I Think This Is Worth A Read To Gain Some Insight Into What Can Trigger Awful Decline And Suffering.

This appeared last week:

Diary of a millennial anorexic: 5 rehabs and 15 lost years

Lara Bowman reveals how she went from being a happy child from a wealthy background to solitary confinement in a treatment centre.

LARA BOWMAN

20 April, 2025

Three years ago, my befuddled brain decided it wanted a cigarette. I stood up and then came the bark, “Sit down. You aren’t allowed to get up.” I had forgotten I was not allowed to get off the sofa without permission. If I needed a glass of water, I had to ask a fellow inmate in the “semi-acute psychiatric facility” to bring it to me.

I was anorexic, and the few steps to the tap were apparently too strenuous for my flimsy, palpitating heart.

Anorexia is the attempt to deny all needs but ends up making you the neediest of all. I had this realisation fittingly on the loo, trying and failing to relieve myself in front of a male nurse. Dignity long gone and used to this routine by now, I couldn’t have cared less.

I can pinpoint the beginning of my anorexia precisely. I caught the mother of all stomach bugs in July 2009, when I was 14. I was bedridden for a month. I lost about 1st in the first week, partially due to my mother’s misguided attempt to starve the bug out. She eventually succeeded, but I’m not sure she ever got her daughter back.

Emerging from my semi-catatonic state, I felt high, emotionless, untouchable. I liked it. So, I just kept going. Still unaware of the existence of a calorie, I mimicked my mother. Skip dinner; stick to vegetables and fish. Kaboom — I was still high. Like any addict, I spent the next 15 years chasing the euphoria of the first fix, but it was never quite as good. So far this morbid pursuit has resulted in seven years in five treatment centres, about thirty medications and a catalogue of psychiatric diagnoses in double digits. This is not to forget countless broken relationships, three incomplete degrees and a lot of my parents’ money.

In many ways I am an archetypal anorexic: female, privileged, perfectionist, bright and white. In my last stint in treatment, my father wrote me a letter that was read out in front of my fellow inmates. He wrote, “Lara’s childhood wasn’t perfect, but she was never hit, there was love, and she grew up with a silver spoon in her mouth. By any objective measure Lara’s life should not have been traumatic, but it patently is.” This is true. I grew up in beautiful houses in Clapham, south London, that featured in the pages of House & Garden. My mum was alternately an interior designer and a stockbroker and the mother of six children. My dad made Coca-Cola ads before he joined Ernst & Young to pay for the ever expanding family. We went to the best private schools, enjoyed lavish holidays and saw the coming and going of nine nannies.

Grown-ups would speak about my mother in awed whispers. She was the supermum of south London. We were the Clapham Von Trapps, dressed in pinafore dresses imported from Hong Kong. Despite the mob of children, the house was always spotless. Perpendicular family portraits lined the walls, our blonde hair perfectly coiffed, smiling obediently into the middle distance in matching white T-shirts.

Still unaware of the existence of a calorie, I mimicked my mother. Skip dinner; stick to vegetables and fish. Kaboom — I was still high. Like any addict, I spent the next 15 years chasing the euphoria of the first fix, but it was never quite as good.

My mother is a quintessentially type-A personality — like most anorexics, incidentally. Rigid, disciplined, hyperorganised and fundamentally controlled, she ran our lives like clockwork. Every minute was accounted for — six lives managed like well-oiled machines. The problem was that I kept accidentally knocking things over, disrupting our neatly ordered world. My mother was baffled by me. Understandably confused as to why I could read Jane Austen at eight but had a habit of tidying newspapers into the fridge, she got me tested for special needs. The psychologist likened my brain to a wardrobe with the hangers messed up on the floor. He diagnosed me with dyslexia, confirmed that I was bright but said that I had a statistically odd brain. He missed the attention deficit hyperactivity disorder, an omission that is unfortunately common for girls. People with ADHD are four times more likely to struggle with eating disorders.

My mum was an almond mum before the term was coined. One week tuna was in; the next, the mercury-infested morsel was banned. Mary Poppins-style, we would guzzle spoonfuls of various fishy oils. We would be allowed two or three Halloween sweets and the rest would still be in the cupboard the next year. We didn’t use toothpaste, as my mum feared fluoride. On playdates, I would precociously declare that Nutella was toxic and frozen pizza was for lazy people.

Being overweight was a moral failure. My father idolised actors who looked like Keira Knightley. My mother said crop tops should only be worn with a washboard stomach. While I don’t think her approach to food gave me an eating disorder, it helped provide the framework for it. All the children were subjected to the same routine. Between me and my two sisters, we have struggled with the trio of eating disorders: one had bulimia, one wrestled with binge-eating and I was anorexic. However, I am the only one who has been institutionalised.

The less you eat, the less you feel

Over the summer, after my tummy bug, I was just eating boiled vegetables. I famously ate half a raisin and put it back in the cupboard for later. Initially, I was praised for my turbocharged self-restraint. “I knew you’d realise you liked salad,” my mother said. “You’ve lost your puppy fat,” my dad said.

I would stand on one leg in chemistry to “tone” and do laps of Starbucks at lunch as my peers were downing frappuccinos. Initially, I tried to keep my more left-field behaviours quiet. I feverishly watched my classmates munch cookies, overwhelmed with a mixture of disgust and jealousy. “Do you want one?” a disconcerted classmate asked. “No, I’m not hungry,” I replied. That was a lie. An early one of many. I was starving, but I was as jealous of her carefree consumption as I was of that devilishly delectable, sugar-laden bomb passing her lips.

I was ahead of the curve on food porn. My Harry Potter books were replaced by baking books. I drooled over Mary Berry’s brownie recipe so often that dribble marked the page. A pathological people-pleaser, I tried my best to keep the extent of my madness private. The mandatory 50 nightly sit-ups would be done in the bathroom. Tiles don’t creak, you see.

Then one day, Mum walked in on me while I was in the bath, curled in the foetal position. She recoiled and I heard a sob. That night I asked her to give me a bedtime cuddle. My newly protruding spine must have poked her, though. “You’re not very nice to hug any more,” she whispered in my ear.

The school called, alarmed at my weight loss and increasingly eccentric behaviour. We dutifully saw a GP, who weighed me and announced that, while underweight, I didn’t qualify for hospital treatment. GPs receive two hours of training on eating disorders, and thus, while mainly well meaning, they don’t know what they’re talking about.

My mother tried her best. She accompanied me to an endless parade of doctors’ appointments. A weekly charade would ensue. I would chug gallons of water to artificially add the pounds, put on my reasonable face and agree to eat malt loaf. They would warn me of the impending horrors of ill health if I didn’t get my act together: osteoporosis, which my mother already had; heart attacks; flaky skin; infertility; early death.

After the weekly weigh-in, I would try to eat my dinner that night but it would never last. I didn’t want to upset anyone, but I had become possessed. Consumed by the art of not consuming. Semi-starvation dulls cognitive function. The less you eat, the less you feel. What was going on in my brain is difficult to describe, and even to me sounds insane. The wires had sort of got crossed. That homely, safe satiation after macaroni cheese evoked terror rather than pleasure. Emptiness was associated with purity and dignity — even when becoming incontinent.

To eat or not to eat. Simples. This streamlining is wonderfully comforting to a tweeny brain overwhelmed by the idea of the fast-encroaching chaos of the adult world. Problem is, neural pathways have a habit of sticking.

I would eat once every two days

It is common for girls with undiagnosed ADHD to fall apart at university. Outside the strictures of school life, responsibilities and possibilities multiply. This can send the dodgy satellite system of the ADHD brain spinning. I was also burnt out. During my A-levels, I had worked 14 hours a day, timetabling every minute, and had seen so little sunlight that my tennis teacher told me I looked like a vampire and that I was going bald. Having failed to hand in an essay, I left Durham University after a term.

This precipitated a full flip into hedonism. The failed perfectionist era had started. I would rather fail on my own terms. I went on my gap yah. Had a ski season, ate lots of cake and went off to the University of Bristol the next September. I made wonderful friends and we partied hard. The next three years were a yoyo of extreme highs and lows. My chums had now joined me in my fantasy world. We would prance around festivals draped in fairy lights, propelled by a concoction of dreams and drugs until we dropped into a narcotic-induced slump. We were the worst intake that Bristol had seen in 15 years. The chaos excused my tics. I fitted right in.

I’d regularly skip dinner and down copious amounts of vodka instead. One time I met a couple while they were graffitiing on the side of the road and paid them to tattoo me. I wanted Donald Duck on my bum; they kindly suggested my shoulder. I was once interviewed by the passport office having lost five passports in two years in various clubs. They concluded that I was not a criminal but an idiot.

It took a while for this to raise alarm. My weight was propped up by alcohol and erratic night eating. I would eat once every two days and my speech was slurred. My third-year flat was nicknamed “the crack den”. I slept in my ski gear on a sheetless bed — the radiator was broken and the flat was too much of a tip to tell the landlord. Food was becoming increasingly intermittent, and for the first time I called my mother and asked for help.

Unbeknown to me, she had been working behind the scenes on an intervention. “Lara, there’s a place you should go which will help you. You can go to Cape Town over the summer and it will make everything all better.”

The insanity of my illness hit me like a sledgehammer

And so I found myself in a minibus in Cape Town, speeding past the townships to the poshest part. We passed three dead bodies. I’d never seen this kind of poverty before. We arrived at Bishopscourt, a maze of mansions cordoned off in rectangular blocks with 10ft barbed wire fences and private security cars whizzing past. The insanity of my illness hit me like a sledgehammer. Here were all these rich white girls being cajoled to eat by black nurses, and people were starving down the road.

I was stripped, weighed and carted off to the psychiatrist. I confounded the poor man, who flatly refused to believe that I was purely anorexic. He added ADHD and bulimia to my psychiatric rap sheet, despite my complete lack of a gag reflex. The girl in front of him had lost more than 50 phones, dropped out of two universities and was still dressed in wet festival clothes, with glitter in every crevice. A form I’d just filled in asked what drugs I’d taken in the past two days. I couldn’t remember; I didn’t want to be caught lying so I just ticked everything apart from crack, meth and heroin. I’m a good girl, you see. “Your brain must be like oil and water,” he said, perplexed.

This was full-on rehab. I lasted three days before I demanded to come home. Screaming matches adjudicated by my therapist ensued. My parents flatly refused. This was fair. So I just refused to eat. No amount of cajoling stopped my hunger strike.

I discovered my spunk in rehab. Unadulterated anger exploded out of me, seeping out of my pores like the stench of vodka. After a couple of weeks I was put into solitary confinement for three days. No one supervised me. I quickly found the blind spot in the CCTV and started stuffing my food into sanitary bags and hiding them in the cupboard. This was the final straw. After a month, my mother got a call in London telling her I was in the lobby and she had to pick me up now. Difficult to do from another continent.

Then one day, Mum walked in on me while I was in the bath, curled in the foetal position. She recoiled and I heard a sob. That night I asked her to give me a bedtime cuddle. My newly protruding spine must have poked her, though. “You’re not very nice to hug any more,” she whispered in my ear.

I was bussed to another rehab centre in Cape Town. This was less bougie and presided over by a man, now dead, whose therapy style has put three people I know of into trauma counselling. By this point I could not string a sentence together; stress had short-circuited my brain. I was assigned a personal nurse. I was also thought to be a flight risk and banned from having contact with my family.

My eating disorder being challenged head-on was, to put it bluntly, torture. But the carefully constructed narrative of my life and world was also crumbling. For all his faults, this therapist could cut through your bullshit in five minutes. There were a few light bulb moments.

Maybe my childhood hadn’t been perfect? My mother’s favoured form of discipline was icy silence. After her parents’ messy divorce, she had vowed never to shout at her children. I remember wishing she would, to get it over with. Her mother had repeatedly abandoned her for a parade of men. Her response to this was to decide emotions weren’t needed. If we were worried, anxious or upset, she would tell us to get up, move on, that it was not helpful to be upset. This steely approach to life was probably solidified by being one of the few women in the City during the Eighties. The family joke is that no one has ever heard her say sorry. Like most of my siblings, I absorbed this. Hypersensitive as a child, I learnt quickly that this was a weakness to be quashed. Not eating was quite a good way to do it. Problem was, in my attempt to shrink myself into non-existence, my torment had increasingly encroached on other people’s lives. My parents once called living with me Chinese water torture.

Maybe I was a narcissistic, spoiled, selfish mess who needed to take some responsibility for her life?

I gained weight — and dropped it fast

After four months, Mum agreed to let me come home for a visit. I left my visa behind and conveniently got banned from South Africa. My therapist called me the next day; I was already drunk, en route to a rave. She asked me whether I’d forgotten the visa on purpose. I told her I hadn’t, but I would have done if I’d had the wherewithal to think of it.

I spent a year in a ridiculously ritzy halfway house. I had gained a lot of weight — more than I was meant to. My body clung to nourishment after years of famine. This, I decided, meant the shrinks and dietitians were wrong. They had stuffed me up like a battery chicken and I quickly rectified the situation. I dropped weight fast, but had no intention of being sent back to Cape Town, so slipped back into straddling the line of acceptability weight-wise — a healthy weight, but just.

At this point, I was on ten psychiatric medications. The shrinks would ask whether they were working and I would be like, “Which one? I’m on all of them.” I don’t trust psychiatrists. They all have different answers and they can’t all be right. One thing did help though: stimulant medication for my ADHD. Suddenly I could focus. I could finish an assignment. I went back to university, this time in London, and started handing in essays. All was ticking along nicely, in a semi-functional manner.

Here is the link:

https://www.theaustralian.com.au/health/mental-health/diary-of-a-millennial-anorexic-5-rehabs-and-15-lost-years/news-story/ce51b43a700a11cf8754b1497337425b

I have to say this is a terrifying view of awful personal suffering. I wonder can anyone help her out of the deep hole she seems to have disappeared down? Really a very, very sad chronicle of some awful human suffering!

David.

It Seems General Practice Is Still Struggling With GPs Pretty Fully Occupied When They Can Be Found!

This appeared last week:

Life support for primary care – but campaigns silent on deeper health system malaise

Labor’s cash injection is no panacea for our ailing medical system and it could well backfire.

Natasha Robinson

Updated 4:03PM  April 18, 2025

The defining image of this election campaign – leaving aside stage stumbles and errant footballs in the Top End – will be Anthony Albanese brandishing a small plastic rectangular-shaped prop: the Medicare card.

For most Australians, the card that has been dubbed by Labor “a little green piece of green and gold” is a means to an end: the delivery of a Medicare rebate direct to their bank account. For the Labor Party, universal healthcare and the nation’s taxpayer-funded health insurance program is its raison d’etre; one of its most compelling political stories.

But the Prime Minister’s sale of the Medicare story – in the form of a substantial boost to bulk billing with a take-home message that people will be able see a doctor for free – was challenged this week by peak medical groups, general practice academics and some frontline GPs.

The crux of their concern is that the growing difficulties facing Australia’s health system are so enormous that populist policies that sell well in marginal electorates in an election campaign could perversely deepen the nation’s health system crisis. The counterargument is that this huge boost to primary care will take pressure off family budgets and hospitals, keeping people well.

That millions of people cannot always afford to see a doctor when they need to is a reality in modern Australia, as documented for several years post-pandemic by the Productivity Commission and the Australian Institute of Health and Welfare.

It’s an unpalatable situation in a developed nation that prides itself on vital welfare safety nets for the disadvantaged.

The potent political message that a Medicare card – not a credit card – is all you should need to see a doctor for free in Australia harks back to a golden age of universal healthcare. It was a time when the current cataclysmic outlook for health systems around the world with rising chronic disease and an ageing population was not yet envisaged. It’s something Bob Hawke could barely have appreciated when Medicare was born 41 years ago after the Labor Accords in 1984 clinched union support for a skilfully resurrected and recrafted version of Gough Whitlam’s visionary but flawed Medibank policy.

Labor in this election is doing everything it can to link its modern Medicare story to Hawke’s original vision. Buoyed by the lift in bulk-billing rates arising out of its 2023 budget measure to triple incentives for GPs to bulk bill pensioners, concession card holders and children, the Albanese government announced even before the election was called that it would extend the triple bulk-billing incentives to all Australians, with an additional kicker boost for GP practices that bulk billed all patients.

The Liberal Party almost immediately announced it would match the policy with even greater funding but has done little to flesh out or sell the details of its own version. Liberal leader Peter Dutton couldn’t afford to be wedged: the marginal-electorate voters who could swing this election result live in a relatively small array of battleground seats. Voters in these seats, like so many Australians, are smashed by the cost of living; some are avoiding seeing the doctor and many are baffled, stressed and angry as to why they’re no longer bulk billed.

The issue is inherently connected with the other big election swinger: cost of living.

Both parties’ willingness to pour vast amounts of cash into a supercharged bulk-billing incentive program speaks to how significantly the well-documented declines in the general practice sector, from the cities to the bush, are affecting the lives of patients who will soon cast their vote.

Albanese’s antidote is simple and powerful politics. “This is all you should need to see a doctor for free in Australia … not your credit card,” the Prime Minister proclaims in social media ads. Vision pans through B-roll historical shots of the titan Hawke, who is also clutching the “little piece of green and gold”. The next shot is of Albanese in front of a rally protesting against cuts to Medicare, a visual nod to Labor’s story that “you can’t trust the Liberals on Medicare”, especially not Liberal leader Dutton, allegedly the worst health minister in 35 years (a sledge based on a medical press survey that has stuck). This moniker has sparked an array of TikTok and Instagram memes.

Labor’s Bulk Billing Practice Incentives Program promises to lift bulk-billing rates to 90 per cent of appointments. Importantly, that doesn’t mean nine out of 10 people. The number of people always or usually bulk billed is much lower. The triple incentives policy extends the existing incentive to GPs to bulk bill pensioners and concession card holders to all Australians, with an additional 12.5 per cent on top of the base incentive for practices that bulk bill all patients.

The government says the policy will increase the total Medicare payment for a short consultation from $42.85 to $69.56 in urban areas and more in regional and rural locations. That includes a 12.5 per cent boost for practices that bulk bill all patients.

According to a federal Health Department fact sheet, which extends existing modelling derived from the largest dataset of general practice billing in Australia of 6500 general practices enrolled in the practice incentives program, 4800 GP clinics will be financially better off as a result of the incentives policy. The modelling is based on the General Practice Registrars Australia earnings calculator and uses Medicare data across all 140 million GP services delivered throughout metropolitan and rural areas during 2023-24 to calculate national averages and the impact for individual GPs and entire practices.

The earnings calculator assumes a full-time GP delivers an average of four services an hour and retains 70 per cent of billings while passing 30 per cent to the general practice to cover its costs and profits.

“If an individual practice would receive more in additional Medicare payments from bulk billing every patient than it currently receives from charging some patients, then that practice would be in a better financial position from adopting full bulk billing,” the fact sheet says.

The department modelling says 4800 practices will receive an average of $344,000 in additional funding a year depending on the number and type of services delivered.

At present a bulk-billing GP earns less than their mixed billing or privately billing colleagues for providing the same number of services, according to the department, which says this policy will close that gap. The difference from November 1 to annual GP earnings if all patients are bulk-billed is relatively modest in a metropolitan area, according to this fact sheet. GPs at a full bulk-billing practice would earn $5357 more than at an average bulk-billing practice, the fact sheet says. In a rural practice, because of a bigger incentive loading, it’s much larger: $23,964 a year.

But the modelling now made public has been picked apart by doctors who have important questions about some of its assumptions, expressing disbelief that it predicts city-based doctors who bulk bill patients for every visit would collect earnings of $403,805 annually if the policy is implemented after November 1. This assumes a full-time GP delivers four services an hour and works for 3.8 hours a session, for 10 sessions a week, with four weeks of annual leave a year, retaining 70 per cent of billings and passing 30 per cent to the general practice to cover its costs and profits.

While welcoming the historic funding injection that few doubt will increase bulk billing rates, the Australian Medical Association and GP groups insist the policy rewards “fast medicine” and shorter consultations, when most of the patients they now see have chronic disease or mental health issues that take time to examine in a consultation.

These groups feel an opportunity for desperately needed structural reform to health systems has been lost in this election.

The question no political party seems to be asking itself is whether incentivising bulk billing for all Australians including the privileged is a smart use of money.

There’s an argument that the era of fully subsidised healthcare amid rising costs driven by chronic disease is not only fiscal folly that privileges those who can and should pay, it also will make it ever harder to shift the dial to focus on structural reform and a serious commitment to gear the system towards the prevention of disease – a reform project that Labor promised to progress four years ago.

Many of the people whose votes may swing the election result know from experience that it’s not only primary care suffering system breakdown. They may, at times, need to go to hospital, where emergency departments are buckling, ambulances are ramping and where getting access to an inpatient bed is challenging. Tens of thousands are stuck on public elective-surgery waiting lists. Countless patients need emergency care for diabetes complications, one of the most common and potentially life-threatening reasons for being admitted to hospital nationwide.

Labor is offering these people an expanding national network of urgent care clinics, open for long hours and designed to avoid people having to go to emergency departments. Urgent care clinics subsidise healthcare at no expense to the patient but are a very expensive model of care in which the ultimate bill is footed by the taxpayer at a rate about five times higher than a standard GP visit. These clinics are criticised by many doctors who say they fragment and duplicate care, but they’re highly popular with voters – and so the money flows.

Not much has been said in this election campaign about tackling the dire state of public and private hospitals. The former are critically overloaded with enormous workforce shortages and dysfunction, and the latter are in a state of near collapse, with maternity units shutting down at an alarming rate, tolling the bell on a looming private sector catastrophe.

Yet these seismic issues have been almost totally neglected in this election campaign in favour of easily digestible slogans that tap into what political parties know is a hot-button issue at their most common interface with medicine: primary care.

And so it is bulk billing that gets $8.5bn in cash as part of the Bulk Billing Practice Incentives Program. This is on the table for all, even people who are sending their kids to private school at $45,000 a year per child.

The politics of whether GPs will or should bulk bill is red-hot. Doctors proclaim that “medicine is not a shop” but a service. It’s clear that the top end of town doesn’t need bulk billing, but some doctors argue that almost everyone should pay a gap, just as they do for any other medical specialist. Those specialists also have been subject to rebate freezes for years and have not seen one iota of extra Medicare support.

Labor began a temporary freeze on Medicare rebates in 2013 that was continued by successive Liberal governments for about seven years. During that time a proliferation of incentive programs poured billions into GP clinics.

Offering incentives to drive billing practices and health service delivery are now firmly the preferred vehicle for funding GP clinics by all governments. Peak GP bodies prefer Medicare rebate lifts, but the dilemma for the government is it cannot control what GPs charge, meaning many would not bulk bill at a greater rate regardless and would bank greater income and profits rather than resolving the access and cost problems for patients.

Election campaigns and their lead-up are arguably terrible environments in which to craft health policy. Labor in fact has been advancing a Strengthening Medicine program of reforms including moving away from episodic care and getting more nurses into GP clinics, but that’s virtually unknown to voters. For the sake of votes, people are now being told they’ll be able to see a doctor for free. The policy risks shifting the dial back towards episodic care and cost, not quality. Many in the health sector are concerned that it sets up a transactional way of thinking about healthcare in primary practice.

After many years of neglect of primary care sector, what’s being delivered in the biggest investment in Medicare since its inception will please voters and will almost certainly significantly raise bulk-billing rates but at what cost to the system?

What is needed most is not only that deeper reform of outdated systems but a 180-degree turn in thinking to fund and incentivise the policies that take pressure off GPs and health systems in the first place: preventive care. It’s the game changer that families really need, yet preventive care makes up a tiny proportion of the health budget and is utterly neglected, including in this campaign.

Here is the link:

https://www.theaustralian.com.au/health/medical/life-support-for-primary-care-but-campaigns-silent-on-deeper-health-system-malaise/news-story/0dc2af3fffb02ba15bd0578a6a0cff2a

I Have to say a pretty much identical article could have been written in one of at least the past 20  years. Very little has changed and it is hard to see how much really can.

Doctors can only see so many patients a day and all those working a pretty much flat out for the whole of their working day. It seems no-one is slacking off but that there is just too much work to be covered by the available GPs. As for longer visits and various specialty activities they are even scarcer!

What is needed is more work in offloading the GP workload to ancillary services and more delivery of care in a collegiate environment where all the staff can work to their potential and their skill level. This transformation is underway but still has a way to go. Ideally we need all professionals working to their capacity with individually satisfying work. However, the nature of individual practices with limited staff presently mitigates against sensible work division and so on.

This is all gradually changing as people adapt to the new ways of work sharing and responsibilities. Come back in 10 to 15 years and I am sure we will see larger and better serviced practices with a wider range of ancillary staff. The change is clearly happening now….

I fear the day of having your own doctor who follows you through life is becoming, sadly, more of a pipe-dream.

The “medical home” concept is probably the best we can aspire to – where a practice knows you and your family pretty well and can provide most of the needed primary care.

What do you think GP should / will look like in a decade or two?

David.

The Rapid Onset Of Obsolescence Is Really Catching Up With Us!

This appeared last week:

Humanoid robots stride into future with world’s first half-marathon

AFP

19 April, 2025

Step by mechanical step, dozens of humanoid robots took to the streets of Beijing early Saturday, joining thousands of their flesh-and-blood counterparts in a world-first half marathon showcasing China’s drive to lead the global race in cutting-edge technology.

The 21-kilometre (13-mile) event held in the Chinese capital’s E-Town – a state-backed hub for high-tech manufacturing – is billed as a groundbreaking effort to test the limits of bipedal robots in real-world conditions.

At the crack of the starter’s gun, and as a Chinese pop song I Believe blared out from loudspeakers on repeat, the robots queued up one by one and took their first tentative steps.

Curious human runners lined up on their side of the road and waited patiently with mobile phones at the ready to shoot each machine as they prepared to depart.

One smaller-sized android, which fell over and lay on the ground for several minutes, got up by itself to loud cheers.

Another, powered by propellers and designed to look like a Transformer, veered across the starting line before crashing into a barrier and knocking over an engineer.

“Getting onto the race track might seem like a small step for humans, but it’s a giant leap for humanoid robots,” Liang Liang, Beijing E-Town’s management committee deputy director, told AFP before the event. Nearby, engineers jogged alongside their machines.

“The marathon helps push humanoid robots one step closer toward industrialisation.”

Tech race

Around 20 teams from across China are taking part in the competition – with robots ranging from 75-180cm tall and weighing up to 88kg.

Some are running autonomously, while others are guided remotely by engineers, with machines and humans running on separate tracks.

Engineers told AFP the goal was to test the performance and reliability of the androids – emphasising that finishing the race, not winning it, was the main objective.

“I think it’s a big boost for the entire robotics industry,” Cui Wenhao, a 28-year-old engineer at Noetix Robotics, said of the half-marathon.

“Honestly, there are very few opportunities for the whole industry to run at full speed over such a long distance or duration. It’s a serious test for the battery, the motors, the structure – even the algorithms.” Cui said as part of its training, a humanoid robot had been running a half-marathon every day, at a pace of about seven minutes per kilometre, and he expected it to complete the race with no issues.

“But just in case, we’ve also prepared a backup robot,” he added. Another young engineer, 25-year-old Kong Yichang from DroidUp, said the race would help to “lay a foundation for a whole series of future activities involving humanoid robots”.

“The significance (of the race) lies in the fact that humanoid robots can truly integrate into human society and begin doing things that humans do.”

China, the world’s second-largest economy, has sought to assert its dominance in the fields of AI and robotics, positioning itself as a direct challenger to the United States.

In January, Chinese start-up DeepSeek drew attention with a chatbot it claimed was developed more cost-effectively than its American counterparts.

Dancing humanoid robots also captivated audiences during a televised Chinese New Year gala.

Here is the link:

https://www.theaustralian.com.au/business/technology/humanoid-robots-stride-into-future-with-worlds-first-halfmarathon/news-story/a351616d1f020e8943061f48a129e134

Another field, it seems, where China is making really rapid progress. It will only be a matter of time when almost all manual work is undertaken by robots.

Over time we are all going to start wondering just what we are really good for I suspect! Time to develop some really interesting hobbies to replace the time we used to spend working I suspect.

What do you think?

David.

To Respect The Late Pope's Passing I Have Updated The Weekly Poll.

 I hope it is not too disrespectful to ask about feelings around the late Pope's legacy.

David.

 

I Had Stupidly Thought Humanity Had Moved Beyond The Use Of Chemical Weapons!

Seems I was wrong and that Mr. Putin has set a new low even for him!

This appeared last week:

Kremlin ramps up illegal gas attacks to secure its gains

Maxim Tucker

19 April, 2025

Russian forces have increased their use of banned gas weapons in Ukraine as they push to seize full control of four occupied regions before a possible ceasefire deal, according to Kyiv’s military.

Although using chemical agents to cause toxic harm in war is prohibited by international treaties, President Vladimir Putin’s troops used tear gas, chloropicrin, a choking agent, and other “unidentified chemicals” a total of 767 times last month, 844 times in February and 740 times in January.

That compares with 166 times in November, when President Donald Trump was elected on pledges to end the war, the Radiation, Chemical and Biological Protection Department of Ukraine’s armed forces (RCBZ) said.

The Times also spoke to soldiers and doctors who claimed to have witnessed the deaths of Ukrainian servicemen as a result of attacks by chemical weapons, as well as pathologists who recorded the deaths of soldiers who were allegedly gassed.

The witnesses suggested the Russians were increasingly resorting to chemical weapons to flush out Ukrainians from defensive strongholds or to immobilise and leave them vulnerable to conventional attacks.

The US State Department and war monitors have previously accused Moscow of using CN and CS gases – also known as tear gas – to deadly effect in Ukraine. It also said that Russia had used chloropicrin, which is severely irritating to the lungs and eyes, to dislodge Ukrainian troops from fortified positions.

Although classified as “riot-control agents”, tear gases are banned from the battlefield under the Chemical Weapons Convention and the 1925 Geneva Protocol as they can cause great harm to soldiers deployed in trenches or enclosed locations. Chloropicrin, a pesticide, is classified as a “toxic chemical” and severe exposure can be fatal.

The Kremlin, which along with Ukraine is a signatory of the 1997 Chemical Weapons Convention, has rejected claims that it uses toxic gases as “baseless”.

But Colonel Artem Vlasyuk of Ukraine’s RCBZ claimed that Russian forces had used the agents at least 7730 times since the beginning of the full-scale invasion in February 2022, including 2351 recorded occasions since the start of this year.

“Forty per cent of these were recorded as the direct use of K-51 and RG-Vo grenades, which contain CS and CN gas,” said Vlasyuk.

“The rest of the cases we identify as the use of dangerous chemicals by the enemy, classified as unknown substances because our units did not have access to the place of use due to intense enemy fire or the loss of positions where these dangerous chemical substances were used.”

The Times received reports of dozens of Ukrainian soldiers affected by gas attacks in at least six frontline zones, as well as those who did not suffer lasting damage, or who were able to put on their gas masks in time.

The RCBZ said that Ukrainian investigators were looking into specific incidents, including deaths, and could not comment before charges were brought. “We can’t exclude the use of deadly substances by Russia in combination with tear gas,” Vlasyuk added.

Kyiv’s Ministry of Foreign Affairs said: “The Russian military regularly uses riot-control agents and ammunition equipped with dangerous chemicals against Ukrainian forces, including those of unknown origin. Unfortunately, a number of fatalities among the Ukrainian military were recorded.”

Russia’s Iranian-made “kamikaze” attack drones have also been armed with payloads of CS gas for attacks from the air, officials from Ukraine’s National Security and Defence Council announced on Wednesday.

The Kremlin has in turn, and without providing evidence, alleged Ukraine’s forces have used “a wide range of toxic chemicals against Russian servicemen and public officials”, including fertilisers, pesticides and other banned toxins. Kyiv has denied this.

On the war’s southern front, Russian troops are pushing to take the town of Orikhiv, which would bring them within artillery range of Zaporizhzhia city, capital of the region of the same name. which Putin claims to have annexed.

Soldiers of Ukraine’s 65th Mechanised Brigade who are defending the town said they were coming under “daily” chemical attacks and displayed used tear gas grenades and improvised canisters they said had been dropped by Russian drones.

Senior Lieutenant Sergey Skibchyk also claimed that “very often the Russians disguise poisonous substances as tear gas, or come up with their own dispersal devices, such as adding ordinary plastic bottles with various elements that, when combined or when exploded, emit aerosols that are lethal”.

“We are not talking tears and coughing, we are talking about chemical burns of the larynx, lungs, oral cavity, nasopharynx and even the skin,” Skibchyk said.

A man was killed and a woman injured in a Russian drone attack on a wholesale bakery making Easter treats on April 18, which is Good Friday, a key Easter date for Christians, according to Ukrainian officials. Footage from the local branch of national…

The Organisation for the Prohibition of Chemical Weapons (OPCW) has issued two reports confirming the presence of CS gas on Ukrainian battlefields, but declined to comment on the use of other types of gases.

Its work is based on samples taken from the Ukrainian side, but it has not attributed blame or commented on the scale of the chemicals’ use.

The UK Ministry of Defence said: “Putin’s use of chemical agents as part of his illegal invasion of Ukraine is a clear violation of international law … in December 2024, the UK contributed a further £3 million for the procurement of respirators for Ukraine.”

Lennie Phillips, a senior research fellow at the Royal United Services Institute, said any international mission to establish what chemical weapons were being used in Ukraine, and how, would be impossible without a ceasefire.

“If you’re talking about chemicals being used against people … in the middle of a conflict, full stop, their eyes are on the enemy [and] dealing with the aftermath,” he explained. “I think the last thing on their mind, understandably, would be, ‘Oh, let’s get a sample so we can send it off and we can see what the Russians have been using.’ … The Russians know that.”

The Times

Here is the link:

https://www.theaustralian.com.au/world/the-times/kremlin-ramps-up-illegal-gas-attacks-to-secure-its-gains/news-story/d862b48b841edda47a84d1a06503e405

I can hear my favourite Ukrainian loudly pointing out that you simply can’t trust Russians (and the Ukranians should know!) and saying how stupid I am to even imagine Russians could be trusted!

Turns out she was spot on! They are really international lowlife behaving like this!

David.

I Really Think It Is Time For The Pope To Retire. He Has Had His Turn And Time For A Younger More Energetic Person!

This appeared last week and rather fits with Easter Sunday.

Pope says doing ‘best he can’ on jail visit before Easter

AFP

1:32AM April 18, 2025

A still-convalescing Pope Francis said Thursday he was doing “as best I can” as he visited inmates at Rome’s central jail before Easter.

The 88-year-old Argentine pontiff spent about a half hour at Regina Coeli, a dilapidated jail in the centre of the capital that is one of Italy’s most overcrowded.

Francis individually greeted about 70 detainees as well as prison management and staff, the Vatican said in a statement.

The smiling pope was later seen in the passenger seat of his white Fiat 500 vehicle as he departed.

“Every time I enter these places I ask, ‘Why them and not me?’” he told a crowd of journalists in a weak, raspy voice.

Asked by a reporter how he was experiencing this year’s “complicated” Easter week following his weeks of hospitalisation and recovery, he answered: “I live it as best I can.”

The Jesuit is under doctors’ orders to rest for two months following his release from hospital on March 23 after five weeks of treatment for pneumonia in both lungs.

But the head of the world’s 1.4 billion Catholics has instead made a spate of surprise recent appearances -- from a private meeting with King Charles and Queen Camilla, to an impromptu visit inside St. Peter’s Basilica, where he met pilgrims and admired restoration work.

At Regina Coeli, Francis did not engage in the traditional rite of washing the feet, which commemorates the gesture of Christ for the apostles.

“Every year I like to do in prison what Jesus did on Holy Thursday, the washing of the feet,” the pope told the inmates, according to the Vatican.

“This year I can’t do it, but I can and wish to be close to you. I pray for you and for your families.”

Pope Francis met on April 16th at the Vatican with members of the medical team who saved his life during a five-week hospital stay for a serious case of double pneumonia, thanking them for their care.

Since becoming pope in 2013, Francis has carried out the washing of the feet rite outside the Vatican, including for repentant mafia members behind bars, for women or teenagers behind bars, or for the sick or disabled.

In Christian tradition, Maundy Thursday commemorates the last meal of Christ, known as the Last Supper, with his 12 apostles.

It is a highlight of Holy Week, which commemorates the last days of Christ before his resurrection at Easter.

Due to his fragile health, the pope has reduced his normally packed schedule for Holy Week.

He does not plan to preside over Saturday’s evening’s Easter vigil nor Easter Sunday mass at the Vatican, both of which have been delegated to cardinals.

Here is the link:

https://www.theaustralian.com.au/world/pope-says-doing-best-he-can-on-jail-visit-before-easter/news-story/abe7cb7c65fa7bf410a71e7666a892c1

I think it is time for our old Pope to rest / retire and a new more energetic man (you can be pretty sure it won’t be a women) to take over! When you are 88 it seems reasonable that his time has come

With the complex world we live in we need a Pope who is intellectually and morally at the “top of his game”!

Maybe we can develop a Pope Retiring Age limitation!

What do you think?

David.

AusHealthIT Poll Number 790 – Results – 20 April 2025.

Here are the results of the recent poll.

Do You Think Mr Trump Is Leading The World Into A New Global Economic Recession?

Yes                                                                27 (96%)

No                                                                    1 (6%)

I Have No Idea                                                0 (0%)

Total No. Of Votes: 28

It seems pretty much every-one is concerned about the Trumpian financial policies!

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

Not too bad voter turnout. 

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

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

David.

I Reckon You Have To Think Very Carefully About Letting Children Play Contact Sports.

I know this will be anathema to all red-blooded Aussie males.

Patient zero: the Wallaby who couldn’t live with the noise leaves a ‘quiet legacy’

Dan Vickerman’s mind had become a war zone and he didn’t know why. A once measured, ‘gentle giant’, there were now times when he’d lose it over the smallest of things. His mother reveals why she believes rugby may have cost him his life.

Jessica Halloran

11 April, 2025

In the middle of the night, when “demons” were raging in Dan Vickerman’s head, he’d call his grandmother, Erna, and her sage words would calm his mind.

Severe insomnia plagued the former Wallaby, but the conversations with his grandmother, who lived in Cape Town, would help fight off the dark thoughts.

In the final years of his life, Dan’s mind had become a war zone and he didn’t know why. A once measured, “gentle giant”, there were now times when he’d lose it over the smallest of things. His mother, Val, ­remembers his moods swinging between incredible anxiety to utter depression.

A few months before he took his life, on the morning of February 18, 2017, Dan bluntly told a friend: “My head is f..ked.” He left behind a wife, Sarah, and two beautiful boys. On that summer morning, Val received a phone call telling her that her only child had died. He was 37.

In the dark, numb days that followed, nothing made sense and in the midst of grief, Val, a ­pragmatic, stoic woman, went searching for answers. When someone dies by suicide there are so many unanswered questions for those left behind, starting with: “Why didn’t I ...?”

“There is also an incredible amount of guilt. So you go looking for answers,” she says.

While researching suicide in sport and personality changes, Val came across chronic traumatic encephalopathy. She had never heard of it. CTE is a brain disease linked to repetitive head knocks. The more Val learnt by reading research papers from Boston University’s CTE Centre and Brain Bank, the more it became clear that her son, who had a three-decade rugby career that included 63 Wallabies Tests, had been suffering from the ­condition. As Val says, “his brain was sick”.

Wallabies great Dan Vickerman achieved so much on the rugby field, but off it, he faced a silent battle with CTE. After his death, his family set out to understand the disease and fight for change. Through their efforts and the creation of the Dan Vickerman…

At Val and husband Les’s home in Bowral, NSW, she sits in a plush armchair in their formal living room, pulls out a sheet of paper and starts reeling off CTE symptoms that related to her son.

“He had mood and behav­ioural changes in his later years; he had exaggerated responses to day-to-day stresses; anger and agitation due to inconsequential happenings; mood fluctuations; depression; anxiety; generalised body aches and pain; and severe insomnia,” she says.

Val believes Dan knew things “weren’t right”. “He went to a psychologist, he went to [another] psychiatrist, and not one of them said it could be CTE,” she says. “It was not ­really out there back then.” It was a time when there was little understanding of the disease, which has since been found, post-mortem, in the brain tissue of several leading Australian footballers, including St Kilda’s Danny Frawley and rugby league player and coach Paul Green. Both took their own lives.

But what sets apart Dan Vickerman – a domineering lock whose international career ran from 2002 to 2011 and who had three seasons with the Brumbies and five with the Waratahs – is that he was patient zero for the Australian Sports Brain Bank.

Michael Buckland, the chief neuropathologist of the Australian Sports Brain Bank, says Dan’s death led to its formation. It is a joint initiative by the neuro­pathology department at Royal Prince Alfred Hospital in Sydney and the Brain and Mind Centre at the ­University of Sydney.

“I was very aware of Dan’s death, he used to play for Sydney Uni, so his passing was very local to us as well,” Dr Buckland says. “The fact his brain was unable to be examined was really the driving force, the motivation for setting up the Australian Sports Brain Bank. We wanted a pathway for families to have their loved ones examined, if they so wanted.

“After we launched the brain bank in March 2018, Val and Les Vickerman were in contact ­immediately.”

Not long after the Australian Sports Brain Bank opened, Val and Les travelled up to Sydney and met with Dr Buckland, with that interaction confirming their thoughts on Dan’s condition.

Soon after Dan’s death, the ­Rotary Club of Bowral/Mittagong suggested establishing the Dan Vickerman Scholarship for PhD students in conjunction with Australian Rotary Health.

The criteria for the scholarship was specific to CTE research and it was to be ­undertaken at the University of Sydney. Covid intervened and it was only this year that the scholarship has been awarded. Young scientist Joanna New is the first scholarship recipient. “Being awarded the Dan Vickerman Scholarship is a great honour to me, it holds to his legacy, his story and it allows him to be an ­example within not only the research community but the sports community,” Ms New says.

“My work is really about trying to address some of the unanswered questions in the CTE space. Practically what we hope to ­develop with this research is to help find a test that can be used in a medical or sporting setting.”

Val has said Dan may have “had a chance” if he had known what was happening inside his head, and life may have played out differently.

“Hopefully with the research we will one day be able to diagnose CTE in life,” Val says.

“If people are able to get a ­definitive diagnosis, even if there is no cure for it now, they will at least feel ‘I am not going mad’.

“There is a reason for it. I think it will make it easier for the ­family. They will have an understanding of what is happening. I think for the children of ­people that take their own lives, who may ask, ‘Why did my dad leave me? Why did my mum leave me? Did they not love me enough?’ I think if there’s an ­answer for the children, it may make things easier.”

Career on the rise

As a child, Dan loved the “crash and bash” of rugby union. He adored the contact and, being tall, he soon found himself playing in the second row.

He played for the prestigious Bishops Diocesan ­College in Cape Town, which has produced many great Springbok players, and he proudly wore the jumper.

“For some unknown reason, the Bishops rugby jumpers were white. The school was located at the lee of Table Mountain, where it rained all winter,” Val says, laughing. “Dan and the jumper would always come home absolutely covered in mud. He loved sports. He aspired to be in the school’s firsts rugby team, which he did.”

While mild mannered off it, on the field Dan was brutally competitive and he had big dreams. In a private moment, a teenage Dan told his father: “I want to be the best lock in the world.” With a link to Australia via Les’s father Leslie, he travelled to Brisbane in 1999.

“After school he played for the Queensland University, then after that he went back to South Africa and played for the South Africa U21 Baby Bok team,” Val says.

While initially he had hoped to ­become a Springbok, his journey back to Australia in 2000 would make him a Wallaby.

While attending Varsity College and the University of South Africa, Dan was lured to the Harbour City in that Olympic year to attend the University of Sydney. He was then contracted by the Brumbies Super Rugby franchise. His selection for Australia “A” sealed his future allegiance and he soon made his Test debut against France in Sydney.

Dan would end up playing in three World Cup campaigns ­before his retirement from the game in 2012.

“He was very uncompromising in battle,” his Tahs and Wallaby teammate – and now Rugby ­Australia chief executive – Phil Waugh said.

After playing at the World Cup in 2007, he withdrew from the Australian rugby scene and ­headed to England for three years. At Cambridge University he earned a masters in land economics and, in another sparkling ­moment in his rugby career, Dan captained Cambridge to a 31-27 victory over fierce rivals Oxford in 2009.

It was, by any measure, a ­glorious career. “He loved the game,” Val says.

Vickerman captained Cambridge to a 31-27 victory over fierce rivals Oxford in 2009.

Suicide links

To Val’s knowledge, Dan was never knocked out or diagnosed with concussion while playing rugby union.

Research by Boston Univer­sity’s CTE Centre and Brain Bank shows CTE is caused by repetitive brain trauma. That trauma ­includes both concussions that cause symptoms and non-concussive hits to the head that do not cause symptoms.

Boston University says the number or type of hits to the head needed to trigger degenerative changes in the brain is unknown.

But what is known is that ­suicidality has been clinically found to be associated with CTE, Dr Buckland says.

“There’s a very strong and ­disturbing association between CTE and suicidal behaviour, ­including suicidal ideation and completed suicides,” he says.

“We are finding that in our ­cohort – and the Boston Univer­sity group have also reported that in their cohort – the majority of people with CTE, they either self-report or their family ­members report suicidal ideation or suicide attempts. Suicide is certainly over-represented in the CTE cases compared to those cases without CTE.

“About just under half our cases, our donors with CTE, ended with us because they suicided.”

Just two years after Dan’s death, Australian rules footballer Danny Frawley was found to have had CTE after he deliberately crashed his car into a tree in ­country Victoria.

In 2020, Richmond player Shane Tuck endured a “war zone in his head” before he took his life at 38. He had CTE.

In August 2022, former ­Cronulla player and Cowboys coach Paul Green, 49, who’d celebrated his son’s 10th birthday the previous day and was tossing up several job offers, took his own life. He was found to have had stage-three CTE. In November 2022, AFLW player Heather Anderson committed suicide. She was 28. Anderson, played rugby league and then Australian rules, from the age of five. She too was found to have had CTE.

Dan was part of the Wallabies team who were runners-up in the 2003 World Cup final against ­England. The mind battles of those English rugby champions have been well documented.

Last year England World Cup player Steve Thompson said he often couldn’t remember the names of his children and had no memories of the 2003 victory. “I can’t even remember being in Australia,” he has said. Thompson, 46, has also said his shock early-onset dementia diagnosis left him feeling suicidal.

So many questions

Val is an advocate for suicide ­prevention awareness and continues to run a suicide support group in Bowral in an effort to help those, like her, who have lost a loved one.

A common conversation can be around the “sliding doors” ­moments. For her, it involves her mother, Erna, who passed away two months before Dan took his life. Val wonders if her mother had been there for another desperate phone call, maybe she could have helped him with his tormented thoughts that night.

“There are many should have, could have, what ifs, you ask yourself when someone suicides,” Val says. “And I wonder if my mother had been alive…”

Dan’s hulking frame still looms beautifully large in his parents’ home. He’s there, grinning gently in his Wallabies jersey, walking off the field, forehead bleeding. A local painter, Dave Thomas, has captured this warm, joyous ­moment, which the Vickermans proudly have hanging on their wall.

“We hope to donate the painting to Sydney University Rugby Club,” Val says. It’s another institution where Dan left a strong legacy, playing 49 games, including three grand finals.

But it’s the memories off the field that shine through the most on this visit to Bowral. Les and Val show a 2016 photobook, capturing an extended family holiday adventure to Cape Town.

Everyone is smiling as they stand in the front of the house where Dan was raised. There are pictures on the beach where he swam and played as a child.

They are all carefree, windswept, happy – it was just months before Dan died. The photos show no hint of what he was battling.

‘Real’ ambition

After Dan passed away there were newspaper and TV reports about athletes suffering post-retirement – insinuating that the former Wallaby was troubled by no longer playing the game – but Val makes it clear, her son’s mental anguish wasn’t related to his sporting ­career coming to an end.

“No, that’s not true,” she says. “Dan actually had prepared for a career after rugby.”

He had worked for KPMG, then in property and just weeks ­before he died he had announced that he had set up a property ­investment fund. His career trajectory was on the up.

But for those close to him, it was clear Dan also had other priorities.

Les recalls turning to his son, after Dan had not long retired from rugby, and asking what his “real” ambition in life was now. “To be the best father in the world,” Dan said.

Val wants the world to remember her son as a “gentle giant”.

“He was an unassuming person that didn’t want the limelight, didn’t court the media … and now he is leaving a quiet legacy,” she says.

If you or someone you know may be at risk of suicide, call Lifeline (13 11 14) or the Suicide Call Back Service (1300 659 467), or see a doctor

https://www.theaustralian.com.au/sport/patient-zero-the-wallaby-who-couldnt-live-with-the-noise-leaves-a-quiet-legacy/news-story/251e9c796e3ce2398e3a6b7bc5c70602

To me the loss of even one young man to this disease is anathema – but I know many will disagree. At the very least we need protocols to track and support those who are at risk and to intervene early if things are “going of the rails:”

We also need to know research and warning signs are properly followed up to ensure those at risk are saved.

Dying for the sake of any game is just plain silly IMVHO. Grumps > /dev/null.

David.

I Am Not Sure Many Realise Australia Has Spawned Three Major Global Healthcare Giants!

 This appeared last week:

Sonic and ResMed rejoin the Buy List

These two leading healthcare stocks now trade at attractive prices.

By Graham Witcomb · 11 Apr 2025 · 3 min read

The best time to put ResMed in your portfolio was during last year's weight-loss drug scare, when the company rejoined the Buy List on 25 Jun 24 (Buy - $27.74). Back then, the share price had collapsed and the price-to-earnings ratio (PER) had fallen below 20. By January this year, the share price had breached $40.

Now Trump is giving us another shot with the company trading on a forward PER of 21, well below historical levels. This is despite medical consensus that sleep apnoea sufferers are best treated with a combination of weight-loss drugs (called GLP-1s) and CPAP machines from the likes of ResMed.

Key Points

• High-quality companies
• Moderate/large US exposure
• Both stocks undervalued

The US is ResMed's largest market by far and the company makes and sells its products across the globe. Tariffs, currencies and regulation are a perpetual threat. So are potential new treatments—surgical or medicinal—that we can't imagine today.

We suggest members deal with these possibilities through portfolio position size rather than waiting for an even cheaper price, particularly as regulatory changes can potentially have huge impacts.

ResMed, last reviewed on 3 Feb 25 (Hold - $38.60), rejoins the Buy List with a maximum portfolio weighting of 5%.

Super Sonic

As for Sonic Healthcare, its share price is back where it was seven years ago, despite almost touching $50 after huge one-off profits from covid testing. That's all gone now, making earnings more predictable. As costs fall, there's the possibility of higher margins while the forecast PER of 20 is the lowest in about a decade.

Sonic's Australian business is mature and isn't growing as fast as ResMed's, but management seems to have done a decent job investing its covid windfall profits in places like Germany, where it needs scale to increase profits and margins.

Overseas markets offer a long growth runway but Australian margins have the biggest impact on profitability. And like ResMed, regulatory and Medicare reimbursement risks are ever-present.

This is best accounted for in a conservative maximum portfolio limit of 5%. Paying a lower price won't protect you from binary outcomes, especially as a fifth of company sales are in the US—as discussed on 21 Feb 25 (Hold - $27.67)—and Trump's eraticism adds to the risk.

Nonetheless, Sonic's revenue is more diversified than ever and the current share price compensates for these risks. Messing with people's pathology tests isn't something governments take lightly. BUY—but again, watch the portfolio limits.

Note: The Intelligent Investor Australian Equity Income Fund (ASX:INIF), Intelligent Investor Ethical Share Fund (ASX:INES), and Intelligent Investor Australian Equity Growth Fund (ASX:IIGF) own shares in ResMed and Sonic Healthcare.

Here is the link:

https://www.intelligentinvestor.com.au/recommendations/sonic-and-resmed-rejoin-the-buy-list/154429 

I have to say that these 2 companies - along with CSL - have proven to be great Australian success stories who have successfully gone global and who have been very worthwhile investments for local investors over the years. I can't think of another industry in which Australia has been quite so commercially successful other than mining. We really do punch above our weight in this industry with 3 globally significant enterprises founded here!

David.

 

These Are Rather Counter-Intuitive Findings On The Safety Of Mothers And Babies At Present!

This report appeared a few days ago:

Problems that put mums, bubs at risk demand urgent action

Bombshell research has highlighted serious problems in our health system – problems that put Australian mothers and their babies at risk and need urgent attention.

Steve Robson

Updated 6:44AM April 12, 2025

An independent study of birth outcomes across the country – led by some of Australia’s foremost health researchers – has yielded deeply concerning results.

The study found that severe adverse outcomes of birth, both for mothers and their babies, are considerably more likely in our public hospitals as compared to private maternity hospitals. It also found that costs of birth were higher in public hospitals than in private maternity settings.

The study’s findings rang alarm bells for doctors, consumer representatives, and even a former federal health minister when presented at a recent meeting in Sydney.

Having a baby is such a fundamental experience for most people – moving beyond the realm of healthcare into a place of deeply personal life experience – that responding to the study’s findings must be finely calibrated. No family can be left behind.

It is important that we draw the right conclusions from the research. We must put the wellbeing of women and their babies at the centre of any response to the study’s findings. It is well past time to heal a key part of our health system that is currently riven by unhelpful cultural and ideological division.

There are few greater responsibilities for our healthcare system than the safe arrival of the next generation of Australians. As birthrates continue to fall across the country, many women now will have only one child. Society has a responsibility to put all resources required into ensuring that birth is as good as it can be.

Mothers-to-be have a right to expect not only that birth is as safe as possible, but also that they are given an informed choice about who delivers their baby and where the birth happens.

Steve Robson, who reviewed national birth outcomes 15 years ago and found a similar result.

Such informed choices are hardly an aspirational target. The federal health department’s own 2019 review of maternity care in Australia clearly affirmed the principle that women’s choices and preferences should be “sought and respected throughout maternity care”.

The bombshell research paper highlights serious problems in our health system – problems that put Australian mothers and their babies at risk and need urgent attention. Every day counts, just as every newborn baby counts.

Yet the research findings were no surprise to me. Fifteen years ago I reviewed national birth outcomes data and reached almost the same conclusions. When the results were published, though, the response from administrators was one of fury. I was told that I would never have access to any data again, so embarrassing had the results been to state and territory governments.

The consequence of this political censorship is that, 15 years later, mothers and babies still find themselves kept in the dark. Important information that should be available to any pregnant woman is obscured by arcane processes that make it almost impossible for researchers to shine a light on the true state of maternity care in Australia.

Mothers-to-be have a right to expect not only that birth is as safe as possible, but also that they are given an informed choice about who delivers their baby and where the birth happens.

The new research has arrived just at a time when private maternity care – provided by midwives and doctors working together in private hospitals – is on the ropes.

Maternity hospitals around the country are shuttering their services, and some capital cities provide few options for private care. So bad is the situation that my own research suggests that private maternity services will be extinct by the end of the decade.

Pregnancy and birth care is very special. Prospective Australian parents have a right to timely and accurate information to guide their birth choices. They have every right to feel badly let down at the moment.

Many women and their partners make their birth choices based not on rigorous scientific information but on social media, or recommendations from friends. Choice is critical to satisfaction with birth, but the information informing that choice must provide a true picture of the outcomes.

To make things even worse, many women are left with little or no choice. This is particularly the case for women who live outside our major cities. Local maternity services have been razed across large tracts of regional and rural Australia, leaving families unsupported at a time they should have our government swing in behind them.

Everybody involved in birth in this country – midwives, doctors, physiotherapists and many more – goes to work wanting the very best for the women they care for. We cannot let them down. As a society we must throw everything we have at supporting maternity services that are as safe and accessible as possible.

Dr Robson says everybody involved in birth – midwives, doctors, physiotherapists and more – ‘wants the very best for the women they care for’.

As Australian families shrink, and we ponder how our country can cope with an ageing population, resourcing of pregnancy services should be a national priority.

The key lesson we should take from this new maternity research report is that transparency is fundamental to good outcomes. Making data about birth outcomes difficult – or indeed almost impossible – to access is a recipe for disaster.

There is absolutely no medical or ethical reason that detailed information about the results of maternity care systems should be kept from women. Indeed, the stakes are so high for society that transparency should be a high priority.

A shining example of how this transparency can revolutionise safety and effectiveness of healthcare is the National Joint Replacement Registry. Information is fed into the registry database and it is publicly available almost in real time. Older Australians facing major procedures – and the surgeons and others providing their care – have access to a gold-standard resource guiding their care.

Australians at the other end of the life cycle – newborns and their mothers and parents – should have access to similar information about the results of maternity care in this country. Instead of dedicated researchers delving into secretive maternity data repositories, parents should have a trove of outcomes information to guide their choices.

When the final research results are published, there is no excuse for failing to heed the lessons of the work. The next generation of Australians – and their parents – must finally have truly informed choices.

Steve Robson is professor of obstetrics and gynaecology at the Australian National University and former president of the Australian Medical Association. He is a board member of the National Health and Medical Research Council and a co-author of research into outcomes of public and private maternity care.

Here is the link:

https://www.theaustralian.com.au/health/medical/problems-that-put-mums-bubs-at-risk-demand-urgent-action/news-story/50425ac1c674af8d70e5bbcf6fb94f8c

It is hard to disagree with any of this, especially the importance of transparency as to the outcomes being achieved to we can be sure that all the care being delivered is the safest and most cost-efficient possible. As children become relatively rarer (and more precious, if that is possible) we are even more obligated than ever to provide the best care possible!

That public care standards are apparently slipping needs to concern us all and the powers that be need to move to correct any issues identified ASAP! If ever there was a case for an expert investigation this is it!

David.