It Looks Like Th Draconian Censors Have Been Retired For A Little While Longer!

This appeared this morning:

Communications Minister Michelle Rowland confirms Misinformation and Disinformation Bill will be pulled

Proposed laws aimed at targeting misinformation and disinformation proliferating social media have been culled after it failed to garner support.

Jessica Wang

November 24, 2024 - 10:16AM

NewsWire

Sky News can reveal the government will dump its misinformation and disinformation bill after it became clear the Opposition and Greens would oppose the bill in the Senate.

Communications Minister Michelle Rowland has confirmed the government will pull a controversial Bill attempting to combat misinformation and disinformation after the Opposition and the Greens vowed to oppose it.

The Bill, which aimed to combat seriously harmful content on digital platforms will be scrapped in the Senate, with the government acknowledging there was “no pathway” for the Bill to succeed.

The proposed legislation was also opposed by a wide-ranging group of community groups, free speech organisations and religious groups over concerns it would harm free speech, with stakeholders questioning how the definition of truth would be enforced.

However, Ms Rowland accused the Coalition of playing politics.

“The Coalition committed to legislating safeguards when in government, but chose to place partisanship above any attempt to navigate the public interest,” she said.

Despite the setback, Ms Rowland said there needed to be “safeguards” to protect Australians from misinformation and disinformation, and urged MPs and senators to work with Labor on alternative concessions.

“Mis-and disinformation is an evolving threat and no single action is a perfect solution, but we must continue to improve safeguards to ensure digital platforms offer better protections for Australians,” she said.

She listed alternative proposals like legislation to strengthen offences targeting the sharing of non-consensual and sexually explicit deep fakes, a proposal to enforce truth in political advertising for elections, and stronger regulations around artificial intelligence.

Greens’ communications spokeswoman Sarah Hanson-Young said that while the intent behind the Bill was “well-meaning,” the proposed laws were “badly and poorly explained and implemented”.

She’s called for stronger regulation, which would target “dangerous algorithms” and heavy financial penalties for social media companies.

“We’ve got to get back to the real problem, and that is how these companies profit off these dangerous posts. If you want to stop the dangerous posts spreading like wildfire, hit them where it hurts, and that’s the dollar,” she told the ABC.

Shadow attorney-general Michaelia Cash said the Bill was an attempt to “censor free speech”.

“This Bill is not about misinformation and disinformation… This Bill is about the Albanese government giving bureaucrats the ability to say whether what you and I say is misinformation or disinformation,” she told Sky.

Here is the link:

https://www.news.com.au/technology/online/communications-minister-michelle-rowland-confirms-misinformation-and-disinformation-bill-will-be-pulled/news-story/ab4c979eeb1434425d917c2844868e14

I have to say that I think this is a very good outcome and that the Minister should just pop back in her box with this sort of censorious proposal!

Within obvious reason we should all be free to say what we like and let what we say be judged on its merits – just as this post should be!

Clearly there are limits to what can be said – defamatory statements, offensive and dangerous deep-fakes etc. – but outside those limits we should be free to say what we like. We have laws to cover that goes over-the-top and pretty sensible judges to regulate significant offending etc. so it is reasonable to let people have their say – hate crimes, flagrant offensiveness and dangerous untruths etc. will be weeded out rapidly I reckon as they are mostly already illegal!

What limits, for example, do people think should apply to commentary on this blog?

David.

AusHealthIT Poll Number 774 – Results – 24 November 2024.

Here are the results of the poll.

Is The Government Doing Enough To Mitigate The Epidemic Of Scams Being Seen At Present?

Yes                                                                      12 (43%)

No                                                                       16 (57%)

I Have No Idea                                                      0 (0%)

Total No. Of Votes: 28

A close run thing with negative answers just ahead!

Any insights on the poll are welcome, as a comment, as usual!

Poor voting turnout. 

0 of 28 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

And Now For Something Completely Different – A View OF 2500 Years Of History!

I really enjoyed this and so decided to share!

World out of order, on the cusp of catastrophe

Paul Monk

16 November, 2024

Whatever you think of Donald Trump’s return to the White House, come January, the next four years promise to be critical in regard to world order. But what is “world order” and how has it evolved out of an anarchy of states and the rise and fall of empires?

In 1784, a year after the United States won its war of independence, Immanuel Kant wrote his Idea for a Universal History with Cosmopolitan Intent, a brief essay pondering whether world order was in fact evolving in the direction of humanity and rationality. Two hundred and forty years later, we might still ask ourselves that question.

The recent BRICS conference in Kazan, hosted by Vladimir Putin, contemplated an alternative to the American-led world order that has existed since 1945. Xi Jinping’s China plainly aspires to reset world order. Within the US, as the recent presidential election showed, polarisation, populist isolationism and irresponsible fiscal governance imperil the Pax Americana from within.

We need to remind ourselves that “world order” – understood as what we like to call these days a “rules-based order” – is a modern development and Western in origin. Kant was aware of its beginnings when he wrote his essay. He died, in 1804, in the midst of the Napoleonic Wars; an enormous upheaval, part a disruption of what order existed and part the harbinger of radical changes to come.

The Congress of Vienna (1814-15), following the defeat of Napoleon, was a conservative attempt to reset and stabilise the European world. There were no such congresses elsewhere, just variations on conquest and submission. The very idea of such congresses and the idea of “rules-based” orders took centuries to evolve. Let’s briefly retrace that process.

In the West, the Roman Empire is still often seen as emblematic of “world order”, and its fall as a catastrophe. But as Walter Scheidel argues in Escape From Rome: The Failure of Empire and the Road to Prosperity (Princeton, 2019), what slowly emerged out of its ruins was a more dynamic order. It is a dynamic, not a static or imperial, order that is being tested right now.

After Rome fell, the Eastern Roman Empire, with its capital in Constantinople, endured for another thousand years, retreating slowly. That retreat was accelerated by Muslim Arab conquest and colonisation of the Middle East, the whole North African littoral and Spain, between 632 and 732, climaxing with the invasion of France and defeat by the Franks under Charles Martel.

The Arab invasions of the Roman and Persian worlds climaxed in attempts by the Umayyad Arab caliphs, based in Damascus, to finish off the Eastern Roman Empire, which still ruled Greece, the Balkans, the Aegean and parts of Italy, by besieging Constantinople twice: 674-78 and 717-18. They failed both times. There were no congresses to settle things. Constantinople would not fall to Muslim forces (the Ottoman Turks) until 1453.

In 750, black-clad Muslim insurgents, the Abbasids, coming out of Central Asia via Persia and Iraq, overthrew and massacred the Umayyads. They established Baghdad as a new city and the capital of the Arab Caliphate. For a while, Baghdad became the new centre of civilisation. Straddling trade routes linking the Mediterranean with India and China, it became richer, more cultivated and a greater centre of learning than any city in the Europe of the Dark Ages.

If you look at a map of the Mediterranean world at about 800CE, the Caliphate extends from Mesopotamia, via where all the Arab states of our time now sit, across North Africa to the Strait of Gibraltar.

The Emirate of Cordoba, in Spain, was separate. It had been created, in 756, by a scion of the Umayyads, who survived the Abbasid revolution, took over Spain and fought off repeated attempts by the Caliph to destroy his realm. It became the fabled Andalusia.

The Franks, under Charlemagne, had reconstructed a considerable part of the old Western Roman Empire, from Central Italy to the Baltic Sea and from the English Channel to Dalmatia. The Celts, Anglo-Saxons and Vikings were vying for mastery in the British Isles. Russia didn’t exist, though Kievan Rus (Ukraine) would arise, under Oleg the Wise, in the final decade of the 9th century. No congresses settled this as a world order.

The Abbasid Caliphate disintegrated before the storied Crusades, which we grew up hearing about and are now encouraged to deplore. It fell apart due to internal religious schism, dynastic strife and poor governance. Above all, it was subjected, between the 10th and 14th centuries, to invasions by Turkish barbarians and the Mongol armies of Genghis Khan and his progeny, out of Central Asia.

The Seljuk Turks, having conquered the Middle Eastern territories of the Abbasids in the 11th century, invaded what was left of the Eastern Roman Empire. They defeated the Byzantine emperor Romanus IV Diogenes at Manzikert in 1071 and began colonising what would eventually become modern Turkey.

The Great Wall of China has only been pierced by Genghis Khan and the Manchus until recently when two construction workers dug a shortcut, says Sky News host Liz Stoker.

The Seljuk Empire, in turn, came apart, due less to the Crusades (between 1069 and 1291) than to devastating invasions by the Mongols, between 1219 (when Genghis Khan was at his height) and the death of Tamerlane, in 1405.

The Crusades are depicted as symbolic of “imperialism” when they were a response to Muslim imperialism and, in any case, trivial compared to the Turkish and Mongol invasions. One can read of the massacre of thousands by Frankish crusaders in the Holy Land, but the Mongols slaughtered millions and laid waste to whole swathes of fertile country. Hulagu, a grandson of Genghis Khan and a brother of Kublai Khan, sacked Baghdad itself, in 1258.

The Mongols conquered Russia and Ukraine (Kievan Rus), occupying them for centuries. They marauded as far as Poland. But the Ottoman Turks came to pose the greater danger to Europe. Taking what remained of the Eastern Roman Empire from 1300 onwards, they finally captured Constantinople in 1453. They kept advancing into the Balkans for the next 200 years, until defeated outside Vienna, in 1683. All this was done without reference to international law or world order.

The Ottomans took over North Africa from the Arabs and Berbers. Their corsairs ran slave raids in the western Mediterranean and the coasts of Western Europe for centuries, until suppressed by American and European fleets in the 19th century. Their famous defeat at Lepanto, in 1571, by Catholic naval forces didn’t lead to them retreating. They rebuilt their Mediterranean fleet within six months.

But from the late 17th century, the Ottoman Empire began to retreat. It was at that time, also, that (Ming) China was conquered by the foreign Manchurians, who added Mongolia, Qinghai, Xinjiang, Tibet and Taiwan to their empire. But that’s another story.

The Ottomans declined due to technological and military stagnation, as Western Europe underwent a remarkable transformation and, also, outflanked the Ottoman Empire by rounding the Cape of Good Hope and circumnavigating the globe, to access the spices and riches of the Far East (and the Americas). No congresses there ­either.

The Russians, centred on the Duchy of Muscovy from the 16th century, over the years of Western expansion, from the 16th to the 19th century, annexed Ukraine, Poland, the Baltic States and Finland, and colonised immense territories in Central Asia, Siberia and the Caucasus.

It was in that era, however, that the very idea of “world order” and the “law of nations” began to develop – in the European heartland. The Dutch jurist and polymath Hugo Grotius (1583–1645) laid the foundations for international law in his treatises The Freedom of the Seas (1609) and On the Law of War and Peace (1625), as well as initiating the development of the very idea of universal human rights – an idea rejected by Xi Jinping and those who think like him.

Grotius expounded the core idea of an order of states, moderated not by force but by rational laws and a common understanding that force should be used only to uphold those laws. Think Camelot. Hedley Bull, author of The Anarchical Society, saw Grotius as the inspiration behind the 1648 Peace of Westphalia, which ended the Thirty Years War. He dubbed Grotius “the intellectual father of this first general peace settlement of modern times”.

It was on the foundation of the work of Grotius and others that Kant could write what he did. It is that tradition in which we are anchored when we talk, in the 21st century, of an international rules-based order. After Grotius, Realpolitik, under which, in the words Thucydides attributed to Athenian commanders at Melos, “the strong do what they can, while the weak suffer what they must”, slowly and uncertainly began to give way to principles of international law and human rights.

In reality, of course, the convening and the outcome of congresses had much to do with the preponderance of power. The First World War saw the collapse of the Ottoman Empire, along with the defeat of Germany, the collapse of the Austro-Hungarian Empire and the expansion of the British and French empires. But all this was orchestrated through international congresses: at Versailles (1919) and Lausanne (1923).

As Sean McMeekin showed, in The Ottoman Endgame (2015), it was at Lausanne, in July 1923, that the carving-up of the Ottoman Empire and the creation of new Arab states in the Middle East was arranged. Contrary to legend, however, the key figure in planning that carve-up (in 1916) was neither Mark Sykes nor Georges Picot, but the Tsarist Russian foreign minister Sergei Sazonov. And the dominant figure at Lausanne (in 1923) was none of those individuals, but Mustafa Kemal, the new, modernist, secular master of Turkey.

Lausanne was necessary, because war over the fate of Turkey did not end in 1918. The liberal democrat Eleftherios Venizelos, a Cretan and the founder of modern Greece, longed to reclaim for Greece the empire lost to the Turks between the 11th and 15th centuries. Mustafa Kemal had other ideas and expelled the Greeks from Turkey with great violence. Lausanne settled it – more or less.

The Treaty of Versailles, in 1919, saw the creation of the League of Nations, the first truly Kantian attempt at creating an international order of a new kind. Its failures are legendary. But it set an antecedent which, after the Second World War, led to a fresh attempt: the creation of the United Nations. Both marked conceptual and substantive progress. The UN is, of course, notoriously disunited and in need of an overhaul. But it represents the ideals of Grotius and Kant.

“The history of mankind”, concluded Kant, “remains as a constant objection, because its spectacle compels us to turn away our eyes in disgust.” And yet it is only by remembering history, in the long view, and studying its often disheartening lessons, its endless complexities, that we can hope to formulate better and more effective modes of international order. We are clearly in need of ­formulating such new, updated ideas in the 2020s.

Right now, we are likely to be distracted by immediate problems – the war in Ukraine, the multi-front war in the Middle East, the tensions in East and Southeast Asia, uncertainties about the US alliance system, governance in the liberal democracies. But it is very important to put all this in a larger frame of reference.

That frame of reference includes the astonishing technological and scientific developments going on, the population implosion taking place globally, as Nicholas Eberstadt points out in the latest issue of Foreign Affairs, and the fact that global challenges require a dynamic and resilient global order of free states more than ever before. Ignore this and you get same old, same old.

The challenges ahead demand that we re-imagine the current order, finding ways to create one able to avert various possible catastrophes.

As things stand, that’s going to take some doing. Kant hoped that “the play of human freedom” would generate rational order. At immense cost, we’ve made progress. The challenge now is to both freedom and order.

Paul Monk is the author of a dozen books, including The West in a Nutshell: Foundations, Fragilities, Futures (2009), Dictators and Dangerous Ideas (2018) and Thunder From the Silent Zone: Rethinking China (2nd edition, 2023).

Here is the link:

https://www.theaustralian.com.au/inquirer/world-out-of-order-onthe-cusp-of-catastrophe/news-story/07d5abb7d587d42df43e11b1f43bc3fa

This helps keep things in perspective – but it is surely true that Trump’s return is NOT a good thing!

David.

It Is Sad That Fraud By Doctors Is Becoming A Problem Apparently…

This appeared last week:

Call for cheating doctors to be named and shamed

By Melissa Cunningham and Henrietta Cook

November 17, 2024 — 5.00am

Doctors who overbill patients should be named and shamed on a public register, according to one of Australia’s top health economists, and a class action against a group of Mornington Peninsula doctors allegedly overcharging might be on the cards.

Patients have also been urged to check their Medicare records to ensure they have not been wrongly charged by their doctors.

The calls come after this masthead revealed allegations against dozens of anaesthetists and surgeons on Victoria’s Mornington Peninsula, in a damning confidential whistleblower complaint accusing them of systematic fraud, double-dipping and pocketing off-the-book fees.

The complaint alleges that a group of doctors has been charging patients hidden out-of-pocket costs up to $5000 – disguised as booking or administrative fees – for their own financial gain, while at the same time, the specialists were purporting to participate in no-gap-fee schemes with health insurers.

Medical fraud and compliance expert Dr Margaret Faux, who has previously worked as a solicitor, believes there may be scope for a class action lawsuit to help consumers if the allegations are proven.

“We actually need to get this in front of a judge as soon as possible,” she said. “This whistleblower letter is a gift in so far as it gives prosecutors everything they need to quickly and easily get to the truth of the matter.”

Faux said of concern were allegations that doctors have been charging fees for no service, which is illegal.

She said charging an anaesthetic administrative fee of more than $1000, with no explanation for example, could be deemed “suspicious”, because the law required consumers to be billed using Medicare codes.

“We know the names of all the doctors,” Faux said. “We know exactly where this alleged conduct is taking place, and there are no excuses for inaction.”

Health economist Stephen Duckett – the man widely regarded as the architect of Medicare – said that while the overwhelming majority of doctors strived to do the right thing, there was also evidence of a minority of greedy specialists who sought to game the system.

‘The patient gets screwed, the insurance fund gets screwed, and the doctor goes all the way to the bank.’

Duckett said doctors found to be breaching their contracts with insurers and overbilling patients “should be named and shamed” on a public register to warn consumers.

“Because the system is so complex, patients don’t know what their entitlements are, and they don’t know when they’re being ripped off,” Duckett said.

“Similarly, because the health fund doesn’t know that a booking fee was charged, they can’t police it on behalf of the patient. So, the patient gets screwed, the insurance fund gets screwed, and the doctor goes all the way to the bank.”

He said insurance funds also must tighten contracts with health practitioners to protect consumers and hold doctors to account.

“Insurers must be prepared to name doctors who are chiselling patients,” he said.

According to the whistleblower, during her employment at a Mornington Peninsula medical clinic which spanned a decade, about 90 per cent of patients were stung with out-of-pocket costs, despite the no-gap-fee arrangements.

Rachel David, the chief executive of Private Healthcare Australia, which represents insurers, has called for Australia to follow the United States and enact a “surprise billing legislation”, which mean if a patient is charged with a bill they don’t expect, they do not have to pay it. She cited instances where a specialist has added an assistant without telling a patient in advance.

“Raising a charge while a patient is under duress is unacceptable … if a patient challenged that under consumer laws I think they probably win.”

David has urged people to examine their medical bills for any service not attached to a Medicare item or for statements on bills labelled as “booking” or “administrative” fees.

“If it says that it’s a separate fee that Medicare or the health insurance fund won’t pay, that is a red flag,” David said.

Insurers nationwide are now scrambling to probe the claims of overbilling.

The federal government’s Benefits Integrity Division – which investigates claims of health and Medicare fraud – is also investigating.

Australian Patients Association chief executive Lisa Robins said hidden specialist billing eroded confidence in the system and deterred some people from taking up private health insurance.

“Many Australians have taken out private health insurance to avoid out-of-pocket expenses. These fees are a betrayal of patient trust and it’s incredibly disappointing to see allegations that some specialists are financially exploiting individuals when they are at their most vulnerable.”

She called on health ministers to put an end to unethical billing practices, which she said were putting undue financial pressure on patients during a cost-of-living crisis. She said healthcare providers also needed to be transparent about their billing.

A spokesman for the federal Department of Health and Aged Care said the government was unable to share details of its compliance investigations, including probes which are still under way.

How to check if you’ve been billed incorrectly under no-gap-fee arrangements

If you have private health insurance, call your health fund to examine your bills and ask questions about whether you should be paying out-of-pocket fees or not. They can help you ask the right questions of your provider. If your Medicare records show you were bulk-billed when you were charged a fee, report it to Medicare.

The Australian Society of Anaesthetists and the Royal Australasian College of Surgeons both said they take allegations of financial misconduct seriously, but strongly rejected suggestions unethical practices were commonplace or widespread.

Australians who have had surgery in private hospitals are being urged to scour their medical invoices and specialist doctors’ bills for “red flags” showing they have been charged hidden fees outside their health funds or Medicare.

How to report potential fraud to Medicare:

• Complete the Government’s health provider fraud tip-off form
• Call the national fraud hotline – 1800 829 403 or the Benefits Integrity Hotline1800 314 808
• Email ReportFraudorCorruption@health.gov.au

Here is the link:

https://www.smh.com.au/national/victoria/call-for-cheating-doctors-to-be-named-and-shamed-20241116-p5kr5b.html

I have to say this is really pretty sad – especially given the amounts one can make without resorting to such activity.

I wonder is the incidence rising compared with other professions?

David.

This Really Is Not Good Enough But It Seems To Be Becoming More Common Sadly!

This appeared last week

Broken teeth, punches and threats: the hospitals where the most violent incidents occur

By Henrietta Cook

November 17, 2024 — 5.30am

Nurses, doctors and other hospital workers are being assaulted at record levels, with more than 20,000 violent incidents unfolding in the state’s public health services last year.

In one recent case, a man brought an axe into a Melbourne hospital and smashed all the glass in the nurses’ station, leaving terrified staff hiding beneath their desks.

Patients have also headbutted, punched and threatened the lives of nurses, according to unions.

Victorian health services recorded 20,902 occupational violence incidents last financial year, according to an analysis by this masthead of 62 annual reports tabled in state parliament this week.

This equates to around 57 incidents every day, and is 26 per cent higher than the 16,547 cases reported in 2022-23.

“Staff are fearful and anxious,” said Paul Healey, state secretary of the Health and Community Services Union. Healey has been inundated with reports of violence from his members, including the incidents detailed above. “They don’t feel safe.”

Healey said a shortage of beds and staff, as well as patients with increasingly complex mental health and substance abuse issues, was fuelling the rise in incidents, which can range from verbal threats to physical assaults.

“We see people coming through our emergency departments in our mental health services and needing to go out pretty quickly because the demand for beds is so high,” he said. “We do not at all want to demonise the patients and consumers – what this is actually about is a severe lack of resourcing.”

He said while the state government had taken important steps to reduce the use of seclusion and restraint in hospitals, there had not been the required investment to de-escalate situations.

Northern Health reported the highest number of violent incidents in the state, with staff at the major hospital recording 3649 incidents, up from 643 incidents the year before.

A spokeswoman for the health service said the rise in incidents was due to the increased size of its workforce as a result of Northern Health becoming a designated mental health service. She said there had also been a push to promote the reporting of occupational violence.

“Whilst the number of [occupational violence and aggression] reported in the last financial year has increased, the percentage of those resulting in injury or illness has declined due to training and early intervention,” she said.

“We continue to work on ways to reduce the number of incidents to protect the safety and wellbeing of our staff, patients and visitors.”

Madeleine Harradence, the acting secretary of the Victorian branch of the Australian Nursing and Midwifery Federation, said violence and aggression was an issue across all clinical areas, with hot spots located in emergency departments and mental health services.

“The time for awareness campaigns is over,” she said. “It is time for real action to ensure nurses and midwives are safe during their shift and go home to their families and loved ones.”

The union has created a plan to address violence in the workplace – which includes boosting security, rolling out risk assessments of patients and improving training – and is calling on the Health Department to roll it out across the state’s public healthcare services.

Harradence urged the Allan government to make health a regulated industry under the Occupational Health and Safety Act’s regulations, similar to the male-dominated industries of mining and construction.

“Then we would start to see prosecutions against hospitals and aged care services for failing to protect their nurses and midwives,” she said.

A mental health nurse, who did not want to be identified for fear of losing her job, said the level of violence in hospitals was the worst she had seen during her 35-year career.

“It has escalated to being out of control,” she said.

She recently witnessed a patient punching her colleague in the face, grabbing her by the hair and throwing her across a courtyard.

A few years ago, she witnessed another violent attack that left a colleague concussed and suffering from whiplash and eight broken teeth.

She has also been injured: three years ago, she tore the ligaments in her knee, and had to go on WorkCover, after being kicked by a patient while they were strangling another nurse.

“You become very desensitised to aggression,” said the nurse.

She criticised the state government for reneging on a promise to create 800 jobs across Victoria’s mental health services, saying it had left the sector under-resourced.

She said the drug methamphetamine, or ice, was also fuelling the rise in incidents as it could make patients aggressive and resistant to sedatives.

“We give them sedatives and it usually has no effect and their only defence is violence,” she said.

Hospitals across the state are rolling out a range of initiatives to try to stem the violence, including training for staff to help them identify and intervene early during high-risk situations and rolling our duress alarms for staff working out in the community. One regional hospital has rolled out “behaviour of concern” scores which are uploaded onto patients’ electronic records.

Melbourne Health, which runs the Royal Melbourne Hospital, recorded 2197 incidents last financial year, which was an improvement on the 2412 incidents logged by staff the year before.

An average of 9 per cent of incidents at Victorian hospitals resulted in an injury, illness or medical condition.

Australian College for Emergency Medicine president Stephen Gourley said violence and aggression was becoming increasingly common in emergency departments.

He said it was fuelled by excessively long wait times, patient frustration and ambulance ramping. Patients who are intoxicated with alcohol or other drugs can be difficult and dangerous to manage, according to Gourley.

“Violence in EDs has significant effects on both the physical and psychological health of hospital emergency department staff, as well as significant economic and social costs,” he said.

Opposition health spokeswoman Georgie Crozier said Labor had failed in its promise to stamp out violence and aggression in hospitals.

“Under the Allan Labor government, amid the chaos in our hospitals, the number of attacks on Victorian healthcare workers continues to rise,” she said.

A government spokesman said nurses, midwives, doctors and allied health professionals deserved a safe environment, free from any physical or verbal violence and aggression.

“As employers, individual health services and their boards have a legal responsibility for maintaining a safe workplace for staff – the Department of Health supports each to ensure they are meeting their obligations to their workforce,” she said.

She said the government had invested more than $47 million on occupational violence training and initiatives since 2015. It has also brought in new laws that make injuring an emergency worker a category 1 offence.

A WorkSafe spokeswoman said employers must do everything possible to prevent work-related violence, including encouraging workers to report incidents.

“No matter the situation, incidents of violence and aggression should never be seen as ‘part of the job’ for any healthcare worker,” she said.

Here is the link:

https://www.smh.com.au/national/victoria/broken-teeth-punches-and-threats-the-hospitals-where-the-most-violent-incidents-occur-20241115-p5kqyf.html

It sounds like I made a good decision to stop working at A&E  a few years ago. From the descriptions it is beginning to sound like a ‘war-zone’!

In any Department there is always the odd incident but this is now sounding very troubling. I wonder how many departments have moved to armed guards to protect the clinical staff. Things should really never to come to that!

Let me know what experience you are having at your workplace….

David.

Is There Any Legitimate Reason For Wanting To Use Cryptocurrencies?

This appeared last week:

Buoyed by Trump win, US pro-crypto lobby group opens Australian outpost

By David Swan

November 17, 2024 — 9.30am

Pro-crypto lobby group Stand With Crypto is hoping to capitalise on a wave of momentum from Donald Trump’s decisive US election win, launching in Australia to push for crypto-friendly legislation and fight the technology’s “crypto bro” image problem.

Using a flashy drinks event at Melbourne’s National Tech Summit to mark its launch Down Under, the advocacy group has met with MPs and senators over the past week to push for what it says is “sensible” legislation to regulate crypto firms operating in Australia.

The group has been launched by Coinbase, the United States’ largest cryptocurrency exchange, and is hoping that Australian politicians will be spurred into action after witnessing crypto’s role in the recent US poll. The cryptocurrency sector won big in the elections: Trump promised the US would become the bitcoin superpower of the world, and the sector raised more than $245 million from a mix of corporations and individual contributors to elect pro-crypto candidates.

The crypto sector outspent oil companies, banks and Elon Musk on the election. Stand With Crypto developed a grading system for candidates across the country, rating them from F to A on their stances.

“Our goal is to shift the narrative from crypto being viewed solely as a speculative investment to recognising it as the future of finance and the internet,” Tom Duff Gordon, vice president of international policy at Coinbase, told this masthead.

“We want to help prioritise getting sensible and good regulation in this space, and what we’ve done in the US has been really successful. In that election we had 1.9 million advocates sign up, and we had 400,000 in the week before the election.

“It was a huge number of people, it was a big mobilisation and we ran events up and down the country. We’ve launched it in the UK, we’ve launched it in Canada, and we’re now bringing it to Australia because there’s a huge opportunity here.”

Crypto has boomed following the election, with bitcoin surging past its all-time high and now on track to hit $US100,000 within weeks. Its price is up 93 per cent over the year to date.

Some 20 per cent of Australian adults hold some form of cryptocurrency, according to Duff Gordon, but the nation finds itself at a regulatory impasse, preventing further adoption and investment.

“We lack a licensing framework for crypto asset providers, so we’re lacking certainty,” he said. “This government and the previous government have done a lot of work with the industry, so we’re supportive of the direction, but we need it to be actualised.

I don’t really see a role for [crypto] in, certainly in the Australian economy or payments system

“It hasn’t been prioritised by the (Labor) government, so we would love for them to step forward.”

It comes after Reserve Bank governor Michele Bullock this month poured water on cryptocurrency, saying it has no role in the Australian economy or payments system.

“I don’t understand it,” she said last Thursday. “But, you know, I don’t really see a role for it in, certainly in the Australian economy or payments system.”

ASIC chair Joe Longo has also dismissed the recent rally in bitcoin and other crypto assets, saying it was an example of “the bigger fool theory”: the idea that people can make money on overvalued assets if those assets can later be resold at an even higher price to a bigger “fool”.

ASIC has indicated it will regulate crypto under existing financial product laws.

Crypto has commonly been linked with scams, fraud and criminal activity, and Duff Gordon acknowledged crypto’s “image problem” but said that hadn’t stopped major financial institutions globally, including Australian banks, from exploring blockchain technology for more efficient digital payments.

“Yes, there were hiccups, but the industry has matured,” he said.

Michael Chmielewski, head of growth at Australian cryptocurrency exchange Day1x, called crypto’s image problem a classic “few bad apples” situation.

“Much like the early days of the internet and the dotcom bubble, though, the strongest companies who take care of clients the most will ultimately rise to the top,” he told this masthead.

“Crypto’s path forward is through delivering real-world value … The goal is to reach a point where people use crypto and blockchain technologies without needing to understand them, just as they now use the cloud without thinking about the underlying tech.”

The Albanese government’s special envoy for cybersecurity and digital resilience, Andrew Charlton, said the government is “100 per cent committed to delivering reform.”

“I acknowledge and support the crypto industry’s proactivity in helping to shape sensible regulation,” he said.

“Our focus is on regulating exchanges - not specific tokens. It is too big to get wrong, and we’ve been working constructively with industry to get the detail right.

“The Coalition failed to act for a decade and have no policy when it comes to crypto. We’ve taken the time to consult with stakeholders so that we can get this right. Our approach will protect consumers and support innovation.”

Liberal senator Andrew Bragg welcomed the launch and said the crypto sector would benefit from stronger advocacy.

“Labor has dropped the ball and they have been able to get away with it. We need hard timetables to get things done otherwise we will be a crypto backwater,” he said. “Stand with Crypto can help us avoid that outcome.”

While Duff Gordon remained tight-lipped about specific meetings during his visit, he confirmed ongoing discussions with Australian officials.

Here is the link:

https://www.smh.com.au/technology/buoyed-by-trump-win-us-pro-crypto-lobby-group-opens-australian-outpost-20241114-p5kqj2.html

I keep reading these articles and keep wondering just what is the value cryptocurrencies bring – other than allowing people to bypass the traditional financial system for no motive I can see as benign.

Can anyone explain to this elderly crypto-ignorant person just why I need cryptocurrencies and why I should invest in them.

As far as I can tell I am better off making any trading profits I can make in real money! Is there any use-case for crypto that is not trying to subvert and / or hide profits from the Tax Office etc.?

Of have I got this totally wrong?

David.

It Really Feels As Though Scams Are Just Running Riot!

 This appeared last week:

‘Psychopaths are the best’: Confessions from inside the scam industry

From marketing and retention to catastrophe and recovery, the life cycle of the scam industry is breathtakingly cruel and strikingly consistent.

By Aisha Dow

November 17, 2024+

Professional scammer Mitch says most people in his industry fall into two categories: They’re psychopaths, who enjoy what they do, or they are deluding themselves about the terrible impact of their crimes.

“Psychopaths are the best agents,” he muses. “But I believe any scammer who’s not psychopathic, I honestly believe they will have lasting consequences.”

Mitch is coy on how he wound up managing a scam centre peddling phoney investment schemes in eastern Europe. He also hesitates when asked if he still thinks about people – victims – he had become close to over the years.

“Yes,” he replies. “I’ll leave it at that.” But then, after a short pause, he continues.

Scam agents start by honing their skills on low-value victims, but hoping to move up the food chain, advancing to new departments where there is more money to be made.

These “low-value” targets are people with the smallest incomes, often with the most to lose.

“You’re not gonna get Mark Zuckerberg, billionaire extraordinaires. No, you get everyone who’s sick, who doesn’t have money, who’s on social support and basically has very bad income.

“The main thing you do to prove yourself is take their last money, put them in crippling debt,” he says. “That’s something that you don’t forget.”

This is the breathtaking cruelty of the cyberfraud world. It’s a place where each scam story is slightly different, but there is a familiar pattern.

This masthead’s investigation used accounts from scam group insiders, private investigators and victims to trace the key steps of a typical online investment scam.

People’s journey might begin with a scam advertisement, reach a false high as victims are tricked into believing they are making windfall profits, and then end with their details being passed on to a new set of scammers who falsely claim they can recover the stolen money.

Australia is considered one of the easier targets for scammers, according to industry insiders and cybercrime investigators. Investment scams cost Australians an estimated $1.3 billion last year.

The fraudsters come for people’s savings, their superannuation and the roof over their heads.

“They promise, promise from the bottom of their heart that everything will be right, but it’s just so full of lies,” says Janelle Free, a retired hairdresser from Queensland.

“They’d take your blood, if they could, they’d take your organs, they would literally kill you to get the last out of you, and they’re so good at it.”

Asked how much she lost to the scammers, Free replies: “I sold my house, darling, and gave him my whole house funds.”

“It all starts from marketing, right?” says Mitch, who is using a fake name. Charming and confident, he is one of several scammers this masthead spoke to who effectively act as double agents, working inside scamming syndicates, while also providing information, sometimes through third parties, to cybercrime investigators or governments.

He explains how he has built rapport with victims, telling the people he’s scamming that he has ties to the country they live in, or that they share the same interest or hobby.

“At the end of the day, if you have any common sense and check where the company is located … you will see there is a scam. So what you do is you create a bond with the client, with the victim, so they don’t do that.”

Marketing is typically outsourced to groups called “affiliates”, organisations that specialise in mass marketing campaigns and search engine optimisation. They collect personal details of potential victims by running scam advertisements, videos and other online content that invite clicks and detail registration.

The affiliates sell these “leads” to companies like the one Mitch works for.

He says affiliate companies charged about $1200 to $3000 for a victim’s details if they had registered with a fake investment platform and then put down a small investment or deposit of around $250. The scamming company might pay $100 for someone’s information if they had only registered their details, but were yet to invest any money in a fraud scheme.

According to Mitch, Facebook is the most common source of victims for his call centre, followed by Instagram.

He says scam ads deleted by Meta were quickly replaced with new ones. By running numerous Facebook accounts and spreading their ad spending among them, criminals were able to keep running a steady stream of advertisements.

“What they usually do is they segregate the accounts. Let’s say they have 100 ads running. It’s not going to be under one roof. It’s going to be under 100 roofs. And if one roof gets torn apart, you just change one roof, not all hundreds.”

“It’s a very, very profitable activity,” says New-York based computer security expert Jerome Dangu, who co-founded Confiant, a company that specialises in blocking scam ads.

Dangu says affiliate marketers commonly deployed single-scam ad campaigns that reach millions of viewers globally.

In the recent past, he says scam ads have often mentioned cryptocurrency Bitcoin. These days, the popular theme is artificial intelligence-powered investments.

Often they exploit the images of celebrities, with altered photos or videos that give the impression the famous person is doing or saying something they are not.

“In Australia, it’s typically billionaires, but also political figures. They make them endorse these offers that are scams. Another component is a fake advertorial with the logo of a newspaper or an online news site… The first step is to collect a name, an email and a phone number, and then that information is transitioned from one bad actor to another bad actor.”

Sometimes, this trade happens in plain sight. Dangu points out a website where affiliate marketers sell services and scammers seek to buy “leads”. Affiliate marketers even publish blogs explaining how they successfully scammed people.

“They say, ‘I’m a smart nimble marketer, and I did all these smart optimisations, and that was really profitable’, which means ‘I scammed a lot of people’,” Dangu says.

Now armed with people’s names, emails, phone numbers, and sometimes even the amount of money they are keen to invest, scammers move to the “conversion” stage.

South-East Asian scammer Ramon, who is also using a pseudonym, says the criminal enterprise uses “lead qualifiers” to making the first call to victims, using a variety of scripts.

They might ask people if they remember clicking on an ad, tell them “we have received your inquiry about potential investment opportunities”, or say that they “know you’ve been looking for fixed-term deposits”.

“So most of the time, they [the victims] will just respond and say ‘oh, I remember that, I did go online and click on your ad’... That’s the time they start pitching them.”

During this first step, it’s common for victims to be asked for a small initial payment or first-time deposit, typically about US$250 ($386), to sign up to a fake investment platform.

“It’s a form of bait,” says Mark Solomons, a fraud and cybercrime expert with IFW Global. “The scammers will purport to show the victims that this $250 has magically been turned into $400 or $500 or $600. As a result, they’re an amazing investment scheme.

“The majority [of victims] probably will leave it at that and think ‘oh yeah, it looks a bit dodgy, or ‘I can’t really afford to invest any more’... but then a significant minority will go on to make larger deposits, and some of those will end up losing millions.”

Meticulous spreadsheets kept by a large scamming syndicate and seen by this masthead give a unique insight into this early step of the scamming process. They show, down to the second, when each victim made their first scam payment, and which particular fake investment brand, with names such as ArrowTeks, Aussie Trust and London Gates, was used to swindle them.

In just one month in 2021, a single team of people overseen by a manager was able to get 1465 Australians to part with a deposit – mostly US$250 but sometimes a little less or little more – the documents show.

Among the rows of Australian victims is a woman called Daphne, many Roberts and several Janets. There are also 62 Austrians, 511 Canadians, 14 Swiss people, 159 Germans, 28 Danes, 278 Britons and 65 New Zealanders.

There is a notable column titled: “sales status”. It shows victims who hadn’t answered their phone, or said they weren’t interested in investing.

Some cells have the phrase “in the money”.

This means the fraudsters have extracted information from the victim that gives them reason to think that they’re a juicy target, explains Solomons. He says the scammers get a sense of this by asking how much people can invest, what their investment goals are and by judging the victim’s general level of enthusiasm.

It’s also not unusual for criminals to apply another filter to who they target, screening out citizens of countries whose law enforcement they fear, and focusing on those they don’t.

Dan Halpin, whose company Cybertrace specialises in cyberfraud investigations, says while some syndicates are shutting down their German teams, and explicitly avoid US citizens, they have no such qualms about fleecing Australians. In fact, he says scam industry insiders tell him they have just put more staff onto the “Australian desk” – a team of scammers whose shift aligns with the Australian time zone, typically with good English and sometimes with connections to the country.

“The German police and the American police do a lot of work. They’ll extradite people from foreign countries, they’ll do raids in foreign countries,” Halpin says. “But Australia, they know that Australia will do nothing, so it’s just basically a free-for-all for Australians.”

Mitch said he worked briefly on an Australian desk last year, but quickly gave up the job as the hours were “devastating”. The shift began at 5am and ended at 1pm.

While the early steps of an online investment scam tend to be structured, based on set scripts and automated systems, the next phase, often dubbed “retention”, is different.

“The longer the relationship lasts, the less scripted it becomes, because the brokers are starting to develop relationships with people, and they know what pushes their buttons,” Solomons explains.

“They’ve been able to persuade them to remortgage their house, to get more money out of them, or to release their superannuation.”

Ramon says the strategy he uses to get victims to part with larger amounts of their money usually begins with a call in which he brings “great news” of a promising but time-sensitive investment opportunity.

Potential investors are told that a private company is about to publicly list its shares and they’ll need to get in early, otherwise the offering could be oversubscribed.

“As they say all the time, it’s not what you say, it’s how you say it. So we’re trained to say it with conviction, to make it sound more credible,” says Ramon, who works in a team that focuses solely on Australian victims.

“Once they fill out the application form and send it back to us, [we then] wait a couple of days for approval, sometimes even more, to make it look like it’s real.”

Looking back, Janelle Free says her encounter with investment scammers was more akin to being taken in by a cult than anything else she can describe.

“I feel now like I have been a victim of a religious society where they brainwash you,” she says. “I thought I was a smart person… then to go through this, you just feel so degraded and so humiliated and so stupid, so very stupid.”

For Free, it began with a fake Gina Rinehart scam ad on Facebook in mid-2022 and led to a man who said his name was Steve Fischer and claimed he was a financier based in London, who signed her up to a fake trading platform called Revenue Centre Pro.

But more important was the relationship she developed with the scammer, the so-called Steve Fischer, who wheedled his way into Free’s loving family, became a presence on speakerphone at dinner, and whom she trusted entirely and above the warnings from her own bank.

“How dare the banks block you from investing your hard-earned money?” Fischer would say.

“We are going to give you between 12 and 14 per cent every month on your money. The banks give you, what, 5 per cent a year if you’re lucky?”

Fischer would ask Free to send him photos of the fish she had caught in their dinghy and the pair planned for a day when Fischer would visit Australia, and she could take him fishing and camping, too.

“I just thought he was like God’s gift. To have someone helping me to be more financially secure [so] that I could help my children. I just had such faith in him and such belief.

“I’d said to him, ‘I hope you’re always going to be in my life’. And I said that to him, I think two weeks before he took all of our money.”

Rather than just silently disappearing with their loot, scammers will often fake a catastrophic investment event. There’s a strategy behind this.

“The scammers are constantly trying to stay ahead of any online complaints or official investigations, so the more delay and confusion and doubt they can create at the end of these relationships, the safer they are,” Solomons explains.

“They’ll keep going for as long as they possibly can, and then there’ll be a decision taken, probably at a fairly high level of a syndicate… as to when to pull the pin. Typically, it’s by engineering some sort of fake event, ‘Oh, there’s been a software glitch and we lost all the money’, or ‘we had a rogue trader who stole your money’.”

Free remembers she was told that Fischer was sick the night it all came crashing down. A man called Jacob was in his place.

“It was very different to how I’d ever traded before,” Free recalls. “And he said ‘This is the big one, Janelle. This is where all your children pay their mortgages off’. And I was so excited… I was counting the zeros because I’ve never traded with this much money.”

Yet when she logged back into her account the next day, everything was in the red. Where there had been hundreds of thousands of dollars in profits, there were now thousands of dollars of losses.

Fischer said he was sorry, and promised he could get her money back, if only she could find him another $30,000.

“Another 30,000?” Free replied. “Steve, you know I haven’t got any more money at all.”

Scammers asked Free to take this photo with her driver’s licence to verify her identity. It illustrates the tactics they used to give her the impression they were a legitimate investment company. 

Several months before, in March, Fischer had convinced Free to sell her house, spinning her stories about a looming boom in the cryptocurrency Bitcoin. He said it would bring Free and her family untold prosperity if she took advantage of it.

Free had purchased the land at Pacific Pines on the Gold Coast many years ago, and then borrowed, scrimped and saved to build a house on it. But she’d never been able to afford to live in it.

“The only thing I’ve got left is my house, but that’s what I live off, that’s my income,” she told Fischer, when he asked her if she had anything to sell.

Fischer had replied that if she sold her house, she could buy four houses with the money she was going to earn.

The grandmother of five had more reason to trust him than most. The fraudsters had been paying back Free a proportion of her investment to give the impression of genuine profits.

The house sold for $930,000.

Free estimates that once expenses were taken out, there was about $900,000 left, all sent to Fischer. The scammer also convinced some of Free’s close friends and relatives to invest. Altogether, the seven victims lost more than $2 million.

Even after scammers have robbed their victims of their home and their savings, they’ll still come back for more. This is the next step.

“They call it recovery,” says Maroti, a source based in Europe who gathers intelligence from informants inside scam syndicates.

He explains that once people have been scammed, they are often targeted by fraudsters a second time.

They will fleece them again, perhaps by tens of thousands of dollars, telling them a fake story that they have retrieved their lost funds, and need to pay international tax for the money to be transferred.

A recovery scam advertisement from social media.

Since she realised she was scammed, Janelle Free has been contacted by two individuals promising they will get her money back. One of them goes by the name Daniel Saunders, and is part of the initial group of scammers.

Where Fischer charmed everyone, Saunders is abrasive and rude.

He has asked Free for more than half a million dollars so that she can reclaim the lost money and continue trading.

“Without signing the documents, I can’t give you the money back!” he once yelled. “Is that clear?”

Free had been stringing along the fraudster with false promises her children would take out their superannuation, hoping to gain some information that might help authorities catch those responsible.

Since reporting the scam, Free says she has spoken to someone from the Australian Federal Police twice, but is frustrated they haven’t been able to track down the scammers.

“I don’t feel there’s been enough effort put in,” she says.

Ken Gamble, executive chairman of IFW Global, says he has forensically linked the syndicate that targeted Free and her associates to an Israeli criminal group with call centres in Cyprus, Bulgaria and Serbia.

Mitch says some scammers justify their actions a bit like a drug dealer would. If they weren’t doing it, someone else would. That their victims are stupid, and would lose their money eventually anyway. That they’re “sheeps” [sic] whose wool is for cutting.

Others are somewhat reluctant fraudsters dealing with difficult personal situations.

“You have people who have family members that are on tubes, and they don’t have money to pay for treatment,” he says.

“If I go to them and tell them, ‘Hey you’re going to work for [€] 2000 ($3257) a month’, and they’re working for 300, for example… Would you continue working for 300 and look at your family member die in front of your eyes? Or would you, you know, say ‘F--- it, I’m gonna get my hands dirty and try to save them’.”

Ramon admits that the guilt from his job weighs less heavily on him these days. Part of that is due to his work as an informant. He passes on information to private investigators in the hope it could help victims regain some of their losses. His heart has hardened, too.

“For my first few years, I’m not really having great nights sleeping, but the way these guys actually help us out in being numb with what’s going on is that they always tell us that, ‘Hey, remember, these guys have millions and millions in worth, so they’re OK losing this money’.”

Of course, this is just another one of the scammers’ lies.

Despite her ordeal, Janelle Free appears warm, talkative and bubbly. She’s made a career of cutting people’s hair and “talking to people”, sharing in their worries and stories.

Asked how she has managed to stay so upbeat, Free offers that she is on medication, wracked with guilt for putting the people she loves the most in the path of a charlatan. Her children fret about her and reassure her that it’s “just money”.

“I just wanted to leave them better off than I ever was. I didn’t want a helicopter or a plane, I just wanted to pay off my children’s mortgages. And now I’ve got nothing, nothing for them,” says Free, her voice breaking.

Here is the link:

https://www.theage.com.au/business/consumer-affairs/psychopaths-are-the-best-confessions-from-inside-the-scam-industry-20241113-p5kqey.html

It is hard to think of much to add, other than to say it pays to be very alert when gathering information from the web. Some of it will not be quite as it seems!

David.

AusHealthIT Poll Number 773 – Results – 17 November 2024.

Here are the results of the poll.

Overall Is The Return Of Donald Trump To The White House A Good Or Bad Thing?

A Good Thing                                                              1 (3%)

A Bad Thing                                                              39 (97%)

I Have No Idea                                                           0 (0%)

Total No. Of Votes: 40

A very clear vote with Trump not much favoured here in OZ apparently!

Any insights on the poll are welcome, as a comment, as usual!

Good voting turnout. 

0 of 40 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

I Think I Said At The Time This Was A Silly Idea. So It Has Proven!

This appeared last week:

08 November 2024

Medical Costs Finder Stagnated, but we’re working on it: DoHAC

By

Laura Woodrow

The $24.2 million project has copped a lot of flak for its poor engagement from doctors. But the department is holding fast that it’s an asset, reaching one million users.

---

Medical Costs Finder has reached the one million users milestone. But are those users getting any value from the $24.2 million service?

Speaking at Senate Estimates yesterday, the assistant secretary of DoHAC’s health system strategy division Brian Kelleher said the number of people who had visited the website had reached one million, with approximately 60,000 new users a month.

The number of doctors registered remains lacklustre – albeit improved – at 218, with only 73 choosing to publish their costs.

The cost for the website remains a whopping $24.2 million.

Independent Senator for the ACT David Polcock queried how the department was measuring the site’s success.

First assistant secretary for health systems strategy Ross Hawkins said a key success measure was people visiting the website.

Mr Hawkins said 70% of consumers supported the concept of an independent and authoritative website about costs.

When asked whether they had data on whether anyone was actually exploring the website, via bounce rates, for example, Mr Hawkins said they would have to look into their analytics data.

“The feedback we’re getting is that people find having median costs useful,” he said.

“[I] appreciate that the number of specialists [registered] is lower than anticipated, but actually in terms of providing those median prices across 1300 different services, giving people an idea of what that’s like locally, giving them indications around the patient journey, out of pocket costs, it’s a useful tool that people engage with.

“Broadly from the indicators, we see around 60,000 new users tipping in over a total of one million users to date and feedback we’re getting from consumer groups, it’s coming across to us as [a] positive experience engaging with the website.

“But again, we’re always happy to work with groups and take feedback and further refine the experience.”

When asked about the possibility of publishing specialist costs without voluntary doctor registration, Mr Kelleher said this was not the path chosen by the department.

“The numbers are low … but we proceeded down the path of engaging with medical specialists on a voluntary basis, and that was a decision that the government took at the time,” he said.

“The department does not generally publish highly disaggregated fee information for medical benefit services.

“That’s why, at this point in time, information on the website is delivered at an aggregate level.”

Minister for Finance, Women, and the Public Service Katy Gallagher said the department had been engaging with the health minister about how to strengthen the website.

“It was started, and then nothing, [or] very little, was done,” she said.

“Minister Butler is keen to make sure it’s providing as useful a service as it can.

“But the reality in health is you do need to work collaboratively with all stakeholders if you’re going to make something a success. It’s simply the reality of the health system.

“And so that does mean working with specialists, doctors and consumer groups to make sure it’s doing what it needs to do.

“But our view is more transparent, more access to information, the better, and the minister’s working on that.”

Here is the link:

https://www.medicalrepublic.com.au/medical-costs-finder-stagnated-but-were-working-on-it-dohac/112347?utm_source=MC-TMR%20List

Can you please explain to me why a doctor would publicize what he charges for a surgical procedure via a Government web site. There is no reason I can think of unless they want to discourage patients or some other reason even more obscure!

Other ideas welcome!

David.

It Looks Like We Are Not Processing New Drug Applications Promptly, As We Should

This appeared last week:

Health officials warn of ‘practical limitations’ to medicine subsidies despite ‘triage’

James Dowling

November 08 2024

Questions from the opposition have detailed the timing and policy of a recent controversial delay to the consideration of new drug subsidies.

Fears of ongoing delays to critical new medicine subsidies have been stoked by a Health Department admission that its independent drug assessor will continue to place a “maximum number” on submissions considered at its meetings, despite Health Minister Mark Butler calling an emergency meeting over the decision to indefinitely delay 45 medications.

It has now emerged that Mr Butler knew of the unprecedented decision for almost a month before the crisis became public.

A group of Health Department officials led by Finance Minister Katy Gallagher was questioned on Thursday at Senate estimates over the Pharmaceutical Benefits Advisory Committee’s unprecedented decision to delay the medication recommendations in response to excessive submissions.

The announcement was quickly followed by departmental efforts to “triage” the delay, and the introduction of an additional PBAC meeting to work through the deferred submissions.

However, Senator Gallagher told the panel on Thursday the PBAC would continue to grapple with “finite resources and time”.

“I think you also need to accept the reality of the fact that there is only so much that one PBAC meeting can do,” Senator Gallagher said.

“If you get double the amount of submissions or whatever it is close to that, including complex submissions, there is finite resources and time to deal with that.

“It’s not a mass deferral. There is triaging under way so that a reasonable amount, or the most that can be done at March’s meeting can be done, and then an extra meeting can deal with the other submissions.”

On November 4, Mr Butler first confirmed he was concerned with the response of his assessor, and directed his department “to urgently engage with (industry body) Medicines Australia to examine all potential solutions”. By November 6 he confirmed an additional PBAC meeting for May 2025.

Despite this, documents tabled by the Health Department following questions on notice indicate he was informed of the excessive PBAC demand much earlier, on October 9.

According to the timeline provided by the Health Department, Mr Butler directed his department to inform Medicines Australia of the problem that day, before contacting independent evaluators on October 11 to determine whether they could meet the workload.

An October 16 PBAC triage meeting was held to determine which submissions would be deferred. Less than a week later, Medicines Australia and the relevant applicants were informed of the decision to hold back some submissions.

On October 23, those same applicants were issued invoices despite the delay to services.

The public was made aware of the change in process on October 30.

Since the announcement, health officials have contended there is no intention to defer future submissions, but confirmed in estimates there were internal processes changed in response to the excessive applications.

Health Department deputy secretary Duncan McIntyre said the new submission limit would not be “a hard and fast number”, as staff indicated the measure was not intended to prevent their scaling up of evaluator capacity.

Health resourcing deputy secretary Penny Shakespeare said in estimates there were “practical limitations to what can actually be considered by our external contracted evaluators in future”, while economist Blair Comley called the measure a “way we can practically work through this unprecedented spike”.

Opposition health spokeswoman Anne Ruston, who initially levied the questions at estimates, told The Weekend Australian Mr Butler had dodged responsibility for the debacle.

“The department has belled the cat and admitted that there is an ongoing cap on the number of medicines that can be considered for listing on the PBS under the Albanese government,” Senator Ruston said.

“After deflections and denial from the department and the government, we now have worrying confirmation that there could be ongoing delays in patients’ access to essential new medicines.

“This is the first time in the history of the PBS that a cap of this nature has been put in place.

“The Minister for Health must clarify whether he agreed to this cap being put in place, and whether he will guarantee its immediate removal.”

A spokesperson for Mr Butler said the Health Department was “ensuring patients get access to life-changing medications and treatments as quickly as possible”.

Former Pharmaceutical Benefits Scheme chief and Better Access Australia chair Felicity McNeill said calling a May 2025 PBAC meeting amounted to an “acknowledgment” of a “breach of the community’s trust”.

“The PBAC is his committee and the community needs him to lead on this issue now and moving forward,” Ms McNeill said.

“The fight is not over until this is all resolved, but seeing the system start to move is a great first step.”

Ms McNeill argued the government response still lacked transparency given a list of delayed medicines had not been made publicly available.

Parliamentary documents indicated the number of submissions to be considered across March and May had reduced from 77 to 63 since the announcement of deferrals.

Here is the link:

https://www.theaustralian.com.au/nation/health-officials-warn-of-practical-limitations-to-medicine-subsidies-despite-triage/news-story/1b9cbcb73c102179df7f10eaa6cbd0a7

I guess it is just bad luck if the drug you need is having its approval slowed for no better than bureaucratic delay and slowness. I hope there is some sort of feedback possible from societies that assist various categories of disease sufferers to speed things up!

A bit of a pity if you die because of bureaucratic delay!

David.

Vapes Are Loose All Over, Despite The Government’s Plan To Regulate Them!

This appeared last week:

About 1 million Australians use vapes. Chemists dispensed them just 3500 times last month

By Natassia Chrysanthos

November 9, 2024 — 4.45pm

Vapes were dispensed behind-the-counter at pharmacies just 3500 times during the first month of the federal government’s scheme to weed out the black market by making them chemist products, despite an estimated 1 million Australians using the devices.

Data supplied to Senate estimates reveals the uptake of pharmacy vape prescriptions was slow in October, the first month that e-cigarettes could be bought after a consultation with a chemist under Health Minister Mark Butler’s vaping crackdown.

With about 5800 pharmacies across the country, the data suggests thousands of them would not have prescribed a single vape product.

The government’s initial policy analysis assumed about 450,000 people a year would seek out medical vape products once illicit products became harder to get.

But many pharmacists say they are holding back from selling vapes on ethical grounds or because the process is too onerous. Illegal vapes are still widely available but have surged to between $40 and $60 a device as retailers bump up prices to compensate for higher penalties.

Health Department officials quizzed at Senate estimates last week said they were not keeping track of how many pharmacies were selling vapes at present. “It is actually quite difficult to get clear answers on that,” said Chief Medical Officer Tony Lawler.

Department official Chris Bedford provided data on the number of times vaping products had been dispensed by pharmacists after a patient consultation.

“There’s been 3500 of those across Australia ... The pharmacist could dispense more than one vaping good per notification, so the patient would go in and have the conversation,” Bedford said.

But the Health Department does not count how many vapes are sold with a doctor or nurse practitioner prescription – the other avenue that people can use to buy vapes legally.

Coalition health spokeswoman Anne Ruston said it was astounding that the department did not know how many pharmacies were selling vapes “when this is a key component of the government’s policy”.

“The number of vapes dispensed by a pharmacist last month represents a negligible percentage of the estimated vapers in Australia,” Ruston said. “We know that the majority of pharmacists do not want to become tobacconists, and this is clearly represented in the department’s figures.”

No vape products have been listed on Australia’s register of therapeutic goods, meaning pharmacists have to prescribe and sell unapproved products. A spokeswoman from the Pharmacy Guild, which represents business owners, said this made pharmacists reluctant to supply them.

”There is limited evidence of their long-term safety or effectiveness in supporting long-term smoking cessation,” the spokeswoman said.

The pharmacy sector has pointed to anecdotal data indicating levels of uptake in lieu of official figures. An Australian Journal of Pharmacy reader survey found 86 per cent were not stocking vapes.

The Health Department told Senate estimates that about 1000 pharmacists took part in an information session run by the Australian Pharmaceutical Society in September to learn more; at the same time, a Pharmacy Guild poster advising patients that a chemist does not stock vapes has been downloaded more than 2000 times.

Richard Lee, chief executive of Liber Pharmaceuticals, which manufactures one of Australia’s main pharmacy vape products, said Butler’s pharmacy scheme had gotten off to a slow but reasonable start.

He said part of the reason for the slow uptake was that guidelines from the Therapeutic Goods Administration and Pharmaceutical Society of Australia had been released only in the days before the new scheme launched, on October 1.

“Nobody had time to process the changes to the framework or put operating procedures in place in time,” he said. “Most pharmacies are saying, ‘We’re in, but we’re not in yet’, because they take their responsibilities seriously and don’t want to get it wrong.”

Lee anticipated a significant uptake as pharmacies absorbed the changes and understood what they needed to do. “But it’s going to take three to six months,” he said.

Butler said his laws were unapologetically focused on protecting young Australians. “Vape stores around the country are closing, and importantly, young Australians are saying they are finding it harder to purchase vapes,” he said.

“The national laws set a strong and uniform baseline across the country that stamps out recreational vaping, particularly for young Australians, while allowing access for hardened smokers who want to kick the habit.”

Here is the link:

https://www.smh.com.au/politics/federal/australia-has-about-1-million-vapers-chemists-consulted-them-just-3500-times-last-month-20241108-p5kp1g.html

This rather looks like a policy mess to me.

I wonder will we get a report in a few months letting us all know just how the regulations are working?  I suspect then we will see much higher usage than expected.

As for illegal sales – will be very interesting to see how they go over the next six months.

Watch this space!

David.