Doctor and activist


Notice: Undefined index: hide_archive_titles in /home/chesterf/public_html/wp-content/themes/modern-business/includes/theme-functions.php on line 233

Category: Constraints

‘Health Policy’

Chesterfield-Evans, A. (2024)

Journal of Australian Political Economy  No. 92, pp. 98-105.

HEALTH POLICY

Arthur Chesterfield-Evans

Just before the 2022 federal election, Mark Butler, now the Minister for
Health in the Albanese government, spoke to the National Press Club,
praising the courage of the Hawke government in creating Medicare in
1984. His speech also set modest priorities for a prospective Labor
government, committing to (1) improve the digital health record and make
the MyHealth record actually useful; (2) develop multidisciplinary care;
(3) establish a new funding model for ‘MyMedicare’; and (4) grow the
medical workforce, with special mention of nurses and pharmacists (Butler
2022). Significantly, Butler did not commit afresh to Medicare as a
universal health scheme free at the point of delivery, the key element of
the original 1984 scheme that he praised. In an environment where,
politically, it seems that taxes cannot be increased, perhaps this ideal may
be an impossibility, but it is surely significant that it is no longer stated as
an aspiration.

Currently, Medicare is quietly dying as the low rebates cause doctors to
abandon it. Australia is moving to a US-type private system by
default. This has resulted in large amounts of hand-wringing rhetoric, but
so far little action. This short article comments on the changes initiated by
the current Labor government during its first year and a half, contrasting
these with the deep-seated problems needing to be addressed if better
health outcomes are to be achieved.

Labor’s reforms

The government has made some minor changes to Medicare which came
in with great fanfare on November 1, 2023. There were new item numbers

for new specialist technologies or treatments and an increased Medicare
rebate for GPs, up to $41.40 for a standard visit for a RACGP member,
which is 40.6% of the AMA fee. Doctors without the RACGP qualification
still get $21, which is 20.6% of the $102 AMA fee.

When Medicare was born, the Medicare rebate was 85% of the AMA fee.
The rebate has risen at half the inflation rate for 39 years, so doctors now
feel ripped off every time they see a Medicare patient. Labor blames the
disparity on the rebate freezes of the previous LNP Coalition governments,
but its own record is poor. Successive governments of all types have
deferred to the private health lobby and are starving Medicare, slowly
defaulting towards a principally private system, as in the USA. This is a
deeply-troubling prospect because the US health system has been
recurrently criticised (Commonwealth Fund 2021) – and rightly so –
because it makes access to health care dependent on ability to pay. Notably,
however, it is the world’s best system at turning sickness into money.

The other recent Labor ‘reform’ was to allow pharmacists to process
prescribed medications to cover patients’ requirements for 60 days, rather
than 30 days, thereby halving the costs of prescribing and dispensing.
While this may seem helpful, patients are often confused by complicated
generic names and generic brands; and compliance or discontinuation of
medicines is a largely unquantified problem. These are existing problems
with the current arrangements for dispensing medications: the recent
policy change, while well-intentioned, does not redress them. It transfers
resources from professional staff to the pharmaceutical industry.

The ‘Strengthening Medicare Taskforce’ had good medical and allied
health representatives and support. Its December 2022 report defined the
problems but, trying to avoid controversy, positive suggestions were thin
on the ground. A deeper analysis and more comprehensive approach to the
redress of health issues is needed.

Basic problems in the health system

Diverse funding sources causes cost-shifting

Fundamentally, no-one is in overall control of the health system. It has a
number of different funding sources: the Federal and State governments,
the Private Health Insurance industry (PHI), Medicare and individuals

themselves. Workers Compensation (WC) and Compulsory Third Party
(CTP) insurers also put in a bit. These arrangements lead to a situation
where each funding entity attempts to shift costs without any real care for
the overall cost of the system. Private entities such as pathology and
radiology also have an interest in providing more services, whether they
are needed or not.

The broad division of the health system is that public hospitals and
emergency departments (EDs) are State-funded, and non-hospital services
are Federally, PHI or self (patient) funded. There is some overlap,
however, because the State’s provision of some community-based services
allows them to save on hospital-bed days; and private funds paid to State
hospital in-patients are eagerly sought. The starvation of Medicare (which
reduces the Federal government’s spending) has resulted in more patients
going to EDs at higher (State) cost, as well as increasing PHI and patient
costs.

This cost-shifting has evident implications for the affordability of health
care: notably, a recent study showed that Australia, when compared to 10
other countries, scored poorly on its measure of affordability
(Commonwealth Fund 2021).


A new health paradigm is needed

Yet more fundamentally, there is a huge problem with the conceptual
model of the health system. In common parlance, the ‘health system’ is the
‘paying to treat illness’ system. Paying doctors to see and treat patients is
seen as the major cost and is the most politically fraught element in the
system.

Historically, everyone was assumed to be healthy and had episodes of
either infectious diseases or surgical problems. They went into a hospital
for a brief period and either recovered or died. The legacy of this is that
heroic interventions are over-resourced and the more cost-effective early
interventions are under-resourced.

Infectious disease is now relatively uncommon, notwithstanding the recent
and ongoing coronavirus concerns. Most disease is chronic; and the
objective is to maintain health for as long as possible and to support those
who need support in the community rather than in institutions. ‘Health’
must be re-defined as a state of physical and mental wellbeing; and
maintaining it as ‘demand management’ for the treatment system.

Life-style diseases of diet, obesity, smoking, vaping, alcohol, drug-use and
lack of exercise need attention. It might be commented that these habits
are more determined by the political economy of the products than by any
health considerations; and the government should intervene to re-balance
this market failure.


Hierarchies, cartels and corporatisation

The medical system is hierarchical with specialists at the top and GPs at
the bottom. The specialist colleges have produced less practitioners than
would have been optimal. The starvation of General Practice has led to
increasing specialist referrals for simple procedures. Most patients are
happy to go along with this, though often much less happy about the rising
costs. Practitioners tend to work down to their station rather than up to
their capacity. GPs, if given the appropriate additional education and
empowered to act, could do what quite a lot of specialists do now, while
nurses could take the load from GPs; and, in terms of home support, a more
comprehensive and flexible workforce needs to be developed.

Private medical insurance systems are a further source of problems. They
have marketing, churn, profits, liability and fraud issues; and they make it
necessary to account for every item of every procedure. While the
corporations watch every cost, the regulator cannot. Corporations buy
medical practices and take up to 55% of the gross revenue. Smaller
radiology practices are being gobbled up as investments (Cranston 2020).
If overheads are defined as the amount of money put in compared to the
amount paid for treatments, Medicare costs about 5% and PHIs, as they
are regulated in Australia, about 12%. In the USA, the private health funds
take up to 35%, and Australia’s CTP system got close to 50%. A universal
health insurance system could avoid many of these costs and would be far
superior from a social equity point of view.

Similar problems are evident in the provision of care for people with
disabilities. Labor pioneered the NDIS when last in office a decade ago,
and rightly claims this as evidence of its commitment to redress the
previous neglect. However, the NDIS can be considered as a privatisation
of the welfare system. It overlaps medical system functions and is poorly
regulated. If its efficiency is judged by the percentage of money put in that
is paid to the actual workers delivering the service, care is not very

efficient. There have also been significant criminal rip-offs (Galloway
2023).

Retirement care arrangements have major flaws too. Aged-care
accommodation is largely driven by the real estate industry; and access to
continuing care is an add-on of often dubious quality.

What should the government do?

The problems described above are diverse, deep-seated and not easily
rectified. However, a government intent on staying in office for a series of
terms could heed the call for some big thinking, drawing on the experience
of health practitioners themselves. Here is a list of what might be done,
becoming more medical and more politically difficult as it progresses:

Keep people healthy with education, clean water, sanitation, housing,
good food, regular exercise, high vaccination rates, road safety,
universal swimming lessons, CPR and first aid training and the active
discouragement of smoking, vaping, alcohol and drug use, junk food
and gambling.

Provide housing with graded community support options for those
people with disadvantage or impairment. Create a registration and
insurance system for home and community support services, so that
individuals can buy standardised services from other individuals.

Maintain fixed staff-patient ratios related to the disability
classification of residents in institutional care.

Make maximum use of community and school interventions and
support services such as District and Community nurses and School
nurses, mental health support networks, Aged Care Assessment
Teams, Hospitals in the Home etc.

Address health problems as early and as low down the support and
treatment hierarchy as possible, by empowering those who provide
the services.

Create a meaningful regulatory, inspection and enforcement system
for support services, both community and residential, and for
workplaces and recreational facilities.

Use the medical information system to research drug and treatment
effectiveness.
Support General Practitioners and try to increase their ability to solve
problems without referral. Have GPs work in Health Centres with
community support workers as far as possible; and improve
communication with data collection a by-product of normal work, not
an additional imposition.

Have independent evaluation of the numbers needed in the specialties
and pressure the colleges to provide these numbers. Use waiting times
as an initial index.

Initiate either university-based or college-based continuing medical or
professional education, with mandatory refresher exams every
decade.

Have universal professional indemnity insurance, with doctors and
other health professionals unable to be sued if they report all incidents
of sub-optimal outcomes within 48 hours of becoming aware of them,
and participate in regular quality control meetings.

Publicise and promote organ donation, end of life plans, wills and
enduring powers of attorney as sensible steps in life-management.

Evaluate Intensive Care interventions in QALY (Quality-Adjusted
Life Years) terms, researching their outcomes and comparing them to
earlier intervention initiatives.

Change the composition of the Pharmaceutical Benefits Advisory
Committee so that it has no pharmaceutical industry representative on
it; and remove ministerial discretion from its decisions. The previous
system evaluated new drug listing approvals with a cost-benefit
analysis (Doran et al. 2008), but the Howard reforms of 2007,
following the Australia-US Free Trade Agreement and lobbying by
Pfizer, put a drug industry representative on this committee, making
its negotiations more transparent and thus more difficult for the PBS
to negotiate prices (Access to Medicine Working Group 2007).

Work towards replacing Workers Compensation and CTP insurance
schemes with income guarantee schemes (this will only be possible
when Medicare allows timely treatment).

Create a credible and indexed scheme for paying medical
professionals which does not have KPIs that distort performance.
Make Medicare a universal taxpayer funded health system that is free
at the point of delivery and stop subsidising PHI. It might be noted
that the Government currently quotes Medicare and PHI costs
together as a sum rather than itemising the two, which serves to
disguise the subsidy to PHI (Parliament of Australia 2022).

Conclusion
The current federal Labor government has made statements about health
policy reform and done minor tinkering during the first year and a half in
office. Based on this start, it is doubtful that it will have the courage to
make the necessary major changes, addressing the systemic problems.
Fine rhetoric is unlikely to achieve much. That makes it doubly important
to develop proposals for more fundamental reform. Written with this
intention, the suggestions made in this article could be the basis for
tackling the fundamental institutional and political economic issues
problems associated with personal and societal ill-health.

Dr Arthur Chesterfield-Evans trained as a surgeon in Sydney and the UK
and is a Fellow of the Royal College of Surgeons. He currently works as a
GP with interests in workers’ compensation and third-party injury. He has
been a tobacco activist and an elected member of the upper house of the
NSW Parliament. He has Master’s degrees in Occupational Health and in
Political Economy.

chesterfieldevans@gmail.com

References

Butler, M. (2022) ‘Address to National Press Club, 2 May,’ available:

www.health.gov.au/ministers/the-hon-mark-butler-mp/media/minister-for-health-and-aged-
care-speech-national-press-club-2-may-2023.

Commonwealth Fund (2021) US Report, available:
www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-
reflecting-poorly.

Cranston, M. (2020) ‘Radiology enjoys a post-virus buying boom’, Australian Financial
Review, available: www.afr.com/policy/economy/radiology-enjoys-a-post-virus-buying-
boom-20201106-p56c7k.
Doran, E., Henry, D., Faunce, T.A. and Searles, A. (2008) ‘Australian pharmaceuticals policy
and the idea of innovation’, Journal of Australian Political Economy, 62, pp. 39-60.
Galloway, A. (2023) ‘Federal crime syndicates using cash vouchers and gifts to steal NDIS
funds’, The Sydney Morning Herald, available: www.smh.com.au/politics/federal/criminal-
syndicates-using-cash-vouchers-and-gifts-to-steal-ndis-funds-20230414-p5d0ma.html.
Parliamentary Library (2022) Health overview, available:
www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/p
ubs/rp/BudgetReview202223/HealthOverview.
PBS (2007) ‘Access to medicines working group’, available: www.pbs.gov.au/info Access to
Medicines /general/working-groups/amwg/amwg-jul-2007.
Sax, S. (1984) A Strife of Interests: Politics and Policies in Australian Health Services,
Sydney: George Allen and Unwin.
Searles, A., Jefferys, S., Doran, E. and Henry D.A. (2007) ‘Reference pricing, generic drugs
and proposed changes to the Pharmaceutical Benefits Scheme’, Medical Journal of Australia,
187(4), pp. 236-39.
Strengthening Medicare Taskforce (2022) Taskforce Report, Commonwealth Department of
Health, available: www.health.gov.au/sites/default/files/2023-02/strengthening-medicare-taskforce-report_0.pdf.
Continue Reading

Secularism Australia Conference 2023

3 December 2023
I attended the Secularism Australia Conference on 2/12/23 at the NSW Teachers Federation in Sydney.
There were some interesting features:

Sponsors
There were a number of sponsoring groups, which cooperated to put it on. They were the NSW Teachers’ Federation, the Secular Assoc of NSW. Humanists Victoria, National Secular Lobby, Rationalist Society of Aust, Plain Reason and Humanists Australia. This seems a new level of cooperation, which is encouraging to see.

The Big Picture
Ex-Senator Chris Schacht drew attention to the 2021 Census which had 93% answer the religion question and a very large rise in the ‘No Religion’ percentage:
No Religion 38.9%
Christian 43.9% (Catholic 20%, Anglican 9.8%)
Not Stated 6.9%
Islam 3.2%
Hindu 2.7%
Buddhism 2.4%

It is also noteworthy that younger age groups are less religious with the 15-24 age group at 45.6% and 25-34 at 48.4%. Chris said that the political system and its patronage had in no way responded to this change and that it was necessary that they be forced to do so by more effective advocacy.

He said that a key problem was the reluctance of both Federal and State governments to reveal the true cost of the subsidies to religions. They get huge grants, pay no tax from their activities, not all of which may be charitable, and also have huge tax exemptions from State land taxes and Council rates. It would take quite an effort to get the full total of this, but it seems that neither Federal nor State gover\nemtns of both major parties do not want to draw attention to the issue. That is without considering aspects like private school funding, which is subsidised inequity. One politician when challenged said, ‘I have a 4% margin in my seat, and if I upset the Churches, it might be enough to change that’. Chris points out that if the ‘no religion’ votes were mobilised, it would certainly counter that fear, but most politicians have not considered the matter. And the ‘no religion’ voters have not demanded the end to these subsidies and unquantified tax lurks.

Senator David Shoebridge (whose speech is on his Facebook page) pointed out that there are 15,000 charities who receive government funding of $24 billion in addition to any tax-deductible donations. This is mostly for contracts for hospital or aged care services, but under legislation by Gillard they do not have to produce reports of how the money is spent!

School Funding
In terms of the Federal Government’s response to funding schools, Whitlam wanted a needs based formula and Gonski in his original report was similar, but the Schooling Resource Standard (SRS) formula under Turnbull was that 80% of Federal money went to private schools and only 20% to public. Chris hoped to change the formula. The slogan should be ‘Excellence through Equity’ not through ‘choice and competition’, which has manifestly failed as Australia tumbles down the OECD Education rankings. Sadly the current Federal Minister of Education, Jason Clare, was photographed with the Parliamentary Friends of School Chaplaincy.

Religion and the Constitution
There was quite a lot of interest in the legal history, with Michael KIrby ex-Justice of the High Court and Prof Luke Beck an academic. The question was whether the government could support religion as the Constitution specifically forbids the government from having an official religion as discriminating on the grounds of it. There had been a prosecution of a Seventh Day Adventist (SDA) in 1894 for illegally working on a Sunday, and he had unsuccessfully argued that their Sabbath was on Saturday and he needed to work on Sunday. The guilty man was fined two shillings and sixpence (=25c) or two hours in the stocks. He chose two hours in the stocks, but it turned out that there were no stocks available and there was a bit of a fuss that the government declined to make any. SDA lobbying may have been the reason that the prohibition on the government sponsoring a religion was included in the Constitution. The precedent of course was the “Church of England’ set up by Henry VIII so he could divorce his first wife. Henry Parkes, the father of Federation did not want any mention of religion in the constitution, but the mainstream churches insisted, so it is mentioned, but not given any practical grounds to empower religious institutions.

When state money was first given to Church schools the Council for the Defence of Government Schools (DOGS) took a case to the High Court that it was unconstitutional to favour a religion. The High Court, whose members mostly came from private schools, ruled against the DOGS, Kirby himself writing a dissenting judgement. He wondered what would happen if the DOGS case were re-litigated today.

Religion and the Radical Right
Chrys Stevenson, a freelance researcher spoke on Christian Dominionism. These folk want a theological world where the second coming of Christ will be when there is a (Christian) God on the top of every mountain on every continent. I was inclined to think that this was crazy stuff, but it seems that huge amounts of money from the Right of US politics links to very conservative Christianity through the Atlas network, the Tea Party Movement and Charles Koch (22nd richest man in the world at $US 60 billion), There are quite a lot of ‘Think Tanks’ funded by these groups. It seems that a preoccupation with letting God fix things aligns quite well with unfettered market capitalism. There have been very successful efforts to put more religious people in political parties, particularly the Right wing evangelicals into the Liberals. The links between the religious Right and the US Republicans are well known. The Labor Party has a lot of Catholics. Chrys wonders if the religious nutters are ‘useful idiots’ for the Right. It may be crazy stuff, but I am less sure that it is irrelevant stuff.

Religious Education in State Schools
There was quite a lot of discussion of religious education in State schools. The National School Chaplaincy program was an idea of Peter Eawlings, taken up via Greg Hunt, Julie Bishop and John Howard. It had been previously called CHIPS (Christians Helping in Schools), but with the new funded program the new name for Chaplains became ‘Student Wellbeing Officers.’ Maurie Mulheron the ex-President of the NSW Teachers Federation noted the lack of qualifications of those delivering religious education in schools, which had increasingly been done by volunteers with a trend towards evangelicals as the only people willing to do it. They see it as an opportunity for recruitment. Bill Browne of The Australia Institute surveyed Chaplains on their knowledge of the National Student Wellbeing Program, which replaced the National School Chaplaincy Program. He asked 50 questions. 71% of Chaplains had not heard of the program, 10% were unsure, and 20% had heard of it.

Most schools had struggled to find alternatives to the Chaplains, and kids who stayed away for a free ‘do nothing’ period tended to be hard to get back to a school focus.

Prof Anna Halafoff had surveyed children 13-18 and found that 52% had no religion, as opposed to 45% in the 2021 census of 15-24 year olds.

A Western Australian teacher said that there was a preoccupation with Christianity, but she was concerned that girls in Muslim schools have to have their menstrual periods recorded as they cannot go to the mosque, which is a significant infringement of their privacy and human rights. She tweets under infidelnoodle.

Ron Williams had challenged religious education in schools under Section 51.23a of the Constitution, pointing out that $1.47 billion was spent on it since Howard initiated it, and that funding of $61 million a year was locked in until 2027. Albanese increased it to $307 million! Williams had run out of money so ran the case himself and lost in the High Court.

There is a group called FIRIS, (Fairness In Religion In Schools) run by Steven Cowgill and Craig McLachlan. The slogan is ‘Teaching not Preaching’. There is a similar group, ‘Queensland Parents for Secular State Schools’. It was felt that the teaching of religions should be by qualified teachers who would explain that there were diverse views with the object of increasing understanding and tolerance as well as ethical values.

Chaplains in the Military
Collin Acton was the former Director of Chaplaincy in the Royal Australian Navy. He pointed out that there needs to be reform of the Aust Defence Force (ADF) Chaplaincy service as the only training that the Chaplains have is a theology degree and there are a lot of problems in the ADF, PTSD being a major one. He wanted secular Chaplains, but the Religious Advisory Committee of the ADF targeted him and he was forced out. (There is a story about this on the Rationalist website). There are 150 full time Chaplains and 150 part-time ones, and all of them were Christian. The Navy changed this in 2017 and now has 2 Buddhists, 2 Islam and a Hindu. The British Ministry of Defence has its first 3 non-religious pastors! Acton points out that the major social divide in the ADF is between the military and the civilians. The Chaplains are embedded within the ADF so can be visited easily and without attracting attention. Seeing a counsellor or psychologist outside the military is likely to be noticed and may impact adversely on promotion prospects, so the existing chaplaincy service has an immense advantage.

Religion in Parliamentary and Council Governance Rules
There was quite a lot of discussion about the extent to which religion had embedded itself in society. Some politicians found it offensive that the Lord’s Prayer was said at the opening of Parliament every day, and absented themselves as I had while it was read. It is an opinion that since the Constitution forbids Parliament to make laws that favour any religion, the reading of the Lord’s Prayer is unconstitutional, but it has never been challenged, so the practice stays.

A local councillor from Boroondara in Victoria, Victor Franco, had challenged reading the prayer in his Council, which was in their ‘Governance Rules’. He pointed out that in the census 47% of his community were non-religious, 40% were Christians and 10% were the rest. He wrote to other councillors who still did not want to change. He said that he was going to mount a legal challenge with Prof Luke Beck and Morris Blackburn lawyers. A call for public submissions had 86% anti-prayer, and the Council caved in.

He had compiled some interesting figures of how many councils have prayers:
NSW 72/129 56%
Victoria 42/79 53%
Qld 35/78 45%
WA 11/137 8%
SA 23/70 28%
191/522 37%

He commented that because his Council caved in there was no test case that clarified the matter, and that it might have affected State and Federal Parliaments also.

Conclusion
The conference was felt to have been very successful in that a number of groups had come together to organise it.
It was intended to hold more conferences, regularly and in different States to draw attention to Secular issues and the anomaly of funding religions.
The huge rise in ‘no religion’ was felt to have been ignored and there was a large need to educate the politicians that the religious subsidies, tax exemptions and lack of financial reporting were no longer acceptable.
There was pressure on the politicians present to get the figures as to the extent of subsidies, which they conceded was necessary. All three present, Chris Schacht (retired Labor Senator), Senator David Shoebridge (Greens- NSW) and Abigail Boyd MLC (NSW Greens) said that they had tried without huge success, but would try again.
At an individual level, we need to get our voices heard!

Continue Reading

Hospital Crisis is just part of the story.

6 November 2023


The hospital crisis is partly because General Practice has been so downgraded that more cases go to hospital than need to. The Federal government starving Medicare has a number of consequences:
Many GPs are simply retiring and there are no enough new ones taking their place, so we are getting towards a serious shortage
GPs cannot survive on the Medicare rebate, so now charge a co-payment.
Since Emergency departments are free, people wait until the situation gets worse then go there.
Emergency Depts are about 6 times the cost of GP visits, so the total cost of the Health Care system rises.
The other part of the Federal government starving Medicare is that the State governments pay for the emergency departments, so it is a case of the Federal government saving money by making it a lot more difficult for the States.
But an overriding fact is that Australia has been convinced by the neo-liberals that tax is a bad thing and government spending must be a small percentage of GDP. Currently this is about 38.4% of GDP, slightly less than the USA, which has very poor welfare and health systems. This means that the governments cannot actually afford to do anything, and behave like a corporation, cutting employee wages and making cuts wherever it thinks no one will notice, or it has the power to do so. Now if Labor ever tries to raise taxes, the Liberals, who are great exponents of small government accuse Labor of being ‘tax and spend’, and Labor, rather than have a serious debate merely retreats. The fact that he Scandinavian countries have government as close to half of GDP and have their citizens much better off never gets mentioned. Denmark is at 49.9%, Germany 49%, Finland 54% and France at 54%. The UK is at 45%.
We now have a failing GP sector, a problem in aged care, a shortage of nurses, paramedics on strike, a hollowed out public service that merely awards its former tasks to private sector operators that it cannot even monitor and Australia falling down the World educational standards table is not a coincidence. The governments have a virtual monopoly of these jobs. They have deliberately let wages fall, so that now people simply will not do them.
We need to stop privatising, rebuild that public sector so that it can deliver services that we need. Profit is merely another unnecessary overhead. We need to decide what needs to be done, and raise enough tax to pay the people to stay in their public service jobs. Education, health and aged care do not need a ‘market’ to function/. If one exists for comparison purposes, that is fine, but there is no actual virtue in having most of the services delivered by corporations that have the choice of good service or good profits. It is a con, and it is time we forced the government to give us Medicare and a health system that actually works for all, and education for all.
Here is a letter from my Medical partner in today’s Sydney Morning Herald.

The horror stories now emerging about overloaded public hospitals, ambulances and emergency departments comes as no surprise to anyone following the downgrading of Medicare to a ‘‘mixed billing’’ system. This has made it unaffordable for many people to see a GP. But the real cost of turning Medicare into a two-tier system has been to the public hospital system. The only winners are private corporations, private hospitals, private health insurance funds and their many lobbyists in Canberra. We are going the way of the US, and if people don’t fight for Medicare, we are all doomed.
Con Costa, Hurlstone Park:


Here is today’s Herald Editorial

Health system needs its own emergency care
The state of health of the health system has dominated the lives of Australians for four years, but it has never been in such need of urgent care. Indicative of how working conditions for frontline healthcare workers have deteriorated, people now spend a median of three hours and 36 minutes in NSW hospital emergency departments, the longest wait ever. It’s little wonder that health workers are suffering burnout, stress and bullying and are leaving the industry in record numbers.
The COVID-19 pandemic sharpened awareness of our vulnerabilities and forced extra spending on hospitals, clinical responses, vaccinations and prevention measures.
And when we emerged from the pandemic’s worst days it became evident the health system too was experiencing difficulty recovering from years of stress. It had been deteriorating for a long time already, but post-pandemic we became uncomfortably aware that ambulances were queueing for hours to offload emergency patients and hospitals were under enormous pressure with lengthy wait times in emergency and admission.
GPs bumped up fees, forcing people who could not afford the $11-a-visit hike into hospital emergency departments. The industry is being further destabilised by the exodus of 6500 nurses and midwives a year.
If anything, the situation is worse outside the big cities. Last year, for instance, five deaths in regional hospitals could potentially have been prevented, but not in an overworked hospital system with staff shortages that make mistakes even more likely. The NSW parliament’s health portfolio committee report on rural, regional and remote health 18 months ago found a ‘‘culture of fear’’ which did not encourage or value feedback and complaints. Some workers say they were even punished for making complaints.
Now an investigation by the Herald has revealed a health system sinking further into crisis. Eight nurses and midwives have taken their lives in the past three years, while nearly 2000 NSW Health workers have lodged compensation claims for psychological injuries over the past two years. More than 33,500 NSW Health employees have also claimed they are burnt out, while 21,000 workers say they have witnessed bullying in the workplace. One in 12 ambulance employees hold a compensation claim for a psychological injury.
Experts and unions warn that the data, drawn from documents obtained exclusively under freedom of information laws and the state government’s recently released annual employee survey, People Matter, shows a workplace struggling with staff mental health concerns.
Further illustrating the stress, NSW Ambulance fielded a record 363,251 calls and fired up the lights and sirens for more than 181,000 emergency call-outs between July and September, the most of any three-month period since the Bureau of Health Information began taking records in 2010.
Money seems to be the root cause of health’s problems. Today’s national cabinet meeting will address the rampant cost blowouts in the NDIS and Canberra wants the states to take responsibility for funding treatments. On Friday, Premier Chris Minns and Treasurer Daniel Mookhey meet the Health Services Union over a protracted pay dispute threatening to collapse the NSW triple zero call system on New Year’s Eve. Minns said the money is not available.
The future funding and structure of our health systems concerns us all. It is an area where the federal and state governments share responsibility. The solution to the healthcare crisis is complex and will take time, but it is an area where increased funding must be found.
That clearly calls for a better national approach and the states responding with an end to parochial wheelbarrowpushing and finger-pointing.

Continue Reading

Apartheid Education Buses

23 November 2023

I live near a turning circle in a good area of Sydney.  There is a Bus Stop there and the government bus there has an ad with a picture of a forlorn looking schoolgirl saying that she cannot have a decent education, so would I donate to The Smith Family so she can.

As the ad displays there, 8 shiny new buses take private school children from the turning circle to 8 different private schools.

It seems that our governments are happy to subsidise ‘choice’ so that they do not have to fund a fair go and we are happy to tolerate an apartheid education system.

 

www.theguardian.com/australia-news/2023/nov/23/australia-100-wealthiest-schools-earnings-income-data-education-department?utm_term=655e79e42ab1fedfc11542549409ff2e&utm_campaign=AustralianPolitics&utm_source=esp&utm_medium=Email&CMP=aupolitics_email

Continue Reading

Climate Change- a Depressing Update

23 November 2023

In Australia the Labor government struggles mightily to get legislation through to allow Woodside to pipe carbon dioxide to East Timor’s territorial waters for supposed CCS (Carbon Capture and Storage) to allow them to develop a new gas field. East Timor is not a signatory to the Paris Accord- convenient eh?  Supposedly the carbon dioxide will be pumped into a reservoir that used to have gas, but Woodside has a track record of not meeting its CCS targets; if you think CCS is a real thing and not a cop-out farce.

 

Evidence suggests that the world is on target for a 3 degrees temperature rise, which may make human life unsustainable in its present form.  Petrostates are installing lights at beaches so that people can go for a night swim to cool off because it is too hot in the daytime!

 

The graphs below show world energy consumption tripling since 2000 and continuing that upward trajectory.  If one considers that the production of energy by a human is about a kilowatt a day, one realises that the amount of energy consumed now per person is many times that, and far higher in developed countries, the situation is unsustainable. The invention of the steam engine in 1690 and the internal combustion engine in 1872 and the use of fossil fuels, which has resulted in the energy and carbon dioxide stored as carbon over tens of thousands of years being released in a century.  It is ridiculous to think that reforestation can capture this amount of carbon as the total area of forests in the world is still declining.

 

COP28 (the 28th Conference of the Parties) of the UN Framework Convention on Climate Change (UNFCCC), will start on 30 November in the United Arab Emirates (UAE), chaired by Sultan Al Jaber, the CEO of the UAE state oil company ADNOC. How much good is this likely to do?

 

COP-out: Why the petrostate-hosted climate talkfest will fail

Continue Reading

Advocacy to Delay the Silica Benchtops Ban

18 October 2023

I wondered why the NSW Government was delaying the ban on silica-containing benchtops until July 2024.  Infectious diseases have no political friends, but industrial diseases do. Below is a full page ad in today’s Sydney Morning Herald advocating a delay on the ban and some regulations about how to cut the benchtops with no dust.  They also point out correctly that other benchtop materials have some hazards, and there are a lot of other products that produce silica dust when cut or dug. And they point out that a lot of people are involved in installing benchtops.

 

It is true about other products being harmful. But it is also true that there are readily available non-toxic alternatives that could be used. It is a bit rich for an industry that did precious little to stop the development of silicosis now to ask to be regulated.  The obvious solution is to minimise the harm from all sources of silica including cutting concrete and digging sandstone foundations.  That requires regulations that often actually exist, but Safework does few site inspections and relies on ‘self regulation’ and a ‘notify us’ system of light regulation, based on a fundamental contempt for OHS as soon as it inconveniences business.

 

The government must be forced by publix pressure to ban silica benchtops, which are basically all silica except for a bit of binder chemical, and to enforce other regulations with filtered air and barriers with PPE (personal protective equipment) as a last resort. Concrete or sandstone must be cut with water on the saw so that there is minimal dust.

 

It is depressing, but not surprising that those who have created so much of a problem by setting up an import system for this toxic product now have the gall to lobby against effective government action.

C:\Users\chest\OneDrive\Pictures\SMH Silicosis Ad 231018.jpg

Continue Reading

Private Schools- part of entrenching inequality

31 May 2023

In the 1960s State Aid for Church schools was initiated in NSW. Then there became an emphasis on ‘choice’ of school and subsidies for children to catch a bus away from where the child lived to the school that they wanted to go to.

Governments, particularly conservative ones want more children in private schools as this lessens total government expenditure, though private schools have successfully demanded closer to the amount of money per student that the public schools get.  The subsidies also favour their conservative voters.

Private school parents, seeking advantage for their students pay high fees so the government funding seems to be spent along with the other money on swimming pools and ‘luxury items’. 

Meanwhile Australia is slipping down the world education ratings, because public schools are neglected. The sociology also needs to be considered. The ‘choice’ is only for some.  The parents who do not have the financial means for a private school, nor the grades to get into a selective school have to take what they can get.  I visited a school in a disadvantaged area in Sydney, and looked at the school photos in the foyer. There was not a white face in the last 15 years- all the students were either of Pacific Islander or Middle Eastern origin.  The Principal said to me that she just wished she had a few Anglo students to model what the majority of Australians do.  There had been a stabbing in the playground about 30 years ago, and this had led to ‘white flight’.  There were also a considerable number of children with disabilities, which may be related to marriages within ethnic family or religious groups.  With poorer facilities, disadvantaged students  a lack of role models and teachers with lower pay, the Principal said it was very difficult to get her graduates good results and able to compete for jobs. 

I live in a relatively good suburb near a place where buses can turn around.  Each day 8 busses leave from close to me to go to 8 different private schools, 4 single sex male, and 4 single sex female. I think of them as Apartheid busses. The buses are all branded and new.  The students getting on board can go in relative luxury from the civilised suburb to the well-endowed schools. They need have no contact with poorer folk, even on public transport.  These advantaged students will go to universities, into top jobs and make decisions for us all.

I am reminded that in the US in the Johnson era there was ‘bussing’ which took more wealthy students to schools in poorer areas to make richer students aware of how the poorer student lived and to increase equality of opportunity. Australia, supposedly the land of the ‘fair go’, is now quite the opposite, subsidising inequality as we become the country with the most privatised (and unequal) education systems in the world. Now, just to emphasis the point, ‘for profit’ schools are coming in. ‘Hey, what is wrong with making a profit?’ we hear them cry.

When I went to school in Port Kembla, half the school were children of post-WW2 migrants from Europe, ‘displaced persons’, or what we would now call refugees. Half the children arrived at kindergarten unable to speak a word of English.  There were 46 in my class. All this was ‘normal’.  There was no anti-discrimination legislation.  But the over-riding unifying factors were that all the kids in the school had the same experience, all the parents had jobs and the Housing Commission was building whole suburbs of houses as fast as they could to settle the new migrants.  By the end of 3rd class there was really no difference between migrants and Anglo-born. It was equality of opportunity, a ‘fair go’. This is what is being lost. We see the example of the US where the gap between rich and poor keeps growing and we are subsidising the same process!

We forgot about the first Gonski report on educational inequality as the politicans did not want to offend the middle class by lessening their education subsidies. Gonski was pressured to do a weaker second report and inequality of opportunity keeps growing.

The politicians tell us that their education funding has never been higher. Perhaps this is so, but while the money is spent on luxuries for some and there is not enough financially or sociologically to help disadvantaged areas, Australia will continue to slide down the international education rankings and the entrenched disadvantage that continues from generation to generation will continue.

Continue Reading

The Arms Industry Distorts US and the World’s Priorities

31 March 2023

The word ‘defence’ seems innocuous enough, and discussion about is generally starts with a diatribe about the threat of Russia or China.

But just as the tobacco industry was responsible for the smoking epidemic, so the Arms industry is responsible for military spending and the consequent need to have wars to justify that expenditure.

The US has had continuous wars for many years; when one ends, another starts. The wars are not because of a threat to the US, but represent the US exerting global influence, and selling weapons to itself and others. 

US foreign policy is hugely affected by its military and a perceived need for global hegemony.  There is pressure on countries that seem susceptible (like Australia) to buy weapons systems (like AUKUS) to fit into this hegemonic world view.  How long this can be afforded by US taxpayers is a key question; the Roman Empire imploded when its tax base could not pay for the mercenary armies that guarded its frontiers. 

A list of some of the wars is; The Cold War 1945-1989, Korean War 1950-55, Vietnam 1955-75, Lebanon 1982-84, Libya 1986, Panama invasion 1989-90, 1st Gulf War 1990-91, Somalia 1992-95 and 2007, Bosnia and Croatia 1992-95, Kosovo 1998-99, Iraq War 2003-2010, Afghan war 2001-2021, North West Pakistan 2004-2018, Libya 2011 and 2015-19, Iraq intervention against ISIL 2014-2021, and now Ukraine 2022-.

Obviously one can argue about the merits of any of these wars, but the success rate of them is not good from a US foreign policy perspective. The returns to the arms industry, however, are always positive.

But the opportunity cost of these wars in terms of the possibility of diplomatic settlement or the use of monies to address the problems in the warring parties is considerable.  The loss of social services and infrastructure to the US population is probably the most critical part from a political level.  Inequality and polarisation in the US are increasing with consequent social disharmony.

The arms industry has to be reined in. Its subsidies to the Australian War Memorial have tended to make this a temple of militarism rather than a place for regret and remembrance.

There was a book, ‘The Secret State- Australia’s Spy Industry’, by Richard Hall which came out in 1978 and compared the reports of the intelligence agencies of 25 years previously with the current affairs commentaries of the major daily newspapers of the same time.  (The 25 years was the time for the release of the spy agency documents).  The rants of the intelligence agencies and their fear-mongering were almost comic and the predictions of the major newspaper editorials were largely proved correct. 

It seems that as ‘Security studies’ replace ‘History ‘ in university courses likely to result in graduates getting jobs, the people who teach world events are changing their perspectives, and not for the better.  Our current policies with AUKUS would seem to derive from a believing a current spy’s paranoid world view. The Arms Industry is to be feared and opposed in Australia as well as the US.

Continue Reading

The Triple Lunacy of Westconnex

17 February 2023

Westconnex, the underground freeway network will open later this year.  Few realised the extent of it and for a period, trafffic will flow more smoothly.

But it was, is and will be a triple lunacy. 

  1. Nowhere else in the world are governments building freeway networks, let alone tunnelling them undergroup at vast cost. Cities like London have congestion taxes, some European cities are even closing their major roads, and it a subject of significant discussion (ww:://h2020-flow.eu/news/news-detail/when-roads-are-closed-where-does-the-traffic-go-it-evaporates-say-studies/).  The world is trying to have more public transport to lessen the need for private cars, their cost, their parking and their greenhouse gases- except NSW!
  2. The underground freeways will be privatised, so represent a huge subsidy  from the taxpayer, as the private monopolies have a track record of huge tolls and guaranteed revenue.  The tolls are already subsidised to lessen commuter pain, which amounts to continuing payments to the toll operators. Chris Minns’ Labor election platform is to subsidise motorists who spend more than $60 a week on tolls. Who are these and how many of them are there?  Logistics companies?  Couriers?  Or tens of thousands of commuters?  Naturally there will only be  a few toll operators.
  3. The money spent on road tunnels was not spent on a decent Metro system, that would have made most trips unnecessary and taken the cars off the roads.  Of course a train tunnel is smaller than a road tunnel, much cheaper to build per Km, carries far more people and does not require ventilation (or very little).

One might ask why all this happened.  My theory is that the RTA engineers were far more politically savvy than the State Rail Authority.  The RTA were dealing with politicians and building motorways all over the state, wherever they could get the government to pay for them.  The SRA confined its thinking to the existing rail network, and thought in terms of better train technology and industrial relations problems, rather than building their network and having a big part in urban planning.  And of course the lobbying was probably helped by big bankers and big construction companies and by ex-politicans at Infrastructure  NSW, which was set up in 2011 by Barry O’Farrell with ex-Premier and ex British-American tobacco executive, Nick Greiner in charge- a great privatiser.

WestConnex has beavered away at vast but unperceived cost and only attracted attention for its ventilation shafts in suburbia, or the chaos on existing roads as its portals were constructed. Now, for the next few years the affluent and the through traffic will have an easier time of it, and we can continue to lobby for the Metro system.

graphic-0

Web of steel, concrete and cable takes shape below

WestConnex is on track to open late this year, writes Matt O’Sullivan. (SMH 17 February 2023)

The scale and complexity of the final stage of the $17 billion WestConnex motorway project, buried up to 60 metres beneath inner Sydney, becomes clear the deeper workers venture into a twisting maze of road tunnels, ventilation passages and giant caverns for jet fans and substations.

Above ground, inner-city residents and motorists get a sense of the scale – and disruption whenever they pass a massive construction depot for the project on a site that was once the Rozelle rail yards, next to the City West Link roadway. However, the surface work represents only a fraction of the motorway junction below, which features three layers of tunnels.

All up, Australia’s most complex motorway project comprises 24 kilometres of tunnels beneath Rozelle and Lilyfield, about seven kilometres of which motorists will never see because it will be used mostly for ventilation. Once opened late this year, the $3.9 billion interchange will connect the recently opened M4-M8 Link between St Peters and Haberfield, the City West Link, the Anzac Bridge, Iron Cove and, by 2027, the planned Western Harbour Tunnel.

Almost four years after construction started, Rozelle interchange project director Steven Keyser said the focus was now on fitting out the finished tunnels and connecting ‘‘everything together, so it all talks to each other’’ as the targeted completion date looms. ‘‘We have the body built, but we need the brains,’’ he said of the mechanical and electrical systems.

Keyser said other road tunnel projects built in Sydney in the past decade had taught his team that fitting them out with mechanical and electrical equipment often took longer than anticipated. ‘‘We’ve got 1.7 million metres of cabling to run through all those tunnels. It’s a real spider network of cabling,’’ he said. ‘‘The back end takes a lot longer, and we’re scheduling far more intensely to get that right. And so we’re in a good position to open at the end of the year.’’

Keyser said that, while facing disruption from the 2019-20 Black Summer bushfires, the pandemic and wet weather, the biggest logistical challenge for the project had been ensuring equipment and componentry arrived in the correct sequence. ‘‘We had 23 road-headers [excavating] and 500 blue-collar workers starting and stopping each day, getting in and out of the tunnels. This is one of the biggest logistical exercises and that’s all hidden,’’ he said.

Like the rest of WestConnex, the Rozelle interchange has been contentious due to the disruption caused to inner-city residents, and the eyesore it has created near Sydney Harbour during the years of construction.

Transport for NSW’s deputy secretary of infrastructure and place, Camilla Drover, said the project would have been far more controversial if early plans for the interchange had been pursued. ‘‘The original scheme for this was all above ground. Can you imagine? It would have been viaduct and overpasses. But the fact that it is now all underground, and we have a park instead, that is the evolution people forget about,’’ she said.

The 10-hectare park, which includes two sporting fields, on the site of the old rail yards, will open late this year when the interchange is completed.

And Keyser said the public would see the construction site change quickly over the coming months as the park began to emerge. ‘‘We’re getting to the stage where you can see what the finished product will look like,’’ he said.

Underscoring the complexity of the underground junction, the state’s transport agency took control of the project in 2017 from a corporation set up to oversee WestConnex after only one bid from contractors to build it was received in the initial tender process. The interchange was also separated from construction of the M4-M8 Link, which forms the other part of the third and final stage of the 33-kilometre motorway project. The upshot is that the risk of delivering the interchange ultimately rests with the government.

While the tunnels for the interchange average 35 to 40 metres beneath the surface, a sump where water is collected before being pumped out is about 60 metres deep. Twin tunnels for the $27 billion Sydney Metro West rail line between the CBD and Parramatta, which will include a train station next to White Bay power station at the so-called Bays West, will be dug even deeper beneath a part of the interchange over the coming years.

For tunnellers, ground conditions have presented a constant challenge during construction. ‘‘It’s always challenging with ground conditions, no matter where you are in the world. Each time we’re digging the tunnels we’re checking the reactions of what’s happening,’’ Keyser said. ‘‘We’re always a step ahead, probing things, making sure that things are only moving to the model. We have probably 5000 instruments around measuring.’’

While sandstone is easier to excavate, softer soil conditions required so-called rock bolts to be installed closer together in the tunnel walls to provide extra support. The closest the tunnels get to each other is about 10 metres. ‘‘You’re basically doing what the Romans did – you’re creating an arch [in the tunnels],’’ Keyser said of the tunnelling techniques.

About a quarter of the $3.9 billion cost of the interchange, being built by contractors CPB and John Holland, has been spent on a labyrinth of ventilation tunnels and related facilities. Three exhaust stacks about 35 metres high, which are connected to the interchange below, have been built on the site of the old rail yards. Large caverns – some about 23 metres high – also had to be dug deep underground for electricity substations and to house giant fans for the ventilation system.

Part of the reason for the mammoth size of the ventilation facilities is the need to design the interchange to cope with a catastrophic event. ‘‘You’re always catering for what is the worst case, which is if something catches fire in the tunnel,’’ Keyser said. ‘‘The standards now are quite high and the design caters for that emergency situation. In the roof, you have a fire deluge system, which is going through its testing.’’

Greens MP for Balmain Jamie Parker, who has been highly critical of WestConnex, said the interchange’s construction had caused major disruption to nearby residents over the past four years. ‘‘Everyone is relieved that it will be over. But the local community feels like they have had such widespread impacts on their homes, and now they have to deal with the longer-term consequences of the three exhaust stacks which should be filtered,’’ he said. ‘‘The impact is really significant, and it is ongoing.’’

While acknowledging the disruption to locals from construction, NSW Metropolitan Roads Minister Natalie Ward said the interchange, along with the rest of WestConnex, would result in significant travel-time savings for motorists once fully completed. ‘‘There are always challenges in construction – it’s messy; it’s disruptive,’’ she said.

‘‘The upside is it gives local roads back to local communities. This area, you might remember, was just disused rail yards; it was overgrown … [and] you couldn’t enter. We are transforming this to see community benefits.’’

Continue Reading

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.

Continue Reading