions continue to this day.  Post-traumatic stress is rife in the Australian army but hushed up.  Foolish wars with people dying for nothing.  John Cantwell, the Australian commander retired with post-traumatic stress and explained this in his moving book, ‘Exit Wounds’.

An ex-US Marine from Iraq lectures on how he tried to keep his men alive but could not get the armoured vehicles he needed to protect them from the roadside bombs.  He believed the US government did not actually care about the troops.  It was ever thus.

Last week I drove back from Western Sydney.  There was a big billboard recruiting for the Army and a much smaller one in the supermarket asking for donations for discharged veterans with post-traumatic stress.  There was a lot of excitement over the Invictus Games as maimed soldiers tried to overcome their injuries.  No one asked why they were injured and the Games were generously sponsored by the arms manufacturers who are on steroids of late as Trump demands countries spend 2% of their GDP on weapons to help the US balance of payments and Australia decides it will become an arms exporter, starting with a big order to our friends the Saudis who are famous for beheading journalists not to mention millions of Yemenis.

This week will have massive speeches and commemorations of our heroic soldiers.  The War Memorial will be upgraded to bigger than any cathedral as our new shrine, generously sponsored by the arms manufacturers again.  And the politicians will make fine speeches and improve their electoral prospects. 

It is the glorification of folly.

Lest We Remember.

Biography

Arthur Chesterfield-Evans is a medical doctor who started as a surgeon but saw that preventive health was more important and went into the anti-tobacco campaign, including time with the activist group, BUGA UP (Billboard Utilising Graffitists Against Unhealthy Promotions).  He spend some time  in NSW Parliament and was for time CEO of the Sydney Peace Foundation.

Summary

Lest We Remember traces the history of how Australia was drawn into wars by the British and the Americans, and looks at how poorly the strategies had been thought out and how poorly the troops themselves have been treated.  The hype and hoopla of the centenary of the end of the First World War will be used by the arms manufacturers and the politicians to cover the folly and indeed to perpetuate it.


[1] Remarque, Erich Maria, Translated by Wheen, Arthur Wesley 1928

[2] https://aso.gov.au/titles/radio/menzies-speech-declaration-war/clip1/

[3] Kipling Rudyard, Epitaphs of War 1914-18.  He had encouraged his son to join up and his son was killed just after his 18th birthday.

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Swiss Democracy. 9/9/18

I visited Switzerland to see the Swiss Parliament and to try to get a feel for how their direct Democracy works. Their basic system is more like Australia’s than might be imagined.  They have two houses of Parliament. The lower one has members elected by a first post the post from individual electorates, and the […]

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Energy Plan- why it is bad, and why there is not much protest.

19 October 2017

No one quite understands the new energy policy, (National Energy Guarantee -NEG) which is why there is not much protest. But I suspect it is very silly. Here is why.

The National Electricity Market worked because suppliers put in bids for a price on 5min supplies. But big producers could withhold creating a shortage, then put in a late bid at a high price. That segment would then go out at that highest price with every supplier getting the higher price. Logically then,the cheaper producers simply made more money. I have heard that a wind turbine in a good location could be paid off in 18 months, and that the price will settle at about $87 a megawatt hr.

The new plan puts big stress on reliability, so the solar and wind people are disadvantaged, but can still make a lot of money. The coal technology is still not much use, as they cannot compete with renewables when the sun shines and the wind blows, and they cannot ramp up supply quickly. They are, as everyone keeps saying, better for base (=constant) load. Added to this they are obsolete as the pipes in the boilers get stress fractures after a certain time and maintenance becomes uneconomic.

Gas is good at turning on and off quickly, but as we know, gas contracts for export has left us short, so Malcolm will create some problems there.

So a system that has been rorted by a few inside players who get supernormal profits will be given a licence to continue. The price of electricity will not fall much, and the consumer will continue to be gouged, with vulnerable industries simply going broke to allow the energy players to get profits that they really should not have. But there is not much protest because either people do not understand what is happening, or they are beneficiaries of a little understood rort that will continue because they have cleverly used fear of blackouts to get a cushy system.

And I suspect Labor will support it, as it has support from the energy industry, and they can claim bipartisanship, and they have been too lazy to get a better plan.

See also the Post ‘A Response to the Libs’ Energy Plan 19/10/17′

www.abc.net.au/news/2017-10-17/explainer-energy-policy-what-is-the-coalitions-new-plan/9057158

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Limits to the Market? A New Paradigm Needed!

15 May 2017

Since the last two world wars were over markets, it was assumed at the conference at Bretton Woods that if there were free markets everywhere there would be no wars and countries who did well would prosper. It worked.  Germany and Japan traded in markets that had been denied to them pre-war and ‘won the peace’. The dogma was that because there was efficiency in production we would all be better off as goods would be available all over the world quickly and cheaply. And, helped by the overwhelming dominance of Milton Friedman’s economic theories the market has spread into every aspect of life. The fact that when Friedman’s theories were actually implemented in South America that they failed miserably was merely a blip ignored. 

Now the market is assumed to be better than anything else as a way of allocating resources efficiently. It is better than government, better than planning, hey it is infallible, and probably inevitable as well!

Governments do not have to manage anything; they can sell it, even if they do not need the money. Inner city buses are the latest. 

If you read Chapter One of most economics books, it tells you about competition and how you cannot charge too much or a competitor will uncut you, so prices are kept down.

The rest of the economics book tells about monopolies or oligopolies, where there is poor competition and you can charge what you like, or there are high set up costs as barriers to competition, or regulatory hurdles, artificial training or registration requirements, geographical limitation, existing facilities, impractical duplication costs etc etc, which make monopoly or ‘supernormal’ profits a certainty.  Yet Governments plough on creating private monopolies and compliant political parties are rewarded by campaign funding to keep on winning elections.

What I am writing is not new or original and is known by anyone with even the most basic grasp of economic theory.  Do the politicians not read past Chapter One?  Do they never think that they are creating uncontrolled monopolies as they transfer assets from ownership by all the society to ownership by a moneyed elite?  Are they so ideologically committed to privatisation that they no longer think at all?  Do they not care, or will they do anything for their own short-term interest? It seems that the answer to all these questions is YES!

They have sold the airport, the sea port, the water supply (an endless subsidy to an unused desalination plant), the railways, the electricity, the road network and easements under it, the world standard database of land titles registration, the small councils power to control development, the list goes on and on.  The health system is being sold by stealth. Medicare is being starved to death, as private health insurance is just subsidised inefficiency, and NDIS disability services will go the same way, no government services, oligopolies for profit paid for by the ‘Medicare’ levy rise, which is not even committed to Medicare.  The education system no longer produces tradesmen to do the job and private education rip offs abound from dodgy day cares to non-Gonski funding to schools to post-TAFE colleges selling dubious certificates to phantom colleges ripping off visa-seeking migrant students.

The public service is being ‘hollowed out’. It no longer retains centres of expertise as it can always buy ‘consultants’ who carry briefcases and impressive CVs and have no interest except the public good.  It closes offices, hires short term workers, relies on PR driven websites and replaces people with knowledge by ‘Services NSW’ which has someone who might know which department might do what you might want.

Our existing political system seems unable to govern in our interest. The interest of the political parties no longer coincide with the public interest. Our governments’ decisions have been bought like everything else.  I do not think that money can be held at bay by electoral funding law reform. When we fought the tobacco industry, it sponsored sport and culture to get political allies. When that was banned, it sponsored ethnic groups, rescue boats and helicopters, any worthy cause that could lobby for it, and that was without gifts in kind, dodgy ‘foundations’ or other less visible influence-buying. 

The only answer that I can think of is Swiss-style democracy where major decisions are taken by referenda of the people, and Parliaments merely implement decisions that the people have made. Any other suggestions?

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My second Obeid story. 29/6/16

I was in NSW Parliament and an old school friend wanted to meet for old times, so we went down to the coffee shop at Sydney Hospital.  As we went in Grahame Richardson and Eddie Obeid were talking together. As we walked past Richo was facing me, Eddie had his back to us. I nodded at Richo and went past.  My friend and I had rather a long chat, but as we came back, Richo and Eddie were still there.  I nodded at Eddie.  Richo, (who is a very sociable guy whatever else he may be) said, ‘Hello Arthur’.  I was a bit surprised he even knew my name, but he is good at that sort of thing. I stopped, turned round and replied, ‘Hi Richo’.  Then a sense of devilment took me and I added, ‘What are you going to do about Beasley?’  Beasley was ALP leader at that time and was not doing very well in the polls, and some people wondered when he would be replaced.

‘We are going to replace him’ said Richo.

‘And who with? I asked.  (No harm in asking).

‘Rudd’, said Richo.

‘He’s not much chop is he? Bit of a Bible botherer?’ I replied.

‘Best we’ve got at the moment’, said Richo.

‘That may be,’ I said and toddled off.

Seven months later Rudd replaced Beasley, and the rest is history.

Richo is not a man to stab you in the back- he stabs in the front, presumably smiling and telling you it needs to be done.  Eddie was the NSW numbers man, which is why no one moved against him.  Carr and Egan kept him out of the ministry, but when Carr went, he came in. Things went bad, and eventually when things were very bad, compromise Premier Nathan Rees tried to clean up the NSW Labor party, and drop Tripodi, a mate of Eddie’s. He failed and was then thrown out.  Kristina Keneally became Premier, just before the election with a good new female image, but of course NSW Labor was not fixable or saleable by then, and Barry O’Farrell won in a landslide, only to lose office due to forgetting that he received a bottle of Penfold’s Grange Hermitage from the property developer today said to have called on Eddie.

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Eddie Obeid. My First Story. 28/6/16

When I first got into Parliament in 1998 Eddie offered me a lift to Parliament.  I accepted. It seemed harmless enough. He had a car with a driver and lived not far from me.  Then he offered to give me some advice about how to get on in Parliament. 

I said, ‘Fine, Go ahead’. There was no harm in listening.

He said, ‘Arthur you are in a very little party, but if you vote with the (then Labor) government, we will give you a little win just before the election and you will be re-elected’.

I said, ‘Well, Eddie, you might think we are a little party, but we have a lot of policies that are important and if you help those policies, I will vote for you and if you don’t I will vote against you. That is my job”. 

He said, ‘No Arthur, you do not understand, we are the government’. 

I said, ‘That does not really impress me, my job is to change the government’. 

He gave me a lift the next 2 times and we had virtually the same conversation. He would say, ‘Arthur, you are not really understanding,’ (meaning I was not voting the way he wanted).  ‘You are a very small party and we are the government and if you vote with us, just before the election we will give you a little win etc’..   So  on the 3rd recitation of this I wondered what a ‘little win’ might be. I had got into politics campaigning against tobacco and I knew that what was needed to save a lot of lives was smoke-free air everywhere, especially in the pubs and clubs that were the bastions of smoking, and a big health campaign against tobacco. ‘So I said, ‘Well, what I came onto parliament for was to fix the tobacco problem, you could fix that at no cost. It is just a ban, and the health campaign would pay for itself in hospital costs almost immediately.  That could be the ‘little win’ you talked about’. 

He said, ‘That is a very big thing. We could never do that’. I said, ‘Well I guess its no deal then’. He turned up the radio and we sat without talking as Ray Hadley rabbited on. 

I did not get a lift in the mornings, but I kept getting a lift with him for some time in the evenings when we finished late.  He was quite friendly and I used to meet him in his office. But one day he said to me, ‘Arthur I give you a lift home and you do not vote for us.’  There was no answer to this.  Could anyone think that a lift home should change a vote in Parliament?  Eddie obviously did.  I figured there were some people who did nothing for nothing.  After that I took a taxi voucher.  The taxpayer had to cop the extra price of an independent mind in Parliament.

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Medicare- Did the Liberals try to abolish it? 21/6/16

This is a current question with Shorten claiming that the Liberals are trying to privatise it and Turnbull calling this a Labor lie. What is the truth? 

The answer is in the history of Medicare funding.  Medibank was set up by the Whitlam government and the bulk billing frees were set at 85% of the AMA ‘Most Common Fee’. The 15% was a discount but saved doctors a lot of costs and all their bad debts. They got slightly less, but the clerical and hassles saved by simply sending the paperwork, and later the computer message to the Medicare computer was felt to be a good deal.  But ever since then both major parties have not raised the Medicare same rate as inflation, in fact at about half the inflation rate.  This has resulted in the Medicare rebate being about half the AMA fees.  Specialists often will not see patients on Medicare unless they have a Health Care card, and GP practices simply cannot survive if all their patients are bulk billed.  GP practices have survived by having pathology companies rent a room where they collect bloods for a relatively high price. This has allowed the government to keep the GP Medicate rebates low. Recently the government tried to change the pathology rebates, and the companies resisted, but the treat was that the pathology companies would stop subsidising GP rental and a whole fuss would have erupted re the uneconomic nature of General Practice.  The government did not want this just before an election, so the pathology system was left as is.  But can we trust the Turnbull government? I don’t think so. A couple of other pointers:

The Emergency Departments (EDs) have recently been in the news as having a hugely increased workload and there was a request for funds, also recently seen as a question to Turnbull on Q&A.   EDs get busier if people do not go to GPs, who are far cheaper, and generally pick up problems earlier than EDs.  So the rise in ED use is likely to be a reflection of the lack of funding of GPs by Medicare.

There have been a lot of rather convoluted plans to deal with chronic illness. As the population ages, and as it gets problems with obesity and diabetes, there are more visits, more prevention is needed.  GPs are the cheapest medical intervention, so one might have expected that they would be the key element in the strategy to deal with it, perhaps supplemented by practice nurses or other slightly cheaper options based around GP-type community health centres.  But instead of this there was a bemoaning of the difficulties and lot of convoluted nonsense trying to avoid raising GP payments to a viable level.  It looked very like the object was not to find a solution to the problem, so that Private Heath insurers and the profit sector could get a look in at the problem and start to make some money.

Now we hear that there has been $5 million to look at outsourcing, just the payments part of Medicare.  Well Medicare is Just a payments system, so that is the guts of it. 

So it is very likely that the Libs want to privatise Medicare and take us to a US model of the health care. The public do not want this, but big business does, a powerful lobby in Canberra does, party political donors do, and the government can lessen the  amount it pays for health, even though the total cost will rise dramatically.

Labor also has historically a very bad record. They have allowed the Medicare rebate to fall with inflation, had a rebate ‘freeze’ of their own, and their only promise is to stop the freeze, which still leaves most doctors either unwilling in the case of specialists or unable in the case of GPs, to survive.

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