Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, September 11, 2017

Weekly Australian Health IT Links – 11th September, 2017.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A very interesting week with lots of commentary on a range of issues covering both the Government and private sector – lots to catch up with if you missed it.
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Philips’ Barrow: funding ‘debacle’ hurts e-health innovation

Former health minister Michael Wooldridge says health IT is a “disgrace”.
  • The Australian
  • 12:00AM September 7, 2017

Sarah-Jane Tasker

Australians want their health information shared among care providers but government funding mechanisms are being blamed for holding back innovation to make that happen.
Kevin Barrow, the Australia and New Zealand head for Philips, said patients were frustrated by the inability of the health system to share what seemed to be fundamentally basic and useful information.
Michael Wooldridge, who was health minister in the Howard government, argued at a recent industry event that in 2000 Australia led the world in health IT but today it was a “disgrace”.
“We don’t still have a functioning e-health and hundreds of millions of dollars have been put into that debacle,” he said.
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Worst health policy No. 5 - My Health Record

4 September, 2017 Antony Scholefield   
One of the tougher questions to ask yourself is the name of the one big Federal Government health reform of the past 20 years that has actually worked.
We’ve had a string of taskforces, special commissions and expert advisory groups, whose seemingly endless consultations were going to draft the government blueprint to fix things.
Yet look at the results and you see little more than the expensive wreckage of botched ideas and failed promises.
This week Australian Doctor offers its countdown of the standout failures, which act as a reminder of why politicians are never paid for performance.
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Worst health policy No. 2 — Real-time prescription monitoring

Paul Smith | 7 September, 2017 |  
This week, Australian Doctor is publishing its top five worst Federal Government health reforms of the last 20 years.
So far we've had the My Health Record, GP Super clinics and Peter Dutton’s GP copay fiasco.
At number two is the long-running failure to introduce a real-time prescription monitoring system at a time when the lives of thousands of Australians are being torn apart by widespread medication misuse.
Milica Minchev’s death in 2013 made the newspapers but what happened to her was not in any way remarkable.
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International experts target uptake of health technology that benefits aged care residents

By Megan Stoyles on September 6, 2017 in Industry, Technology
Aged care sectors around the world remain slow to adopt policy initiatives and sophisticated advancements in electronic communications that have stimulated the adoption of technology in other healthcare sectors, international researchers have told a health conference in China.
Australia’s Professor Andrew Georgiou and Professor Johanna Westwood from Macquarie University’s Australian Institute of Health Innovation were among international experts on a panel at the recent World Medical Informatics conference in Hangzhou, China.
They joined their American and Norwegian counterparts to discuss the idle adoption rates of technology that could benefit residents in aged care facilities, a situation largely put down to a lack of financial resources, skilled people or vital partnerships for implementing and sustaining suitable technologies.
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6 September 2017

How to slash specialist waiting times – but don’t hold your breath

Posted by Felicity Nelson
It sounds too good to be true. In the space of just three years, a small country in eastern Europe successfully eliminated waiting times for specialist appointments.
In Macedonia, patients now have an average delay of one day to see a specialist.
At the heart of the transformation was an Australian-Macedonian technology partnership called Sorsix.
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GPs need to see when a secure electronic letter has been delivered

4 September 2017

IMPROVING PRACTICE SOFTWARE

Secure messaging systems such as Argus, Healthlink and Medical-Objects enable health professionals to communicate with each other electronically while maintaining the patient’s privacy.*
Some GPs hesitate to send referrals and other messages via these systems because they are not notified automatically and promptly about whether the message was delivered successfully. Secure messaging systems provide facilities to let users view the progress of messages that they have sent, but GPs don’t like using those facilities either, because it requires extra work.
Sometimes GPs have to check repeatedly on the progress of a message, because acknowledgment of delivery can take several hours, or days if the recipient’s computer system is shut down for maintenance or over a weekend.
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Alarm fatigue is problem. Here’s a pragmatic solution.

4 September 2017

COMMENT

I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic.
The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin.
The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite honestly, I am so used to getting irrelevant warnings that it has become a reflex to bring the cursor to the spot where I can make the warning go away after a quick glance at it. Even though I have chosen the setting “Pop up drug interaction window only when the interaction is severe,” I get the pop up with almost every prescription.
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8 September 2017

College pushes for telehealth rebates

Posted by Julie Lambert
The RACGP is urging the removal of curbs on telehealth consultations and opening up point-of-care tests to GPs in the next round of MBS reforms.
As a principle, the Medicare Benefits Schedule should offer patient rebates for telehealth consults between a patient and their regular GP or practice, the College says in a submission to the MBS Review Taskforce.
It suggests amending an explanatory note to clarify that professional attendances by medical practitioners cover consultations either face-to-face or via telehealth.
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New Royal Adelaide Hospital opens: CIO talks clinical collaboration and ‘cool’ tech

Lynne Minion | 06 Sep 2017
As the emergency department treated its first patients and the wards continued to be filled yesterday, the much anticipated, $2.4 billion, high-tech Royal Adelaide Hospital was officially open for business.
Since Monday more than 300 patients have been transported the short journey along North Terrace from the old RAH in a fleet of 16 ambulances and an ambulance bus, while the new 65-cubicle emergency department accepted its first patient — a walk-in — just after 7am yesterday.
Following a decade of controversy, including a delay of 17 months, cost blow-outs, political infighting and construction fatalities, the mammoth task of relocating South Australia’s flagship hospital will be complete today when the last patient is transferred.
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SMS suicide prevention trial announced in bid to save lives

Cameron Mee
Published: September 10 2017 - 12:00AM
Survivors of suicide attempts will receive supportive text messages under a landmark trial that will be conducted by Sydney hospitals.
The text messages will feature words of support and information about how to access help for patients for up to a year after their discharge. 
The trial will start at Westmead Hospital before expanding to Nepean and Blacktown hospitals and it is hoped that the new service will complement existing treatment options.
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'One-person army': GP exposes specialist fees on new website

6 September 2017

NEWS

A GP frustrated by the lack of transparency over specialist fees has launched his own website listing the cost of an initial consultation with thousands of specialists in Australia.
Dr Richard Zhu (pictured), who practises at the City West Medical Centre in Sydney, says he has personally rung the specialist clinics to find out if they bulk-bill, as well as initial consultation fees.
In an Australian first, the GP has published the information on his specially created website, SeekMedi.
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AMA backs GP's website that reveals specialist fees

Rachel Worsley | 6 September, 2017 |  
The AMA has cautiously backed a GP-led website that lists specialist fees but has warned it could have “an inflationary effect” on fees.
SeekMedi, which was set up by Sydney GP Dr Richard Zhu, allows GPs and patients to search for the fees of individual doctors for initial consultations.
It also lists doctors from the cheapest to the most expensive across individual specialties. 
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SA to develop black boxes for soldiers

A South Australian company will develop wearable sensors similar to aircraft black boxes to capture critical battlefield data.
Australian Associated Press September 7, 201711:25am
Wearable sensors that record a soldier's movements will be developed in Adelaide and deployed to the battlefield.
Defence Industry Minister Christopher Pyne says the sensors, which are similar to aircraft black boxes, will record data and act as emergency beacons helping find soldiers who have been injured or killed.
"Survival rates for battlefield casualties are closely tied to response times and the Fight Recorder will enable defence to quickly locate and treat casualties," Mr Pyne said in a statement on Thursday.
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Doctors resisting health records being sent to insurance companies

By political correspondent Louise Yaxley
Doctors are pushing back against insurance companies asking them to send them their patients' entire health records as they make decisions about life insurance.

Key points:

  • Labor's Deborah O'Neil is concerend aout the number of health records stored with insurance companies
  • Annie Trimmer from the AMA says it's challenging for doctors to determine which parts of files are relevant
  • Managing Director of CBA's life insurance arm says their claims principle is to only ask for information that is relevant to the claim
"I am very alarmed that there might be tens of thousands of people's entire health record across the country now stored with insurance companies," Labor Senator Deborah O'Neil told Parliament's joint committee on corporations and financial services.
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Parliamentary inquiry: CBA vague on patient medical records

  • The Australian
  • 12:00AM September 9, 2017

Michael Roddan

Commonwealth Bank has admitted it has no idea how many copies of patients’ full medical records it keeps for insurance purposes, and has warned an audit to find out would be an “impost” on its business and may not even establish an answer.
Senior executives from the bank’s life insurance division, CommInsure, were also unable to tell members of a parliamentary inquiry into the industry yesterday how much it paid doctors who complied with the company’s request for patient information. The inquiry into the $44 billion sector was established in the wake of revelations CommInsure was using outdated medical definitions to deny insurance claims. Allegations of poor claims handling procedures and of pressuring doctors to knock back legitimate claims also plagued the group. Comm­Insure was cleared of any “systemic” wrongdoing by an Ernst & Young review earlier this year.
During the parliamentary inquiry, life insurance providers revealed many doctors were volun­tarily sharing their patients’ entire medical histories, even though insurers had only asked for information relevant to a claim. Many customers were unaware they had consented to sharing their entire medical history when applying for a claim.
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Security breach feared after private patient records found outside old Royal Adelaide Hospital

PRIVATE patient documents were accidentally left outside the old Royal Adelaide Hospital overnight in a potential security breach that has been labelled ”a serious matter” by doctors.
KATRINA STOKES
The Advertiser September 8, 20176:27pm
PRIVATE patient documents were accidentally left outside the old Royal Adelaide Hospital overnight in a potential security breach that has been labelled ”a serious matter” by doctors.
An Adelaide man on his morning walk found dozens of boxes left out in the open — sitting on a loading dock — on the old hospital site this morning, left outside after the move to the new RAH on Tuesday.
A statement provided to The Advertiser from the Central Adelaide Local Health Network admitted the Health Department was “aware of an isolated issue regarding the collection of pharmacy documents during the hospital move, where two pallets of boxes remained on the loading dock at the old RAH overnight”.
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NASA trials Australian mental health tool for the treatment of astronauts

Lynne Minion | 07 Sep 2017
Preparing for a 30,000km/h take-off, orbiting earth from 75.3 million kilometres away or living on an uninhabitable planet for a couple of years could all generate some anxiety or depression, which is why NASA is funding research into an ehealth treatment tool produced by the Black Dog Institute.

As part of its plans for colonising Mars, the US space program is looking into the delivery of mental health treatments to patients up to 300 days away from earth, and myCompass could be ideal for providing interstellar assistance.

Developed by researchers at the Australian mental health not-for-profit as an interactive self-help tool, the online platform will be studied in the NASA-funded clinical trial beginning this month for possible use by astronauts on long-duration space missions.
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September 8 2017 - 8:33PM

Gold Coast man receives 3D-printed shinbone in world-first surgery

·         Tony Moore
Surgeons at Brisbane's Princess Alexandra Hospital have performed world-first surgery and transplanted a 3D printed shinbone into the leg of a man who faced losing his leg.
Two weeks ago, the 3D printed tibia was transplanted into the Reuben Lichter’s right leg.
It was wrapped in leg tissue and blood vessels from both his legs.
It was the first stage in a nine-month journey, at least, to grow new bone in his right shin and allow Mr Lichter, of Mudgeeraba, to support his weight and walk again.
Health Minister Cameron Dick said the successful transplant, led by reconstructive surgeon Michael Wagels, opened the door for the successful transplanting of major bones in trauma accidents throughout Queensland and the world.
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GPs tell inquiry into the Medicare data breach that HPOS and My Health Record are safe

Lynne Minion | 04 Sep 2017
In the wake of the discovery of Medicare numbers for sale on the dark web, the peak body for general practitioners has said it is satisfied with the current security protocols and cautioned against tightening of access.
The Guardian broke the story in July that a dark web vendor – the Medicare Machine – could provide Medicare numbers to order for about $30 each, with the Department of Human Service’s Health Professional Online Services the likely access point.
In its submission to the Senate inquiry into the data breach, the RACGP claimed HPOS, which is used throughout the healthcare system to retrieve Medicare numbers for patients, is essential for patient care.
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Three reasons why pacemakers are vulnerable to hacking

6 September 2017

THE CONVERSATION

The US Food and Drug Administration (FDA) recently recalled approximately 465,000 pacemakers made by the company Abbott’s (formerly St. Jude Medical) that were vulnerable to hacking, but the situation points to an ongoing security problem.
The reason for the recall? The devices can be remotely “hacked” to increase activity or reduce battery life, potentially endangering patients. According to reports, a significant portion of the pacemakers are likely to be installed in Australian patients.
Yet the qualities that make remotely-accessible human implants desirable – namely, low cost, low maintenance batteries, small size, remote access – also make securing such devices a serious challenge.
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$6.61 Million For Medical Breakthroughs

Wednesday, 30 August 2017
A revolutionary real-time monitoring pregnancy patch and targeted prostate cancer therapy are among four top innovations awarded $6.61 million under the NSW Government’s Medical Devices Fund.
Minister Brad Hazzard announced the four winners of Medical Devices Fund grants at a ceremony at Parliament House last night.
“The NSW Government is taking home-grown medical innovation to the next level, firmly placing this state at the forefront of global health technology,” Mr Hazzard said.
“This fund gives entrepreneurs the opportunity to get game-changing ideas to market, not only keeping medical device companies in NSW, but significantly improving health outcomes and even saving patients’ lives.”
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Interfacing brains with computers for stroke recovery

Researchers from the University of Adelaide and the University of South Australia have discovered that they can enhance stroke rehabilitation with the use of a brain-computer interface (BCI) system. The BCIs overcome a previous issue in the technology, in which the patient’s brain triggers a movement on a screen, but the patient receives no feedback to their senses. The authors wrote in Royal Society Open Science that their device provides the needed feedback, and it provided a single patient with a 36% increase in relevant test scores over the course of the training. “To the best of our knowledge, the optimal feedback update interval (FUI) during motor imagery remains unexplored,” the authors wrote. “There is evidence that sensory feedback disinhibits the motor cortex. Thus, in this study, we explore how shorter than usual FUIs affect behavioural and neurophysiological measures following BCI training for stroke patients using a single case proof-of-principle study design. The action research arm test was used as the primary behavioural measure and showed a clinically significant increase (36%) over the course of training. The neurophysiological measures including motor evoked potentials and maximum voluntary contraction showed distinctive changes in early and late phases of BCI training. Thus, this preliminary study may pave the way for running larger studies to further investigate the effect of FUI magnitude on the efficacy of restorative BCIs. It may also elucidate the role of early and late phases of motor learning along the course of BCI training.
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AUSTRAC built a big data platform for DHS to fight welfare fraud

By Justin Hendry on Sep 5, 2017 6:45AM

In pursuit to return $1.7 billion to bottom line.

The Department of Human Services has clawed back in excess of $25 million in fraudulent welfare payments using an open source data analytics platform developed by the anti-money laundering agency AUSTRAC.
It is part of a four-year data matching project between the two agencies to improve the federal government's ability to detect welfare recipients with unexplained wealth.
AUSTRAC received $21.1 million in 2015 to build the platform as part of the DHS-led plan to return $1.7 billion to government coffers over five years.
AUSTRAC's deputy chief executive officer Gavin McCairns told senate estimates last month that the platform, which is still in beta phase, would replace manual processes with an automated data-sharing protocol.
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8 September 2017

A GP guide to bring order to health-app chaos

Posted by Julie Lambert
A web-based guide to popular digital healthcare apps promises to put GPs just a few clicks away from a store of data, quality ratings and journal articles.
The Digital Health Guide is currently being made available for free to GPs in Tasmania during an initial year of testing and refinement, with several hundred of the most commonly used mobile healthcare apps listed.
“(The selection) is based on the popularity of apps being used and what our user base are actually using,” developer Tim Blake said.
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Will a machine take your job?

6 September 2017

ROBOT VS GP?

An international survey shows most patients would accept treatment guided by artificial intelligence without a doctor present. But Zilla Efrat discovers Australian GPs have little to worry about.
A survey of 11,000 people across 12 countries shows 55% are open to artificial intelligence (AI) devices replacing GPs during a consultation.
The study by international consultants PwC suggests the presence of a doctor may be less important to patients than accurate test results and prompt access to treatment
But willingness to sacrifice a doctor’s presence varies widely between the countries in the survey, from 39% in the UK to 94% in Nigeria.
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Let artificial intelligence master the mundane

  • Francois Ajenstat
  • The Australian
  • 12:00AM September 5, 2017
As experts continue to research and debate the power and role of artificial intelligence, public discourse swirls more around risk than reward.
However, the notion of AI completely replacing the work of humans is a long way off in most real-world cases. If we can approach AI as assistive intelligence and seize opportunities to enhance, rather than replace, our skills, humans will reap the benefits of this smart technology.
Applications of AI have the ability to empower workers and increase efficiencies across industries. A recent study from AlphaBeta commissioned by Google argues that machines will “unburden the average Australian of two hours of the most tedious and manual work a week over the next 15 years”.
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ANU 10-year program to drive AI revolution in Australia

The ANU has announced “a major expansion to drive societal response to the artificial intelligence revolution.”
The Australian National University (ANU) has announced it’s 10-year Australian artificial intelligence revolution “will be led by one of the world’s top technologists Professor Genevieve Bell and will be based within the ANU College of Engineering and Computer Science.”
Professor Bell recently joined ANU from Intel as “the first of five appointments under the ANU Vice-Chancellor’s Entrepreneurial Fellows scheme.”
Bell has also been appointed the inaugural Florence Violet McKenzie Chair at ANU, named in honour of Australia’s first female electrical engineer.
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Cancer gets the better of IBM super computer Watson

Oliver Moody, Science Correspondent
September 8 2017, 12:01am, The Times
Watson, IBM’s supercomputer, has trounced human quiz champions and come up with a recipe for maple syrup and curry powder ice cream. For its next trick, the company says, it will tackle cancer.
Far from finding new treatments, however, Watson’s handlers say that it is still struggling to master the basics in spite of five years’ intensive research and billions of pounds of investment.
Some medical experts argue that artificial intelligence heralds a new age of healthcare in which doctors’ decisions will be guided by data-crunching computers, but the setback suggests that this may to be a longer and more frustrating process than many imagined.
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Citadel acquires Brisbane e-health system developer

$8.2 million acquisition expected to close by mid-September
Samira Sarraf (ARN) 04 September, 2017 13:07
The Citadel Group has entered into an agreement to acquire Brisbane-based Charm Health, which supplies specialist oncology e-health systems.
Terms of the deal will see the business make an $8.2 million upfront payment, with additional payments to be made for agreed over-performance, staggered over the two years following completion.
Citadel’s board has approved the acquisition, which is subject to customary conditions precedent, and is expected to complete by mid-September 2017.
Charm Health’s solutions are used by both public and private health providers of cancer care.
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FDA nod opens US market to G Medical’s Prizma phone ‘doctor’

  • The Australian
  • 12:00AM September 6, 2017

David Swan

ASX-listed e-health provider G Medical has received US Food and Drug Administration ­approval for its Prizma medical smartphone jacket, paving the way for US commercialisation.
The Prizma is a smartphone product which turns a consumer’s phone into a mobile medical monitor, measuring vital signs and performing diagnostics. It connects to an app which stores that data in the cloud, and presents a health profile by continuously collecting and analysing medical data, detecting trends over time.
G Medical chief executive Yacov Geva told The Australian the FDA approval came much sooner than he was expecting. Similar regulatory approval applications were in progress in China, Europe and Australia.
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Melbourne Health seeks network provider as it readies electronic record system

Victorian healthcare provider Melbourne Health has published a request for tender to support its proposed electronic medical record system.
By Asha McLean | September 4, 2017 -- 02:14 GMT (12:14 AEST) | Topic: Enterprise Software
The Victorian government has gone to tender, seeking a provider to upgrade Melbourne Health's network and site infrastructure.
The successful vendor will be charged with enabling appropriate levels of clinical and administrative user access to a proposed electronic medical record (EMR) system to be introduced at Melbourne Health, the Peter MacCallum Cancer Centre, and the Royal Women's Hospital, the request for tender (RFT) explains.
In preparing the EMR proposal, Melbourne Health conducted an assessment of the readiness of its IT infrastructure to adequately support the initiative.
The assessment identified IT-related improvements necessary to implement an EMR, which included the replacement of old and out-of-support network and firewall equipment and the need to increase the speed and redundancy in the network infrastructure at the Parkville and Royal Park sites.
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Chip off old block proves quantum leap

  • The Australian
  • 12:00AM September 7, 2017

John Ross

Sydney physicists are claiming a breakthrough in the race to build quantum computers, with a “conceptual leap” that brings the ­fabled machines closer to reality.
University of NSW researchers have invented a way of spacing quantum “bits” — subatomic particles that store information — much further apart than is currently possible. The “radical new architecture” would make it far easier for manufacturers to install the wires and transistors needed in functional quantum chips.
The approach, outlined in the journal Nature Communications, is the latest breakthrough in a race that is hotting up locally and globally. Quantum computers — which harness the weird properties of electrons, atoms and ­atomic nuclei to perform calculations far beyond the scope of today’s most advanced supercomputers — have massive ­potential in areas such as drug ­design, finance and security.
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NBN Co's HFC cable rollout hits a speed bump

Problems surrounding the connecting of consumers to the NBN via HFC cable have led to the NBN Co, the company rolling out Australia's national broadband network, changing the way it provides these connections.
In a statement on Monday, NBN Co's chief network engineering office Peter Ryan said in the case of about half the premises ordering an HFC service, the company's technical staff needed to visit said premises and build a new lead-in conduit to connect the co-axial cable into the premises.
This was "something that can often be problematic and can cause delays", he admitted.
Given this, Ryan said it had decided "to hold back a proportion of these premises in order to better manage consumer expectations on wait times once they've placed an order".
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Enjoy!
David.

Please Comment To Explain To Me Why You Don't Want The ADHA To Introduce A CIAP Like Program.

As I understand it this is a proven evidence based intervention so what is not to like?

CIAP in NSW is especially useful in rural areas.

I would love to understand the response to the poll.

Thanks

David.

Sunday, September 10, 2017

A Former Liberal Health Minister Points Out Just How Badly We Have Done With E-Health Over 20 Years.

This appeared late last week:

Philips’ Barrow: funding ‘debacle’ hurts e-health innovation

Former health minister Michael Wooldridge says health IT is a “disgrace”.
  • The Australian
  • 12:00AM September 7, 2017

Sarah-Jane Tasker

Australians want their health information shared among care providers but government funding mechanisms are being blamed for holding back innovation to make that happen.
Kevin Barrow, the Australia and New Zealand head for Philips, said patients were frustrated by the inability of the health system to share what seemed to be fundamentally basic and useful information.
Michael Wooldridge, who was health minister in the Howard government, argued at a recent industry event that in 2000 Australia led the world in health IT but today it was a “disgrace”.
“We don’t still have a functioning e-health and hundreds of millions of dollars have been put into that debacle,” he said.
Mr Barrow said one of the problems for e-health was the funding mechanism, adding it was challenged by the fee-for-service model.
“Things like the My Health record is rapidly starting to be more of a real time repository of information but it is not a way of easily sharing clinical information,” he said.
“It’s starting to change but the proliferation of technology is one thing ... but how do you build a care system around that, which actually uses that technology appropriately?”
More here:
While it is hard not to feel that Dr. Wooldridge is not looking backward through rose tinted glasses it is true that we have been at this as a nation for close to two decades and somehow the progress has been less than hoped. Political recognition of the failure of the  myHR is welcome however!
On the positive we do now have General Practice and the Public Hospital Sector pretty well automated with the private sector moving along close behind. Where we seem to have trouble is with interoperability and national infrastructure as well is the implementation of co-ordinated national initiatives – especially in the public sector.
We have also had some missteps with various entities such as NEHTA, some underutilised infrastructure and ill-fitting Standards etc. and I won’t even comment on the myHR debacle as I see it.
To me we need a better thought out approach and I have to say the new ADHA Strategy really does not cut it for me.
Where do you see Australian Digital Health as being positioned and what changes in direction would you like to see if any?
David.

AusHealthIT Poll Number 397 – Results – 10th September, 2017.

Here are the results of the poll.

Should The Secure Messaging Task Force (Fax Replacement Task Force) of The ADHA Be More Publicly Transparent And Open About The Options, Obstacles and Progress?

Yes 97% (141)

No 1% (1)

I Have No Idea 2% (3)

Total votes: 145

Almost unanimous view the task Force is being pretty uncommunicative. No one will take any notice of what they have to say unless this changes and quick!

Any insights welcome as a comment.

A great turnout of votes!

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

David.