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Category: Health

08/03/2023

The Silicosis Epidemic- A Symptom of Wider Regulatory Failure

Dr Arthur Chesterfield-Evans 28 February 2023

The epidemic of silicosis amongst tradespeople working with manufactured stone was predictable, preventable, and an illustration of a broken OHS system across NSW and the rest of Australia.

Until 2011, NSW had a workplace health and safety regulator whose statutory role was to “promote the prevention of injuries and diseases at the workplace and the development of healthy and safe workplaces”. The WorkCover Authority of NSW included specialist sentinel groups that researched, monitored, inspected and educated workplaces for dust diseases, farm and rural health (including pesticides) and noise, amongst other matters. Crucially, WorkCover also employed industrial hygienists and an occupational medicine group. These groups enabled the agency to anticipate many problems before they manifested in the state. The current furore over manufactured stone using powdered crystalline silica would probably have been averted if the dust diseases group were still in place.

For example, manufactured stone was previously produced in NSW, but made with powdered talc or limestone in a fibreglass matrix. The Dust Disease group discovered an employer using the cheaper silica flour and immediately put a stop to that. Similar proactive actions by this group halted the importation of mineral-bearing products adulterated by asbestos, such as brake shoes and gaskets, before they became a problem. Issues raised by the increasing use of carbon fibre and nano particulates would also have been within the purview of the Dust Disease group.

However, following the election of the coalition in 2011, the NSW government’s focus shifted to the financial losses of the workers compensation scheme. The insurance and workers compensation schemes were split from WorkCover with the creation of iCare and the State Insurance Regulatory Authority (SIRA). Workcover also lost its independent source of premium income.

Limited funding for the remaining inspectorate and other functions such as promoting workplace injury prevention now came from Consolidated Revenue, set by NSW Treasury. Over the next few years WorkCover’s management under John Watson (the generic manager, not the Labor politician) shed many of its professionally qualified staff. New inspectors were less qualified than previously, a rule book replaced comprehensive understanding of occupational health and safety, workplace inspections decreased and in-depth investigations virtually vanished.

WorkCover’s system of Authorised Medical Practitioners, which trained GPs in occupational medicine across the state, was completely abolished. The excellent training manual for AMP’s, better than most textbooks, was written and maintained by Dr Kelvin Wooller at WorkCover. When he left, the regulator would not allow Dr Wooller to continue using the manual to train NSW medical practitioners but did nothing with it. Expertise in occupational medicine has consequently decreased in the wider medical community, making it difficult for many employers to find “a registered medical practitioner with experience in health monitoring”, as specified by the Work Health and Safety Regulation, and for workers to get a definitive diagnosis and compensation for workplace illnesses and diseases.

WorkCover was abolished in 2015, replaced by SafeWork NSW, which is now part of the Department of Customer Service, the department that is all things to all people. The government seems not to understand what its function should be.

The regulation of workplace health and safety in NSW should be handled by vigilant sentinel occupational disease groups to provide workers with proactive protection and help keep workplaces safe. A core group of government-employed professionals is necessary as a repository for learnings and information that would otherwise be lost. This is the OH&S philosophy that drives other countries.

NSW has few workplace inspections, almost no penalties for appalling workplace practices and a cost-minimisation approach to the treatment of injured workers as the government reduces the premiums of workers compensation to make NSW ‘business-friendly’ at the cost of workers’ lives. There are currently a lot of inspections of benchtop manufacturers and suggested and overdue bans of manufactured stone with silica, but reactive activity in response to a significant epidemic has not fixed the systemic problem.

This needs to be an election issue in NSW. It should also be noted that John Howard’s similar 2007 changes to the Federal government regulator –the National Occupational Health and Safety Commission, (WorkSafe Australia), now Safe Work Australia –meant that that policy/advisory body also has far fewer personnel, less expertise and a less pro-active approach. The perception of OHS as merely slowing industry’s “progress” has damaged the process nationally in a similar way to that of NSW. The Federal government also needs to act in this area.

This article was published in John Menadue’s Pearls and Irritations 28 February 2023

28/12/2022

Please Write Submission re Vaping by 16 January

28 December 2022

Vaping is now own by tobacco companies who are following exactly the same path as they did with tobacco. They managed to get out of having to prove it was safe because a few naive doctors, still fight the tobacco wars said it was ‘better than tobacco’, an incredibly low bar to clear- not really a bar at all.

Then they said it could be used to quit, and a handful of doctors who made a living from Quit clinics when 99% of people quitting just do so, supported this. Now it is being marketed in new ways to that the adds are not visible to those who are likely to oppose vaping and the habit is growing hugely, with the Industry also using peer-to-peer marketing to evade and futures regulations or prohibitions.

Vaping is now more of a gateway to smoking than a path from it, and that suits the Industry just fine.

It is likely that the solvents will be harmful in the long term, so the precauti0onaly principle would mean that it should be banned until it is proven safe, which is frankly unlikely.

In London there is now a coffee shop that advertises Vaping and Coffee’ which assumes that indoor vaping is not smoking and will be tolerated by non-vapers. Presumably they will resists vaping controls indoors until passive vaping is shown to be harmful and tat might take 30 or 40 years- a total tobacco epidemic re-run. So please write a submission to the inquiry.

smh.com.au

Now here’s a deadline: We have until January 16 to help stop toxic vaping

18/12/2022

Trust – a letter to Ross Gittins, who wrote the below article on Trust

18 December 2022

Dear Ross,

I congratulate you on your article on ‘Trust’. It is the glue that holds society together, and when it is broken there are huge consequences.

Since the first plane hijacking in 1970 checking people onto planes is a growth industry. Years ago you could walk into any office building, take the lift to the top floor and ask the General Manager’s secretary if you could speak to (almost always) him. Now everyone carries tags even to get in the front door or the lift. This may all be related to inequality or only mostly.

But it is also the rise of the manager. The best expose of this I have read is ‘The Political Economy of Health’ by Julian Tudor-Hart. He follows the British NHS from its founding till 1998. At first it was a noble experiment with all those in it paid adequately and trying to give health for all as well as they could. The whole thing was self-governing, and everyone was trusted to procure things as cheaply as possible and look after each other and the patients. Then managers came and asked ‘What is the cost of a day in hospital?’ or’ What is the cost of an X-Ray?’ Some said that it was unwise to ask this, as keeping records that detailed would simply add to costs, which everyone was reasonably sure were as low as possible already. Hart details successive management demands and consequent cost increases until the cost of management became about 35% of the total, without any apparent improvement in the service.

Managers do not trust people to do their jobs, so they insist on KPIs, which then become more important than the job itself, distort the tasks done and kill any initiative that might have been used by the staff. Since the task are all defined to be as simple as possible the staff are de-skilled or not allowed to use any initiative and the managers award themselves a pay rise, so the gap between the lowest and highest paid reaches its current obsene level.

We now have a situation where most people work down to their station rather than up to their ability. We have a huge workforce in security and no one is allowed to use their own initiative beyond their management defined protocols as they pour time into producing KPIs so that they can be checked up on. Management has created immense overheads, even on top of their own inflated salaries. And no one can figure out why productivity growth is stalled! More trust is one solution. I can think of others.

2022: The year our trust was abused to breaking point

Ross Gittins Economics Editor SMH

December 14, 2022

As the summer break draws near, many will be glad to see the back of 2022. But there’s something important to be remembered about this year before we bid it good riddance. Much more than most years, it’s reminded us of something we know, but keep forgetting: the central importance of trust – and the consternation when we discover it’s been abused.

Every aspect of our lives depends on trust. Spouses must be able to trust each other. Children need parents they can trust and, when the children become teenagers, parents need to be able to trust them. Friendships rely on mutual trust.

Trust is just as important to the smooth functioning of the economy. Bosses need to be able to trust their workers; workers need bosses they can trust. The banking system runs on trust because the banks lend out the money we deposit with them; should all the depositors demand their money back at the same time, the bank risks collapse.

Just buying stuff in a shop involves trust that you won’t be taken down. Buying stuff on the internet requires much more trust. Tradies call on our trust when they demand payment before they start the job.

Our democracy runs on trust. We trust the leaders we elect to act in our best interests, not their own. Our country’s co-operation with other countries rests on trust. Of late, our relations with China, our major trading partner, have become mutually distrustful.

The trouble with trust, however, is that it can make us susceptible. And, as Melbourne University’s Tony Ward reminds us, it can be just too tempting to the less scrupulous to take advantage of our trusting nature.

They can get away with a lot before we wake up. But when we do, there are serious repercussions. Much worse, the loss of trust – some of it warranted; much of it not – makes our lives run a lot less smoothly.

The truth is that, as a nation, we’ve slowly become less trusting of those around us. But this year is notable for events where trust – or the lack of it – was central.

It’s widely agreed that the main reason the federal Coalition government was tossed out in May was the unpopularity of Scott Morrison. The Australian National University’s Australian Election Study has found that the two most important factors influencing political leaders’ popularity are perceived honesty and trustworthiness.

Its polling showed Morrison 29 percentage points behind Anthony Albanese on honesty, and 28 points behind on trustworthiness.

By contrast, many were expecting Daniel Andrews to be punished at the recent Victorian election for the harsh measures he insisted on during the pandemic. It didn’t happen. We don’t have fancy studies to prove it, but my guess is he retained the trust of the majority of voters.

The ANU study always asks questions about trust in government. This year it found 70 per cent of respondents agreeing that “people in government look after themselves” and only 30 per cent agreeing that “people in government can be trusted to do the right thing”.

This helps explain why the federal election was no triumph for Labor. The combined primary vote for the major parties fell to 68 per cent, the lowest since the 1930s. Labor’s own election report explains this as “part of a long-term trend driven by declining trust in government, politics and politicians”.

Related Article

Jessica Irvine

Senior economics writer SMH

Ward reminds us of the benefits of a high level of trust. It reduces “transaction costs” – the cost of doing business. “Profits and investments are higher if you don’t have to spend lots of time and money checking whether other parties are honest or not,” he says.

“People invest more in their own education if they believe a fair system will reward their efforts. If you think the system is rigged, why bother?”

Comparing countries, economists have found strong links between more social trust and higher levels of income. Trust is one of the top determinants of long-term economic growth.

And high-trust societies, with less distrust of science, had better outcomes in tackling COVID. That’s one respect in which we didn’t do too badly this year.

16/12/2022

A Scientific Approach to Conspiracy Theories

16 December 2022

It seems that alienation and feelings of impotence increase the likelihood of conspiracy theories.

If this is so, a social policy that lessened economic polarisation might be a good idea.

www.scientificamerican.com/article/people-drawn-to-conspiracy-theories-share-a-cluster-of-psychological-features/

11/12/2022

China Relaxes COVID Zero Policy

11 December 2022

President Xi Jinping has relaxed China’s Zero Covid policy.

One is reminded of King Canute, who wished to show his flatterers that there were limits to his power, so he took them to the seaside, planted his throne on the sand and commanded the tide to come in no further. Naturally it came in and his legs got wet.

President Xi Jinping recently made himself the most powerful man in China since Mao Zedong, but has also insisted on the Zero Covid policy.

As viruses evolve, they usually change to strains that are less lethal but more infectious, which helps them to spread. So trying to go back to zero was almost certainly impossible and the attempt was obviously disrupting Chinese society a lot. It may have been that while Xi was impregnable within the People’s Congress, if his Covid policies totally lost him support in the population change would still occur.

Relaxing the policy is likely to cause a big spike in infections. This will cause a lot of problems as older Chinese are less vaccinated- perhaps only two thirds, though 90% of younger people are. Older folk are therefore more likely to die, particularly as the Chinese vaccines are not quite as good as the Western ones.

From an Australian perspective the improvement in the Chinese economy is likely to help us. We rode through the last global recession, with the Government congratulating itself on our resilience and their wisdom, but the point was that our trade was principally with China, which was not having a recession. If China starts growing again, it may help us a lot. Hopefully this time, if things go well, we will take an opportunity, rather than just handing out tax cuts to the rich.

https://www.pbs.org/newshour/world/china-relaxes-covid-restrictions-braces-for-wave-of-infections

07/12/2022

Brittany Higgins trial shows that legal system is not fit for purpose

7 December 2022

Everyone is aware that the Brittany Higgins trial was abandoned as some material was found in the jury room which showed that a juror had researched information on false memories. Jurors are specifically not allowed to look at material outside the courtroom, presumably so that their judgement can only be based on information from that source.

The ACT Director of Public Prosecutions was going to have a re-trial with a new jury, but the trial was abandoned because of the state of Brittany Higgins’ mental health.

I had spoken to some barristers who were of the opinion that the prosecution should never have been attempted because she could never win because no one would be convicted when it was one person’s word against another. This was demonstrated in the High Court decision when Cardinal Pell was accused of sexually molesting two boys, one of whom had suicided. It was the surviving boy, (now man) v Pell, so Pell was acquitted.

I spoke to a retired prosecutor who disagreed with this. He said that the accused, Bruce Lehmann, had been ‘very well advised’. Lehmann stated that there had been no sexual contact; he had merely retrieved some documents and left the building. This meant that there would be no argument over ‘consent’ and he would not have to go in the witness box. My prosecutor said that the circumstantial evidence was that Higgins was found naked and distressed in a foetal position on a couch and it was unlikely that she would have simply taken off her clothes and adopted this position for no reason, so the trial had a reasonable chance.

But because Lehmann was not giving evidence and Higgins had to make the prosecution case, she was the one effectively on trial with a hostile defence barrister.

Unsurprisingly this was very traumatic. Whether she had done enough to convince the jury will never be known as the trial was aborted by the judge. But she was not in any mental state for a retrial, which presumably would have followed the same course.

Her lawyers will apparently sue her employer and she will presumably only have to prove this on the balance of probabilities.

Lehmann plans to sue the media for defamation, and presumably hopes either to repair his reputation or at least recover some settlement monies.

But the obvious conclusion is that if you are raped in Parliament House, it is not worth trying to pursue justice. As my father told me as an adolescent, ‘Avoid the Courts son; you will get law, but you will not get justice’.

Here are some references, with a ‘w’ missing, except for Jacqui Maley’s SMH article.

ww.abc.net.au/news/2022-12-02/bruce-lehrmann-rape-charge-to-be-dropped-brittany-higgins/101725242
ww.smh.com.au/politics/federal/media-alleged-that-bruce-lehrmann-assaulted-other-women-court-20221202-p5c39n.html
ww.canberratimes.com.au/story/8010840/bruce-lehrmann-preparing-defamation-action/?cs=14264
www.smh.com.au/politics/federal/the-brittany-higgins-matter-is-closed-has-anything-really-changed-20221202-p5c3b4.html

03/12/2022

Children in Care- a Brief History

3 December 2022

One summer evening when I was still a medical student, I was strolling with friends through a festival with stalls and lights in Hyde Park. A young woman approached me and said “I’m a ‘Hookah for Christ, will you come with me?”, and handed me a leaflet. She was a few years younger than I and one of the most stunningly beautiful women I have ever seen. I paused, somewhat shocked, and wondered how much Christ and how much hookah was in this Goddess incarnate and whether I should follow her path to enlightenment. My girlfriend reappeared at this point and was very definitely of the opinion that I should not.

Some years later, in 1992, I had further cause to rue this ignorance as DoCS (Department of Community Services) were involved in a court case with a sect called the ‘Children of God’, who, it was alleged, had used young girls sexually to recruit members for their cult. The sect maintained that the term ‘Hookahs for Christ’ was merely a rhetorical device. The sect had expensive lawyers and won the case , though there was considerable public doubt about the freedom of cult members. DoCs was highly criticised over the case and the Premier, Nick Greiner, cut huge number from its middle management.

Neo-liberalism was new at that time, and his slogan was ‘Putting people first by managing Better’, which was in itself reflected an attitude of the time that managers knew better than those who actually did the work. A contemporary management slogan was ‘If it ain’t broke, don’t fix it’, which tended to translate into ’Don’t spend any money on prevention, as it might not break’. Money spent supporting families has trouble showing big returns on management KPIs. The NSW Public Service was being massively downsized and there are some of the view that DoCS has never recovered from this downsizing, as human organisations rely on human knowledge and if there are just generic managers and new recruits, there is not enough corporate memory and experience to handle cases.

In 1999 when I was in Parliament, I was approached by a number of people telling me that DoCS was failing children at risk. The children with dysfunctional families from drug abuse, alcohol or domestic violence were not getting home support, and the initiation and supervision of fostering arrangements were poorly executed. I tried to set up an inquiry into DoCS. I had a number of NGOs speak to the cross bench. I had to get enough numbers so that there was a majority in the upper house. One of the groups suggested that the UN treaty on the Rights of the Child be a term of reference. This seemed reasonable, but Fred Nile said that he and Elaine would not vote for the inquiry if this was in the terms of reference. Richard Jones said he would not if it was omitted. I needed both of their votes to be sure of the numbers. I thought Richard would fold if I left it out- I was pretty sure Fred Nile wouldn’t. The Liberals, who were in Opposition at the time, were generally up for anything that would embarrass the Labor Government. I asked if they would support it, and told them that if Richard Jones changed, we had the numbers. They said, “We are a serious political party. If you cannot guarantee the numbers, we will not support you”. I regretted telling them about Richard and I did not move the motion. 21 months later the Liberals decided to support the idea, and approached me to amend my motion slightly, which initiated an inquiry (10/4/2002) .

The 2003 Inquiry found that DoCS was indeed dysfunctional . It had contracted out quite a lot of work to charitable NGOs without them having either the funds or the expertise to deal with difficult cases. Huge resources were spent monitoring wayward adolescents to keep them out of the criminal justice system until they reached 16, after which DoCS were not legally responsible for them. Cases did not have much preventive work done or decisions made and tended to stay on the desks of managers ‘unallocated’ until there was a problem . When there was a crisis or the matter went to Court, a relatively junior DoCS person would be allocated the case and have to face a crisis situation. The plans given to the Children’s Court for approval were hastily cobbled together at the last minute, often by new case managers who had only just got the brief. The Government had introduced ‘mandatory reporting’ with a phone and fax Helpline. This meant that there were huge numbers of reports, and huge efforts dealing with multiple reports on the same child or situation, but the call centre gobbled up resources that would have been better spent actually managing cases. The government was reluctant to get rid of the mandatory reporting ’Helpline’ as it was supposed to force schoolteachers etc. into reporting cases, which would leave no stone unturned. The function of DoCS seemed more concerned with appearances than reality and it got a lot of negative press.

Behind all this was the Children’s Court, where the conscientious Senior Magistrate, Scott Mitchell, was about the only quality control on the Department as he insisted in fulfilling his legislated role of ensuring that there was a realistic plan for children placed into custody of relatives or foster homes.

The Minister for Community Services, Fay Lo Po was sacked as was the head of DoCS, Carmel Niland. Neil Shepherd, who had been Deputy Director of the Cabinet Office and Health of the EPA replaced Niland. The Labor government promised a billion dollars over 10 years (most towards the end of the 10 years). Prevention was addressed with a new program, Brighter Futures, but the key problems remained with lack of action on 21% of cases noted by the Helpline, so there was another Special Commission into Child Protection Services in NSW in 2008 by Justice Wood , (who had achieved fame because of his work on Police corruption and paedophiles in 1997 ). Wood was helped by DoCS officers and one of their complaints was the stress that the Children’s Court put them under when they had to front up to Scott Mitchell with their child management plans. The report recommended weakening the power of the Children’s Court, and Scott Mitchell was disposed of by appointing a new President of the Children’s Court, who was to be a Judge- a level higher than Mitchell, who would have had to apply for the promotion that he was not going to get. On 1/9/2009 Attorney-General John Hatzistergos appointed Judge Mark Marien the new President , claiming he was strengthening the Court as he expanded on the new Judge’s CV, which lacked anything relating to child welfare.

An academic researcher, Katherine Macfarlane, noted that even in 2015 there was no data collected on how many Australian children in Out of Home Care ended up in the criminal justice system. She termed it ‘Care Criminalisation’ and noted that this data is collected in other jurisdictions .

It would seem that DoCs, which had a name change to Dept. of Family and Community Services (FACS) and then in 2019 came to be part of the Dept. Communities and Justice, still has its problems .

A report in the Sydney Morning Herald on 28/11/22 noted that a private contractor, Lifestyle Solutions, had subcontracted a child’s care to another subcontractor, Connecting Families and the children in question could not go to school as they were too cold without a winter uniform, despite the payment of $77,000 per month to the contractors to look after them . The Office of the Children’s Guardian has not accredited the Dept of Community and Justice Western NSW District to look after the 547 children in its care as it did not ‘meet the requirements‘ in the frequency of visits and that it had ‘limited evidence to demonstrate the district’s support for children’, its record-keeping was inconsistent, and its work in keeping in touch with families came in for questioning .

The Department has never been run properly. One of my minders in Parliament had worked there and spoke of the immense stress of going to Court almost unbriefed or accompanying Police to take children from the parents to foster homes. One of my patients who is an upper-middle level case manager has been off work on stress for 14 years, with no serious effort made to rehabilitate her.

But when there is no public housing, rents are unaffordable, welfare payments are insufficient to survive on, day care is expensive, Aboriginals are becoming increasingly isolated from both mainstream Australia and their own community leaders, ‘choice’ and subsidies have left poorer public schools as ghettos of disadvantage, inflation is rising and services are now for profit, it is hardly surprising that things are not going well. Anyone trying to put together a stable social situation for a disadvantaged family would struggle without these basic elements.

Society’s systemic problems need to be addressed if we are to return to the halcyon Aussie concept of a fair go.

https://www.smh.com.au/national/nsw/left-hungry-and-too-cold-to-go-to-school-urgent-review-of-children-in-care-20221127-p5c1kr.html

27/11/2022

Robodebt- an ongoing saga

25 November 2022

Robodebt involved looking at the tax records of welfare recipients over a year, and then demanding money back from them over their year’s income. The Social Services Act specified that their income should be calculated fortnightly. Many people, particularly unemployed and disadvantaged ones, live from week to week, and don’t keep good records for tax purposes, as mostly they do not have enough income to pay tax, or the tax is already deducted from their income before they get it. So when a computer algorithm stated that they owned money to the Taxation Dept. and they had to prove that they did not, they were in no position to dispute this and the money was automatically taken from their already meagre welfare payments.

It seems that a number of public servants told the government that the process was neither wise nor legal, but it went ahead anyway.

This was in sharp contrast to the JobKeeper scheme, where businesses could estimate the costs of keeping their staff and be reimbursed. The JobKeeper legislation was modelled on New Zealand legislation, which had ‘claw-back’ provisions if businesses were overpaid. So the government did not ‘forget’ the claw-back provisions, they actively deleted them from the template.

It is difficult to see these actions as anything other than an ideological, punitive approach to people on welfare combined with a willingness to overpay those were approved of. It is difficult to see the Morrison government except in the light of rewarding friends and punishing people that were not approved of. The exemption of university academics and the performing arts from JobKeeper is further evidence of this proposition.

Since one of the significant public servants has now died, it may be that there will be no answer as to who is responsible for the Robodebt fiasco, but this maladministration has immense consequences for those denied income, with a number of suicides linked to the stress.

We can only hope that our arcane legal system will find a crime was committed and that someone will be charged and found guilty. What is more likely is that there will be shared responsibility, ministerial discretion, people in charge protesting their unawareness of the effect of the algorithm, a few embarrassing moments for a few people and nothing substantial happening. I hope I am wrong.

Here is part of the legal saga so far, as told by an ex-public servant.

Robodebt: can you recall a greater failure of public administration?

24/11/2022

iCare- a letter to the Editor of the Sydney Morning Herald

24 November 2022

Dear Editor,
iCare was set up by private insurers on their model with the NSW government keen to minimise costs, take profits and distribute them (just before the last election). So iCare delays or refuses treatments to the needy, and was very careless about what their Pre-Accident Average Weekly Earnings (PIAWE) were. Many accident victims complained that they were underpaid, and that was before their compensation was stopped or cut because they were certified partially fit to do jobs that could not be found.

The overheads of Medicare are about 5%, iCare about 38%, so it is totally inefficient as well as incompetent with bloated salaries for the top executives who think it is a financial problem rather than a medical one and hence are unable to solve it. The real solution would be to fund Medicare as the only medical system and let the insurers have widespread income-guarantee insurance.
Sincerely
Dr Chesterfield-Evans- works as a GP specialising in Workers Comp and CTP injuries.

Here is an article from today’s SMH

EXCLUSIVE
Injured workers to lose benefits
Adele Ferguson

Greg Dayman is one of almost 400 workers who will get a Christmas ‘‘present’’ they will never forget.

The Sydney construction worker was badly injured on a building site in 2013, which left him unable to work with chronic pain in his neck, the side of his head, down his arm, torso and leg.

In 2017 he was among thousands of employees whose compensation payments to cover wages were cut as part of controversial reforms to the state’s scandal-ridden icare organisation. Changes to the legislation terminated injured workers receiving weekly wage benefits after five years unless they met a whole body impairment assessment of more than 20 per cent.
However, he still received medical or health benefits. Now he has found out even these will be cut from December 25.

‘‘It’s another upper-cut,’’ he said. ‘‘And to do it on Christmas Day, that’s just cruel.’’

Dayman is one of 395 workers facing a grim future as a crisis at icare deepens, with a document prepared by the State Insurance Regulatory Authority (SIRA) revealing the workers’ compensation scheme ‘‘has deteriorated to the point the longer-term sustainability of the scheme is under threat’’.

NSW Auditor-General Margaret Crawford will hold a performance audit into icare next year that will examine how effectively key risks are managed, including the rising cost of workers’ compensation claims and its payment processes. Dayman said he lost everything after his injury.

‘‘I lost my health, my career, and financially I’m in a position that if my specs break I can’t afford to buy them. The system dehumanises you, so you give up.’’

He does now qualify for a disability pension but will have to rely on Medicare for future medical treatment. ‘‘I have been suicidal at times because of the system and the way it treats you,’’ he said. ‘‘My time is spent trying to survive.’’

In the executive summary of SIRA’s review into icare’s Nominal Insurer Improvement Plan, dated September 26, the authority said it had a ‘‘low level’’ of confidence icare’s strategy would improve return to work rates and overall performance.

In 2015-16, 93 per cent of injured workers were back at work 26 weeks after their injury, compared with 84 per cent in August 2022.
SIRA said it believed icare’s strategy ‘‘encompasses an increase in work capacity decisions to cease worker benefits instead of focusing on improving health and recovery through return to work’’.
Richard Harding, icare’s managing director and CEO, said it was the insurer’s role to implement the law, and legislation ‘‘does not give icare any discretion to act outside that’’. ‘‘Tailored and individualised support is provided to workers transitioning from the workers’ compensation scheme,’’ he said. ‘‘This may include support from NDIS, Community Support Services and Medicare in conjunction with their GP.’’

This masthead this week revealed a third underpayment scandal of injured workers and concerns raised by NSW Treasury in August that a deterioration in icare’s finances would require insurance premiums to rise 33 per cent by 2025, or $1 billion a year, to cover the shortfall.

Against this backdrop, the icare board granted pay increases to 116 of its executives, including Harding, making him one of the state’s top-paid public servants, earning more than $1 million a year.
Shadow Treasurer Daniel Mookhey said icare’s finances were in a catastrophic condition.

‘‘They’ve lost billions. They are planning massive premium hikes. And their next step is to expel even more injured workers from the system,’’ he said.

‘‘It is a ruthless tactic stemming from their financial desperation.’’
In a statement, SIRA chief executive Adam Dent said its views on the Nominal Insurer Improvement Plan in September were made with limited detail on how the plan would be executed.

‘‘Over recent weeks, SIRA has continued to engage with icare to address information gaps, including detailed briefings on managing IT and transition risks associated with the onboarding of new claims services providers.’’

But SIRA said poor return to work performance continued to be an issue of concern.

‘‘Icare’s targets for 2023 are lower than current return to work rates, and they are projecting a further decline of 2.5 per cent on 26-week return to work rates through 2023 and 2024 as the scheme transitions to new claims providers,’’ Dent said.

Icare said its focus was building injured workers’ capacity for employment using rehabilitation providers and associated vocational placement interventions. ‘‘This includes assistance with job seeking and vocational retraining. Work capacity decision-making is applied when the worker has a demonstrated capacity for work and has been provided the right support.’’
Lifeline: 13 11 14

23/11/2022

British American Tobacco launches new Campaign to legitimise Vaping.

23 November 2022

Almost all the vaping products are owned by tobacco companies, and the marketing is almost a re-run of their tobacco campaigns. i.e:

1. Assume that it is here to stay, and hence legitimate and unstoppable.
2. Suggest that ‘courtesy and consideration’ is all that is needed.
3. Fight regulation as much as possible.

Naturally they are keen to say that any attempt to restrict nicotine is doomed to failure as it is already totally available on the Black Market.

It might be noted that when there were different regulations in Canada from the US for tobacco labelling, cigarettes were smuggled through the Indian reservations, and all labelling that used to allow the source of the cigarettes to be identified was removed from the packaging, which showed what contempt the tobacco industry had for regulations that lessened their sales.

We might expect that similar things are happening in sales of vaping products and liquids. Naturally as they talk about how hopeless it is to regulate vaping products they want to hark back to the failure of alcohol prohibition in the 1930s, which led to Al Capone and his gangsters.

Older folk will remember that as the tobacco control movement grew stronger in the late 1970s we were attacked as ‘wowsers’ and ‘killjoys’, with the implication that we were stopping people having a good time, which was what smoking was all about. It is the same tactic again. We want to stop all the happy vapers.

The tobacco industry used the fact that some doctors think that vaping can help people QUIT to allow them to sell their product without having to prove it was safe. They only had to prove it was less dangerous than tobacco- a very very low bar.

Now vaping is used more as a gateway to smoking than a path from it, and often if there is nicotine in the vape it can be used alternately as a substitute. So presumably will be a move to push vaping in smoke-free areas. Then vaping will be the ideal product for the tobacco industry, being used everywhere, helping consumption, and keeping some people smoking at other times. Just like the good old days.

Health interests have to keep the government onside, but also demand some serious anti-vaping campaigns.

Vaping uses solvents, which dissolve fats. If this is the case, it is like upmarket petrol sniffing, as it will dissolves cell membranes, especially in the brain, which has the highest blood supply of any fatty tissue in the body. This is likely to lead to gradually progressive dementia. Naturally this may take years to manifest, and even longer to be identified and scientifically proven, given that a highly sceptical Industry that will criticise the research; in short a re-run of the tobacco wars.

If we look at the history of tobacco, it was used in relatively small quantities until the invention of the cigarette rolling machine by Duke in 1898. It was massively marketed during and after WW1 from 1914. It was shown to cause lung cancer in 1950. Advertising bans started in the mid 1970s, but full sponsorship bans and smoke-free indoor air did not come until 2000. The tobacco epidemic lasted a full century; so watch out for a vaping re-run with a dementia epidemic in older folk. Unlikely? No;. quite possible. So will the tobacco industry prove it is is safe. They can’t, don’t want to; now don’t have to, and have put out this BS new organisation.

www.theaustralian.com.au/the-oz/news/big-tobacco-company-behind-vaping-overhaul/news-story/1078baf2358e5ba3d96c6235aac49610