Friday, August 30, 2024

Surely It Has Come Time To Have Just One Private Health Insurer Who Can Be Regulated To Do The Right Thing!

This appeared last week:

Health insurance shouldn’t be private hospitals’ field of dreams

Instead of protecting private hospitals from predatory insurers, an obsolete contract framework protects hospital operators from full accountability for avoidable inefficiencies and commercial misjudgments.

Terry Barnes Contributor

Aug 25, 2024 – 12.23pm

Yet again, Australia’s private hospitals and health insurers are at each other’s throats. As The Australian Financial Review has reported, Catholic Health Australia, representing 63 Catholic hospitals, seeks Australian Competition and Consumer Commission authorisation effectively to represent member hospitals in contract renegotiations with insurers, while blocking five big insurers, including listed companies Medibank Private and Nib, from entering contracts with individual Catholic hospitals as “collective” discussions take place.

Private hospital operators, and even big for-profit ones such as Ramsay and Healthscope, routinely claim they are saints in the dysfunctional relationship between hospital operators and insurers, and that insurers are rapacious sinners.

The truth, however, is that both payers and providers play the contract game hard. Hospital operators know that, without them, insurers have no product. On the other hand, without private insurance, only the wealthiest could afford to go private and hospital operators would collapse. The federal and state governments, already strained to the limit in funding and running public hospitals, need them both.

Catholic Health’s ACCC case reinvents history by presuming the hospital contracting deck is stacked for insurers against providers. In fact, the contracting regime it complains about now is what the private hospital industry (PHI) demanded and got when the current legislative framework was legislated in 1995.

In the dying days of the Keating government, just before the internet transformed the healthcare business, PHI participation was at a record low, and then-unsubsidised premium increases were killing the sector, Labor health minister Carmen Lawrence reluctantly agreed to make the industry more commercial by allowing insurers to negotiate and enter into contracts with hospitals and doctors.

The resulting regulatory framework was established only with acrimonious negotiations and political gamesmanship involving the then government and opposition, hospitals, insurers and the Australian Medical Association. The AMA and hospital lobbies shamelessly invoked the spectre of “US-style managed care” – with insurers telling members who would treat them and where they could be treated.

Lawrence’s resulting settlement, still fundamentally in place today, bent over backwards to guarantee providers’ clinical and commercial autonomy, and to restrain insurers’ ability to play negotiating hardball by denying hospitals contracts altogether.

If operators ... sink their own money into unprofitable white elephants, insurers and the insured shouldn’t carry the can.

The regulatory compromise underwriting this is the second-tier default benefit. This mechanism guarantees accredited private hospitals at least 85 per cent of an insurer’s average charge for equivalent treatments in negotiated agreements with “comparable private hospitals”. In other words, hospitals receive a guaranteed floor price from any insurer, whether or not they are in contract.

Thirty years on, however, default benefit revenue protection for providers arguably has contributed to a Field of Dreams “if we build it, they (the insurers) will come” mindset for at least some private hospital and day procedure centre operators, entrepreneurs and investors. If operators and their backers run inefficient facilities or sink their own money into costly and unprofitable white elephants, insurers and the insured shouldn’t carry the can for operators’ poor management decisions, through inflated premiums and out-of-contract patient costs.

To that end, second-tier default is obsolete and counterproductive, and should be abolished. Instead of protecting private hospitals from predatory insurers as intended, it actually protects hospital operators from full accountability for avoidable inefficiencies and commercial misjudgments.

But insurers need to accept that private hospitals cannot control all unavoidable expenses in providing vital services, and do their best to contain costs. The Victorian government’s profligate 25 per cent enterprise bargaining agreement with nurses and midwives, for example, sets a new benchmark, which all other hospital operations, private and public, will be forced to follow to retain vital nurses, and those huge extra unavoidable costs will be passed on.

Meanwhile, the AMA plays all sides, knowing its political leverage with the government, insurers and hospitals gives it power without responsibility.

The real problem

Federal Health Minister Mark Butler is reviewing the financial health of private hospitals, testing operators’ claims of being dudded by insurers. The real problem, however, is that the industry’s contracting framework, established by Labor three decades ago, is no longer fit for purpose in a radically different healthcare environment.

What’s really needed is wide-scale policy reform that understands current and future market and provision cost pressures. It should ensure purchaser-provider regulation adopts current and emerging clinical and technological best practice, including better funding for out-of-hospital and preventive care; anticipates future demographic and demand pressures; and ensures better resolution of contracting disputes between private hospitals and insurers.

Such needed reform involves political courage, especially in an election year, for none of the insurers, private hospitals and, especially, the AMA, will ever be satisfied.

Although Butler has missed the main private health reform game, providers and insurers can’t just run to mummy – whether the government or the ACCC – to resolve their differences. They must work together in the common interest. Yet, by constantly battling each other, each side inflicts collateral damage on those who should matter most: long-suffering private healthcare consumers.

Here is the link:

https://www.afr.com/policy/health-and-education/health-insurance-shouldn-t-be-private-hospital-s-field-of-dreams-20240820-p5k3v6

This problem is obviously in the too hard basket as neither patients, doctors, private hospitals, Governments or insurers are fully happy with the status quo! If they were there would be much less in the way of political noise and complaint! Sadly to fix things is a 'wicked' problem, that may be near to insoluble!

How to fix things is well above my pay-grade so I guess we will just keep paying the premiums It would be nice to be sure everyone was getting value for money out of the system!

In my dreams I guess…

David.

Thursday, August 29, 2024

It Rather Looks Like That The Basic Band-Aide Is Past Its Use By Date!

This appeared last week:

These smart bandages talk to your doctor while speeding up healing

There has been little innovation in our medieval practise of wound care, but that is about to change, thanks to rapid advances in technology.

Elizabeth Cohen

25 August, 2024

A new generation of smart bandages that could allow doctors to remotely monitor wounds, decrease scarring and speed up healing with a zap of light or electricity is on its way.

These hi-tech bandages could eventually replace today’s usually simple constructions of gauze and plastic or latex, which can’t detect anything about the wound underneath and don’t do much more than apply pressure or hold a cream or ointment in place.

“We kind of are practising medieval medicine in wound care. It’s a lot of poultices and salves,” says Dr Geoffrey Gurtner, chairman of the surgery department at the University of Arizona College of Medicine, who is among those working to develop a smart bandage. “There hasn’t been a lot of innovation.”

Smart bandages are part of the burgeoning wearable-tech industry, aided by more advanced microsystems and flexible electronics, and fuelled in part by $80m in funding announced in 2019 by the research arm of the US Defence Department, to develop bioelectronics to help wound healing.

Now smart-bandage prototypes fill display halls at medical conferences. Many contain small electronics that can detect how a wound is healing and wirelessly transmit the information to a doctor.

Some enable the doctor to remotely dispense treatments. Such technical sophistication likely wouldn’t be necessary for a simple cut or scrape, but could be lifesaving for severe wounds treated in the hospital or chronic wounds cared for at home.

“You could have healthcare centres that monitor these devices and contact the patients when there’s a potential problem, and advise them on next steps,” says Dr William Tettelbach, a wound care specialist and president of the American Professional Wound Care Association. “I think it really is the future.”

Many of these inventions are in the early stages – some in animal or human testing, and others still in the lab – and far from coming to market.

“It’s a very hot area right now,” says Guillermo Ameer, a biomedical engineer and professor at Northwestern University in Illinois. “When we first started in this area five years ago, there were very few people, very few labs, looking at smart systems or smart bandages,” he says. “Now we have many researchers and colleagues, not only in the United States but in China and Europe, that are pursuing this.”

Many of the smart bandages use a piece of electronic circuitry that goes into a pocket in the bandage itself. When the bandage needs to be changed, the circuitry would come out of the pocket and be put into a new bandage. The circuitry is often flexible, such as that developed by a team of researchers led by Stanford University and described in a 2022 study.

Researchers at the University of Pennsylvania and Rutgers University are testing a bandage in mice and rats that can detect infection and then deliver electrotherapy – a zap of electricity – to help speed healing.

Some studies have shown that electrical stimulation can increase the migration of immune cells to kill germs and remove dead cells at the wound site, and randomised clinical trials have indicated that electrical stimulation can improve wound healing.

They envision the bandage sending reports via a cellphone app, says Yuanwen Jiang, an engineer and assistant professor at the University of Pennsylvania who is working on the project with Simiao Niu, an engineer and assistant professor at Rutgers University.

“The bandage will be able to transmit the signals of the wound in real time to the physician, so they will be alerted if there’s anything that’s dramatically off-track happening,” says Jiang, who was previously a postdoctoral fellow at Stanford and co-author of the 2022 study.

The bandage could also have the ability to deliver antibiotics, which could be stored in a small capsule or hydrogel. If infection strikes, a doctor could remotely order a valve to be opened and the ointment delivered to the wound. The theory is that if the antibiotic is delivered early and the wound heals easily, it would help avoid an overproduction of collagen, which can produce scarring. The team hopes to start testing in humans next year.

At Northwestern, Ameer is a principal investigator with teams that are working on two smart bandages, both of which have been tested in mice and are now being tested on pigs.

One dispenses a drug – in this case, a compound called panthenol citrate, which Ameer says has antioxidant and antibacterial properties and can encourage blood vessel growth.

The other smart bandage has two electrodes – a flower-shaped one on top of the wound and a ring-shaped one around it – that send out electrical currents to measure how moist it is. Moisture indicates the wound is still trying to heal, and a drier environment indicates healing is further along.

The bandage wirelessly transmits the moisture levels to the doctor, who can remotely program the electrodes to deliver electrotherapy, promoting the growth of new skin cells and blood vessels.

A tiny coil in the bandage, similar to those used to wirelessly charge cellphones, powers the system, and the entire electrical apparatuses is covered with a protective transparent tape. With electrodes made from a metal called molybdenum, which is thin enough to biodegrade, the entire bandage dissolves when its job is done. The researchers hope to start human testing with both bandages next year.

In other technologies, a team at the University of Southampton in England is developing a bandage that uses tiny LED lights to emit ultraviolet-C light, sterilising the wound as it heals. The bandage isn’t yet in animal trials.

Smart bandages might even go beyond wounds. The Southampton team, led by engineering professor Steve Beeby, is also working on a bandage to monitor atopic dermatitis – a common type of eczema that causes cracked, dry skin – using a sensor that detects moisture levels in the skin. It sends that information to doctors, who can use it to help determine whether a treatment is working.

Smart bandages could cost more to produce than traditional devices, and it is too early to say how they would be covered by insurance. But researchers say early detection and care for infections could ultimately save lives and medical costs.

Diabetics make up a large portion of those suffering from wound complications, with an estimated 160,000 hospitalisations for amputations among diabetic adults in 2020, according to the US Centres for Disease Control and Prevention.

Medicare expenditures for all chronic wounds in 2019 amounted to an estimated $33bn, according to a study published in the Journal of Medical Economics.

“I’ve seen patients that have had wounds for 10 or 20 years, and they’ve probably racked up millions of dollars, one hospital, one (doctor) visit at a time,” says the University of Arizona College of Medicine’s Gurtner.

A bioengineer as well as a surgeon, he is developing a smart bandage born of his experience at weekly wound clinics.

“I see patients on Tuesday, and they look good, everything looks good – they’re healing. And then you see them the following Tuesday, and they have rip-roaring cellulitis, and you have to send them to the emergency room to get an amputation,” he says. “At some point between those two moments in time, something changed.”

Gurtner is developing a bandage along with engineers at Stanford University. It uses electrical stimulation and biosensors to help increase blood flow to the injured tissue, close wounds more quickly and reduce infection. A thin electrical layer contains sensors, an electrical stimulator and wireless circuitry to power the electronics and provide Bluetooth transmission of data. Together, they measure the wound’s healing process, increasing electrical stimulation if the wound becomes infected or is healing too slowly.

In March, Gurtner’s team started testing the device on humans. The team expects the tests to conclude in 18 months, and then it will apply for approval from the US Food and Drug Administration.

One ultimate goal would be for the smart bandage to fix the problem without a doctor being involved at all. Gurtner – who has $250m in funding from the Armed Forces Institute of Regenerative Medicine, a collaboration of the Defence Department, academia and private industry – envisions his smart bandage being used to detect and treat infection in soldiers wounded on the battlefield.

THE WALL STREET JOURNAL

Here is the link:

https://www.theaustralian.com.au/business/the-wall-street-journal/these-smart-bandages-talk-to-your-doctor-while-speeding-up-healing/news-story/7f66cd04cb980ad9403bb3e56daa0425

Is there nothing those engineers won’t try to improve? I guess little harm can come from bandages that work better – save for the cost!

The market will decide I am sure!

David.

Wednesday, August 28, 2024

It Is Good To See At Least Some Of The Fraudulent Scams Are Being Nobbled!

This really has to be good news – may they rot in Hell!

ASIC shuts down more than 7000 scam websites in major crackdown

By John Collett

August 20, 2024 — 11.07am

The Australian Securities and Investments Commission (ASIC) has made headway in its efforts to stem the seemingly never-ending tide of scammers, taking down more than 7300 phishing and investment scam websites in the past year.

The amount of money lost to scams is also falling. It was at $2.74 billion in 2023, down from $3.1 billion in 2022. The regulator attributes this, in part, to its taking down of dodgy websites since last year.

More than 5500 of the website take-downs were investment scams and more than 1000 were “phishing” scams. Cryptocurrency investment scams accounted for more than 600 of the shutdowns.

Phishing is where criminals trick you into handing over personal information. They often send emails or text messages pretending to be from large organisations you know and trust.

ASIC deputy chair Sarah Court says the technological landscape around scams is rapidly evolving. “Innovative technology developments may improve how we live and work, however, it is also providing new opportunities for scammers to exploit,” Court says.

“Every day an average of 20 investment scam websites are taken down [by ASIC]; the quick removal of malicious websites is an important step to stop criminals from causing further harm to Australians.”

ASIC refers suspicious websites to a third-party company specialising in cybercrime detection and disruption. Many of these websites are operated by criminal syndicates offshore, in countries where Australian law enforcement cannot reach.

Websites taken down include those run by people not licensed or authorised to offer investments or other financial services in Australia and ‘impostor’ style scams, run by those who impersonate or falsely claim to be associated with a legitimate business.

However, scammers continue to find new ways through new technology to lure Australians into their traps, Court says.

“Anyone can fall victim to these scams ... the level of sophistication of scams, the use of artificial intelligence, deep fakes and alike, just makes it very difficult to tell whether... something is fake or not,” she says.

Most of these scams pop up in social media feeds and are designed to get your attention, she says.

ASIC’s take-downs of websites, the recently established National Anti-Scam Centre and other initiatives of the Albanese government are likely driving the fall in the total amount of money lost to scams, however, the number of people affected by losses continues to rise.

Investment scams remain the leading type of scam impacting Australians, resulting in $1.3 billion in losses in 2023.

Some of the sites taken down by ASIC can be viewed here.

ASIC’s Moneysmart site shows if a company or person is licensed or authorised to offer investments. The regulator’s tips for avoiding scams include not providing personal information or acting on investment advice you have seen on social media.

Consumers need to be hyper-vigilant as scammers can create fake news and reviews to make an investment seem legitimate.

Here is the link:

https://www.smh.com.au/money/investing/asic-shuts-down-more-than-7000-scam-websites-in-major-crackdown-20240815-p5k2q3.html

More power to their arm!

David.

Tuesday, August 27, 2024

There Are A Lot Who Agree With This And See A Huge Problem Going Forward.

This appeared last week:

Exclusive

‘Degree-factory unis fail the best, carry the worst’, says report

Natasha Bita

12:00AM August 24, 2024

Universities have turned into ‘degree factories’ that lower academic standards to reap revenue from students, the Menzies Research Centre claims in a new report.

Australian universities are ­“degree factories’’ that dilute ­academic standards through group assignments, woke teaching and cheating, a conservative think-tank has warned.

The Menzies Research Centre says universities should pay interest on student loans so they have “skin in the game’’ to ensure graduates earn enough money to repay their HECS debts.

It also calls for a crackdown on group assignments that force the smartest students to carry those who are struggling.

The report concludes that “a culture of credentialism’’ is watering down the value of a university degree, and calls for independent checks on student achievement and academic research.

“Universities are incentivised to accept academically marginal students and then lower the standards to pass them,’’ it states.

“Young people feel forced to obtain a tertiary qualification even though it provides them with no specific skills.

“Students and taxpayers have no guarantee about the quality of teaching they are purchasing with billions worth of student fees and taxpayer dollars.’’

The report calls for changes to the Higher Education Loans Scheme (HELP), which lets students borrow their tuition fees from the federal ­government and then repay the debt through higher taxes once they earn more than the minimum wage. The report says HELP loans “blunt the ­immediate price signal’’ to students, and encourage universities to “herd academically marginal students” into degrees.

It wants universities to be held liable for paying the indexation – which is pegged to the lower of ­inflation or wage growth – on student loans outstanding after five years. “Universities receive loan-financed student fees regardless of whether the tertiary training that it pays for is equipping these students with valuable or marketable skills and knowledge,’’ the ­report states.

“There is no penalty when universities fail to equip students with the skills they paid for.

“While the universities get off scot-free, it is the students themselves – along with the taxpayers … who are left bearing the burden.

“Future loans should be amended to include an interest charge to universities on any loan balances still outstanding after (five years).

“This reform would immediately force universities to start to care … whether their courses are actually equipping students with any meaningful understanding and skills.’’

The Menzies Research Centre has accused universities of cashing in on students by lowering academic standards.

The Menzies Research Centre also singles out a “tertiary credentials scam … where more and more jobs now require a univer­sity qualification, even when this is plainly unnecessary’’.

“The push to get more young people into university education, driven by a fear of being left ­behind in a service-based economy has, ironically, led to critical skills shortages in the trades ­sector,’’ it states.

Group assignments come under fire, too, with the report concluding they “lower the grading workload for academics’’ while disguising students who are struggling. The report calls on universities to do more to crack down on cheating, plagiarism and research fraud, citing a Nature magazine study that counted 10,000 research retractions worldwide last year.

The report takes aim at the “weaponisation of identity politics’’ in degrees in anthropology, history, media studies, gender studies and sociology.

It notes that maths and sciences degrees have been protected from woke instruction “by the ­objective standards that lie at their heart’’.

The report was written by the Menzies Research Centre’s youth policy director, Freya Leach, who is studying a bachelor of commerce and a bachelor of laws at the University of Sydney and stood unsuccessfully as a Liberal Party candidate in last year’s NSW election.

Here is the link:

https://www.theaustralian.com.au/education/degreefactory-unis-fail-the-best-carry-the-worst-says-report/news-story/1436137bb6e2153d0ac19ec5a0e3a75b

I have a pretty wide cohort of friends and colleagues who have PhDs after their names and who work at various universities.

To a person they all agree that things are on the slide and that major change is needed. The shape and cost of that change is what is the subject of contention and I can say I would not be the Federal education Minister for quids – it really would be just too hard!

I have no idea how to fix things from where we are but know for sure major fixing is needed!

Does anyone have any good and workable ideas?

David.

Sunday, August 25, 2024

It Has Been A Week I Could Have Done Without!

 I have to say it is good to be writing my Sunday blog this week. In the middle of the week there was a very real chance it may not have happened!

No sooner had I finished the lot for last week than I had an episode of  big time bleeding which resulted in a 5 day stay in the big hospital up the road where I once worked for a good few years many eons ago!

I have to say that on this occasion I was very, very grateful to the ambulance team who very swiftly got a very pale and rather unwell old man into the arms of the Ancient And Honourable St Leonards By The Railway where, despite the shortage, it was possible to administer some life-saving fluids and have me start to improve - while buying time for cross-matching a few bottles,of the high class claret to Red Cross so kindly provides in such dire circumstances!

Pleasingly the bleeding stopped quickly and I made it home by Friday - having been partially topped up, but still looking rather pale and wan I am told by everyone who sees me!

Of course there will be follow up to track down the source but I have to say I can happily not feel as crook again as I did with the initial episode for a very long while.

Blogs may be a bit irregular this week depending on recurrences etc.

Many,many thanks to all who made it possible for me to be typing to you this afternoon! I owe you one!!!

David,

AusHealthIT Poll Number 761 – Results – 25 August 2024.

Here are the results of the poll.

Should There Be More Effort Put Into Conservative Management Of Knee Pain To Assist More Patients Avoid Major Surgery?

Yes                                                                               17 (81%)

No                                                                                 4 (19%)

I Have No Idea                                                              0 (0%)

Total No. Of Votes: 21

A rather sad but very clear vote, suggesting we could do more to preserve those knee joints. More conservative work is definitely needed!

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

A totally disconnected voting turnout. 

0 of 21 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.

Friday, August 23, 2024

This Really Is A Pretty Awful Indictment Of The Australian Education System

This appeared last week:

This school has joined the education revolution. What about your kids?

Australian schools are finally catching up with a back to basics revolution that is lifting results all over the world.

Julie Hare Education editor

Aug 16, 2024 – 1.30pm

Steve Capp’s decision to get on board a grassroots movement that is shaking up Australian classrooms came after he witnessed the power of taking an evidence-based approach to how children are taught.

In the short time he has been principal at Chelsea Heights Primary School on Melbourne’s Mornington Peninsula, Capp’s approach has borne fruit. The proportion of children in his school above the national benchmark in literacy has jumped from 69 to 90 per cent.

“That’s just grade three and in only one year,” Capp says.

The approach, which has been dismissed and contested by much of the educational fraternity for decades, is a kind of back-to-basics approach which uses explicit instruction and a structured and sequenced approach to delivering new information.

“It’s about getting the basics right,” says Capp. “If you can’t spell, you can’t put good sentences together, never mind paragraphs.”

The school has seen improvements not only with children who previously struggled but also with high achievers after finding they can be extended. At the same time, behaviour has improved so much there is almost no need for disciplinary action.

The approach adopted at Chelsea Heights is building up a head of steam in schools across Australia as a growing number of teachers and principals became increasingly frustrated by the underperformance of the children in their charge.

There are changes in how classrooms are structured, and how teachers instruct their pupils. Gone are group desk formations. Rows of desks are back. Explicit instruction replaces curiosity-led learning. Phonics replaces whole language. Learning is disaggregated into bite-sized chunks that can be committed to memory and called on as necessary.

Not so long ago, this systematic style of teaching was considered old-fashioned and thought to suffocate creativity. But now federal Education Minister Jason Clare is demanding the states and territories that receive the bulk of public school funding go down the route of Chelsea Heights Primary School.

Experts say it’s the revolution we have to have as the nation reels from two decades of decline then stagnation on national and international tests.

A baseless theory

It seems bizarre, almost unbelievable in fact, that universities have for at least four decades being peddling a baseless theory of early literacy and reading – the whole-word approach – that has undermined the educational attainment of millions of children and sabotaged many adulthoods.

The cost of that experiment in what has been dubbed “pseudoscience” has been high for millions who have passed through the education system over the past few decades and left without the reading, writing and numeracy skills to be able to function effectively as an adult.

This year’s National Assessment Program – Literacy and Numeracy (NAPLAN) has provided yet another sad indictment on the impact of that prevailing orthodoxy.

One in three children is behind on where they should be at their stage of learning, one in 10 desperately so. The poorer a child is and the further away from a major city they live, the worse their results are.

One in 10 are so far behind they are at a high risk of becoming functionally illiterate as adults.

As The Australian Financial Review pointed out, NAPLAN has become a closer measure of family wealth than of student ability. It’s a sad fact that wealthy kids do well at school, poor kids don’t.

Today, as many as 40 per cent of year 9 boys and one in three girls are functionally illiterate, according to the latest NAPLAN scores. That has vast implications for their future lives – and for the nation’s productivity.

The evidence of Australia’s educational malaise is not limited to NAPLAN. On the OECD’s Program for International Student Assessment (PISA), just three in every five 15-year-olds can read at the “national proficient standard” – which is not very demanding – and just over half reach that benchmark for numeracy.

Finally, though, there is hope of a turnaround. The voice of reason, backed by science and evidence, is finally winning.

Experts largely agree on four things. First, money is important, but Australia is spending too much in the wrong places. Second, geographical differences in student performance are a national embarrassment. Third, the gender divide in academic performance needs a lot of attention. Finally, behaviour issues and school attendance are at all-time lows and that is in no small way linked to what is happening – or not happening – in classrooms.

Failing the majority

Whole-word and student-led learning might work for the brightest children, but they fail the majority. An analysis of NAPLAN writing data, which took in 10 million results spanning 2011 to 2021, found that the ability to write persuasively – or to be able to clearly organise thoughts and construct an argument supported by reasoning and evidence – has been declining over the past decade, even among the most high-achieving students, as the gap between high- and low-performing students became wider.

The dire state of Australia’s school education system, in particular its failure to pick up and remediate children at the lower end of the achievement spectrum, was writ large in a Productivity Commission report released last year.

The terse report was overflowing with data and facts that should be unacceptable in a developed economy such as Australia’s.

It found that despite a 21 per cent increase in student funding in the decade since the Gonski funding began, there had been no noticeable improvements in student learning outcomes.

Students who live outside major cities are, on average, 1.75 years behind their city cousins in literacy and two years behind in numeracy. The poorest 25 per cent of kids are 2.75 years behind rich kids in reading and three years behind in numeracy.

Melbourne University’s dean of education, Professor Jim Watterston, has previously pointed out that Australia has four education systems based on geography.

“It’s like a stepladder. If you take the eight metropolitan cities, students are as good as anywhere in the world. When you get to regional, it’s one step down where outcomes are average. When you go down another step to rural, the outcomes are really poor – and by the time we get to remote and rural, then we are in a Third World country,” Watterston says.

Proof outside Australia

Australia is late to the party, where the case for evidence-based learning from overseas is compelling. One needs only to look to Mississippi in the United States. One of the poorest states, it is ranked worst in the country for child poverty and hunger, highest in teen births, and third-last for adults with a high school diploma or equivalent.

However, since teachers started receiving training in scientifically based reading instruction with coaches embedded in schools, and additional intervention for all students having difficulty learning to read, the turnaround has been staggering.

As education advocate Leslie Loble points out: “The results from Mississippi show that students experiencing severe disadvantage are not only able to improve beyond previous state levels, they are improving so much they are overtaking other states in national rankings.

“Mississippi is one of only two states with improved fourth-grade maths scores over the past decade, and one of only three states with gains in fourth-grade reading over the decade.”

Over the past 10 to 15 years, the literacy and numeracy skills of children in England have improved measurably and significantly compared to most other high-income countries.

On PISA tests, England eclipses the G7 average and outperforms the OECD average – despite a squeeze on school funding over much of this period.

While England is middle of the pack on inequality, among OECD nations only Canada, Estonia, Ireland and Japan manage to deliver both stronger average attainment and lower inequality than England.

“This speaks to the success of teachers, schools and policymakers in improving the productivity of England’s education system,” reads a research paper released in June by the Institute of Fiscal studies.

This is despite, as in Australia, rising incidence of absenteeism, poor mental health, and the lagged effects on academic performance of lockdowns during COVID-19.

England’s success in turning around the academic performance of its students began in 1997 when Tony Blair became prime minister. He was hailed for saying his top three priorities in government were “education, education, education”.

At the time, England’s school system was sadly lacking compared to other industrialised nations. But the Blair government put in place ambitious standards, clear targets and straightforward accountability measures, while also increasing funding to improve the professional development of the teacher workforce.

Ross Fox is director of Catholic Education Canberra Goulburn (CECG), which has taken a system-wide approach to what is taught, how it is taught and how it is assessed.

This approach systematically builds one piece of learning on top of another to ensure students master key concepts before progressing to more advanced areas.

“Teachers realise that what they’ve been relying on as their knowledge base to achieve high-quality teaching and learning is insufficient,” Fox says, adding that much has been invested in professional development.

“Students learn in the right sequence. Teachers check in with high frequency that what they have taught is being learned. We need to make precious use of the million minutes that students have with us from kindergarten to year 12 and ensure they are engaged from the highest possible expectation of cognitive tasks.”

The diocese, which takes in the south-east coast of NSW, has since 2019 produced statistically significant improvements in NAPLAN reading in year 3 and year 5.

For example, the average year 3 reading score for children in CECG in 2023 was 422, while the national average was just 404. In numeracy, the score was 419 against a national average of 407.

While the comparative lead by year 5 is not as dramatic, it’s still there. In reading, for example, the average across CECG is 506 while the national average is 496. For numeracy, CECG children scored an average of 490, slightly above the national average of 487.

A survey of teachers in CECG found four in five agreed that using high-impact teaching methods meant students learned more and that it was worth the time and effort to implement.

Back to the lab

Professor Pam Snow and her college Professor Tanya Serry from La Trobe University were so frustrated with the lack of foundational understanding of the science of learning and explicit instruction most teachers had after graduating from university, they set up their own short course – the Science of Language and Reading (SOLAR) Lab – in 2020.

The lab takes the basic principle that teaching is largely a science, not an art. They were gravely concerned that most graduates were leaving their courses without basic knowledge of explicit teaching methods, and only the barest of skills in classroom management.

“There will not be any change in Australia’s educational outcomes until entire systems adopt new approaches that are based in evidence,” Snow says.

If schools were delivering evidence-based literacy programs as a whole-school approach, we wouldn’t be in this mess.

— Stella Finch, teacher and school counsellor

“The Commonwealth government has been complicit in not holding university education faculties to account. Teachers have to go and get the information themselves in a really inefficient way.”

They have put 12,000 teachers through the program since it began.

There is movement. NSW, Victoria, Tasmania, Western Australia, the ACT and the Northern Territory have all signed on to a federal government request that they implement evidence-based teaching in their classrooms. Only Queensland and South Australia are hold-outs as the clock ticks for a new national funding agreement set to be signed by the end of September.

Under current arrangements, the federal government puts up 20 per cent of funding for public schools, while the states contribute, in theory, 80 per cent. The total annual cost is more than $9 billion in federal money and $46 billion for the states.

The 20:80 formula was agreed under the last reform agreement, based on businessman David Gonski’s review of school funding. It calculated what is known as the schooling resource standard – an estimate of how much each student needs to have their educational needs adequately met.

In 2024, the SRS funding amounts are $13,570 for primary students and $17,053 for secondary students. The states want the federal government to contribute 25 per cent and an additional $32 billion over 10 years. The federal government has offered 2.5 per cent and wants the states to chip in the other 2.5 per cent.

The stand-off continues.

Shopping around

Stella Finch (not her real name) is a teacher and school counsellor who works in public schools in Queensland. She has seen the dysfunction when schools don’t prioritise evidence-based teaching and the desperation of young teachers who believe they lack the resources and knowledge to lift their students’ performance.

“If schools were delivering evidence-based literacy programs as a whole-school approach, we wouldn’t be in this mess,” Finch says.

“I have been privy to many choose-your-own-adventure literacy programs that are far from evidenced based. And I’ve witnessed the resistance – or the ignorance – of principals who choose not to opt for evidenced-based programs, even when advised otherwise.”

There is a personal edge to her professional experience – her own son could not read by the end of year 2. Frustrated by the school’s indifference to what was happening, she moved him to another school that had adopted a whole-school evidence-based reading program.

Two years later, her son is close to the top band for year 5 reading on NAPLAN.

“I just hope that my story can somehow help convince our ministers of education that putting some simple reforms in place is critical so we are not sitting here with the same problem in 20 years.”

Here is the link:

https://www.afr.com/politics/federal/this-school-has-joined-the-education-revolution-what-about-your-kids-20240814-p5k2ef

It really is pretty sad what a mess we somehow seem to have wound up in!

Some have suggested recalcitrant teaching unions may be at least part of the cause – I wonder if it is true?

No matter how you see it – bureaucracy is partly to blame I am sure! It is a worry we are apparently yet to really make strides towards to present state of the art - and all that can bring for our kids!

David.

Thursday, August 22, 2024

No Matter Who Is To Blame This Is An Appalling Catastrophe! God Is Not To Blame But Neither Did He Prevent It!

This appeared last week:

As Gaza toll passes 40,000, the dead are buried in yards, streets, stacked graves

By Julia Frankel and Wafaa Shurafa

Updated August 16, 2024 — 7.06pm first published at 6.59pm

Deir Al-Balah, Gaza Strip: Tiers of graves are stacked deep underground in a bloated Gaza cemetery, where Sa’di Baraka spends his days hacking at the earth, making room for more dead.

“Sometimes we make graves on top of graves,” he said.

Baraka and his solemn corps of volunteer gravediggers in the Deir al-Balah cemetery start at sunrise, digging new trenches or reopening existing ones. The dead can sometimes come from kilometres away, stretches of Gaza where burial grounds are destroyed or unreachable.

The cemetery is 70 years old. A quarter of its graves are new.

The death toll in Gaza since the beginning of the 10-month-old Israel-Hamas war has passed 40,000, according to the Health Ministry in the Hamas-run territory. The count does not distinguish civilians from militants.

The small, densely populated strip of land is now packed with bodies.

They fill morgues and overflow cemeteries. Families, fleeing repeatedly to escape offensives, bury their dead wherever possible: in backyards and parking lots, beneath staircases and along roadsides, according to witness accounts and video footage. Others lie under rubble, their families unsure they will ever be counted.

‘One large cemetery’

A steady drumbeat of death since October has claimed nearly 2 per cent of Gaza’s prewar population. Health officials and civil defence workers say the true toll could be thousands more, including bodies under rubble that the United Nations says weighs 40 million tonnes.

“It seems,” Palestinian author Yousri Alghoul wrote for the Institute for Palestine Studies, “that Gaza’s fate is to become one large cemetery, with its streets, parks, and homes, where the living are merely dead awaiting their turn.”

Israel began striking Gaza after Hamas-led militants stormed across the Israeli border on October 7, killing about 1200 people and taking some 250 others hostage. Israel seeks Hamas’ destruction and claims it confines its attacks to militants. It blames Hamas for civilian deaths, saying the militants operate from residential neighbourhoods laced with tunnels. The fighting has killed 329 Israeli soldiers.

Even in death, Palestinians have been displaced by Israel’s offensives.

Palestinians move corpses, shielding them from the path of war. Israel’s military has dug up, ploughed over and bombed more than 20 cemeteries, according to satellite imagery analysed by investigative outlet Bellingcat. Troops have taken scores of bodies into Israel, searching for hostages. Trucked back to Gaza, the bodies are often decomposed and unidentifiable, buried quickly in a mass grave.

Israel’s military said that it is attempting to rescue hostage bodies where intelligence indicates they may be located. It said bodies determined not to be hostages are returned “with dignity and respect.”

Haneen Salem, a photographer and writer from northern Gaza, has lost over 270 extended family members in bombardments and shelling. Salem said between 15 and 20 of them have been disinterred — some after troops destroyed cemeteries and others moved by relatives out of fear Israeli forces would destroy their graves.

“I don’t know how to explain what it feels like to see the bodies of my loved ones lying on the ground, scattered, a piece of flesh here and bone there,” she said. “After the war, if we remain alive, we will dig a new grave and spread roses and water over it for their good souls.”

Honouring the dead

In peacetime, Gaza funerals were large family affairs.

The corpse would be washed and wrapped in a shroud, according to Islamic tradition. After prayers over the body at a mosque, a procession would take it to the graveyard, where it would be laid on its right side facing east, toward Mecca.

The rituals are the most basic way to honour the dead, said Hassan Fares. “This does not exist in Gaza.”

Twenty-five members of Fares’ family were killed by an airstrike on October 13 in northern Gaza. Without gravediggers available, Fares dug three ditches in a cemetery, burying four cousins, his aunt and his uncle. Survivors whispered quick prayers over the distant hum of warplanes.

Those who died early in the war might have been the lucky ones, Fares said. They had funerals, even if brief.

Nawaf al-Zuriei, a morgue worker at Deir al-Balah’s Al-Aqsa Martyrs Hospital, is on the front lines of the rush of dead. Workers cover the damaged bodies in plastic to avoid bloodstains on white shrouds.

“We wipe the blood off the face so it’s in a suitable state for his loved ones to bid him farewell,” he said.

Following Israeli troop withdrawals, dozens of bodies are left on streets. With fuel scarce, workers collecting the dead fill trucks with corpses, strapping some on top to save gas, said civil defence official Mohammed el-Mougher.

Headstones are rare; some graves are marked with chunks of rubble.

When a corpse remains unidentified, workers place a plastic placard at the grave, bearing the burial date, identification number and where the body was found.

Searching for lost loved ones

The uncertain fate of relatives’ bodies haunts families.

Mousa Jomaa, an orthopedist who lives in al-Ram in the Israeli-occupied West Bank, has watched from afar as the war claimed 21 relatives in Gaza.

Jomaa’s cousin Mohammed was killed in an Israeli airstrike early in the war while operating an ambulance in southern Gaza and was buried in Rafah, away from the family’s home in central Gaza. The cemetery was damaged in a later offensive. There’s no sign of Mohammed’s body, Jomaa said.

Ceasefire talks are underway as the number of Palestinians killed in Gaza surpasses 40,000.

A strike in December then destroyed Jomaa’s uncle’s house, killing his aunt and her children, 8-year-old Mira and 10-year-old Omar. Jomaa’s uncle, Dr. Hani Jomaa, rushed home to search the rubble. Before he could find Mira’s body, a strike killed him too.

Because her body has not been recovered, Mira has not been counted among the dead, said Jomaa, who showed a photo of the young girl standing beside her brother, with a rainbow handbag matching her barrette.

In July, an Israeli tank killed two more cousins, Mohammed and Baha. Baha’s body was torn apart, and the shelling made it too dangerous to collect the remains for weeks.

Jomaa said that come the end of the war, he plans to visit Gaza to search for Mira’s remains.

Smashed graves and cemeteries off-limits

Israeli evacuation orders cover much of Gaza, leaving some of the largest cemeteries off-limits.

Jake Godin, a Bellingcat researcher, has used satellite imagery to document the destruction to more than 20 cemeteries. Sandy, bulldozed expanses appear where some cemeteries once stood. Gaza City’s Sheikh Radwan graveyard is cratered. In Gaza’s Eastern Cemetery, roads carved by heavy vehicles bury headstones under tyre tracks, he said.

“Anywhere the [Israeli military] is active, they bulldoze and destroy the ground without regard to cemeteries,” Godin said.

The military said it does not have a policy of destroying graves. “The unfortunate reality of ground warfare in condensed civilian areas” can result in harm to cemeteries, it said, adding it found Hamas tunnels underneath a cemetery east of the southern city of Khan Younis.

Mahmoud Alkrunz, a student in Turkey, said his father, mother, two brothers, sister and three of his siblings’ children were buried in the Bureij refugee camp’s cemetery after Israel bombed their home.

When Israel withdrew from Bureij in January, the graves were found unearthed. Alkrunz fainted when his uncle delivered the news.

“We don’t know what has happened to the bodies,” he said.

AP

Here is the link:

https://www.smh.com.au/world/middle-east/as-gaza-toll-passes-40-000-the-dead-are-buried-in-yards-streets-tiered-graves-20240816-p5k2vv.html

I have nothing to add except my horror and sadness. This many deaths just makes a mockery of all I did as a doctor and many like me as well!

We really should be able to do better than this!

David.