Doctor and activist


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Category: Government

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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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Murray-Darling Farce- Another Summit.

19 March 2021

One of the more absurd ideas of neo-liberalism was to privatise ownership of all the water in the Murray-Darling and then rely on ‘the Market’ to allocate the water optimally. All that happened was that water was another commodity to be traded with its price more related to its possible future price than any physical or environmental constraint.

I learned a bit about this many years ago from my grandparents. One of my grandfathers was a retired metallurgist who would tell me about world trends in metal demands and buy shares accordingly. His wife, my grandmother, knew nothing about this but would buy shares based on what the market was doing and tell me separately about how she despaired of my grandfather’s share investments. After a few years, she was much richer than he from a much lower base. The moral was that the share price had little to do with reality.

Why anyone would think that turning water into a speculative commodity would optimise its use is beyond understanding. But that was what happened. Joh Bjelke-Peterson built Cubby dam on the Queensland border and used the water to irrigate cotton, so NSW was behind the 8 ball from the start. NSW cotton farmers used surface water and took water from aquifers with no supervision of their meters. Brokers with mobile phones bought and sold water entitlements, and famously recently a Singapore-based company sold a lot of water rights to a Canadian superannuation fund, who felt that growing almonds (which are heavy water users) would be a good thing to do. (SMH 3/12/19) Hey, the price of almonds is good at present and you cannot smell rotting fish from Canada.

The idea that if you fix the money, everything else will come right seems to permeate every aspect of our neo-liberal, managerial society. I think of it as a religion, that ‘the market knows best and will allocate optimally with the unseen hand’. It also seems that religious folk are more prone to believe this, happier to believe that an unseen force can magically fix things and that it morally worthy to suffer now for some future redemption.

But in politics, we do not even have to debate these things; there is another option, ‘kick the can down the road’. Having the CSIRO produce a report in 2008, ‘Water Availability in the Murray Darling Basin’, led to an inappropriate Murray-Darling Basin Authority report in 2009. The CSIRO’s scientific response in 2011 was ignored. There was a Royal Commission inquiry by Bret Walker which found that the Authority has shown ‘gross negligence’. So they had another ‘Summit’, just last month.

All this is not to mention that Angus Taylor spent $80 million in taxpayer money to buy back water rights from a company called Eastern Australian Agriculture registered in the Cayman Islands and run by an ex-rowing mate, with the deal signed off by Barnaby Joyce. (The Guardian 19/5/19)


It is a worry, when the senior counsel assisting Walker inquiry writes a book called ‘Dead in the Water’ and still comes back with an opinion piece like this.

www.smh.com.au/national/murray-darling-basin-summit-a-laughable-response-to-finding-of-gross-negligence-20210318-p57brq.html

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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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iCare Doesn’t Know and Doesn’t Pay Underpaid workers

7 March 2121

The incompetence of Perottet’s iCare never ceases to amaze.

It underpaid injured workers but was not sure how many. It was initially 240,000. Then it changed its to estimate to 52,000 people underpaid up to $80 million. Then possibly as little as $5 million. In March it is 23,000 and $20 million. They don’t actually know. After 18 months 25 have actually been compensated!!!
This is all treated as some of ‘management error’ as if this makes it OK. These are a lot of abstract words, but few concrete ones. The idea of abstract words is that the concepts can be discussed better. But mostly management words are so general as to be meaningless, and principally serve to make everything non-specific and also euphemistic. No one says, ‘They did not know or care and their incompetence led to immense suffering for the families who were underpaid’. It becomes, ’There was a lack of management understanding and focus and some workers may have been paid less than their entitlement’.
Naturally no one will be punished.
All I know is that even the routine service takes about 3 weeks to get anything done. I had a patient doubly incontinent after a spinal injury. It takes up to 10 working days to get a claim approved, then up to 10 working days for them to approve an MRI and a specialist consultation. This is normal. When they delay things it is worse, and sometimes they refuse to pay at all.
www.smh.com.au/national/nsw/scathing-icare-review-finds-a-need-for-cultural-change-20210301-p576tq.html

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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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