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Health – Page 16 – Dr Arthur Chesterfield-Evans

Doctor and activist


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Category: Health

COVID-19 crisis highlights Market Failures

22 April 2020 The COVID-19 crisis highlights the failure of market mechanisms. The lack of good health care in the USA will highlight how private medicine simply does not deliver the health care people need. The same can be said in Australia, though we still had a bit more public system to build on. But […]

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Management of COVID-19 in the UK

12 April 2020

Prof John Ashton CBE, Ex-President of UK Faculty of Public Health is extremely critical of the Johnson government’s management of the corona virus epidemic.  He says that the idea of herd immunity was an absurd one and amounted to an unlikely theory being preferred to information that had come from overseas, including China, which had initially covered up but once the WHO had come in were forthcoming of their experience in managing the epidemic. 

The current problems include lack of PPE (Personal Protective Equipment), ventilators and even oxygen are because of the lack of recognising the seriousness of the problem and failure to order equipment and to prepare.

He urges more attention to cleaners and porters who are as important as doctors in nurses in the spread of virus in a hospital environment, but the class system, which lessens their importance, has meant that they have not had enough attention to their PPE and this will lead to spread. 

The other aspect is Private Public Partnerships, which have seen the creeping privatisation of health in Britain.  He makes the point that there are no longer Community Nurses to trace contacts of the corona virus in the community as private corporations only do what is in their contracts, and are only of peripheral use in a pandemic.  He wants a fundamental re-think of the privatisation of health, and a real investigation of who made what decisions when, not merely the outcome of awards to people who were high in the hierarchy, however incompetent their decisions.

Many countries have had health systems inappropriately evolved to deal with an infectious disease pandemic. How well countries have done is measure of the flexibility and responsiveness of their political systems as well as their health systems.  His view is the UK has not done well.

We all need to look at our governments in the light of how well they responded to this challenge.  The danger is that initial dilatoriness will then be replaced by authoritarianism, imposed on people while they are frightened.

www.youtube.com/watch?v=YBm7LCeOzHU&feature=emb_rel_end

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COVID-19 Does Hydroxychloroquine and Azithromycin treatment work?

2 April 2020 This is now a current question because of a French trial. When a new disease comes there is a rush to test existing substances to see if they work. When AIDS arrived, many drugs were tested. One drug, acyclovir was found to help. Acyclovir had been developed as an anti-leukaemia drug but […]

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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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Mental Health. Small wins, more needed.

20 October 2019 When I was in Parliament, 4 things happened in quite rapid succession.  I was part of an inquiry into prisons and a Dept of Corrections psychiatrist who attended court to question accused people told the committee that it was much easier to get into Prison than the mental health system and that […]

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Drug Research Crisis

3 October 2019 Governments say that they want to fund research, but think that they are very clever if they can do it ‘in cooperation with the private sector’.  They think that they will save money and get some inside running to a share of profits.  Mostly they are played for mugs.  The private sector […]

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My Health. Should you opt out?

25 July 2017 It is good to have a health record available for a complicated case. It saves doctors a lot of time.  When Records started to be computerised in the early 1980s the people at North Shore Hospital where I worked had a working party. I offered to help, but they said that they […]

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The Decline in Trust.

11 October 2017 It is getting harder to trust people.  Once we trusted our teachers, our doctors, our bank managers and our politicians to lead us.  And people trusted that people could do their jobs. But we became obsessed with competition instead of cooperation.  Everything had to make money. Everything was a commodity.  It was […]

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Tobacco Control Lobby goes silly on vaping.

28 September 2017 People who see the world from a very narrow perspective generally get it wrong, however clever they are in their own specialty.  If the only problem in health were smoking, perhaps vaping could be justified.  But the realities of money and marketing is that a whole industry will try to get the […]

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NDIS- National Disability Insurance System.

1 July 2017 I have grave fears for this system. I am unsure even of the goodwill of some of its advocates. I was on the Social Issues Committee of the NSW Parliament and we looked at Disability services and the way that these were delivered. Basically if you ask how big the disability problem […]

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