AusHealthIT Poll Number 787 – Results – 30 March 2025.

Here are the results of the recent poll.

Do You Think The National Disability Insurance Scheme (NDIS) Has Been A Successful Innovation?

Yes                                                                      9 (45%)

No                                                                       9 (45%)

I Have No Idea                                                   2 (10%)

Total No. Of Votes: 20

Well the split vote to end all split votes. Obviously opinion is well and truly split!!!

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

Very poor voter turnout. 

2 of 20 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.

This Is Your Feel-Good Doggie Story For The Week!

This appeared last week:

The Observer Cystic fibrosis

Doctors’ best friends: dogs will help sniff out bacteria for cystic fibrosis sufferers

Imperial College project could lead to less invasive testing and combat increase in antibiotic resistance

Robin McKie, Science Editor

Sun 23 Mar 2025 02.15 AEDT

Jodie is a canine with special ­powers, scientists have discovered. The golden labrador can smell and ­identify ­particular bacteria and could soon play a key role in helping researchers develop a programme in which dogs could sniff out individuals infected with dangerous microbes.

The project, recently launched by scientists at Imperial College London, could be vital in the battle against antibiotic resistance as well as the treatment of patients with lung ­disease and other conditions, they say.

“We believe Jodie and her fellow medical detective dogs point to a new way to spot infected individuals, just by having a sniff of their socks or shirts,” said Professor Jane Davies at Imperial College.

“They could become a major help in tackling antimicrobial resistance and conditions like cystic fibrosis.”

Cystic fibrosis is one of the world’s most common inherited illnesses. A defective protein allows mucus to build up in lungs and other organs, triggering chronic infections that worsen through life.

Eighty years ago, most patients died in their teens. However drugs, called modulators, now offer patients a chance to live into old age. But this success has brought ­problems.

Modulator drugs have greatly improved patients’ overall conditions but they do not entirely kill off all the chronic lung infections that affect them. Most are still infected with bacteria whose growth could jeopardise their health.

“The problem is that ­bacteria in these patients are now much harder to detect,” said Davies. “Modulators greatly reduce the mucus in their lungs and ­without that it is difficult for them to cough up the sputum in which their bacterial status can be evaluated.” “This is where the dogs come in.”

For the first time, we may be able to train dogs to detect pseudomonas on patients’ skin, in their urine or clothing

Professor Jane Davies, Imperial College

Several years go, Davies and her team, supported by the Cystic Fibrosis Trust, carried out research in which dogs demonstrated they could detect samples grown in the laboratory which contained a bacterium called pseudomonas, which can ­trigger pneumonia, ­urinary tract infections and ­septicaemia – often a serious health problem for cystic fibrosis patients.

As part of the trials, dogs, which were provided by the charity Medical Detection Dogs and which included Jodie, were brought into a testing room where samples were set on stands at dog-head height. These stands either included pseudomonas, other bacteria or no bacteria at all.

The dogs walked around the room sniffing each sample and when they had detected the pseudomonas, they sat down.

“We showed that in laboratory settings dogs can detect pseudomonas in samples,” said Davies. “Now we want to expand that work and have just been given funding from the medical charities LifeArc and the Cystic Fibrosis Trust to ramp up our collaboration with Medical Detection Dogs so that, for the first time, we may be able to train dogs to detect pseudomonas on patients’ skin, in their urine or in their clothing.”

Crucially, this system could be expanded to detect bacteria in other patients, not just those with cystic fibrosis. And such an ability would have important implications.

Microbes such as pseudomonas are difficult to detect in clinics and techniques to test for it are often invasive, uncomfortable, expensive and cannot be repeated on a regular basis. Dogs could get around that problem.

“Bacteria like pseudomonas are often resistant to certain anti­biotics,” added Davies. “We need to pinpoint them with precision to ensure they are treated with the right antibiotic and so keep down the growing ­problem of antimicrobial resistance, which will be worsened if we give patients the wrong type of antibiotics.”

About a million people now die every year across the world because of the spread of microbial resistance and that figure is expected to rise over the next 25 years.

Recent data suggests problems arising from resistance are easing for the under-fives, but for the over-70s mortality rates have gone up 80% since 1990.

“In the fight against ­anti­microbial resistance, we are ​going to need all the help we can get – and dogs like Jodie could be the perfect allies that we could recruit in this battle,” said Davies.

Here is the link:

https://www.theguardian.com/society/2025/mar/22/dogs-will-help-sniff-out-bacteria-cystic-fibrosis-sufferers

I have nothing to add!

David.

I Think It Is Fair To Say That The World Is Becoming A Much More Dangerous Place!

This appeared last week:

Trump is not wrong to remind the world that a third world war is a risk

Conflicts imposed on Ukraine, Israel and Taiwan are intensifying rather than breaking out in peace. The assumption that they aren’t central to Australia’s interests is dead wrong.

Peter Jennings

12:00AM March 22, 2025.

The seven-front war against Israel is heating up once again and the intensity of fighting in Ukraine shows we are a long way away from a sustainable peace.

China meanwhile, in the words of Admiral Samuel J. Paparo, head of US Indo-Pacific Command, is not only exercising its military forces but also engaging in rehearsals for war. To win a war over Taiwan, China thinks about projecting power everywhere – space, cyberspace, the central Pacific and underwater.

There are people who think Australia has little or no interests in any of these conflicts. Ukraine, a democracy of 33 million brave souls, can be bargained away in a deal with Vladimir Putin.

Israel, the Middle East’s only genuine democracy, bizarrely is condemned by the green left as a “colonial settler society”, one that must fall so rough Palestinian justice can reign. In thought and deed the Albanese government has sided with the anti-Israel position.

Democratic, liberal, pluralist Taiwan is far from us and close to China. The Taiwanese are (mostly) ethnically Han Chinese. Does Australia even need to take an interest? So many of our elites are looking for the escape hatch from our own region.

Beyond token military aid for Ukraine – remember the Australian Army burying helicopters rather than handing them to Kyiv? – under Australia’s increasingly narrowed foreign policy the Albanese government has opted out of any attempt to influence the world’s three big military-strategic flashpoints.

The underlying assumption is that Ukraine, Israel and Taiwan aren’t central to our interests but somehow the rest of the world has Australia’s back in our collective defence.

I doubt it. We are the energy-rich country that’s running out of power; the AUKUS industrial giant that can’t repair its Collins-class submarines; the sub-2 per cent of GDP defence budgeter with a military much smaller than an MCG crowd, one that still faces a “workforce crisis”.

None of those measures will incline a transactional Trump administration to defend Australia to the last American. And why should Donald Trump be expected to take more interest in our security than we do ourselves?

Look at the direction of the two current wars and the third in its rehearsal stage. What’s happening is that the conflicts are spreading in inverse proportion to talk of peace.

Across the remainder of 2025 there is a strong chance that international conflicts will grow.

Peace will not break out, not before a lot more violence, and the edges of conflict will broaden to take in other regions, nations and interests.

Ukraine struck Russia's Engels strategic bomber base on Thursday with drones, triggering a major blast and fire about 435 miles (700 km) from the front lines of the war, Russian officials and media reported.

That’s the geopolitical context for the Australian federal election. If you are worried about the cost of living, remember that the cost of dying is always higher.

In the Ukraine war, Russia is intensifying its military ground offensives along the entire east and southeast front. This is a severely hard-fought conflict with high casualty rates similar to fighting that took place here during WWII.

The trend is that Russia is slowly taking ground. Ukrainian forces have achieved notable success but right now they are struggling to hold on to Russian territory taken in the Kursk Oblast. Putin wants to regain Russian ground and not leave Kyiv with a small bargaining point in negotiations.

Notwithstanding Putin’s phone call with Trump, Moscow is putting a major effort into attacking Ukrainian population centres with missiles and drones – many of the latter from Iran. Most are shot down but a few always hit their targets.

Putin will use the cover of negotiations to aggressively pursue his war effort. I cannot see Kyiv or the Europeans agreeing to Russia’s demand that Ukraine disarms, is not supplied with weapons and has no security guarantee. Why would Putin make these demands unless he wanted to attack Ukraine later?

Strategic Analysis Australia Director Michael Shoebridge has criticised the ceasefire agreement reached by Donald Trump and Vladimir Putin as it is “not a ceasefire”.

My hope is that the deeper the Trump administration engages in real negotiations (as opposed to Oval Office press conferences), the more it will conclude Putin can’t be trusted. A strong Ukraine is a bulwark that suits American interests – keep Kyiv strong if you don’t want doughboys fighting and dying on Europe’s central plains.

If Trump opts for a fake peace while leaving Ukraine vulnerable to Russia, then Putin will have won a Pyrrhic victory, but he will have a “forever war” insurgency on his hands that will make South Vietnam look like a minor police emergency.

Russia is arming itself in ways that convince many Europeans they will be attacked. The excellent Institute for the Study of War notes: “The Russian military is reportedly increasing the number of its information and psychological operations units … to intensify its informational war against Ukraine, Europe, the United States, the Middle East and Asia.”

Trump is not wrong to remind the world that a third world war is a risk. Like the last two, it could start with aggressive authoritarian military manoeuvres in central and northern Europe. And like the last two world wars, appeasement rather than strength is what leads to conflict.

In the Middle East, Israel is intensifying strike operations in Gaza because it is inescapable that Hamas must be destroyed as a political force to avoid further terrorist attacks.

Israeli Prime Minister Benjamin Netanyahu needs to reduce Hamas to the point that the Israel Defence Forces can reconstitute for wider, heavier and deeper strike operations against Iran’s nuclear program, missiles, the Islamic Revolutionary Guard Corps and proxy forces.

Watch what Israel does with its ground forces in Gaza. They have retaken part of the Netzarim Corridor that splits the strip into north and south zones. Is the aim to bring part of the strip back under Israeli control? Jerusalem made a big mistake by leaving Gaza in September 2005.

Israeli strategic thinking has changed in a way that has broad domestic support – there is no future in just “cutting the grass” in Gaza – that is, using airstrikes to hit terrorist cells and missile stockpiles. The need is to destroy Hamas once and for all.

It’s often said that one can’t kill an ideology. I’m not so sure. The Allies did that quite effectively with fascism in 1945. Israel will try its hardest to eliminate Hamas. It’s in the interests of humanity and civilisation that it succeeds.

Sky News Contributor Kristin Tate says America finally has a president who “acts” like he is the leader of the most powerful nation in the world.

Netanyahu must have an understanding with Trump about the next steps for Gaza, and for a military campaign after that to reduce the Iranian nuclear threat.

Netanyahu can make such a deal with Trump because Israel is strong enough to prosecute major military campaigns with its own power. Australia should take note: this is the difference between a strong ally and a free-riding security rent-seeker.

I have written in these pages that Iran with nuclear weapons threatens global security. Tehran is literally weeks away from realising the capability. The regime sees value in being ambiguous about when it might take that final step to weaponise a nuclear bomb. The second half of 2025 is the moment.

Israel has the air power and long-range strike assets to severely reduce Iran’s nuclear program. Its actions in the past few months to destroy Iranian air defence, Syrian airpower and many of Hezbollah’s missiles create a brief opening for Israel to take strikes deeper into Iranian territory.

American intelligence, weapons supplied to the IDF and a strong presence of aircraft carrier battle groups in the eastern Mediterranean will enable an Israeli strike.

How will Russia and China react? Moscow needs Tehran’s drones. Tehran wants Russian missiles, and needs Chinese funding and weapons technology from both countries.

Israel's military said it intercepted a missile launched from Yemen early on Thursday (March 20) as hostilities with Iran-backed Houthi militants intensified.

Note in the Middle East that the US is striking Houthi facilities in Yemen. Trump is not an isolationist. He wants a powerful America and will use force when he sees US interests attacked.

Beijing’s rehearsal for war in the Pacific is massive, covers numerous areas and is being done in the bright light of publicity to inspire and direct Chinese nationalism towards aggressive militaristic ends.

Just in the past few weeks we have seen the People’s Liberation Army-Navy doing live-fire operations in the Tasman Sea, in the Gulf of Tonkin off Vietnam, in the Yellow Sea near the Korean Peninsula and near Taiwan.

A fifth aircraft carrier is under construction, this one large enough to operate four catapult aircraft launchers.

There is a massive program to build amphibious landing vessels with a focus on Taiwan, along with the capacity for massed airborne assault forces to attack in a way similar to the 2022 Russian paratrooper assault north of Kyiv.

Strategic Analysis Australia Director Peter Jennings claims Beijing’s live fire drills were an act of “Chinese intimidation”.

China has just concluded manoeuvres in space to move satellites tactically in ways that could destroy US military and communication satellites.

In the Pacific China’s recently concluded strategic co-operation agreement with the Cook Islands – the content of which remains secret – shows that Beijing puts a high priority on establishing and maintaining a political, diplomatic and military presence throughout the region.

Xi Jinping’s speeches to the military identify 2027, the 100th anniversary of the PLA, as the time the military should be ready to undertake military operations against Taiwan. In practice the time is so close, and the PLA has made such significant advances, that Beijing has the option to launch an assault at will.

In a strange logic inversion some think that it is “hawkish” merely to write about Chinese military power, but the developments are happening. Ignorance is not bliss.

It is certainly true that Xi would prefer to win without fighting. Much of the PLA’s military posturing is, I suggest, a way of testing Trump’s resolve and regional responses. Weakness or uninterest or disarray will be read by Xi as a sign that he can advance China’s strategic aims at minimal cost.

The Coalition is considering increasing Australia's defence spending by $15 billion annually, raising expenditure to at least 2.5 per cent of GDP by 2029.

Speaking at the Lowy Institute on Thursday, Peter Dutton foreshadowed a need to lift defence spending. He said: “You can’t sign up to AUKUS without putting new money into defence.” That is exactly what the Morrison and Albanese governments did.

The Opposition Leader said a priority was to stop a flood of people leaving the Australian Defence Force. He also wants to expand Australian industry, making drones, missiles, uncrewed ships and underwater vessels. That takes defence money.

Interestingly, Dutton suggested that Australia could use shipbuilding and sustainment industries in South Australia and Western Australia to lift the viability of US Navy and other navies’ operations in the region.

Dutton declined to put a dollar figure on the additional investment he plans for defence. It all comes down to money – money and leadership – at the end of the day.

Xi has said to Putin in recent meetings that Russia and China working together will bring about “changes the world has not seen in a century”. Their most recent phone call discussion (that we know of) happened on February 24. The leaders affirmed their “no limits” partnership, signed just before Russia’s 2022 re-invasion of Ukraine, stressing their “long-term” alliance.

What’s at stake in the current two big wars and the war in rehearsal is an authoritarian challenge to the Western world order. All the pieces are connected, drawing in Australian interests.

After decades of underperformance, we must quickly and substantially lift our defence effort. Along with the US and allies, that effort might build a form of deterrence to keep the Asia-Pacific peaceful. We are almost out of time.

Peter Jennings is director of Strategic Analysis Australia and was executive director of the Australian Strategic Policy Institute from 2012 to 2022. He is a former deputy secretary for strategy in the Defence Department (2009-12).

Here is the link:

https://www.theaustralian.com.au/inquirer/labors-premise-seems-to-be-that-ukraine-israel-and-taiwan-arent-in-our-interests-but-the-world-has-our-back/news-story/f073e72182a07d3954607fad81385789

We should be in no doubt we are living in very dangerous times!

David.

Does This Mean We Can Forget About The Dutton Nuclear Fantasy? I Think So!

This appeared a few days ago:

Energy

Proposed nuclear power plants in Queensland could not access enough water to prevent a meltdown, research finds

About 1,000 times the combined capacity of Wivenhoe and Boondooma dams was required to cool Japan’s Fukushima nuclear reactors in 2011

Joe Hinchliffe

Sun 23 Mar 2025 06.00 AEDT

Proposed nuclear power plants in Queensland would not have access to enough water to stop a nuclear meltdown and could strain capacity on drinking water and irrigation supplies even under normal operations, research has found.

Analysis by the Queensland Conservation Council (QCC) has found that one of the two nuclear reactors proposed for the sunshine state under the energy plan that the Coalition will take to the upcoming federal election would require double the water currently used by the existing Callide coal-fired power station. The other, Tarong, would use 55% more water than its existing coal station.

Tarong’s primary water source is the Boondooma Dam, from which it is allocated 30,000 megalitres per year, and which also supplies drinking water for the nearby town of Kingaroy and irrigates the rich agricultural country along the Boyne River. But Tarong also has a pipeline to the Wivenhoe Dam, the main supply of water for Brisbane and Ipswich, which – due to substantial premiums – it only uses when Boondooma Dam levels are low.

More than 1.3 million cubic metres of seawater were required to cool Japan’s Fukushima nuclear reactors and prevent a complete meltdown in 2011 – about 1,000 times the combined capacity of Wivenhoe and Boondooma dams.

The report has been described as “flawed and highly politicised” by the coalition.

The QCC director, Dave Copeman, said the fact there was “nowhere near enough water capacity in our dams to stop a nuclear meltdown if things go wrong” exposed the Coalition’s energy plan as a “nuclear fantasy”.

“If there was an emergency, you could run the whole [Wivenhoe] Dam dry and still not have enough water to stop a meltdown,” Copeman said.

“The Coalition is not being honest with farmers and the community about the realities of their nuclear scheme. At best it’s impractical, at worst it’s grossly irresponsible and could result in a major incident.”

Here's why Peter Dutton's nuclear power plan is a fantasy - video

The Callide coal-fired power plant has a 20,000 ML of annual water allocation from the Callide Dam, which is fed by the Awoonga Dam. As of Wednesday, Awoonga – which supplies the city of Gladstone’s water – was at 46% capacity, and Callide – which supplies drinking water to Biloela – was at 16.5% capacity. Callide Dam is also used to replenish aquifers that irrigate crops in the Callide Valley.

Callide would have to find an additional 27,000 ML of water to power the kind of power plants implied by the Coalition’s nuclear plan, the QCC report found – with Copeman saying there was simply “not enough water available”.

Clare Silcock, the renewable energy engineer for the QCC who crunched the numbers on the report, said the Coalition’s nuclear proposal was scant on details. Instead she drew upon the Frontier Economic’s modelling that the opposition has relied upon to argue its nuclear vision for seven reactors across the country would be 44% cheaper than the government’s renewables-led plan.

That report models just over 100,000 gigawatt hours of nuclear electricity in the National Electricity Market (NEM) – which covers Queensland, New South Wales, the Australian Capital Territory, Victoria, Tasmania and South Australia – by 2050.

Six of the proposed nuclear sites are within the NEM, and so the QCC report assumes the generation would be spread equally across those sites.

But Silcock said none of the other four proposed plants were “going to be particularly better in terms of water availability”.

“This is going to be a problem for anywhere in Australia,” she said. “Particularly in South Australia, they’re in a brutal drought at the moment. We’ve just done the analysis for Queensland – but the question is valid around all those six sites”.

Ian Lowe, emeritus professor at Griffith University’s school of environment and science, said the QCC research was “sound”.

Lowe said that a rule of thumb was that a nuclear power station needed about 15% more water than a coal-fired power station of the same capacity. So whether the proposed Tarong and Callide nuclear plants would require more or less water than the current coal stations would depend on the capacity for which they were built.

“[But] if we were to build the amount of nuclear power proposed in the Frontier Economics report as part of the Coalition’s long-term approach for 2050 electricity, there would not be enough water for Tarong and Callide to provide the proposed share of power,” he said.

That meant that the Frontier report was “implicitly assuming that the nuclear power program would be expanded” beyond the sites already identified by the Coalition.

“So it would be reasonable to ask the question: if the much larger nuclear program proposed in the Frontier Economics report were to go ahead, where would all the extra power stations be sited?” Lowe said.

“Given that we are the driest inhabited continent and rainfall patterns are being significantly disrupted by climate change, they would have to be on coastal sites and using sea water for cooling, which would add further costs due to the design complication of resisting corrosion”.

Shadow energy minister Ted O’Brien MP described the QCC report as “flawed and highly politicised” criticising it for making assumptions about water usage based on a 2006 feasibility study into the possibility of establishing a nuclear power industry in Australia commissioned by then prime minister John Howard.

“The fact is, the latest nuclear power plant designs are incredibly efficient and their water usage is comparable to coal fired power stations which they will eventually replace,” O’Brien said.

“The Coalition has embraced a world’s best practice ‘coal to nuclear’ because it allows us to leverage existing infrastructure – including water, transmission and a local workforce.”

The Coalition minister pointed to the Palo Verde Nuclear power plant in the Sonoran Desert, one of the United State’s largest power producers and the only one in the world not near a large body of water as it uses treated wastewater from nearby cities.

Here is the link:

https://www.theguardian.com/australia-news/2025/mar/23/proposed-nuclear-power-plants-in-queensland-could-not-access-enough-water-to-prevent-a-meltdown-research-finds

I think this suggests we should give the Dutton nuclear fantasy a miss until say about 2100!

It will be of very little concern to me, and most of you, by then I reckon.

David.

This Is A Useful Discussion Of Some Worthwhile Diagnostic Tests That Can Be Done At Home.

This appeared last week:

Expert guide to home health tests: Great idea or pandering to the ‘worried well’?

Australians can now do at-home tests for everything from menopause to sexually transmitted diseases. But which DIY kits can you rely on?

Stephen Lunn

23 March, 2025

Walk down the aisle of any chemist and you’ll come across a growing list of home self-testing kits. Vitamin D deficiency, perimenopause, urinary tract infections, STIs are among the conditions to be tested. Go online and there are even more – including at-home cholesterol and blood-glucose testing.

As we all strive to understand our health better, information is key, but context is critical.

The Covid pandemic normalised home testing. But like Covid, the results of point-in-time home tests may not be as black and white as they seem.

Mark Morgan, chair of the Royal Australian College of General Practitioners expert committee on quality care, says the fallibility of Covid tests, which can depend on many factors such as how sensitive the test is and when it is taken, can apply in situations beyond the pandemic.

“Pregnancy self-testing kits have been around for decades,” Professor Morgan says. “A positive test is life-changing, but a negative test might miss very early pregnancy.”

Home testing is generally carried out through either pinprick blood tests or urine testing. Professor Morgan says at a helicopter level, this self-testing has its place, with significant caveats.

“Home testing certainly kicks goals for convenience. For some tests such as sexually transmitted diseases, home tests also afford some additional privacy. On the flip side, results of tests can be confusing, inaccurate and misleading.

“Imagine doing a self-test that turns out to be falsely reassuring. For example, using a phone app to look at a new dark spot on your skin. If the phone app provides false reassurance it might delay your diagnosis of skin cancer,” he says.

“Buying a self-test to engage in some sort of hunt for conditions may well do you more harm than benefit. An example might be self-testing for food allergies that might then lead to a lifetime of restricted diet with no appreciable benefits to health.

“One helpful rule of thumb before doing any test – ‘will the result change what I do next?’

“There are thousands of blood tests available, but doctors will be highly selective about which ones to recommend because some tests just don’t matter,” Professor Morgan says.

But John Kelly, chief executive of Atomo Diagnostics, a listed company providing HIV self-testing kits and developing a syphilis home-test, says Australia has been “relatively slow to adopt widespread rapid testing, due in large part to the reimbursement for testing being heavily skewed to laboratory testing services”.

“This can adversely impact how testing is offered to the community, and we saw this with an over-reliance on PCR testing during the Covid pandemic,” Mr Kelly says.

“There are certainly participants in the healthcare industry that will lose market share as the transition to decentralised point-of-care testing and self-testing accelerates.”

In an effort to provide some clarity for consumers, we’ve had medical experts take a look at some of the raft of home-tests now available.

Cholesterol home screening

Product: Lifesmart Cholesterol Multifunctional Monitor – cholesterol, blood glucose, ketone. $69 plus shipping (Online from ablehealth.com.au). Cholesterol test strips sold separately. $39.95 for 10.

The test requires a small pin prick to obtain a blood droplet, which is placed on the test strip. That strip is put into the monitor for analysis.

It connects to a smartphone via Bluetooth, so that all information can be viewed and analysed in real time. You are also provided with a guide as to what is considered desirable, borderline high, or high, with advice on what to do next, including contacting your GP if it is high.

A free app will allow you to share the data with your doctor, dietitian or family. A similar product in the UK allows a patient to send the results directly to the NHS.

Paul Glasziou, emeritus professor of evidence-based practice at Bond University, says cholesterol is just one element to consider when assessing someone’s risk of heart disease, so an overemphasis on it can be risky.

“Further, even with a good lab analysing a good blood sample there can be significant variation over different days, between 5 and 10 per cent, even if the person’s cholesterol is stable,” Professor Glasziou says.

“Clinically there is really only a need to test a person’s cholesterol every one to three years, for instance during someone’s annual health check.

“All the rest is just noise, a waste of money, and anxiety-inducing. The random variations mean a person is likely to over-interpret the results. I think it’s an appeal to the worried well,” he says.

STI self-screening

Product: TouchBio Chlamydia and Gonorrhea rapid test (for females) $24 (available online)

Product: Atomo Diagnostics HIV Self Test ($25 online or in selected pharmacies) (Syphilis test in development)

The first of these tests is conducted by collecting a vaginal swab, and using a process similar to a Covid RAT test to obtain a reading. It has some limitations, in that it may not detect some chlamydia strains contracted within 60 days of the test, and similar for gonorrhoea strains within 10 days.

The second test is done by a pin prick blood test.

The RACGP chair of specific interests, sexual health medicine, Sara Whitburn, says “better access to testing and subsequent treatment for positive results is crucial for reducing the transmission of STIs, so new initiatives to encourage testing are welcome”.

Mr Kelly says his company’s experience with HIV testing reveals many people will avoid going to the doctor when concerned about sexually transmitted infections.

“This is due to a broad range of factors including embarrassment, cultural barriers to seeking testing, familiarity – their doctor knows the partner or children.

“Some people don’t want an STI test registered on the Medicare record. A lot of immigrant arrivals are not in the healthcare system and don’t have a doctor,” he says.

Dr Whitburn warns the chlamydia and gonorrhoea test is limited.

“It is validated only for vaginal samples, so it can’t be used to screen for oral or anal chlamydia and gonorrhoea,” Dr Whitburn says.

“Chlamydia also often presents as asymptomatic, and gonorrhoea may by asymptomatic or symptoms may not present until months after infection.

“Improved access to screening is valuable, but regular testing with your GP or a sexual health professional who can test for these and other infections is still essential for sexually active people,” she says.

Bowel screening

Product: Colovantage Home Test ($45 online or in some chemists)

This is a faecal immunochemical test for the screening of bowel disease. It detects whether there are traces of blood in the stool as a result of colorectal disease. The method is somewhat complex, including collecting water around the stool in the toilet for analysis.

Australia already has a free national bowel screening program. Test kits are sent every two years to all Australians aged 50 and over. And since last year those aged 45-49 are eligible to screen with the program if they apply.

There has been some recent concern about younger people being diagnosed with colorectal cancers.

“Colorectal cancer was the fourth-leading cause of cancer death in both men and women younger than 50 years in the late-1990s but is now first in men and second in women,” the American Cancer Society wrote in its report Cancer Statistics 2024.

Professor Glasziou says the Australian government’s screening program is about right on a cost-benefit analysis.

“There has been some argument about the age at which the free screening starts, but I would say about 50 is the right age.

“The exception would be for those with a family history. I’d suggest they maintain regular contact with their GP on this,” he says.

Perimenopause

Product: WeTestBio Perimenopause FSH Home Test Kit ($29 for a two-pack online or at pharmacies)

The test is performed using a urine sample. The information coming with the test says that “as the female body ages and produces less oestrogen, FSH (follicle stimulating hormone) levels increase as the hormone tries to stimulate the ovaries to produce a healthy egg”.

Here is the link:

https://www.theaustralian.com.au/health/medical/expert-guide-to-home-health-tests-great-idea-or-pandering-to-the-worried-well/news-story/3be9c94d816645f9918f3b6b5fac9de3

This is a useful review of what is presently available for home – testing and I am sure there are a few more in the pipeline. Seems to me such testing is useful to help people decide if they need to seek professional help as well as ease the worry of those who test negative.

This is surely the start of a trend which will only ramp up over the next few years.

Watch this space!

David.

It Seems We Have Got The NDIS Working Reasonably Well Without Bankrupting The Country – As Was Feared By Some!

This is a useful review of the NDIS – suggesting we have got the system working pretty well.

Here is some expert commentary:

Steve Robson

Let’s not forget how bad it was before the NDIS

23 March, 2025.

Australians have every reason to be proud of our National Disability Insurance Scheme. Introduced with bipartisan support, it has been, by any measure, a great success. The lives of hundreds of thousands of vulnerable Australians and their families have been transformed for the better. Yet despite this record of success, the NDIS has a giant target painted on it and has become the program that many people love to hate.

As its cost reaches almost $45bn a year – and more than 660,000 Australians now have funding packages – attacks on the sustainability of such a monolithic social program have reached fever pitch. Some accuse it of “strangling” the private sector, others rage against what they see as fraud, overspending, and mismanagement. Still others point to disastrous outcomes for participants.

Where does the truth lie? Is the scheme a really a giant white elephant sitting squarely on the chest of our economy?

A dozen years after the NDIS was introduced it is easy to forget just how bad disability supports were in this country. As far back as 1974, the Woodhouse Report advised the Whitlam government to institute an NDIS-like system. Whitlam was dismissed before any legislation could see the light of day, and the privations suffered by many Australians with a disability and their families continued to worsen.

By the dawn of the new millennium, tens of thousands of people with major disabilities lived lives of social isolation, unemployment, impoverishment, and commonly a major burden fell to their families. After years of kicking this can down the road, Australia became a signatory of the UN Convention on the Rights of Persons with Disabilities in 2007, the result of strong and spirited advocacy from disability and carers’ groups. At the time, no-fault schemes were up and running in NSW and Victoria. These funded supports for some people with acquired disabilities but little was available for people who were born with them.

In 2009, the Productivity Commission was tasked to come up with a plan to overhaul the broken system. The resulting report shocked many Australians. “The current disability support system is underfunded, unfair, fragmented, and inefficient,” the report read. So bad was the pre-existing system that the commission found itself “overwhelmed by the social and economic disadvantage manifest among people with a disability and their families – and the inability of the existing system to cope”. Evidence was heard of carers contemplating “murder-suicide” plans, so intolerable were the lives of many Australian families struggling to find help.

The “system”, as it was, seemed to lurch from crisis to crisis. Indeed it barely qualified as a system at all. Yawning service gaps were found across all of the states. Many people outlived family members who cared for them, and carers were under immense pressures and were found to have the lowest levels of wellbeing of any Australians. People with similar levels of disability received head-spinning differences in the levels of support they received – this was so bad the Productivity Commission described it as a lottery.

The report recommended a national social insurance scheme to provide certainty for every Australian in the event of a major disability. The resulting NDIS is almost unique globally and we should be proud of this. Similar but smaller-scale schemes operated in some European countries but were opt-in. In Australia, the NDIS was to become compulsory. Our trailblazing path also meant, of course, that there was no blueprint to follow from overseas. A scheme so ambitious, so large in scale and scope, and of such complexity was always going to experience a difficult birth. Yet “the benefits of the scheme would significantly outweigh the costs”, the report stated.

Before the NDIS, state and territory governments provided so-called “block funding” to disability service providers to deliver services – the funding then was rationed out to recipients of services. Supports might include care at home, day activity centres, or other services. The level of service and support varied between and within states, and there often was little or no choice. Even changing providers could be a challenge.

The NDIS flipped this completely by providing the funding to the person, not the organisation. The NDIS was all about putting Australians in charge of their own plan. The person with the disability was better placed to determine what they needed than to have external providers impose “one-size-fits-all” solutions on them. The NDIS would fund “reasonable and necessary supports” to allow people to live their lives in a way as ordinary as possible. Such supports could vary, from having personal care at home, to buying aids and equipment, funding various therapies such as physiotherapy, increasing social participation, and purchasing transports.

To be eligible for NDIS funding a person has to have a permanent disability that has substantially reduced their intellectual, neurological, physical or social functioning. Because of this strict definition the great majority of the millions of Australians who have a disability aren’t eligible for NDIS funding – only about 10 per cent meet the criteria. The NDIS also was not designed to replace the Disability Support Pension, which provides income for living. It is about additional costs, such as a wheelchair or home support.

Applying for NDIS support is not easy. It requires paperwork proving that the applicant’s disability is permanent and substantially reduces their capacity to undertake activities of living. Independent medical assessments were instituted to avoid “sympathy bias”. Packages are declined if the person’s condition has treatments available that could alleviate the disability.

So far, so good. The next step was funding a scheme that was hailed as the greatest social policy initiative since Medicare. The Productivity Commission recommended the commonwealth be the single funder of the NDIS, although this did not end up being the long-term reality. The initial funding boost was an increase in the Medicare levy from 1.5 per cent to 2 per cent. The NDIS was to be controlled by the National Disability Insurance Agency, designed from its inception to be independent of government – for that read “political meddling”.

Prime Minister Anthony Albanese confirms the NDIS will not be means tested under his government claiming the scheme is about “access”.

The NDIS was introduced carefully over seven years, but so massive was the undertaking that it was described as like a plane taking off while still under construction. The first trials were in 2013, and the full national rollout began in 2016 with NDIS being accessible across all states and territories by 2020. With that rollout, states and territories quietly defunded legacy programs. As a consequence, much of the funding for people who have a disability but don’t qualify for the NDIS has dried up.

More than a decade since first trials of the NDIS, where do we find ourselves? By any measure the NDIS has been transformative for hundreds of thousands of Australians. Unpaid carers have returned to the workforce and those already working have been able to work for longer. Many package recipients themselves can enter the workforce, often for the first time. Countless lives have been improved and dignity has returned to a generation of Australians.

The NDIS behemoth has been the largest social reform most of us have lived through – and that makes the NDIS a large target. Indeed, it draws a lot of fire and ire. Absolutely there are problems with the scheme – as you would expect with any massive national project – but it is important to be clear that the NDIS well and truly delivers on most of its aims, and delivers handsomely.

It is important to take a close look at public criticisms of the NDIS; first and foremost is the cost of the scheme. The Australian Institute of health and welfare reports that roughly one Australian in six has some form of disability. Fortunately, for the majority of people, their disability is not too disruptive. However, for many people the effects of their disability have a greater impact on their lives. Although the Productivity Commission estimated that just over 400,000 people would be eligible for NDIS support, at the moment more than 660,000 Australians are receiving packages. Why were the commission’s predictions so wonky? The main reason is that states and territories provided woeful statistics to feed into the commission’s models. This speaks to the low priority state governments gave to Australians with a disability at the time.

The fact that autism now is the most common primary diagnosis for persons funded by the NDIS is regularly aired as evidence of something suspicious. Indeed, about a third of all funded packages are for autism. Intellectual and mental health conditions are the most common disabilities experienced by Australians, as occurs globally. Research into autism has been intense in recent years and this has seen many people who formerly were told they had “intellectual disabilities” now recognised to have autism as the underlying condition. Whereas mental health conditions may wax and wane, autism is commonly pervasive and lifelong.

Could it be that the presence of the NDIS has fuelled a tsunami of bogus “autism” diagnoses? The reality is that the diagnosis of autism for teenage Australian children, as reported by the scientifically watertight Longitudinal Study of Australian Children, was one in 23 before the NDIS existed. The current rate is actually lower now – at about one in 31 children – after the NDIS was supposed to have driven the rate up. The proportion of people with autism in the scheme has indeed increased, but only by about 6 per cent over the past seven years. Australia’s current rate is in line with comparable countries such as the UK, the US, and even Japan. Packages for autism average just over $30,000, in comparison to supported living packages which are almost 10 times higher. It is likely that, rather than the NDIS luring bogus claims, in most cases people now have a source of support that was not available in the past.

Another factor is that exit rates – the number of people leaving NDIS packages – are lower than predicted. People are opting to stay in the scheme rather than move to other forms of care – which would cost the government money anyway. Another factor is that people who were assumed to be receiving suitable care in existing schemes were, in fact, receiving poor quality care. They very sensibly decided to take the superior packages on offer with the NDIS.

What about the $45 billion yearly price tag? Surely that is a fiscal fiasco? Well actually it isn’t. The scheme’s packages directly employ 270,000 Australians, and providing associated services employs many thousands more. A conservative estimate is that every dollar spent by the NDIS generates $2.25 in economic activity. That money isn’t hoarded – it is spent and most of it goes to small business and sole traders. They pay tax and also spend on goods and services. NDIS spending is a major economic stimulus.

Let’s compare this to defence spending where each dollar only generates about $1.70 in economic stimulus. Putting this in economic terms, NDIS spending is better for the economy than defence spending, where much of the money goes overseas. Defence also regularly clocks up monstrous cost overruns – $5bn wasted on disastrous helicopter programs, more than $1bn lost for battle management systems. In comparison to the profligacy of defence losses, the NDIS is a model of prudence and frugality.

In response to political concerns about NDIS expenditure, a razor-gang went through the schemes in 2022 with average packages being trimmed by about 4 per cent and one third of people taking a haircut of greater than 5 per cent. Family members who had returned to the workforce had to quit again to take up the slack at home. Since that time the number of people disputing NDIS decisions has increased by an incredible 400 per cent. This blowout not only disrupted the lives of deserving people but piled additional legal costs on the NDIA. The Administrative Review Tribunal adjudicates on disputes where people protest against NDIS decisions. These wrangles cost more than $17m a year in legal fees to the government.

Naturally, where there is government money there is the potential for fraud. No surprises there. This is well recognised by the NDIA and fraud management processes encourage package recipients to report suspected misconduct – from other recipients and providers. It is impossible to imagine a multibillion-dollar scheme funding hundreds of thousands of providers that doesn’t attract some rorters, scammers and outright crooks. Investigations show that malicious fraud costs the scheme less than $50m a year – a lot, to be sure, but a small proportion of the total spend. Although it is difficult to estimate, audits suggest that less than 5 per cent is inappropriately spent. Let’s compare that to Medicare, where Pradeep Philip’s recent comprehensive review suggested that somewhere around 12 per cent of expenditure was potentially subject to issues with compliance.

It will soon be even harder for dodgy NDIS providers to take financial advantage of vulnerable Australians.

There are undoubtedly some big problems with the NDIS that are much more difficult to tackle and cause major difficulties. With the incredible demand for disability services, there simply are not enough staff, not enough providers, and major geographical restrictions on service availability. So bad is this problem that many package recipients have no way to spend the money the receive – disability services are not sufficient to provide the care they need.

The risk of poor-quality services is another concern. The NDIS Quality and Safeguards Commission was set up to protect participants from poor-quality care. Many providers must become “registered” with the QSC as a quality measure. Yet this system is hardly a guarantee of quality; the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability unearthed myriad cases of dreadful care from registered providers. Becoming a registered provider is challenging, an exercise in navigating through a sea of red tape. For this reason many smaller providers choose not to become registered to avoid the expense and stress. Unfortunately, commentary often paints “unregistered providers” as villains and shonks but this is far from the truth. Many NDIS recipients greatly value their flexibility, cost-effectiveness – and because they are the only option.

Another issue affecting costs is that registered providers must abide by the NDIS price guide that sets out price ranges with price ceilings. Naturally, providers are going to set their prices at the maximum allowed. This is known as the “disability mark-up”. Providers in a tight market will look to cherry-pick the “easy” participants and often find it uneconomical to provide services in regional areas. The NDIA itself is overwhelmed by demand and struggles to find staff – as anyone applying for a package knows well.

Is the NDIS delivering what it promised and what so many Australians desperately needed? Yes, and no – but mostly yes.

Australia now has a world-leading system that aims to provide care for people with serious disability no matter who they are, how their disability came about, and where they live. Any scheme the size and scope of the NDIS will have problems – just look at the average home renovation. At the moment, though, the NDIS is delivering for hundreds of thousands of Australians. Its problems can be addressed without the need for hysterical hype.

Steve Robson is professor of obstetrics and gynaecology at the Australian National University and a former president of the Australian Medical Association. He is also a council member of the National Health and Medical Research Council.

Here is the link:

https://www.theaustralian.com.au/health/caring/lets-not-forget-how-bad-it-was-before-the-ndis/news-story/759137d2ff74a3ce5699215d6473b07a

It is pleasing to read expert commentary reporting that we now have a system that is working pretty well for most of our most vulnerable, and we have not bankrupted the country. It was never going to be perfect, but it looks to be making a real positive difference!

Australia should be proud of implementing a system that has managed to improve the lot of so many who really needed our help and compassion.

Well done to the advocates and experts who got it all together, and made it work!

David.

AusHealthIT Poll Number 786 – Results – 23 March 2025.

Here are the results of the poll.

Should Voluntary Assisted Dying Be Available For Individuals With A Reasonable Need For Such Services With Sensible Safeguards?

Yes                                                                    15 (83%)

No                                                                       3 (17%)

I Have No Idea                                                    0 (0%)

Total No. Of Votes: 18

Most seem to be comfortable with legalised euthanasia with safe-guards

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

Very poor voter turnout. 

0 of 18 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.

At The Song Said – The Times, They Are A’Changing. We Need To Face The Future More Alone.

This appeared last week:

Australia is trying to pretend the world hasn’t changed

Trump’s revolution has upended politics in the US, Canada, Germany and the UK. Neither Labor nor the Coalition has seriously confronted the difficult policy responses required.

Michael Stutchbury Editor-at-large

Mar 15, 2025 – 5.00am

Donald Trump’s new world disorder is gate-crashing Australia’s now-prolonged election campaign just as it is upending politics on both sides of the Atlantic. But will Labor and the Coalition face up to what this means?

Wall Street has been spooked into a correction-sized sell-off over Trump’s preparedness to let an escalating global trade war trip the American economy into recession. For Australia, that’s just the start of it.

The Queensland and NSW floods have forced Anthony Albanese to delay a pencilled-in April 12 election to May. Treasurer Jim Chalmers will now hand down a March 25 election budget that wasn’t supposed to happen.

That will give Labor an opportunity to set an election narrative. But a decade of looming budget deficits amid stalled productivity will expose the old assumptions that have underwritten Australia’s envied prosperity.

First, that Chinese demand for Australia’s iron ore, coal and gas will readily finance the politicians’ elect-me promises, such as Albanese’s Medicare bulk-billing policy costing $8.5 billion over the next four years.

And, second, that Australia can keep free riding on the American alliance that has kept the peace in the Asia-Pacific.

Neither Labor nor the Coalition has seriously confronted the dismantling of these foundations of Australia’s modern prosperity.

A probable post-election minority government would lack the stability to take the difficult policy responses required.

---

Trump’s willingness to favour authoritarian Russia over democratic Ukraine and to risk the NATO-led Western alliance signals Australia’s need to ratchet up defence spending amid the forecast decade of fiscal deficits.

UK Labour Prime Minister Keir Starmer has announced a sizeable increase in defence spending, financed by cuts to foreign aid.

In Berlin, new centre-right Chancellor Friedrich Merz seeks to exempt Germany’s military budget from the nation’s constitutional debt limit. It would be a historic development.

Germany’s centre-left-led coalition collapsed hours after Trump’s November 5 election and amid the rise of the anti-immigrant far-right Alternative for Germany party.

Shortly after Germany’s February 23 election, Merz said his absolute priority would be to strengthen Europe so that it could “really achieve independence from the USA”.

“I never thought I would have to say something like this on a television program,” he said.

While Germany is surrounded by like-minded European states, the circling of Australia by Chinese warships exposes the nation’s vulnerability in the absence of the American security blanket.

The popular backlash against Trump is testing the Albanese government’s support for the American alliance and the Coalition-inked AUKUS nuclear-powered submarine deal opposed by a broad progressive front from the Greens to Paul Keating and Bob Carr, to Malcolm Turnbull.

The global cost-of-living squeeze is prompting pro-growth deregulation and smaller government, such as through Elon Musk’s controversial Department of Government Efficiency.

Push to smaller government

In the UK, Starmer vows to cut the cost of business by 25 per cent and trim the “flabby” British state.

“We’ve created a watchdog state completely out of whack with the priorities of the British people and that is unfit for the volatile and insecure world we live in,” he said overnight Thursday AEDT.

This includes abolishing NHS England, the “bloated” bureaucracy that runs the National Health Service, at the cost of 13,000 jobs. Imagine the Mediscare if the Coalition proposed that in Australia.

Australia’s government spending blowout has been driven more by in-kind programs such as the NDIS, childcare and Medicare than by means-tested transfer payments.

That has left the government spending less targeted on lower income earners, according to a report this week from the e-61 economic research institute and the University of NSW.

US Treasury Secretary Scott Bessent says America’s biggest banks are being weighed down by “unduly burdensome regulatory requirements” and “backward looking policies in response to an undercapitalised system predating the global financial crisis almost two decades ago”.

Starmer announced plans to axe the UK Payments System Regulator by folding most of its functions into the Financial Conduct Authority. UK Chancellor of the Exchequer Rachel Reeves says that post-financial crisis banking regulations have “gone too far”.

Threats by the New Zealand government to wind back increased post-GFC capital requirements to help revive economic growth were a factor in Kiwi central bank governor Adrian Orr’s sudden and unexplained exit last week.

There is no such push from Australian Labor, which forced the previous Coalition government to set up the pro-regulation Hayne royal commission into banking misconduct.

Shadow treasurer Angus Taylor vows to attack “excessive regulation and compliance costs” exceeding $1 billion annually for some big financial firms.

That would include requiring the Australian Prudential and Regulatory Authority to emphasise competitive access to finance as well as financial system stability.

“Over-regulation has left Australians under-insured, under-advised, and under-banked,” Taylor said last month. But the Coalition’s commitment is undermined by Peter Dutton’s populist threats to wield the big stick on insurance companies.

Pro-growth deregulation

Trump’s “drill, baby, drill” withdrawal from the Paris climate accord is mirrored by new Canadian Prime Minister Mark Carney’s immediate dumping this week of a consumer carbon tax on petrol, diesel and gas scheduled to rise to $C170 ($187) per tonne of carbon emissions by 2030.

Australia’s still-rising energy costs were confirmed by this week’s Australian Energy Regulator’s ruling that benchmark household power bills could increase by up to almost 9 per cent because of a more-expensive and renewables-driven electricity network.

Labor’s political response in the March 25 pre-election budget is set to be a Band-Aid debt-financed repeat of its $300 energy bill rebate to households and small businesses.

Australia’s clean energy transition is more costly than promised, undercutting the cheap energy advantage needed for Albanese’s Future Made In Australia hopes to become a so-called green energy superpower. The Coalition’s ambitious nuclear energy policy lacks a mechanism to bring down energy costs in the next decade.

While energy costs remain high, increased green, red and black tape is closing down parts of Australia’s industrial processing base and eating away at the nation’s comparative advantage in resource development. Trump’s America is overtaking Australia as an LNG exporter.

Labor’s empowering of trade unions and increased workplace regulation is undermining workplace-level productivity.

In his prime ministerial acceptance speech this week, Canada’s Carney vowed to “win” the trade war with Trump. “These are dark, dark days brought on by a country we can no longer trust,” he said.

Even though not even in parliament, the former Bank of England governor won the Liberal Party ballot to replace the unpopular Justin Trudeau as leader of Canada’s ruling centre-left government.

Like in Germany, Canada’s leadership change was Trump-induced. Trudeau resigned on January 6 in the face of looming defeat by populist Trump-lite Conservative Opposition Leader Pierre Poilievre.

Since Trump launched his trade war on Canada, however, the government’s patriotic tariff counter punches have clawed their support back to level-pegging with the Conservatives.

Unlike in Canada, though, Albanese rightly rules out tit-for-tat trade retaliation against Trump’s refusal to exempt Australia from his 25 per cent global aluminium and steel tariffs. That would be self-defeating for a medium-sized commodity-exporting economy at the foot of Asia.

But there is more to come, including Trump tariffs on beef and pharmaceutical imports. And, from April 2, the big one of global “reciprocal” tariffs.

Trump’s new global disorder will require Australia to compete more sharply. If the election campaign does not recognise this, the next government will lack the mandate needed to deal with the world in which we live.

Here is the link:

https://www.afr.com/policy/economy/australia-is-trying-to-pretend-the-world-hasn-t-changed-20250311-p5lil1

All I can say is that we look to be in for a pretty rocky ride while ever Trump is in the White House so we need to get used to living “on the edge”!

We would do well to watch Mark Carney in Canada and learn what we can from him as he also manages Trump.

Stand by for fireworks and instability!

David.