Doctor and activist


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Tag: Accountability

Sex, God, Anger, Mental Health, Guns, and Racism

20 March 2021

In a recent article about a mass shooting in a number of brothels in Georgia, USA, the Police were criticised for saying that the alleged killer had ‘had a bad day’.  Obviously his day was not as bad as those who were shot.  The Police were in trouble for not being condemnatory enough in their statement.  There was a lot of discussion whether the shootings were racially motivated as they were in Asian massage parlours.  An alternative explanation was that he was getting rid of the outlet for his temptations.

The study of accidents or ‘adverse events’ is a somewhat neglected science.  The legal system has graduated from ‘guilty or not guilty’ to ‘at fault or not-at-fault’, as this makes it simple to dispense justice.  The more nuanced study of adverse events has been mainly done in the aviation and oil industries where a number of small errors or omissions may magnify each other.  The oil industry has tried to quantify the probabilities, which of course is much beloved by the insurance industry, which wants to set its premiums on some sort of rational basis. (How many valves are there in the plant? What percentage of valves leak? What percentage of the valves control volatile liquids?  How many areas can form explosive clouds? What sources of ignition are there? etc.)

A common analogy used for major accidents is that there are a series of discs with a hole in each of them all revolving at different rates, and if all the holes line up, something can get through.  So if each disc is something that can fail, the combination of failures leads to the disaster.

There is then discussion of the environment, the primary, secondary and tertiary causes and the immediate precipitant.

So the headline of this article was an attempt to put some discs in line to look at why the shooting happened.  It is obviously a tragedy and totally unethical, but it is still helpful to discuss its elements coldly and logically.

Sex is a primal drive. An explanation offered for many species is that the males try to reproduce as much as possible, with the females acting as ‘quality control’ selecting who they will mate with and when.  Male libido is rarely discussed except as an embarrassment to harmony or a non-justification for unwanted sexual advances.  The Christian churches have generally had a very negative attitude to sex.  It seems that sex is defined as only acceptable in a monogamous relationship, the alternatives being states of either abstinence or immorality.  The word ‘morals’ has come to mean sticking to a sexual code, rather than behaving ethically in business, commerce or anywhere else.

This attitude to sex has made it an exceptional act.  When a baby girl first rolls over, everyone claps. When she first sits, stand, walks, talks or rides a bicycle everyone is similarly delighted.  But when she first has sex, the world seems terrified.   With boys it is similar, but there is much less terror.  Christian-ethos-based  societies do not seem to have come to terms with our basic humanity and its natural functions.  In consequence prohibitions and guilts are major elements in our society.

In Shakespearean society the serfs had nothing to inherit, so were not really concerned who fathered the village children. The middle class had money to inherit, so were very fussy who slept with who, and the kings staffed the Court with eunuchs just to be on the safe side.  In some Asian societies the men visit the brothels on the way home so that they will leave their wives alone. This also occurs in Western societies, but with the sex industry more marginalised. 

So if a man is at the extreme end of the libido spectrum, but due to personality characteristics is continually denied sex, he may become angry and frustrated.  This is unsurprising.  If his libido is then defined as abnormal, he may be termed ‘sex-addicted’.  Is this then a psychiatric diagnosis?  Probably not.  There is no real connection between psychiatric diagnoses and physiological brain function, and mental illness is often a question of definitions, which change significantly with time.  The diagnosis ‘nymphomaniac’ has gone out of use.

In the US with guns readily available, killing people is much easier; uncontrolled anger is much more dangerous.  Obviously an angry man is far more likely to kill 8 people if he has a gun that if he does not.

In that brothels tend to be staffed by people who are marginalised either by race or income, it is observed that many are staffed by Asian women.

If one accepts that there were 6 discs that had holes in them, one could argue which causative factor was the most important.  The Police may have been keen to play down the racist element.  They may assume that the guns and the ‘moral framework’ are not able to be changed, hence not worthy of mention.

Australia has no gun problem like this, but sexual consent is certainly the topic of the moment. A more natural and secular approach to sex education would seem to be necessary, and an obvious approach is to put it into a civics and ethics class into schools.  The crunch question will be whether it displaces scripture, which increasingly seems an anachronism.

www.smh.com.au/world/north-america/alleged-killer-says-sex-addiction-not-racism-motivated-atlanta-shooting-spree-20210318-p57bqb.html

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Aged Care Reform Now

20 March 2021

Aged Care Reform Now is the name of a group that is working to try to get the Aged Care Royal Commission conclusions implemented. Like many inquiry reports, implementation is by no means certain.

John Howard’s Aged Care Act of 1997 allowed the sector to be ‘for profit’, and a poor system was made worse. At a webinar that I attended geriatrician, Joseph Ibrahim was of the opinion that when the dust settled, the government would do what the big for-profit companies wanted as they had a direct line to the government, and there was no serious organised advocacy as there had been for the gay lobby in the AIDs crisis or for disability. (The write up of that seminar is on this website- search Ibrahim).

Here is group trying to do advocacy. They will need all the help that they can get!

https://agedcarereformnow.com.au/

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Mutual Obligation and ‘Noblesse Oblige’

18 March 2021

‘Mutual Obligation’ is the new buzz word for unemployed people.  If they are to get ‘welfare’ they have to be trying to get a job.   An index of this is to make a lot of job applications, that surely must be the bane of every employer in the land, with an obligation of job seekers to apply for 20 jobs a month and about 8 job seekers for every vacancy.

‘Noblesse Oblige’  is a French term dating from when English royalty spoke French after the Norman conquest (of 1066)  and refers to the benevolent, honourable behaviour considered to be the responsibility of persons of high birth or rank.  The term is so quaint and medieval that is often used ironically. But these days with the growing gap between rich and poor, and the lack of sanction on poor behaviour by the empowered class, it may be that old fashioned ethics is all that remains to help poorer people. And they are in short supply.

If there were mutual obligation, a government would be obliged to give its citizens a decent life.  In the 1950 and 1960s it was considered a government responsibility to get everyone a job and governments fell if the unemployment rate was over 1%.  In the 1980s when I worked at Sydney Water, it ran employment programmes for ex-prisoners, people who had been unemployed for more than 3 months, and people with disability.  The employment was for a 6 month term, and my job was to check that applicants were physically able to do the job.  There was a programme to separate sewage and rainwater in inner city areas and a pipe replacement programme.  Both of these programmes were simply canned.  The Apprentice School, which had about 180 apprentices including plumbers, electricians and carpenters was closed.   Sydney Water’s staff went from 17,000 to less than 3,000, and all the wages saved were simply turned into ‘dividends’ from the State Owned Enterprise’.  A tax in short.  Contractors were used, and mains repaired when they burst.  The government had out-sourced the work and outsourced the responsibility for employment.  The latter was less obvious. 

The Global market place that was created in 1944 to lessen the chance of wars allowed countries that produced things cheaper due to cheaper labour costs to prosper, and multinational corporations moved their factories.  The Americans call it ‘off-shoring’.  But our governments have acted as if none of this exists. An abstract entity, ‘The Economy’ is now responsible for job creation and unemployed people are responsible for getting them.  The government has outsourced job seeking to private corporations, and as we know, their duty is to make as much money for their shareholders as possible.  So if it is better to churn many people through short-term jobs to get a commission every time someone starts, hey that is the way to go.  So it is about how the rules are written.  If the old CES (Commonwealth Employment Service) clerks could find someone a job they did.  No one complained that they did not try to place people, and there was no incentive for them to do anything other than to try to place people in the best way possible.

I work with the Workers Compensation insurer, iCare, whose remit seems to be to minimise the cost of claims by saving on both claims managers and payments to injured people, and they are still paid a bonus if the ‘customer’ (i.e. patient) gets back to work, so there is pressure to force them back.  The CTP insurers are always in a total conflict of interest position. They get the premiums and every dollar they avoid paying out goes to their bottom lines.  The idea that a private market will fix things is complete nonsense.

Now we have revelations of gaming the system in the privatised job placement agencies.  The whole dismantling of the public system relies on the assumption that people will not work without incentive payments and private is always better than public.  I was in the public sector for many years as a salaried doctor and then in Sydney Water.  My experience was that the public sector did its job quite well and thought about better ways to act, undistracted by incentive schemes that would distort resource and time allocation.  The Dept. of Public Works built most of this state; Sydney Water built Warragamba Dam.

Privatised rorting is now a major industry draining resources from CTP insurance, Aged Care, the NDIS and now job search. This is not to mention over-priced private monopolies in toll roads, transport, land titles office or oligopolies gaming electricity supplies.

Will there ever be a government that rebuilds the public sector to put an end to this?  Will Labor just roll over as Liberal Lite as they did to get an extra $3.50 on ‘JobSeeker’?

But the key issue is that everyone has the right to decent life, and if the government cannot provide jobs, it should provide income support.  Noblesse Oblige.  As one of my more insightful friends said, ‘There is no shortage of work. Everyone I know can think of things that need doing. It is not a shortage of work, it is an unwillingness to pay’.

Watch this video re the privatised employment agencies.

https://nsfuw.com/?secure_token=8fb90d8862532ccff17c55370720566372b28b851af78200f9c4a13b9171c28e&t=GZ1ZJT09R&utm_campaign=Expose_predatory_job_agencies&utm_content=30518&utm_medium=email&utm_source=blast
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Porter’s Defamation Case Against the ABC

17 March 2021

Many were surprised when Attorney-General Christian Porter sued the ABC, using the very defamation law that he has criticised as favouring the plaintiff.

What will happen? Will it go ahead?  Will he win?  And what will be the effect?

I do not pretend to be an expert on defamation law, but I did run a live radio programme that called tobacco executives mass murderers most weeks for 14 years and I gave some thought to avoiding being sued.  The advice was basically that if you spoke about a class of people, it was OK, but if an individual was identifiable you were in much more danger.

Defamation was defined merely as likely to lower the opinion of someone in the opinion of their peers, so was relatively easy to prove.

The defences were that it was true, or that it was in the public interest, or it was ‘fair comment’ on a known situation.  (There was also ‘qualified privilege’ if the allegation was made to a closed body entrusted with maintaining standards, such as a complaint to a Medical regulatory body).

But after the lawyers had given this rather bleak advice, they said that main question was whether it would actually be in the interests of tobacco companies to sue a little-known doctor speaking on a little-heard community radio station.  They could send him broke, but the issue would get a lot of publicity and how many people they killed would compete with how callous they were to stuff up the life of a little truth-teller.  So I was to be careful, but not fearful.

Porter has raised the stakes in that if the ABC wants to run the truth defence, it has to prove it, which is hard with Katherine Thornton dead and the Police saying that without even a sworn testimony there was no hope of proving the case.  If the story is not true, then arguably it is not in the public interest to discuss it, and since the ABC raised the issue, it is hardly fair comment on an existing discussion. Most people did not know which individual it referred to, but some did.

I am unsure to what extent comment will be shut down by the fact that it in sub judice, but I think if it is not a jury trial, judges are supposedly uninfluenced by the media, and you can comment  on civil but not criminal matters.  There is no doubt that everyone in the pub or tea room will have an opinion.  If the ABC settles without running the case, Porter will claim a big victory.  If the ABC fights and loses, he will also claim a big victory, but the damage done to him in the process is likely to be terminal.  Most people are likely to continue to believe the story and he is likely to look like a privileged pratt using a bad law.  This is not good when both he and his party have to face the voters.

Also, if the ABC loses, it will have a large budget blow, a loss of prestige and probably a budget cut from a vengeful government.  But the process may have damaged the government enough to turn the next election and Labor may then restore the funding. 

If you look at the tide of history, this issue is one that’s time has come. The coverage and discussion of the issue will make this a watershed moment where high legal costs are merely an investment in hastening a major social reform, though we cannot reasonably expect the ABC’s lawyers to see it that way.

Crikey looks at the strength of Porter’s team and case.

www.crikey.com.au/2021/03/16/christia-porter-defamation-trial-of-the-century/?fbclid=IwAR1_dcbIg1jexXl3TUkooK73YSy9yEIlKjTJ6CvMuE68BSqqZtKENo-TbvU

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Ex-Solicitor-General Calls for Inquiry into Porter’s Rape Allegation

14 March 2021

The former Solicitor-General, Justin Gleeson has made the case as to why there needs to be an investigation into Katherine Thornton’s rape allegation against Attorney-General, Christian Porter.

The mechanism for this would be that Morrison should ask the Solicitor-General for advice as to the situation.  This Morrison has so far declined to do. 

Interestingly, Justin Gleeson was highly respected Solicitor-General who resigned in 2016 after a very public argument with the then Attorney-General George Brandis, when Brandis wanted all referrals to the Solicitor-General to go through his office.  Gleeson felt that this was restricting his freedom to give advice and effectively politicising his office.  Prior to Brandis’ restriction he had made a statement about the legality of refugee legislation. (Guardian 24/10/16)  The Prime Minister not asking the Solicitor-General now and the Solicitor-General not making a statement does sound like the same issue.  Brandis, like Porter, was also accused of making poor appointments (of political party hacks) to judicial bodies. 

In terms of the reasons for having an inquiry into the rape allegation, this opinion is as good as it gets.  At least as an ex-Solicitor-General, Gleeson can speak publicly.

www.abc.net.au/news/2021-03-09/christian-porter-historical-rape-allegation-gleeson/13229880

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Time to Look at the Legal System

12 March 2021

As a schoolkid, I was a good debater and the vocational guidance advice was that I should be a barrister.  My father was dead against this idea. His dictum was, ‘Don’t go to court, you will get law but you will not get justice’.

He was a surgeon and to prove his point he took me to a court case where he was an expert witness. A company that manufactured concrete pipes was having an industrial dispute. The workers had stopped work and the union delegate was standing on a pipe giving an impassioned speech about how terrible the company was and that they should all go out on strike immediately.  As he spoke a runaway truck crashed through the fence, knocked him off his pipe and broke his leg. It seemed obvious that was injured but he was not at work.  The Union claimed that he was at work.  The employer argued that he was not at work, and threw in that he was not injured either, which was why an expert witness was needed. 

My father’s point was the process had nothing to do with the truth of the matter- it was just a talkfest that would give me the sh-its after a while.  He won in the sense that I did not do law.

40 years later I went to a Family Law barrister as a support person for a friend getting divorced.  The barrister, unprompted, said that he had thought about being a doctor, and regretted having done law as, ‘there is right and wrong on both sides, it all becomes adversarial, it is random which side you are on, and it is all about money.’

When I lived in New Zealand there was a high profile trial where a man had allegedly shot his brother in law. The brother in law was to inherit the family farm and he was jealous. The evidence looked very strong. His barrister managed to create a shadow of doubt in one of the juror’s minds and he walked free.  It then came out that the man had been released charged with damaging farms, killing stock and burning buildings where he felt that he had been slighted, But the jury had not been allowed to know this.  The defence barrister, Greg King, a family man with two children suicided a few months later.  (Radio NZ 17/10/13). In his obituary people said he was a good kind man who did jobs that had to be done but no one else wanted.

I had a barrister acquaintance who said he had had a bad week in that he had been vehemently abused by a stranger as he tried to buy a pizza.   He had been recognised by his critic as the defence barrister for a paedophile. He felt that this was completely unreasonable as he was ‘just doing his job’.

Our legal system is adversarial. Effectively there is a debate, with one side saying that the person is guilty and the other that they are not.  It is about winning the argument; the truth is often an early casualty. The people running the system are as affected as those in the dock, albeit differently.  The adversarial model in our legal system spills over into our parliamentary party system.  It is more about winning than the truth. 

Napoleon reformed the French legal system by making it inquisitorial rather than adversarial. The object of all parties to the court proceedings is to get to the truth, then the judge deals with that. Lawyers trained in our system think this is a terrible idea, but it seems very reasonable to me.

Now, because the complainant in the alleged rape by Christian Porter is dead there supposedly cannot be an inquest. No adversary, no action.  No truth either.

Minter Ellison is a big end of town law firm which advised Christian Porter.  Now its chief executive, Annette Kimmitt is being forced to resign because she questioned the firm’s support for him.  Is giving him advice supporting him?  Obviously she is not alone in thinking so.

Is there any chance of Australia getting a cost-effective, affordable legal system that gets to the truth, or is it too long after Waterloo?

SMH article today

MinterEllison boss exits after Attorney-General all-staff email

MinterEllison’s board and its chief Annette Kimmitt have ‘‘mutually agreed’’ she will leave the law firm after she sent an all-staff email critical of a senior partner for providing advice to Attorney-General Christian Porter about a 1988 rape allegation.

In an email to staff this week, MinterEllison chairman David O’Brien said the board had come to an agreement with Ms Kimmitt that she would depart the firm.

Managing partner Virginia Briggs, who heads the firm’s infrastructure, construction and property division, will serve as acting chief executive while the board considers a permanent replacement.

Ms Kimmitt has faced pressure since she sent an all-staff email last week that was critical of veteran partner Peter Bartlett for not following ‘‘consultation or approval processes’’ before he provided advice to Mr Porter. The Attorney-General has denied the allegation.

She apologised in the email to staff who may be experiencing pain over ‘‘the nature of this matter’’ and said that she too had been ‘‘triggered’’.

The email divided the firm and implicitly questioned whether the firm was right to represent Mr Porter.

Mr Bartlett, who also provides advice to the Herald, wasn’t aware of the email until it landed in the inboxes of the more than 2000 staff and partners it was sent to, some of the firm’s lawyers have said.

Tammy Mills, Chris Vedelago

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Scathing PWC Report Finds Perottet’s iCare Incompetent

6 March 2021

A 100 Page report by consulting from international PWC (Price Waterhouse Coopers ) found weakness in performance and governance, and the Board did not hold management to account. 

We might also consider that the Minister, Dominic Perottet did not hold the Board accountable, and appears to show no interest at all in the injured people for whom the whole scheme supposedly exists. We might note that no doctors or patients appear to have been interviewed either- Hey, it’s all about money you know!  One could ask why PWC did a report when Justice McDougall was simultaneously doing one that it coming out in April?  Perhaps he is a lawyer and does not know enough about money.

The bottom line is that it was run from the top by people who only knew about money with little input about its proper function from the people at the coal face, who presumably should have some knowledge of the people that they are supposedly helping.  (I say that with reservation, as the case managers that I deal with have high turnover, little insight and seem to assume that a large percentage of their cases are fraudulent, the doctors are hell-bent on inventing pathologies to over-treat and they have to follow elaborate protocols designed to ensure that no one could under any circumstances get one cent more than was absolutely necessary).

So we digest the Management-speak of this report and await the McDougall report which had terms of reference that allowed little input from patients or doctors, held no hearings and seemed to exist principally to take the heat off the Minister from last August until its April release.

It seems that there has been a generic concept since the 1980s that managers know best, that other degrees and knowledge from lesser beings or lesser ranks and incomes are not of value or to be listened to.  It has come unstuck in so many situations that its time that some little boy (or girl) points out that ‘The Emperors have no Clothes’.  Then we can go back to an older time, where people had appropriate training, worked their way up, knew their jobs, were promoted on merit and had small salary increments reflecting their incremental status rise.  But I suppose that this would rely on people having permanent jobs and depower the whole new managerial class and their symbiotic consultants and reduce the workplace ‘flexibility’ that allows the obscene salaries at the top and insecurity at the bottom. 

If Anglo society does not want to fall to more realistic societies in Germany and Asia, there needs to be a large rethink of the Harvard 1980s management nonsense that is the foundation of these sort of debacles.

www.smh.com.au/national/nsw/scathing-icare-review-finds-a-need-for-cultural-change-20210301-p576tq.html

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Insurance for Farmers with Coal Seam Gas

6 March 2021

I have minimal faith in insurers. Many years ago, one of my friends was killed falling down a crevasse hiking on a NZ glacier. A meticulous person, he had checked his AMP insurance before he left- the only exemptions were scuba diving and private flying. The company told his widow with her 6 month old baby that it was a dangerous sport and he was not covered and the broker he checked with had no right to say that he was covered. They offered her half. She was of substance, hung on and they settled on the steps of the Supreme Court rather than go on with their unwinnable case.Another friend had his house burn down, and was only given the depreciated value rather than the replacement, which was about half; small print as usual- do you feel like fighting Goliath?An acquaintance, who was a merchant banker with a lot of money got a nasty brain tumour and needed expensive chemotherapy. The gap between his Top Cover health insurance and what the bills were was so great that he left St Vincent’s Hospital and readmitted himself to Westmead as a Medicare patient. (Sadly the medical outcome was as expected).Every day I see people injured in Workers Comp or motor vehicle accidents have their treatments denied by insurers on grounds that could only be called spurious. In my practice’s statistics IAG (NRMA) refuse a higher percentage of treatments than any other insurer.It is, of course, impossible to say that fracking for Coal Seam Gas is safe. It involves breaking the rock strata to let the gas come up. Presumably these fractures will also let the water move to a lower level and be less available to the surface. And chemicals are pumped in so that the water may not be fit to drink, and there is no natural mechanism to purify it. Now unsurprisingly the insurers do not want to cover the farmers. For once I am on their side. Fracking is simply not safe. The gas companies will get their gas and move on-the farmers may have land that is useless, or at best less productive than it was before. Because of the nature of the law, farmers only own the surface of the land- mining rights are a separate thing, which is why the government can give companies the right to do what they like below the surface. The government needs to stop this- it should not be left up to the farmers. What a neat piece of nonsense that they are now supposedly protected from Public Liability claims- it might protect them if they are defendants, but it is far more likely that they will be plaintiffs!

www.abc.net.au/news/2021-03-05/big-on-spin-light-on-detail-as-gas-industry-touts-new-insurance/13216226?fbclid=IwAR26XpOCZk9aqusgrEukN44T-esmX-OhNFe4sgj4X7A9-Drtt9_3V-L6SxY

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JobKeeper becomes an Unaudited Subsidy to Big Business

6 March 2021

It seems that while JobKeeeper did help employees, some businesses did not actually need it, but got it anyway.  Now it is ‘moral issue’ that they give it back- that is to say it is voluntary.  If they have already taken it as executive bonuses or shareholder dividends it is probably not refundable.

The welfare recipients who had spent money and were accused retrospectively of Robodebt could not repay it either, but were hounded till the end.  All that will happen to the big end of town is a few days of newspaper articles.   

It is surely a reasonable principle that if taxpayers’ money is given away there should be monitoring of where it goes. If it was too hard to set up a monitoring system quickly, the obvious solution would be to make a regulation that it had to be used for purpose and would be checked and there would be prosecutions if it were misused. This would have allowed follow up, a few prosecutions and majority compliance.  This government seems incapable of any sensible management of anything, unless you think that deliberately handing money to mates is an unwritten policy.

Now even small businesses are annoyed.

www.smh.com.au/politics/federal/pretty-close-to-theft-small-business-slams-big-corporate-jobkeeper-profits-20210304-p577sn.html

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