Australia Needs To Get Out From Under The US Hegemon And Its Warped Trumpian Strategies And World View!

There is a better way!

CANZUK: An idea whose time has come

Daniel Hannan

Mar 16, 2025 – 9.39am

Within hours of Britain’s declaration of war on September 3, 1939, Michael Joseph Savage, New Zealand’s first Labour prime minister, made a statement from his hospital bed (he was to die seven months later).

“Both with gratitude for the past and confidence in the future, we range ourselves without fear beside Britain. Where she goes, we go. Where she stands, we stand.”

With how many nations does the UK have such a bond, an alliance so instinctive and automatic that it needs no explanation? The list is a short one, but it surely includes the three countries with whom we truly do have a special relationship, namely Australia, Canada and New Zealand.

We are linked by language, culture and kinship. We share a legal system, drawing on one another’s precedents. We have similar parliamentary forms, complete with maces, state openings, green benches, the works. We salute the same king.

The modern campaign to knit the four chief realms into a closer association was launched in British Columbia in 2015, and goes under the acronym CANZUK, a term first coined by UN officials because the four nations almost always voted en bloc.

CANZUK campaigners want closer diplomatic and defence collaboration, an automatic right to work in each other’s countries and a common market based on mutual recognition of standards in goods, services and professional qualifications.

For a decade, CANZUK was treated by politicians as a worthy idea, but not an urgent one. Then came the second Trump term, the tariff wars and the upending of US foreign policy. Both main Canadian parties have warmed to a CANZUK-type deal, as have all three coalition parties in New Zealand. In Britain, too, the idea is gaining in popularity. And you can see why.

To grasp the extent to which the world has tilted on its axis, try the following thought experiment. Suppose that Donald Trump was secretly working for Vladimir Putin. What would he be doing differently?

It is one thing to halt weapons shipments to Ukraine, including those batches already in transit, and to cut off intelligence sharing. But Trump is going well beyond such measures. He has repeated Putin’s propaganda claims, calling Volodymyr Zelensky a dictator and accusing him of having started the war. He has told his cybersecurity agency to deprioritise the threat from Russia. He has relieved pro-Ukrainian US generals of their commands. He has voted in the UN with Russia, Belarus and North Korea against a motion condemning the invasion of Ukraine from which even China abstained.

Most seriously, he has picked fights with NATO countries, threatening to annex Greenland and is waging economic war against Canada.

The leaders of the other Anglosphere democracies have been left stranded, like governors of outlying Roman provinces when the Eternal City was sacked. Consider, if nothing else, the impact on Britain’s defence procurement.

Since the 1950s, Britain has assumed that, in a big war, we would be fighting alongside our American allies. Yes, we could manage smaller wars on our own: Aden, the Falklands, Sierra Leone. But, if things turned truly nasty, we’d be in a US-led coalition.

Like other Western allies, we therefore specialised rather than developing full-spectrum defence capacity. We relied on the US for heavy lift, advanced satellites and intelligence. More seriously, we depended on it for the development and maintenance of our nuclear missiles.

Our current deterrent, Trident II, will last until 2040. And then? Can we be sure that the US will be a dependable ally? I think it likely; but, after the past two months, I can no longer be certain.

What of Europe? Again, I like to think that we will still be on the same side – the side of freedom and democracy – but it was not long ago that the EU planned to close the Irish border out of pique because our vaccine roll-out had been faster than its own.

In the run-up to Brexit, Jeremy Hunt, as foreign secretary, was astonished to find that Britain’s investment in the defence of Europe – armoured regiments in Estonia and Poland, the RAF effectively acting as Romania’s air force and much else – generated no bankable goodwill. Even now, when you might think the EU would be falling over itself to draw Britain into a closer defence arrangement, it sticks doggedly to the position that it won’t talk to us about anything else until we give its vessels the right to fish in our waters.

No, there is only one set of countries with whom it is unthinkable that we would fall out 40 years from now: the other CANZUK nations. This matters, among other things, because we need to make decisions soon about our next-generation deterrent.

If we decide to build a fully autonomous nuclear capability – one that needs no US storage or spare parts, like France’s – we will need our own rocket-making capacity. That will cost around twice as much as buying the off-the-shelf US alternative. On our own, we couldn’t afford it; as part of a CANZUK consortium, we could.

CANZUK has consistently polled at around two-thirds support in the four putative constituent nations, making it by far the most popular policy that governments could feasibly implement but haven’t.

Why haven’t they? Partly because enthusiasm, until recently, came largely from parties of the right: Conservatives in the UK and Canada, Liberals in Australia, and all three right-wing parties (National, New Zealand First and ACT) in New Zealand.

Some leftists reflexively opposed anything that looked like imperial nostalgia or, worse, a pining for the White Commonwealth (though, in reality, all four nations have larger non-white populations, proportionately, than the EU has). In Britain, Euro-nostalgics were upset to see Leavers proposing free movement with distant countries, on grounds that British people could more easily imagine themselves working in Australia or Canada than Finland or Slovakia.

But all that was before Trump began menacing Canada with annexation – and, indeed, roughing up other US allies. When Australia signed its trade agreement with the US in 2005, it specifically exempted its steel exports from any tariffs decreed in the name of national security. Trump has imposed them anyway.

Suddenly, CANZUK is beginning to look both inevitable and urgent. At Canada’s Liberal leadership debate last month, the candidates were falling over each other to demand closer economic links with the other great English-speaking monarchies – despite it being the French-language debate.

When I suggested CANZUK in the House of Lords this week, the level-headed minister, Baroness Chapman, replied that the government would listen sympathetically to any proposal.

I don’t, from first principles, prefer a CANZUK pact to a US-led one. I would rather keep the US-UK Mutual Defence Agreement, NATO, AUKUS and all the rest of the apparatus we have built since the 1941 Atlantic Charter. I am delighted to see New Zealand, under its impressive defence minister Judith Collins, lining up with AUKUS.

If the American alliance can be salvaged, CANZUK will complement it. But if not, it is a comfortable fall-back, constituting, as it would, the third most powerful military force on the planet.

How quickly can we put it in place? Well, October of next year is the centenary of the 1926 Imperial Conference which began the formal transformation of the British Empire into a voluntary association, a Commonwealth.

As King George V hosted his various premiers on that occasion, so his great-grandson, Charles III, should invite the prime ministers of his four chief realms – who by then, with a bit of luck, might include Peter Dutton in Australia and Pierre Poilievre in Canada as well as Christopher Luxon in New Zealand. That meeting should announce the formal creation of a CANZUK secretariat, based, for time-zone reasons, in Vancouver, and tasked with ensuring free movement of labour, market reciprocity and a common defence among the four kindred nations.

It would give every participating premier a massive electoral boost. And you know what? If Sir Keir Starmer can pull it off, he’ll deserve it.

Daniel Hannan is a former Conservative MEP, a House of Lords member and a founder of Vote Leave.

Here is the link:

https://www.afr.com/politics/federal/canzuk-an-idea-whose-time-has-come-20250316-p5ljw2

I could not agree more. The Trumpian experiment has failed and we need to get out from under.

I sure do not want to be led by a nation which has a man with the morals of an alley-cat as its leader. We are a good deal better than that, and we should takes steps to maximize our distance until such time as more sensible rulers emerge in the US. JD Vance is equally repugnant IMVHO….

We have our own values and interests and should follow them! Let the Americans fester until they can put true decent American values back into action and kick these bounders out!

David.

This Is An Epidemic We Have Brought on Ourselves. Silly Us!

This very alarming article appeared last week:

Our children are rapidly losing their sight. What can be done?

The sudden rise of short-sightedness worldwide, particularly among kids, has experts alarmed and rushing for answers before a myopia epidemic takes hold.

Richard Godwin

The global myopia rate tripled between 1990 and 2023. Why?

12:00 AM March 15, 2025

The Weekend Australian Magazine

Every morning – shortly after checking my phone and shortly before brushing my teeth – I pull down my lower eyelids in turn and smush a contact lens on to each of my eyeballs. I’m pretty good at this by now and can do it without a mirror. After a heartbreaking diagnosis when I was 12 – and a genuinely tragic first pair of glasses – my vision declined throughout my teenage years, finally stabilising at -4.5 dioptres, which means that objects come into focus at 22.22cm (ie one metre divided by 4.5) in front of my face.

My eyeballs are the wrong shape. They grew into eggs instead of perfect spheres. My increased axial length – that’s the distance from my corneas in the front to my retinas at the back – means that objects come into focus in the wrong place. Without contacts or glasses, everything is underwater.

Like most of my fellow myopes (shortsighted people), I have come to view this as a mild hindrance but a manageable one. It hadn’t occurred to me until I began speaking to the world’s leading myopia experts that I suffer from a disease. Least of all a preventable ­disease. Least of all a disease that if left to spread at its current rate will result in millions of people going blind.

It sounds alarmist and yet when you look at the numbers, alarm feels appropriate. Necessary, even. The global myopia rate tripled between 1990 and 2023, according to a recent study in the British Journal of Ophthalmology. The World Health Organisation predicts that by 2050, half of the world will need glasses and 10 per cent will be high myopic (a -6 dioptre prescription or higher), which carries severe risks of complications and even blindness.

“Myopia should absolutely be viewed less as an inconvenience and should take its proper place as a disease,” says Dr Donald Mutti, professor in optometry at Ohio State University.

“Not all myopic eyes have the pathologies that threaten vision,” he explains. “But it’s ­absolutely the case that myopia increases risk for ocular disease.”

Ocular diseases include cataracts, glaucoma, and the two that cause the experts most concern. One is retinal detachment, which is when vitreous fluid – the jelly inside your eyeballs – begins to leak and pushes the retina away at the back, “a bit like a bubble in wallpaper” as a leaflet from Moorfields Eye Hospital in London helpfully puts it. Moorfields has been handing out a lot of such leaflets recently. Amid a ­“substantial” increase in retinal detachment surgery, the hospital recently reported a sharp increase in the proportion of myopes undergoing the treatment, with the steepest rise among younger patients.

“If your retina detaches, you lose vision,” ­explains Dr Annegret Dahlmann-Noor, the ophthalmologist who led the Moorfields study. “It starts in the periphery and moves towards the centre and if it gets to the point where it affects your central vision, then usually recovery is not complete. We’ve seen teenagers and people in their early ­twenties present with retinal detachments. It’s a trend we can see.”

The other condition that “really destroys” your vision, as she puts it, is macular degeneration. This is now the leading cause of blindness in working age people in China, explains Dr Jan Roelof Polling, who is part of the myopia working group at the Erasmus University Medical Centre in Rotterdam. “As your eyeballs grow longer, it puts the tissues under strain,” he says. “The stretching is OK when you’re young. But when you’re older you lose collagen – and there’s lots of collagen in the eye. So now the eye is stretched but it has holes in it.”

Again, this is a condition that once mainly affected older people but is now hitting ever-younger patients. Unlike retinal detachment, there’s not a lot that can be done about it. “You can have injections into the eyeball to take the bleed away but that’s about it,” says Polling. “One third of all high myopes develop myopic macular degeneration, which almost always ­results in visual impairment or blindness.”

One third of all “high myopes” … if you scale that up you begin to see the cause for alarm. The world population is expected to be 10 billion by 2050. One-tenth of that is one billion; one-third of that is 333 million. That’s a USA of blindness.

“That’s why we’re starting to worry now,” says Polling. “You only have to look at China, where 80-90 per cent of people have myopia and a significant proportion become blind or visually impaired within their working careers. It’s a huge worry and a huge expense for families. This will become a much bigger problem.”

At this point, you’re probably wondering why. Why has the world’s eyesight deteriorated so badly? The current estimate is that 15-20 per cent of British teenagers are myopic, but our data gathering isn’t nearly as good as it is in East Asia and Singapore, where this is already recognised as a dire catastrophe. In Singapore, the “myopia capital of the world”, around 80 per cent of adults are myopic. In Seoul, South Korea, the condition affects 96.5 per cent of 19-year-old males.

This is where we are heading, stresses Dahlmann-Noor. “We analysed hundreds of data sets last year. We used to have a rigid algorithm to find out what the underlying problem was when a five-year-old already had myopia. We would do our diagnostic tests and we would ­reliably be able to find something wrong – ­genetically, metabolically, whatever.

“Now? If we do the same tests as before, we find children with myopia who don’t have a thing wrong with them. They only have myopia. So there is a trend for the onset of myopia to be earlier. And there is a trend for children with simple myopia coming into our NHS [National Health Service] clinics at an earlier age.”

There is a strong genetic component to ­myopia. If both of your parents need glasses, you probably will too; rates of myopia are also higher in certain Asian and Afro-Caribbean populations than in white people. Still, none of this explains the rapid increase in recent years. It isn’t the gene pool that has changed, says Dahlmann-Noor: “What has changed very ­dramatically are our lifestyles.”

There are two factors of particular concern. One is that children are not spending nearly as much time in daylight as they need to. Daylight is thought to stimulate the release of dopamine in the retina, which inhibits eyeball growth. Given that we evolved as an outdoor species but now spend around 90 per cent of our lives indoors, the idea that our eyes are struggling to cope with our low-light interiors isn’t so ­surprising. The other factor is that children are spending too long engaged in “near-work”, i.e. concentrating on things too close to their face and thus squeezing their eyeballs into the wrong shape from an early age.

Since myopia develops while the eyeball is still growing, the crucial window is in childhood. Hence the standard advice for children is known as the 20/20/2 rule: for every 20 minutes of near-work, spend 20 seconds focusing on something in the distance; and most importantly, spend two hours outside each day. Also, go and get your eyes tested.

So, environment plays a crucial role. Much of the blame for the shockingly high rates of myopia in East Asia (notably in urban areas) seems to come down to the highly competitive education system. East Asian children start school earlier in life, work longer days, receive far more homework, and spend very little time outdoors. Similarly, in Singapore, children spend as little as half an hour a day outside.

One of the few East Asian countries to have seen a decline in myopia rates in recent years is Taiwan, which in 2010 introduced a policy known as Tian-Tian 120, which encourages schools to incorporate 120 minutes of time outdoors into their daily schedules.

You would think that “less homework, morebreaks” is a message that most schoolchildren could get behind. But it’s not solely schoolwork that’s to blame – children’s leisure time has shifted too. China also tops the global chart of hours spent playing video games each week (12.4 hours on average, compared to the UK’s 7.2). And one of the things that Polling has noticed from studying Dutch teenagers is that it’s no longer principally the academic children who need glasses – it’s everyone. “There has long been an association with education and myopia,” he says. “It used to be that the kids with glasses were the ones who went on to study at university – and the kids who played soccer stayed without glasses. That’s changed with people born after 2000. Everyone is on their phone now.”

Dahlmann-Noor is reluctant to draw conclusions before the link between early eyeball development and devices has been more rigorously researched. However, she does stress that if children only had access to phones when they were 16 or 17, the effects on their eyesight wouldn’t be nearly as bad. “That’s when the eyeball has reached its final state. But I have families coming into the consultation rooms who clip a smartphone on to their child’s ­pushchair and have Peppa Pig running. Why does a one-year-old need to have Peppa Pig on a smartphone? But these things have invaded everyone’s private space and we don’t even ­notice them any more.”

We are by now fairly used to the idea that phones have made a generation of teenagers anxious, depressed, sleep-deprived, narcissistic, susceptible to terrible influencers – and the rest. US social psychologist Jonathan Haidt lays out the evidence in grim detail in his bestseller The Anxious Generation, and if you’re on any parental WhatsApp groups you’ll be aware of his thesis: the wide adoption of the smartphone since 2010 plus a gradual erosion of unstructured outdoor play has prompted a teenage mental health catastrophe, resulting in higher rates of suicide and self-harm, particularly among teenage girls. Nonetheless, the idea that these same forces might literally be destroying our children’s ability to see things clearly – might even eventually blind them – is not one that I’ve seen discussed, even in the most tech-phobic parental forums. And yet: one Danish study found double the risk of myopia in 16- to 17-year-olds who used electronic devices for more than six hours a day. Chinese studies have correlated axial length with time spent on both computers and phones and found that yes, there is a link.

It should be stressed, however, that experts are cautious about pushing the thesis too hard. Dahlmann-Noor points out that the myopia trend long predates smartphones. Concentrating on anything close to your face can be bad for your eyesight. Your child could be copying out The Book of Common Prayer, she could be performing a mindful colouring exercise, she could be playing Tetris on a Game Boy in 1992 or she could be doomscrolling TikTok. The eyeball would be under the same strain.

Moreover, it’s generally agreed that near-work is secondary to time outdoors as a determining factor. “If you’re looking at school-age kids from six or seven or so, we have not found that near-work has the influence that people often think it does,” says Mutti. “It just doesn’t show up as that significant a factor in cohort or longitudinal studies.”

Mutti has been collecting data on ­behavioural patterns and myopia since 1989 and is convinced that time outdoors is the ­significant factor. “It’s pretty clear that kids are spending less time outdoors than they used to,” he says. “When I was a kid, my mum would ­encourage us to get out of the house: ‘Come back when it’s dinner time’. But indoors is just a lot more entertaining than it used to be. And parents have more concerns about unsupervised kids running wild on the streets.”

Many of these are perfectly rational, I’d add. I’d love my children to play outside more. But my immediate urban environment is designed for cars, not children. There are few activities for children to safely do outdoors that don’t ­require parental supervision and/or cash.

And it’s not as if time spent on screens and time spent outdoors are unrelated. If my eldest is playing football with his mates, he is, perforce, not playing Roblox. If my youngest is watching Bluey while I get some work done, this is almost certainly happening indoors. And it’s the youngest I should be most worried about, says Mutti. Even as a “near-work ­sceptic”, he is extremely concerned about the effect of screens on the very young. “To me, the preponderance of evidence is not in favour of near-work being so important in school-age kids,” he says. “But could near-work influence a young child’s eyes? A preschooler’s eyes? That’s a valuable question to ask. In my ­research on refractive development, there are strong effects of near-focusing on the ­development of infants’ eyes – maybe into the toddler years.”

He demonstrates this to his students with balloons. “The focusing muscles act as a ­mechanical force, tensing force at the front of the eye. If you put a squeeze around the balloon in the front, it elongates at the back. So it’s not hard to see how near-focusing could change the shape of an infant’s eye. That makes me very concerned about how toddlers are spending their time.”

And here is an “absolute difference” brought on by technology. “You no longer have to be able to read to be an intense near-worker as a toddler,” he says. “If you watch small children, they love their iPads. They’re very adept at swiping and scrolling and finding their next video even at age two. I’m concerned about the intense use of electronic devices among toddlers.”

Polling adds that just because it’s harder to find a direct link between myopia and screens, it doesn’t mean it doesn’t exist. “It’s relatively straightforward to measure light exposure or even simply how much time a child is outside. It’s much harder to measure focal distance.”

But either way, it hardly seems surprising that myopia rates rapidly accelerated during the Covid-19 pandemic, during which children were both locked up indoors and forced to look at screens. Neither I nor my 11-year-old have forgotten the torture of his Year 1 Zoom lessons. Indeed, the pandemic period of 2020 to 2023 saw a “notable” increase in myopia rates. One recent Scottish study found a 42 per cent rise in the incidence of myopia. And a recent study in Hong Kong found that myopia rates in six to eight-year-olds had doubled during the Covid-19 pandemic: 25 per cent of six-year-olds and 46 per cent of eight-year-olds were myopic.

It’s worth stressing again that the earlier ­myopia presents itself, the worse it will be. “It’s difficult because you don’t see immediate ­effects,” says Polling. “You need a lot of ­exposure from a very young age and then, at the age of eight, you finally become myopic.” Some parents with mild myopia aren’t too ­concerned if their child is diagnosed with a similar prescription, he says. But if you’re -3D at eight you are basically certain to be -6D or above at 18. And macular degeneration might arrive in your forties or fifties. “These windows are precious and fleeting,” says Polling. “If we can delay the onset of myopia until 12 instead of 10, that’s a huge difference.”

What’s interesting – OK, what’s maddening – is that when you bring this sort of thing up with parents, they will often treat screens as a symptom of myopia as opposed to a cause. As in: “Oh yes, I’ve noticed that Rosa always holds the phone up close to her face when she’s watching cartoons in bed.” Here is an account from an online myopia community from a ­parent panicking about the results of their three-year-old’s first eye examination: “He would watch TV up close (but most kids seem to) and also watch the phone up close with his head tilted to one eye …” It’s almost as if we ­accept it as inevitable. A bit of genetic bad luck. As opposed to a situation we might ­actually do something about.

The difficulty for ophthalmologists comes with framing a condition that will be perfectly manageable for most people and may not present any complications as a matter of urgency until decades down the line. The costs involved in requiring contact lenses might focus minds. As might the risks. A few years ago, I contracted acute keratitis from dirty contact lenses. This is an infection of the cornea that can lead to blindness – and honestly, the pain was ­unbelievable. It was like having sandpaper and chilli alternately rubbed into my right eye and the cure was almost as torturous. I had to apply eye drops every 30 minutes for 48 hours. I have been scrupulous about contact lens hygiene ever since.

But that’s the thing about eyes. You take them for granted until you don’t. “I speak to people who have macular degeneration in their forties and fifties,” says Dahlmann-Noor. “They are incredibly bitter. They say, ‘I just wish someone had warned me that this was on the cards’.” It’s certainly enough to be a serious long-term worry for the NHS.

Still, Dahlmann-Noor expresses some optimism. “For all my life, there was nothing you could do about the growth of the eyeball,” she says. “You’d go and have your eyes measured, you’d get your new glasses, and that was it. But now myopia has become such a problem that there has been a lot of research and there are ­finally treatments.”

It is not possible to stop or reverse the onset of myopia. But it is possible to slow it down. Corrective glasses and contact lenses work by creating a second image shell in front of the retina, which pulls the image forward and counteracts the elongation of the eyeball. These have been shown to slow the progression of myopia by 40-50 per cent.

Then there are atropine eye drops, which are already widely prescribed in Asia (sometimes to pre-myopic infants) and are likely to become available in the UK this year.

There are factors that are beyond the control of medics. “These Big Tech companies need to start taking care of kids’ health,” says Polling. “They need to make their apps less addictive. And to warn parents not to give children phones before the age of six, and keep them to a minimum after that.”

Given the extreme indifference tech ­companies have so far displayed towards the welfare of children, you’d have to say they are extremely unlikely to do that without being ­legally obliged to do so. “Now, I’m sorry, that’s not very optimistic!” he laughs.

“But there is something children can do,” he stresses. “Just play outdoors.”

I suspect that would do most of us adults some good too.

Here is the link:

https://www.theaustralian.com.au/weekend-australian-magazine/our-children-are-rapidly-losing-their-sight-what-can-be-done/news-story/83b93c845b07f3404f5fd775c7743070

We need to get these little mites out and in the broad daylight for a decent spell each day,

Just how that fits with school, music and so on I have no idea but they need to get out there somehow! 

I suspect the harm is done after 15 or so but before then its all hands to the pumps of glasses by the time 15 rolls around!

David.

It’s Wonderful To Read A Real Expert When They Show Us What A Mess We Are In.

This revelatory article appeared last week:

We wasted a $400b windfall, and now we’ll all have to pay

An audit of federal finances finds Australia has never seen rivers of gold like this, but the hangover will be brutal.

Chris Richardson Economist

Mar 16, 2025 – 12.59pm

Paul Keating famously declared that you change the country when you change the government. Yet, while that might have been true when he fought Fightback! a third of a century ago, these days elections are solely about style rather than substance: our politicians stopped challenging us decades ago.

Our oppositions complain loudly but only pretend to oppose, essentially adopting the policies of the government of the day and relying on its unpopularity to win power.

The proof? Follow the money. Although dollars aren’t a perfect yardstick of policy differences, they are an arms’ length one. Australia has budgeted $6 trillion across the next four years: half as spending going out, and the other half as taxes coming in.

Yet, with big-ticket items such as nuclear power plants and extra fighter jets sitting mostly some years away, the difference between government and opposition policies in this election will be comfortably less than 1 per cent of the amounts we’re set to tax and to spend in the next four years.

And yes, that’s typical. For decades now our oppositions have promised their taxing and spending to be more than 99 per cent matching those of the government they’re campaigning to replace.

In the election campaign both sides are therefore promising Australians that they’ll remain mediocre.

I believe them, and you should too. This article spells out why.

Our national social compact

We tax workers and businesses so we can spend that money – more than a quarter of all national income – on the young, the old, the sick, the poor and a defence force.

That makes the federal budget our national social compact. It’s marvellous when we get it right, disastrous when we get it wrong.

The good news is there’s lots to like about our Australian federal finances: debts and deficits here are a fraction of those in many nations.

The bad news is we’ve done well thanks to luck rather than good management. And the worse news is that, despite the luck that’s come our way, our social compact isn’t delivering prosperity: Australian living standards stood still over the past decade.

What’s that about luck?

Budgets move because of two things – the decisions of politicians, and “everything else”. The latter category – luck – often plays a bigger role than policy.

And recent times saw our biggest ever surge of budgetary luck. Wars pushed up the price of what Australia sells to the world, and we got tax windfalls from that. Many migrants meant more people to tax. And inflation took money from families and handed it to the taxman.

Politicians who live through a phase of budgetary luck tend to claim that their budgetary success was due to their superb management. Yes, Peter Costello, I’m looking at you.

Yet the windfalls of the current government dwarf those Costello benefited from. And as the noted budget economist Cyndi Lauper points out, Money changes everything.

The government’s own figures estimate that, since its election, revenue revisions dropped an extra $85 billion into the taxman’s pocket in 2022-23, followed by another $102 billion last year.

Adding my own estimates of yet more luck of late (including commodity price strength and a weaker Aussie dollar), that windfall eases to a still remarkable $89 billion next year and $85 billion the year after.

Remember, those revisions weren’t due to any policy change by any politician. Rather, they came via the combined impact of war and migration adding to the size of the pie we tax, plus inflation giving the taxman a bigger slice of that pie.

That surge in luck is unprecedented. Last year’s windfall more than paid for nine of the 20 largest federal programs – more than all of the cost of unemployment benefits, plus childcare subsidies, the capabilities of each of the army, navy and air force, federal subsidies to state schools, as well as our support for carers, fuel tax credits, plus spending on public sector superannuation.

Please read that last sentence again. And marvel. Australia has never seen rivers of gold like this. Never. Yet although luck’s a fortune, it isn’t a strategy. The glory years of luck are fading, and the challenges are rising.

The key challenge is that we took our luck to town. Spending was 24.4 per cent of national income in 2022-23, but it’ll be 27.2 per cent next year. That’s the fastest and largest increase in the size of the federal government since Whitlam’s expansion half a century ago.

Luckily, that lurch coincided with our luck, so we still saw surpluses. Yet luck is temporary, whereas the promises we’re making to ourselves are permanent.

Why has spending gone up so much?

The government didn’t plan to drive a major expansion in the size of government. Yet that’s what’s happened.

The key driver wasn’t pre-election promises. It was Australia’s fight against inflation.

The Reserve Bank’s famous “narrow path” saw them reduce inflation with a much smaller increase in the ranks of the unemployed than earlier such fights. But the winners in a slow fight against inflation – those who don’t become unemployed – don’t realise their good fortune. So they don’t thank either the government or the RBA.

Yet a slow fight against inflation is one in which wage earners and borrowers and taxpayers all lose out for longer. And they sure as hell know they’re hurting.

Although overall living standards in Australia have stood still for a decade, that hides the recent pump-and-dump. Living standards were making modest progress before hitting an artificial peak as the then government handed us money during COVID.

As of today, however, they’re down 9.9 per cent from that peak. That’s why polls have narrowed and the punters are cranky: with its small number of ungrateful winners and its many losers (wage earners, borrowers and taxpayers), the RBA’s fight against inflation was an economic success but a political minefield.

No wonder, then, that state and federal governments have spent a fortune. And the federal surplus made it harder to ignore those insistent calls for more spending – after all, the punters could see that they didn’t have money, so how come the government wouldn’t hand over its surplus?

What next?

But you needn’t worry: the government is promising to go on a diet in the next three years, with its spending growing just 1.8 per cent faster than inflation. Even better, federal spending in a decade is promised to be a smaller share of national income than next year.

Phew ... Except there’s no actual details of that diet. Worse still, those official forecasts of a diet pre-dated the phoney war election campaign now under way, where the pace of new promises has accelerated towards an extra half a billion dollars of spending every single day.

So we’re promising to go on an unspecified diet while busily still stuffing our face with Doritos.

A promise to spend is a promise to tax

Even those vague promises of a switch to a harsh spending diet aren’t enough to generate official projections of an eventual narrowing in deficits. To get back close to a balanced budget in a decade, the official forecasts also have to assume the tax take reaches its highest recorded share of national income.

Yes, you read that right: the official figures say the tax take will leap, and they do so by assuming there won’t be another personal tax cut in the next decade. That means bracket creep will get decidedly creepy, with average full-time wages busting into the 37 cent tax bracket halfway through the coming decade.

Mistakes – we’ve made a few

Can we do better? You bet. Much of our spending is stupid, much of our taxing is terrible.

Let’s start with the WA GST deal. The federal budget tries to deliver fairness across states, but the WA GST deal works to neatly undo those, meaning we spend $5 billion a year to worsen fairness.

And while there may be dumber things you could do with taxpayer money, they’d probably involve smoking $100 notes.

Or what about the NDIS? It should be a triumph of targeted support for those who need it, but it was littered with poor incentives from the get go. The upshot is that one in every seven (14.2 per cent) boys aged six in this nation are in the NDIS, and 69 per cent of those entering it are aged under 15.

To its credit, the current government – having blocked the modest reform efforts of the previous government – realised the need for change. But although Australia needed leadership, most of what we got was creative accounting: moves that pushed more NDIS costs on to the states and set up a new scheme specifically for kids.

Yet that came at the cost of further bribes to the states, reducing federal NDIS spending but at the cost of raising a bunch of other federal spending.

Or how about student debt? The government recently announced some good changes, but threw in a $20 billion clanger – forgiving student debt.

Why is that bad? Because students end up earning more than the average, meaning that forgiving student debt means lower taxes on those who’ll eventually be better off. That comes at the cost of everyone, including those who aren’t well off.

Worse still, our budget accounting standards are so broken that, because student debt is off budget, that debt forgiveness magically costs nothing in terms of bigger deficits.

I could go on. Whyalla … why? Or fossil fuel subsidies masquerading as electricity cost-of-living relief. Also why? Or bulk billing incentives that put three dollars in the pockets of doctors for every dollar they put in the pocket of patients. (You’d have a bigger impact on our health – and definitely on fairness – if we followed the recommendations of the Economic Inclusion Committee.)

And tax? I’m sad you asked

Australia may be a first-world nation, but we increasingly have a third-rate tax system. It last got a spit and polish a quarter of a century ago, with the subsequent neglect leaving it ever more reliant on a handful of increasingly damaging taxes.

In the meantime, we’ve built a system with:

• Superannuation taxes that raise next to nothing (less than the sector takes in fees) while busily shovelling money from poorer Australians to richer Australians.
• Taxes on our gasfields that also raise next to nothing – we built that tax with oilfields in mind, and it’s been an epic disaster when applied to gasfields.
• A fringe benefits tax that began as a force for good but is now so riddled with loopholes that it has become a force for evil.
• A levy on banks that massively undercharges them for their “too big to fail” insurance.
• Perhaps most spectacularly, we raised cigarette taxes through the roof, but didn’t match that with better enforcement. That blew a huge hole in the tax take, while simultaneously making smoking cheaper for most Australians and underwriting the rise of the most lucrative (and least risky) market that organised crime in this nation has ever had.

This isn’t the Deep State. It’s the Dumb State.

Then there are the taxes we don’t have but should, including everything from a carbon tax through to a wealth tax. Hate me.

And the poster child for tax reform in the current election campaign? If you wait two years, a pint in a pub will cost five cents less than otherwise. Here’s cheers to that shattering reform …

A more dangerous world is a more expensive world

As Lenin said, “There are decades where nothing happens; and there are weeks where decades happen”.

Recent weeks saw decades happen, as the Trump administration beat a retreat from the world stage rivalling that of Milli Vanilli.

Key nations are now run by old men with big agendas and poor impulse control. And, like it or not, that says Australia will need to spend more on defence. Worse still, the reliability of the US as a defence supplier also took a hit in recent weeks, as Ukraine can attest.

That backdrop says a whole bunch of budget trends are not our friend:

• We’ve wasted a blinding burst of budgetary luck, making permanent promises to ourselves off the back of temporary gains, generating a worsening structural budget deficit;
• That’s left our budget absolutely covered in barnacles – terrible taxing meets stupid spending;
• Yet a bunch of expensive challenges are rising fast, not least on the geopolitical stage; while
• There’s a looming hung parliament, suggesting we will struggle as a nation to take the rapid and decisive action we need.

Poor fellow my country.

Here is the link:

https://www.afr.com/policy/economy/we-wasted-a-400b-windfall-and-now-we-ll-all-have-to-pay-20250314-p5ljjv

This really is a terrifying condemnation of Governmental waste and a total real lack on insight on just how things work!

This litany of errors and mistakes identified here is both epic and shameful. There is great and penetrating insight here!!!

I will follow up Mr Richardson’s finale with one of my own…

“God help us all”!

David.

I Feel This Is A Topic We Need To Think About Every Few Years….

This appeared last week and reminded me of the importance of having a thought through view on the topic:

‘We’re going to talk about death today – your death’: a doctor on what it’s like to end a life rather than extend one

I used to focus on maternity and newborn care, but when Canada legalised assisted dying in 2016, I began helping people with a different transition

By Dr Stefanie Green

Sat 15 Mar 2025 22.00 AEDT

The patient referral comes through my reliable old fax machine on a single sheet of paper. “Thanks for seeing this 74-year-old gentleman with end-stage liver failure. He’s been following the news carefully and is eager to make a request for an assisted death. I hear you’ll be providing this service here in Victoria – courageous! I look forward to your assessment. Summary of his file is below.” I read it twice to myself before sharing it with Karen, my office manager. We look at each other for a short moment before I break the silence. “His name is Harvey. I’m going to need a chart.”

While Karen makes a chart for Harvey – demographics on the front sheet, blank request forms in the back – I dial his number. His wife, Norma, answers. As Harvey isn’t mobile, I agree to meet them at their home.

Three days later, I stand in my bathroom brushing my teeth and practising what I will say, the tone I want to set. If Harvey meets all the criteria, he will be the first patient to whom I will offer medical assistance in dying (MAiD), following its legalisation in Canada just a few days earlier, in June 2016.

At the time I had been practising medicine for more than 20 years, trained as a family physician, and focused on maternity and newborn care, preparing women and their families for the profound transition a new baby would bring to their lives. But when it became clear the law was about to change to allow MAiD, I changed course with it, learning everything I could about this newly emerging field so that I could support people with their final wishes and their transition at the other end of life.

When I arrive at Harvey’s home for the assessment, a man in his 70s with a bushy grey moustache opens the door and smiles sadly as he extends his hand. “Hi, thanks for coming. I’m Rod, Harvey’s brother-in-law.”

I cross the threshold and am ushered upstairs, where I see a man in a bathrobe and a woman sitting close together on a couch. “Hello, Doctor, thank you for coming,” she says, smiling. “I’m Norma.” Her hands fidgeting, she appears slightly nervous, or maybe just awkward. I recognise the same feeling within myself.

Dressed in grey pyjamas and covered with a warm blanket, Harvey looks years older than Norma. I notice his protuberant, fluid-filled abdomen and papery, yellowed skin, signs that his liver failure is advanced. I see his frail hands and gaunt, unshaved face. He likely has only weeks left to live.

“Good to meet you,” I say as I give his hand a squeeze. It is cool and bony, mottled with purple, and has little musculature left, but he holds on a little tighter and just a moment longer than I expect, slowly shifting his gaze to look me straight in the eye before letting go. I sit down in front of Harvey and ready myself to begin what I have been practising all morning. “I’d like to start by breaking the first rule of medical school.”

Harvey musters a sly grin, intrigued, but doesn’t say anything, which I take as an invitation to continue.

“In medical school, they taught me that when I meet a new patient, I should let them speak first … But I want to start by telling you something about myself. I want to tell you that I am pretty direct,” I say.

Harvey is egging me on with a slow, wobbly nod.

“We’re going to talk about death today, and we’re going to talk about dying,” I continue. “We’re going to talk about your death, and we’re going to talk about assisted dying. We’re also going to talk about what’s important to you. I’m going to talk about these things frankly. I’m not going to use euphemisms or talk about ‘passing over meadows’.” I pause and lower my voice, addressing Harvey directly. “You OK with that?”

I am relieved to see he is smiling. “Yes, that’s exactly what I hoped for,” he says. “No more bullshit.” His voice is a bit gravelly, but this last word comes out strong, emphatic. “We’re going to get along just fine,” he adds.

What to wear? All black seems morbid, bright colours too festive. I want to look professional but not cold, casual but no jeans

I get down to the essentials. “Why do you want to die?”

Harvey smirks. “I don’t! I’d rather live. I’ve had a great life. But it seems I no longer have much say in the matter.”

It’s my turn to nod.

“I’ve got great friends, great kids, we’re blessed with family all around us. I know I’m lucky. I’ve been married to this gal here for 52 years … ” He trails off, holds Norma’s hand, shakes it at me a bit and swallows some emotion before continuing. “I really wanted to make it to 52 years, and I did.” He’s quieter now, his energy already drained. “Now I’m ready.”

Harvey is straightforward with me. He knows he is dying, that it will not be long, but he wants to control the how and the when.

“I want Norma and the kids with me at the end,” he says with a flash of spirit, “here, in my home, in my own bedroom … I want to do it my way. I want to have my friends over this weekend, have one last bash, maybe even sneak a sip of a beer.” He smiles at the thought. “I’ve seen friends linger on at the end … in bed … out of their minds. I’m not interested in putting myself or my family through that.”

Harvey ticks every box of eligibility. He is capable of making his own decisions, he is making a voluntary request, and he has a grievous and irremediable condition. He will need to sign an official request form, and Norma assures me it will be completed by the end of the day, witnessed by two independent people. After that, a mandatory 10-day reflective period can begin. The law also requires a second clinical opinion, so I will call a local colleague to see if he is available.

The next few days are busy. As is expected with his liver failure, Harvey continues to decline cognitively. If he declines too much, too quickly, he won’t be able to give his final consent immediately before the procedure, which is required. Because the second doctor and I agree this risk is imminent, we are allowed to shorten the waiting period. Harvey chooses a date three days out.

True to his word, two days before his scheduled death, Harvey and Norma host an open house for friends and neighbours to celebrate his life and say goodbye. Meanwhile, I review all the practicalities and guidelines. I am keenly aware that if I get anything wrong, I could be liable for criminal charges. The words “up to 14 years in prison” keep flashing in the back of my mind. No one yet has a sense of the mood of the prosecutors. Are they waiting to meticulously comb through each case and make an example of a clinician who makes a mistake? I’m not willing to leave anything to chance. Harvey isn’t just my first assisted death. His is the first on Vancouver Island and among the first in Canada. I am aware that I need to get this right – for myself, for the MAiD programme but, most important, for Harvey.

---

It’s 16 June 2016, the day Harvey has chosen to die. This is all about him, but it’s momentous for everyone involved. This morning I stood in my bedroom, staring into my closet, considering choices and discarding them immediately. What does one wear to a scheduled death? All black seemed morbid, bright colours too festive. I wanted to look professional but not cold, casual but no jeans. How could this be the hardest part of my day? I’ll  be picking up the medication at 10am, I’m expected at Harvey’s by 11 and I suspect he’ll be dead before noon.

I pull up outside, close enough to have arrived, far enough that no one from inside can tell I’m here yet. I take a deep breath. In medical school, the saying was “see one, do one, teach one”. But in this case, there has been no way for me to “see one”. The law changed only a few days ago. I am about to take a big, blind step.

I leave the car and stride to the door. Once inside, I head upstairs. I catch Norma’s eye from across the room, but before I can get over to greet her, I meet Jessica, the nurse practitioner who will assist me, standing at the top of the stairs in her scrubs and stocking feet. All I can think of is that I do not want the family to suspect we have never actually met. I don’t want to do anything that might remind them I have never done this before.

There are eight close family members in the house. I ask to speak privately with Harvey for a few minutes and am told he’s in his bedroom, so I head there. Sitting in the chair by the bed, I begin, “How was your night?”

“It was what it was,” he replies. “I’m ready to go. I need this to be over today.”

The official purpose of this talk is for me to verify that Harvey is still clear of mind, that he still wishes to proceed and, if so, to obtain his final consent.

“Are you having any second thoughts?”

“No, none at all.”

Harvey reassures me that his affairs are all in order; his funeral plans have been made, the names of his lawyer and his accountant have been written out for the family. He expresses some concern about those he will be leaving behind. I try to reassure him I will provide them with some resources.

“Thank you for making this possible.”

I don’t recall who reached out first or when we began holding hands, but, once again, he is holding mine a little longer and a little tighter than expected.

“You know, I’m a little scared.”

“Of course you are … that’s OK.”

We talk, take the time we need. No one is in a rush.

“What do you think comes next, Dr Green?”

“I really don’t know, Harvey. What do you think?”

“I’m not a religious man, not even very spiritual. But I do not believe this is the end. It just can’t be.”

‘I join the family in the living room, explain the order of events, the number of syringes.’ Photograph: Rachel Pick/The Guardian

“OK. But what if it were, Harvey?” I ask. “What would you change, do differently?”

He continues to hold my hand. I hear his regrets – there are few – and of what he is most proud. I learn so much from Harvey. I am already grateful that he is my first MAiD patient.

At some point we both fall silent. I explain that I will go speak with his family about what to expect. By now I’ve reassured myself that he is still capable of making this choice. I hand him the required form and watch as he scratches out an unsteady version of his signature, then I join the family in the living room. I explain the order of events, the number of syringes – Harvey has chosen the intravenous option for his final medications – and the time for last words. I ask if there is any ritual or ceremony they’d like to incorporate, then I get down to the details. “The first medication is an anti-anxiety drug. It will make Harvey relax, feel pretty good, pretty sleepy. He’s already quite weak, so I expect he’ll fall quickly into a nice light sleep. We might hear him snore; that’s one way you’ll know he’s truly comfortable.”

I am trying to be as transparent and informative as I can.

“The second medication is a local anaesthetic to numb the vein. It may not be necessary if he is sleeping already, but some of the other medications can sting a bit, so I’ll use this to be sure he won’t feel any discomfort.”

I notice involuntary nodding from Harvey’s brother, his son. I recognise relief on Norma’s face and see blank stares on the others’ … the reality is starting to sink in.

“The third medication is the stuff we would normally give someone for an operation, except it’s a much larger dose. With this, Harvey will go into a much deeper sleep, down into a coma over the course of a couple minutes. If you’re looking carefully, you might notice his breathing begins to space out with this medication.”

I am using my hands now to gesture what is going to happen. “His breathing will become more shallow and will most likely stop.”

I am looking around, trying to judge reactions.

“Even though I expect Harvey will die with this third medication, I will go ahead and use the fourth in our protocol, which ensures there is no muscular movement in the body. I will let you know when his heart has stopped. This whole process is likely to last between eight and 10 minutes.” I lower my voice a little. “I do not expect you will see any gasping or twitching or anything unsettling. My goal is to make this as comfortable and as dignified as possible. But there is a real possibility his breathing will stop before his heart does. If that’s the case, you will likely see a paling of his face, maybe a bit of yellowing. His mouth might drop open slightly. His lips may turn a bit blue. If you find yourself uncomfortable at any time, please feel free to step back, sit down or step out. There is no medal for staying in the room. I will be focused on what I am doing, so I’ll need you to take care of yourselves in those few moments, if necessary. OK?”

Muted nods. A few people breathe out as if they hadn’t realised they were holding their breath.

“That’s the nuts and bolts of it. I expect it’s all feeling a bit real right now. Any questions?”

There’s a pregnant pause, then a previously quiet man in his mid-70s asks, “You got any extra of that anti-anxiety stuff, Doc? I could use a dose myself right now.”

Harvey’s wife tells him to let go. As on most nights of his life, hers are the last words he hears as he falls asleep

Back in Harvey’s room, he is calm, he is smiling, and he appears certain. His love for family has been evident from the start and they are all here with him now. We are huddled in closely around his bed. I ask if anyone has anything left unsaid. Harvey’s son reaches out from beside me and places his open palm directly on Harvey’s chest. He repeats that he loves Harvey and thanks him for being such a great dad. Harvey reminds them all that this is what he wants and asks them not to be sad.

I take hold of Harvey’s left arm. Only after he looks me in the eye and thanks me one last time do I think to begin. When I announce I will start, I sense Jessica reach out from behind me. I didn’t realise how tense I was until she put her hand on my back. I feel myself relax as I push the first medication through the syringe.

“Maybe now is a good time to think of a great memory,” I begin, “doing something you loved, with someone you loved … Go to that place now, feel that moment again … If you feel sleepy, go ahead and close your eyes, you’ve earned it. We’re all here with you.”

Then Harvey dies exactly as he wished: being held by his children and gazing into the eyes of his wife as he begins to feel sleepy. They connect, forehead to forehead, whispering to each other as I continue. She holds his face in her hands, strokes his head and tells him it’s OK. She tells him she loves him, that she will miss him, but that she is all right. She whispers inaudible words, evoking private memories, and he smiles. The intimacy of this moment is so absorbing that I struggle to focus on what I’m doing. She tells him to let go, that she is here with him, and as on most nights of his life, hers are the last words he hears as he falls asleep.

Harvey musters a light snore. Norma recognises the sound and dabs at her eyes. I continue with my protocol, and Harvey soon stops breathing; no one says anything, but I am certain we all take notice. I understand in that moment that I am witnessing this event as much as I am orchestrating it. I continue on to the final medication and immediately notice it doesn’t flow as smoothly as the others did. I have an instant of panic, wondering if my IV line is blocked, but it takes only a moment for me to understand it’s because Harvey’s blood is no longer circulating. I am certain his heart has stopped, but I continue nonetheless. Only after the last medication is delivered do I cap and lock the IV. Only after the empty syringes are resealed within the plastic container do I reach for my stethoscope. And only after I listen for a complete 60 seconds do I announce, “He’s gone.”

Only then do his family members allow themselves to be overcome by their loss. There are sobs, tight-clenched hugs and flowing tears. To my utter astonishment, there is also an immediate outpouring of gratitude for what I have just done, and for this, I’ll admit, I was unprepared.

---

By February 2017 I’d gone from being a beginner in a new field of medicine to feeling more certain of what I was doing. I was becoming known among local family practitioners and specialists for my work in assisted dying, and the number of referrals to my office continued to climb. The latest concerned a patient called Edna, whose worsening multiple system atrophy was affecting every aspect of her life. Two weeks earlier, her palliative care physician, Dr Vass, had been visiting when she’d asked him for MAiD by scratching out letters on a whiteboard. It was one week after her 77th birthday, just after she’d returned home from a hospitalisation, and she had repeated her plea several times since.

Edna managed a slight smile upon my arrival at her home a few days later, but her eyes seemed locked in a blank gaze. I noticed her frail body was strapped into her padded chair to stay upright. Before I even began, Edna was already scratching on the whiteboard. I waited for her to finish, three letters that said it all: “D-i-E”.

I was surprised and thankful she was still able to write. She looked up and I thought she was done. She uttered a sound I didn’t understand, then brought the marker down forcefully, drawing my attention to her message. “D-i-E P-L-S-!”

Request received.

Edna was close to her sister, Mindy, from whom I learned that Edna had been a pioneer for most of her life, one of only two women to graduate with a bachelor’s degree in biology from her college back in 1960. She taught high school science for two decades, did a few stints as the principal of two schools, then retired from her post as superintendent of the school district at 68. An avid hiker and a supporter of women’s rights, Edna had remained active and involved in various volunteer positions until her diagnosis overwhelmed her.

Edna was now unable to walk or talk, and had become dependent on others for care. Recently, she’d been losing the ability to swallow, and had landed in hospital last month after aspirating food into her lungs. There was talk of inserting a feeding tube into her stomach. She didn’t want that. She saw no reason to prolong her life as it was, but did not wish to starve to death.

I spoke again to Dr Vass and two weeks later I returned to Edna’s bedside with the news that I was convinced she was eligible, and I was willing to help her. She drew a happy face … no eyes, just a smile. We then turned to practical matters. Edna had been raised in a religious home and still had family who were deeply faithful. She’d been worried about their reaction, so she’d kept much of the decision-making to herself. Now she would share her choice, and hoped they’d be willing to join her on the day of her death. With Mindy’s help, we discussed some of the obstacles she foresaw, and I arranged for a hospice counsellor to facilitate what everyone expected would be a difficult conversation.

It didn’t go well. The counsellor said she had encouraged people to express their feelings and listen to others’ points of view, but much of the meeting had felt like a sermon: “As her brother was talking, she took the time to write out ‘CHRiStN ANtAgONiSM’. I’d say she’s determined to proceed.” When I returned to talk about choreographing the day of her death, Edna informed me that her relatives would not be joining us.

On the afternoon of Edna’s scheduled death, I arrived at her home expecting it would be a quiet affair. Instead, I walked into a chaotic scene. I could hear a man’s voice yelling as I opened the front door. Edna’s nephew Andrew and his wife were standing at the foot of her bed, pleading with her to reconsider.

“They have poisoned your mind!” Andrew thundered. “The church will never condone this. Your soul will never rest.” His anger was mounting. “We will never condone this!”

“Good afternoon,” I announced loudly. The yelling stopped immediately. “I’m Dr Green.”

Edna looked calm, but her face was hard to read. I asked Andrew and his wife if we might talk in another room. I told them I respected their position, but it really didn’t matter what they wanted or believed: “This decision is Edna’s and Edna’s alone.”

Andrew lapsed into silence. He stood up abruptly, then sat back down. “How can it be possible that, as a close family member, my arguments won’t be taken into account?” he asked.

I assured him his arguments were important but only in relation to his own healthcare and no one else’s. “This is unconscionable!” he began ramping up again. “If you proceed, I’ll call the police. In fact, I’ll call them anyway. This must be stopped. You cannot just kill my aunt.”

I was concerned to see him so upset, but Edna’s diagnosis was clear and she had made a voluntary, formal request. I felt sorry for her family, I understood they would need support, but I would not be bullied out of my responsibilities, nor would I let them bully Edna.

“You can call,” I said. “I suspect they will be helpful in enforcing the law and escorting you out of this house.” Then I checked my tone and took a breath. “It would be a shame if that were Edna’s final memory of you.” We stared at each other in silence.

“I see,” he said, and stood up once more. “Alice, we are leaving. We’ve done what we could. Aunt Edna will pay the price. I will not attend her murder.”

And with that, they walked out. Mindy was just arriving, but they did not stop to talk. I was saddened to see them go, but I was also relieved.

In an odd twist of fate, I was alone at this procedure. There had been a conflict in scheduling, so Jessica had come by earlier to start the IV, then left. In the end there was just Edna, Mindy and me in the bedroom, and Edna used the whiteboard to provide her consent. When I asked if she was ready to begin, she grunted and nodded slightly, then grabbed my hand and squeezed firmly, three times. I didn’t really know what her hand squeezes meant, but they felt like a thank you to me. For a woman who couldn’t speak any more, I thought she’d communicated beautifully. I began.

Later, alone in my car, I ran over the events in my mind. Andrew referring to Edna’s death as a murder had been upsetting, even though I knew it was purposeful hyperbole. I had to remind myself it was Edna’s disease that was killing her and my role was only to facilitate her free will. Afterwards I asked colleagues if they’d ever encountered such resistance, and I’m sorry to say I wasn’t alone. Much more common, though, were friends or family members who declined to attend, citing differences in values, but remained respectful of their loved one’s right to do as they pleased.

I spent several weeks worrying about whether Edna’s event might lead to a complaint to the professional licensing body. I was confident of the outcome, but dreaded having to go through the process. I took comfort in the fact that, in the end, Edna died with dignity, holding the hand of a person who loved her, confident in her decision and empowered by a rights-based legal system. I’m happy to report no complaint was made.

This is an edited extract from This Is Assisted Dying: A Doctor’s Story of Empowering Patients at the End of Life by Stefanie Green, published by Simon & Schuster on 27 March at £20. To support the Guardian and Observer, order your copy at guardianbookshop.com

Here is the link:

https://www.theguardian.com/society/2025/mar/15/were-going-to-talk-about-death-today-your-death-a-doctor-on-what-its-like-to-end-a-life-rather-than-extend-one

I thought this was an excellent discussion of a topic which I still find somewhat unsettling. At an intellectual level I am comfortable in easing severe unending suffering when it is needed but I still have a concern about the mechanics and actuality of the process and think careful reflection upon actions in this domain is vital.

Despite knowing this is a desired outcome by a clearly well supported and genuinely requesting patient at the practical end of their life one still has to take careful pause….

I am not at all sure I could be an active participant in delivering such care, although I am sure knowing the patient, their circumstances and the degree of their suffering would make such action far easier

How do you feel about personal involvement in such processes?

David.

AusHealthIT Poll Number 785 – Results – 16 March 2025.

Here are the results of the poll.

Are The Terrible Floods In Northern NSW Being Managed Reasonably Well By State And Commonwealth Governments?

Yes                                                                    26 (90%)

No                                                                       2  (7%)

I Have No Idea                                                   1 (5%)

Total No. Of Votes: 29

A clear outcome with most feeling Government is actually helping. This would make a change!!!

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

Fair voter turnout. 

1 of 29 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.

Will Australia Ever See An AUKUS Submarine? I Think Not!

This appeared last week:

Aukus

Surface tension: could the promised Aukus nuclear submarines simply never be handed over to Australia?

The multi-billion dollar deal was heralded as ensuring the security of the Indo-Pacific. But with America an increasingly unreliable ally, doubts are rising above the waves

Ben Doherty

Fri 7 Mar 2025 01.00 AEDT

Maybe Australia’s boats just never turn up.

To fanfare and flags, the Aukus deal was presented as a sure bet, papering over an uncertainty that such an ambitious deal could ever be delivered.

It was assured, three publics across two oceans were told – signed, sealed and to-be-delivered: Australia would buy from its great ally, the US, its own conventionally armed nuclear-powered attack submarines before it began building its own.

But there is an emerging disquiet on the promise of Aukus pillar one: it may be the promised US-built nuclear-powered submarines simply never arrive under Australian sovereign control.

Instead, those nuclear submarines, stationed in Australia, could bear US flags, carry US weapons, commanded and crewed by American officers and sailors.

Australia, unswerving ally, reduced instead to a forward operating garrison – in the words of the chair of US Congress’s house foreign affairs committee, nothing more than “a central base of operations from which to project power”.

Reliable ally no longer

Officially at least, Aukus remains on course, centrepiece of a storied security alliance.

Pillar one of the Australia-UK-US agreement involves, first, Australia buying between three and five Virginia-Class nuclear-powered submarines from the US – the first of these in 2032.

Then, by the “late 2030s”, according to Australia’s submarine industry strategy, the UK will deliver the first specifically designed and built Aukus submarine. The first Australian-built version will be in the water “in the early 2040s”. Aukus is forecast to cost up to $368bn to the mid-2050s.

But in both Washington and Canberra, there is growing concern over the very first step: America’s capacity to build the boats it has promised Australia, and – even if it had the wherewithal to build the subs – whether it would relinquish them into Australian control.

We cannot assume that the Americans will always turn up

Malcolm Turnbull

The gnawing anxiety over Aukus sits within a broader context of a rewritten rulebook for relations between America and its allies. Amid the Sturm und Drang of the first weeks of Trump’s second administration, there is growing concern that the reliable ally is no longer that.

With the casual, even brutal, dismissal of Ukraine – an ally for whom the US has provided security guarantees for a generation – the old certainties exist no longer.

“I think America is a much less dependable ally under [president] Trump than it was,” the former prime minister Malcolm Turnbull tells the Guardian this week. “And this is not a criticism of Trump, this is literally a feature, not a bug: he’s saying that he’s less dependable.

“It may be that – regrettably – we do end up with no submarines. And then we have to invest in other ways of defending ourselves. But the big message is that we are going to have to look at defending Australia by ourselves.

“That’s really the issue. We cannot assume that the Americans will always turn up.”

Trump can hardly be accused of hiding his priorities. If the 47th president has a doctrine beyond self-interest, “America First” has been his shibboleth since before his first term.

“Our allies have taken advantage of us more so than our enemies,” he said on the campaign trail. He told his inauguration: “I will, very simply, put America first.”

‘The cheque did clear’

On 8 February, Australia paid $US500m ($AUD790m) to the US, the first instalment in a total of $US3bn pledged in order to support America’s shipbuilding industry. Aukus was, Australia’s defence minister Richard Marles said, “a powerful symbol of our two countries working together in the Indo-Pacific”.

“It represents a very significant increase of the American footprint on the Australian continent … it represents an increase in Australian capability, through the acquisition of a nuclear‑powered submarine capability … it also represents an increase in Australian defence spending”.

US defence secretary Pete Hegseth – joking that “the cheque did clear” – gave succour to Aukus supporters, saying his country’s mission in the Indo-Pacific was not one “that America can undertake by itself”.

“Allies and partners, technology sharing and subs are a huge part of it.”

But, just three days after Australia’s cheque cleared, the Congressional Research Service quietly issued a paper saying while the nuclear-powered attack submarines (known as SSNs) intended for Australia might be built, the US could decide to never hand them over.

It said the post-pandemic shipbuilding rate in the US was so anaemic that it could not service the needs of the US Navy alone, let alone build submarines for another country’s navy.

Under a proposed alternative, “up to eight additional Virginia-class SSNs would be built, and instead of three to five of them being sold to Australia, these additional boats would instead be retained in US Navy service and operated out of Australia along with the five US and UK submarines that are already planned to be operated out of Australia”.

The paper argued that Australia, rather than spending money to buy, build and sail its own nuclear-powered submarines, would instead invest that money in other military capabilities – long-range missiles, drones, or bombers – “so as to create an Australian capacity for performing non-SSN military missions for both Australia and the United States”.

On some forecasts, the US is projected to have half the working submarines it needs in 2032 and is building new boats at half the rate it needs to.

Trump believes it can be fixed. He told an address to Congress-cum-campaign rally this week he would “resurrect the American shipbuilding industry” by establishing a new “office of shipbuilding” inside the White House.

“We’re going to make them very fast, very soon.”

A sunken history

Submarines have long presented logistical and political turmoil for Australian governments.

The country’s first submarine, HMAS AE1, hit the sea floor near Papua New Guinea in September 1914, barely seven months into service. All hands were lost. The second was scuttled by its crew the next year after five days of operations during the Gallipoli campaign.

In 1919, Australia was “gifted” six obsolete J-class submarines by Britain. They were sold for scrap within five years. Subsequent decades brought persistent issues with costs and crewing and difficulties simply keeping boats in the water.

The nation’s current submarine fleet, the Collins-class fleet, was built over two decades from 1990, with the first boat put to sea in 1996.

But to replace that now-ageing class, three different submarine designs have been pursued by successive governments, with boats to be built by Japan, France and now – under Aukus – the US and UK.

Indecision has brought delay, and with it, a capability gap: a vulnerability exposed in recent weeks when a flotilla of Chinese warships – perhaps accompanied by an undetected nuclear submarine – circumnavigated Australia, and undertook allegedly unforecast live-fire drills in the Tasman Sea.

‘They have no obligation to sell us a submarine’

In 2016 then prime minister Turnbull signed a $50bn deal with the French Naval Group for new diesel-electric submarines to be built in Australia.

That agreement – which had subsequently encountered delays and cost over-runs – was unilaterally cancelled by his successor, Scott Morrison, who, in 2021, dramatically signed Aukus with US president Joe Biden and UK prime minister Boris Johnson. None of these men are in office any more.

Turnbull argues pillar one of the Aukus deal was a “catastrophe” from conception, and its liabilities “are becoming more apparent every day”.

“We are spending a fortune vastly more than the partnership with France would have involved. We’re spending vastly more and we are very likely, I would say almost certainly, going to end up with no submarines at all.

“We’re giving the Americans US$3bn to support their submarine industrial base, but they have no obligation to sell us a submarine.”

He says Morrison’s agreement to Aukus “sacrificed Australia’s honour, sovereignty and security”.

“Australia has to be sovereign. It has to have sovereign autonomy. We need to be more self-reliant. Unfortunately, the problem with Aukus was that it made Australia much more dependent on the United States at a time when America was becoming less dependable.”

Former prime minister Kevin Rudd, now serving as ambassador to the US, said from Washington DC this week the Aukus deal has been consistently reaffirmed under the new Trump administration, including by the defence secretary, Hegseth, and secretary of state, Marco Rubio.

He said Aukus would equip Australia with the “most advanced weaponry in the world”.

The submarines “will have … a lethality and utility across the Indo Pacific, which will make Australia more secure in the decades ahead”.

“This is a multi-decadal, multi-billion dollar investment by the Australian government.”

And Rudd told a University of Tennessee audience last month that Aukus was in the interests of both the US and Australia.

“The strategic geography of Australia is quite critical to America’s long-term strategic interests in the wider Indo-Pacific. It’s good for us that you’re there,” he told his American audience, “it’s good for you that we are there”.

This is a key argument behind the Aukus agreement, bolstering the belief of those who argue it can and will deliver: Aukus is a good deal for America. Bases on Australian soil – most notably Pine Gap and HMAS Stirling (as a base for submarines) – are critical for US “force projection” in the Indo-Pacific.

But the same argument in favour of Aukus is also used by its critics: that Australia is being exploited for its geo-strategic location – as an outpost of US military might.

‘Almost inevitable’

Clinton Fernandes, professor of international and political Studies at the University of New South Wales and a former Australian Army intelligence analyst, says the Aukus deal only makes sense when the “real” goal of the agreement is sorted from the “declared”.

“The real rather than declared goal is to demonstrate Australia’s relevance to US global supremacy,” he tells the Guardian.

“The ‘declared goal’ is that we’re going to become a nuclear navy. The ‘real goal’ is we are going to assist the United States and demonstrate our relevance to it as it tries to preserve an American-dominated east Asia.”

Fernandes, author of Sub-Imperial Power, says Australia will join South Korea and Japan as the US’s “sentinel states in order to hold Chinese naval assets at risk in its own semi-enclosed seas”.

“That’s the real goal. We are demonstrating our relevance to American global dominance. The government is understandably uneasy about telling the public this, but in fact, it has been Australia’s goal all along to preserve a great power that is friendly to us in our region.”

Fernandes says the Aukus pillar one agreement “was always an article of faith” based on a premise that the US could produce enough submarines for itself, as well as for Australia.

“And the Congressional Research Service study argues that … they will not have enough capacity to build boats for both themselves and us.”

He argues the rotation of US nuclear-powered submarines through Australian bases – particularly HMAS Stirling in Perth – needs to be understood as unrelated to Aukus and to Australia developing its own nuclear-powered submarine capability.

“Submarine Rotational Force-West (SRF-W) is presented by the spin doctors as an ‘optimal pathway’ for Aukus. In fact, it is the forward operational deployment of the United States Navy, completely independent of Aukus. It has no connection to Aukus.”

The retired rear admiral and past president of the Submarine Institute of Australia, Peter Briggs, argues the US refusing to sell Virginia-class submarines to Australia was “almost inevitable”, because the US’s boat-building program was slipping too far behind.

“It’s a flawed plan, and it’s heading in the wrong direction,” he tells the Guardian.

Before any boat can be sold to Australia, the US commander-in-chief – the president of the day – must certify that America relinquishing a submarine will not diminish the US Navy’s undersea capability.

“The chance of meeting that condition is vanishingly small,” Briggs says.

It now takes the US more than five years to build a single submarine (it was between three and 3.5 years before the pandemic devastated the workforce). By 2031, when the US is set to sell its first submarine to Australia, it could be facing a shortfall of up to 40% of the expected fleet size, Briggs says.

Australia, he argues, will be left with no submarines to cover the retirement from service of the current Collins-class fleet, weakened by an unwise reliance on the US.

The nuclear-powered submarines Australia wants to buy and then build “are both too big, too expensive to own and we can’t afford enough of them to make a difference”.

He argues Australia must be clear-eyed about the systemic challenges facing Aukus and should look elsewhere. He nominates going back to France to contemplate ordering Suffren-class boats – a design currently in production, smaller and requiring fewer crew, “a better fit for Australia’s requirements”.

“We should have done all this 10 years ago. Of course, it’s too late, but the alternative is no submarines at all … that’s not a good idea. They give us a capability that nothing else does.

“It’s worth the hunt.”

Here is the link:

https://www.theguardian.com/world/2025/mar/07/surface-tension-could-the-promised-aukus-nuclear-submarines-simply-never-be-handed-over-to-australia

It looks like all the nuclear sub options are fantasy and we really should get into an agreement with Japan for 3-4 modern conventional boats to replace the Collins Class boats. I suspect that is the best we can do! Anything else looks like a fantasy.....

David.