This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
The world is having affair bit of trouble with Trump at present. As I type the Turkish economy is tanking (which could damage a range of other economies – our dollar has also plummeted) and we are seeing both loud noises directed at China and the EU. A fine mess!
Here at home the NEG remains un-agreed, the Parliament is back this week and the Royal Commission is beginning to make one wonder if ‘under the bad’ is not the best place for one to keep your money!
For economists, previewing the RBA's monthly monetary policy decision has come to resemble a daily weather forecast for the Sahara desert: dry; no chance of rain.
Come Tuesday and another decision to keep its cash rate target steady at a record low of 1.5 per cent, the RBA will celebrate the completion of two long years of policy paralysis; or, as they would prefer, policy patience.
It will be the 21st consecutive meeting on hold – extending what is already a historically long period of inactivity that started with former governor Glenn Stevens and has extended under the current leadership of Philip Lowe.
Race politics is back – and the far-right are loving it
By Tim Soutphommasane
6 August 2018 — 12:22am
Race politics is back. Right now, it feels like there has never been a more exciting time to be a dog-whistling politician or race-baiting commentator in Australia.
Five years ago, when I began my term as Race Discrimination Commissioner, I wouldn’t have said it was likely that we would see the resurgence of far-right politics. I wouldn’t have expected that the biggest threats to racial harmony would come from within our parliaments and media.
Race looms large. It’s there in the panic about "African gangs", the warnings about multiculturalism veering into "ethnic separatism", the questioning of a non-discriminatory immigration policy, the alarm about foreign influence by China.
Updated 6 August 2018 — 7:17amfirst published at 12:04am
A high-powered coalition of business, energy and agricultural groups have laid down the gauntlet to Labor state governments, demanding they pass the National Energy Guarantee this week or voters will pay the price.
The Labor led cabinets of Victoria and the ACT are set to debate their position on the contentious policy on Monday, days before Environment Minister Josh Frydenberg calls on them to sign up before it heads back to the Coalition party room.
The ultimatum from the Business Council of Australia, National Farmers’ Federation, Australian Energy Council and three other lobby groups warns "households cannot afford the costs of yet another cycle of political sparring, indecision and inaction".
Sydney's housing slide is one more reason for rates to stay on hold
6 August 2018 — 1:04pm
Sydney's bubbly house prices are sinking and tipped to fall for at least another year, pushing the central bank even further to the sidelines.
Given Australia's tepid wages, tame inflation, range-bound currency and exposure to a global trade war, governor Philip Lowe and his board are almost certain to keep the benchmark cash rate at a record-low 1.5 per cent when they meet on Tuesday.
Throw in the precedent that the Reserve Bank of Australia hasn't raised rates while property prices in the nation's largest city were falling at any time this century and the hold is all but guaranteed.
Chair of the Corporate Governance Council Elizabeth Johnstone has flagged dropping a requirement for companies to hold a "social licence to operate" from controversial changes to the ASX Corporate Governance Principles, as insiders revealed that industry super funds have been behind the push.
Speaking to The Australian Financial Review of Monday, following a week-long debate sparked by AMP chairman David Murray, Ms Johnstone said the ASX Corporate Governance Council welcomed "the high-level of interest in, and robust debate" around the proposed changes. But she emphasised "the document being commented upon is a consultation draft, not a final or fixed position. It is appropriate and important that a consultation draft explore new ideas and test boundaries."
It remains one of my favourite bits of rugby writing.
In the late 1980s, after a Wallaby of modest repute changed national rugby camps to turn out for the Irish team instead, a writer for the Irish Times commented: “Why is Ireland importing bad rugby five-eighths? Don’t we have enough bad rugby five-eighths of our own?”
Might I ask a different version of the same question for Australia in 2018?
Why on earth are we importing so many “alt-right” political nutters to Australia on speaking tours? Seriously, don’t we have enough alt-right – whatever that is – nutters of our own?
Domestic politics and protectionism still meddle with Australia's approach to foreign investments.
By Stephen Kirchner & Jared Mondschein
7 August 2018 — 12:00am
When Australia and the United States were negotiating their free-trade agreement in the early 2000s, Australia's regulation of foreign direct investment was a key stumbling block that nearly sank the deal.
One of the US government's negotiating priorities was to eliminate the Foreign Investment Review Board. The US saw Australia's regulation of foreign investment as a protectionist relic and the board as a vehicle for political interference in cross-border deals. The US, by contrast, maintained a largely open-door policy on foreign investment.
The International Monetary Fund (IMF) is warning world economic leaders that the recent wave of trade tariffs would significantly harm global growth.
Conservatives and progressives have contributed to making the bureaucracy's leadership a political battleground.
By Richard Mulgan
7 August 2018 — 12:11am
The recent appointments of Phil Gaetjens to succeed John Fraser as Treasury secretary and Peter Woolcott to replace John Lloyd as public service commissioner mark the end of the Abbott era in the upper echelons of the Australian Public Service. Abbott, in appointing Fraser and Lloyd, as well as Michael Thawley at the Department of the Prime Minister and Cabinet, made a point of choosing people with known pro-Coalition or pro-business sympathies to lead central agencies. Thawley left PM&C soon after Malcolm Turnbull took over the prime ministership, while Lloyd and Fraser only recently threw in the towel.
Turnbull's earlier replacement of Thawley with Martin Parkinson, a respected career public servant who had fallen foul of Coalition conservatives because of his role in managing climate change policy, appeared to signal a return to less partisan appointments, a pattern followed in filling subsequent, less high-profile vacancies.
It might seem a big deal, Sky News admitting that it made a terrible mistake giving a platform to Blair Cottrell, the human protein slab, convicted criminal and Adolf Hitler superfan. But all of this has happened before on Sky News After Dark, and all of this will happen again.
Cottrell’s appearance was not a mistake, or an aberration. It was a perfectly routine part of Sky’s business model. When the working journalists clock off for the day, the network ceases to report information. Instead it offers meaning. A human centipede of jabbering trolls tries to explain the world in a way that identifies who are friends, who are enemies, and what must be done to protect the former from the latter.
Sky News After Dark isn’t a news operation, it’s a digital Nuremberg Rally. That’s how somebody like Cottrell ends up looking like a legitimate contributor to the national discourse, at least for the short time he’s in studio framed by green screen effects and the ever present chyron.
Name a group that accounts for about a third of the population and rising, is much more likely to suffer stress in affording their housing than other groups, and yet has never had much sympathy from politicians, voters or the media.
Ironically, the bit of sympathy they’ve had in recent days hasn’t been warranted.
They’re the forgotten minority – more forgotten than the forgotten people we keep being reminded about. They’re renters.
Open banking is coming but Australians are sceptical
By Saman Shad
8 August 2018 — 12:00am
Ask someone about open banking and they're likely to respond with a shrug.
If you go on to explain it – that by next July new laws will permit consumers to allow other financial companies and third parties access to their banking information - you'll almost certainly get a resounding "no way!"
Consumers are resistant to open banking but might come around if they see the benefits.
Are we really comfortable with ASIC government spies in businesses?
by Rodney Maddock
The Hayne royal commission is damaging a lot of reputations. Much of this was to be expected from an inquiry into misconduct. Somewhat less expected has been the damage to the reputation of the Australian Securities and Investments Commission and the Australian Prudential Regulation Authority. Most of the egregious behaviour that has been revealed to the public was previously well known to the financial sector regulators.
The questions we need to ask are: why they did not act, or why they did not act more decisively?
Broadly there are three sorts of inference we might draw. The regulators have the wrong mandates, that they have the right mandates but insufficient resources to pursue them, or they lack the capabilities or will to do what they are charged with.
The biggest financial swindle in Australian history was not masterminded by a smooth-talking shyster in silk tie and fancy loafers.
It didn’t involve complex money shifting to the Bahamas, the establishment of sham companies or falsified documents.
The biggest financial scam ever perpetrated against ordinary Australians unfolded – and continues to unfold - in plain sight.
The government knows it’s happening. Regulators know it’s happening. The people responsible for safeguarding the money being effectively stolen know it’s happening.
$5.4 billion - China's infrastructure commitment in 2017 to the Pacific region
$374 million - China's commitment in 2016
Chinese infrastructure in the Pacific island region built through soft loans appears to have peaked and a “hangover is setting in” as countries have to start repaying debts, a major study has found.
The Lowy Institute has painstakingly gathered figures on all development projects in the neighbourhood from 2011 to 2016 and concluded that while Chinese aid has grabbed attention by focussing on headline-generating projects, Australia remains the most important donor to the region.
Migrants have put Australia in a better position than most other advanced economies, the Reserve Bank governor has said, in a speech designed to inject an economic perspective into the immigration debate.
Philip Lowe said Australia's relatively high immigration rate had created one of the youngest countries among advanced economies, lowered the old-age dependency ratio, increased fertility rates and driven economic growth.
The 1.5 per cent annual growth rate of the population, which reached 25 million on Wednesday, outstripped the 1 per cent rate of most other advanced economies over the past decade.
Australian governments have struggled for decades to strike the right tone in responding to China's growth as a global power. China's huge economy makes it an indispensable partner but its closed, communist political system is a threat to the values Australia shares with its key strategic ally the United States.
By the time Malcolm Turnbull and representatives from the nation's most prestigious universities met in the Prime Minister's Sydney office in late March, the mood between the two parties was toxic.
It wasn't just the billions in funding that Education Minister Simon Birmingham had stripped from the sector months before, but the diplomatic and economic problems that had been created by the universities allowing themselves to become economically reliant on China.
So much so, that on occasions when Beijing became upset with Canberra, it would threaten to diminish student numbers and create economic havoc.
The internet trolls have won. Sorry, there’s not much you can do.
By Brian X. Chen
9 August 2018 — 11:57am
Over the last decade, commenting has expanded beyond a box under web articles and videos and into social networking sites like Facebook and Twitter. That has opened the door to more aggressive bullying, harassment and the ability to spread misinformation; often with difficult real-life consequences.
Case in point: the right-wing conspiracy site Infowars. For years, the site distributed false information that inspired internet trolls to harass people who were close to victims of the Sandy Hook school shooting. This week, after much hemming and hawing about whether to get involved, some giant tech firms banned content from Infowars. (Twitter did not, after determining Infowars had not violated its policies.)
What does that show us? That you as an internet user have little power over content you find offensive or harmful online. It is the tech companies that hold the cards.
State and territory energy ministers have agreed to take the Turnbull government’s national energy guarantee to the “next stage”, delivering Josh Frydenberg a win at today’s Council of Australian Governments meeting.
The Australian understands the ministers agreed to release the exposure draft of the National Electricity Law amendments that would implement the NEG following confirmation of a tele-conference on Tuesday.
Sign off on the NEG’s design is unlikely until after the four-week consultation process.
Battered by boycotts, will Sky News now ditch its right-wing formula?
After a week from hell, Sky’s opinion-driven programming is under scrutiny.
By Michael Lallo & Jennifer Duke
11 August 2018 — 12:00am
A scandal at one of News Corp’s major television outlets probably isn’t the warm welcome Rupert Murdoch hoped for. The 87-year-old media mogul, who arrived in Australia on Friday, was greeted by the growing storm engulfing Sky News.
No doubt he'll have many questions about the disaster that unfolded on The Adam Giles Show last week: far-right extremist Blair Cottrell, a convicted criminal who wants a picture of Hitler in every classroom, proposed a ban on immigration to Australia – white South African farmers excepted.
Victorian Public Transport Minister Jacinta Allan announces that Sky News will be removed from train station screens after the decision to air an interview with far-right nationalist Blair Cottrell.
I’m not sure he’s right. Like most economists and business people, Lowe is a lot more conscious of the economic benefits of population growth than the economic costs. As for the social and environmental costs, they’re for someone else to worry about.
But whatever your views, you’ll be heaps better informed after you’ve seen what he says about our changing “population dynamics” and absorbed his tutorial on demography.
A deepening financial crisis in Turkey has sparked a 10 per cent plunge in the lira, with the currency woes sweeping the region again and sorely testing Europe’s banks.
The crisis spilled over to the Australian dollar and the euro which remain vulnerable to ongoing US dollar strength.
Investors fear Turkey is teetering on the edge of financial shock following a 30 per cent plunge in its currency this year and skyrocketing bond yields.
At the same time US sanctions against top Turkish government officials and the unorthodox economic policies of Turkey’s President Recep Tayyip Erdogan have spooked markets.
A strengthening US dollar and higher US interest rates are making life difficult for the weakest emerging markets and Turkey is prime among them.
How do you protect yourself from the rip-offs in super unveiled this week by the royal commission?
We see where the banks are charging people for doing nothing; we hear of outrageous fees on cash savings … at worst the banks continue to clip the accounts of dead customers.
In dollar terms the biggest rip-off so far appears to be the so-called “fee for no service” scandal.
Australian school students are becoming more likely to identify with “no religion” even in religious schools, including a 68 per cent increase in Catholic schools.
The trend, which mirrors changes in the wider population, has led the peak independent schools body to warn religious schools to rethink their marketing.
At government schools, 45 per cent of students profess to no religion or did not specify a religion in the 2016 census, up from 38 per cent in 2011 and the highest proportion ever recorded.
When Home Affairs Minister Peter Dutton suddenly became concerned at the plight of South African farmers earlier this year, he may not have been aware that he was echoing ideas and memes not only of the alt-right, but also potentially of a global Russian effort to weaken democracies.
Publicity around the persecution of white farmers can be traced back through the alt-right, which has embraced it, to the well-worn conspiracy theories of white supremacists.
In recent years, however, the alt-right has used the idea to seed online discussions that are then amplified by Russian bots on the internet.
Australia's $2.6 trillion superannuation industry is bracing for two weeks of damaging public hearings as data shows the number of disgruntled retirement savers has doubled over the last five years.
The Hayne royal commission will today turn its attention to 14 superannuation funds and the two regulators who oversee them as part of its expose of misconduct in the financial services sector and is expected to focus on uncompetitive deals, excessive spending and archaic back office systems.
Directors representing some of Australia's biggest and well known industry super funds will appear with AustralianSuper, Host-Plus and CBUS appearing alongside retail super funds operated by the big four banks, AMP and IOOF.
A multibillion-dollar Commonwealth superannuation fund whose 137,350 members include public servants, defence personnel, SES officers and some former politicians, has been labelled a rip-off, opaque and not acting in members' best interests.
Since he joined the $12.5 billion Public Sector Superannuation Accumulation Plan (PSSAP) last September he was put into a default insurance scheme he didn't know he was in – and didn't need - which has been deducting a whopping $774 a fortnight in income protection premiums. In July 2018 he checked his account balance (not for the full year) and noted it was $9000 less than it should have been.
Australia’s $2.6 trillion superannuation industry is shrouded in darkness due to a lack of regulation of the conduct of the trustees running funds, the royal commission has heard.
The criticism of the lack of regulation of the sector was delivered by counsel assisting the royal commission, Michael Hodge, QC, at the start of two weeks of hearings into misconduct within the sector.
Mr Hodge started the morning by pointing out the gap created by the way the Australian Prudential Regulation Authority (APRA) and the Australian Securities and Investments Commission (ASIC) regulated the sector.
The Hayne royal commission has surprised observers by giving industry super fund Cbus a reprieve from the fifth round of hearings after revealing a new format that will focus on the hidden conduct of superannuation fund trustees.
Counsel assisting Michael Hodge QC explained the hearings will take on a new format on Monday morning where he announced there will be no consumer witnesses nor open findings relating to specific case studies at the completion of the hearings.
He also said that despite asking $46 billion industry super fund giant Cbus to appear, the union-linked fund would be given a reprieve from the witness box after careful consideration of the fund's payments to unions.
The Hayne royal commission has put industry super funds on notice saying it will investigate payments to unions, allocation of member funds and the credit card use of executives in detail over the next two weeks of public hearings.
The opening statement delivered by counsel assisting Michael Hodge, QC, revealed a new set of targets for the hearings on superannuation which included shadowy trustee figures, invisible regulators and dubious arrangements that have allowed the banks to gouge customers with fees.
The actions of trustees to registrable superannuation entities (RSEs) will come under particular scrutiny and the "temptation" they face to feather their own nests.
Is superannuation a sinister industry more akin to the dark arts than one providing the service of boosting the quality of our retirement? That's how it was characterised at the Royal Commission into financial services.
So much for all those advertisements featuring those attractive greying couples enjoying a post retirement cruise down the Danube, the royal commission has painted a picture of an industry cloaked in secrecy and motivated by commercial avarice.
Senior Counsel Assisting Mr Michael Hodge says Australia's $2.6 trillion superannuation industry is operating in darkness with no dedicated regulator watching the trustees running the funds.
'Quarter of a century behind': Regulation gaps leave consumers in dark on super
By John Collett, Clancy Yeates & Sarah Danckert
6 August 2018 — 6:27pm
The banking royal commission has accused the $2.6 trillion superannuation industry of leaving super fund members in the dark and at the mercy of a gap in regulation when it comes to ensuring customers are not ripped-off.
In an assessment backed by industry experts, counsel assisting the royal commission Michael Hodge, QC, described the superannuation sector as lacking transparency.
Senior Counsel Assisting Mr Michael Hodge says Australia's $2.6 trillion superannuation industry is operating in darkness with no dedicated regulator watching the trustees running the funds.
When is a fee charged to customers for no service not a fee-for-no-service and does that make it a commission? According to the royal commission testimony of National Australia Bank’s chief customer officer Paul Carter, it’s not a fee-for-no-service if that service is the promise of being able to “access” that service, whether or not the customer actually uses — or knows about — the service.
It turns out, the definition of whether an instance of customer gouging is a “fee” or a “commission” could end up costing NAB tens or hundreds of millions more in compensation.
The royal commission yesterday spent hours encouraging Mr Carter to explain what exactly customers were getting when they were automatically charged the so-called “plan service fee”. That fee was charged to NAB’s superannuation customers at a rate of up to 0.44 per cent of assets — enough to push it into the hundreds, or thousands, of dollars for a customer.
The process that saw NAB's superannuation trustee NULIS advised by the bank's wealth management arm was hopelessly conflicted, the Hayne royal commission has heard.
Counsel assisting Michael Hodge QC put to former NULIS chairman Nicole Smith that there was an inherent conflict of interest between the trustee, which had the sole duty of acting in the best interests of the super fund members, and the administrator, which was concerned with making profits for the bank.
"It's hopelessly conflicted isn't it? How can it advice you as to what's to be done...when it's the one that will have to pay the money back?" Mr Hodge said.
Superannuation funds are in front of the Hayne royal commission into banking and financial services this week and have been asked to reveal their entire fee and cost structures for the first time. The suggestion is that retail funds controlled by big institutions have been charging high fees and delivering low returns.
Well, hello! Finally the royal commission is about to highlight what I consider to be the biggest rort in our whole industry: paying someone to advise you to buy products that deliver average returns.
You do not need to pay anyone to set you up in no-brain, no-value-add products such as exchange traded funds (ETFs) or managed index funds that hold almost everything. You can buy them yourself through an online broker.
It was a question that would have caused trustees of superannuation funds around the country to gulp in terror.
The Hayne royal commission continued to examine how National Australia Bank's wealth arm, MLC, charged plan service fees to members of super funds who had no financial adviser linked to their account. It was a classic case of fee-for-no-service.
Nicole Smith, who was until recently the chairwoman of NAB's superannuation trustee, NULIS, was asked whether she had been concerned that the events could result in civil or criminal proceedings. She replied in the negative.
Is this company really just a pathological liar? That’s the question when it comes to National Australia Bank.
To the public and the regulator the bank tries to paint itself as making the odd mistake and when it does it fixes it, apologises and compensates.
Andrew Thorburn says sorry after examples were raised at the Financial Services Royal Commission where NAB failed in its objectives to “serve our customers with honour”.
Michael (Baby faced) Hodge versus Chris (Killer) Kelaher was the royal commission’s top-billing bout on Friday. It was bloody - and one well worth the price of the admission. It followed the morning’s supporting act, in which counsel assisting Hodge made mincemeat of IOOF’s distribution manager Mark Oliver.
The point of the exercise was to get to the bottom of how IOOF had compensated members for a distribution error - what triggered the compensation and whether the members ultimately paid for it themselves.
IOOF managing director Christopher Kelaher is questioned why he believes the handling of compensation passed “the pub test”.
In terms of passing the IOOF “pub test” as a proxy for members’ best interests, the financial services giant scored a massive fail at the Hayne royal commission on Friday.
The overwhelming take out from IOOF’s testimony and internal documents was that super fund members had been stitched up, that there has been a breach of fiduciary duties and that there are conflicts of interest and systemic internal problems across the organisation.
IOOF managing director Christopher Kelaher is questioned why he believes the handling of compensation passed “the pub test”.
High drama as 'baby-faced assassin' puts super trustees in spotlight
By Jessica Irvine & John Collett
11 August 2018 — 12:00am
Hillary: “Just promise the cheating will end ... ”
Bill: “You have my promise. You know that I am honest, 110 per cent.”
Hillary: “But how can I know that’s true?”
Bill: “Would I ever lie to you?”
Lyrics from Clinton: The Musical, co-written by brothers Paul and Michael Hodge, QC
Trust. Temptation. Betrayal. These are the key themes of the satirical 2015 off-Broadway hit Clinton: The Musical, which tells the story of Bill Clinton’s presidency through the novel dramatic device of splitting the central character into two roles - “good” Bill and “bad” Bill 0- played by separate actors.
The Reserve Bank has kept the official interest rate on hold at a record low of 1.5 per cent.
It has now been two years since Australia went through a rate change as the central bank wills the economy through sluggish wage growth, low inflation and cooling housing markets in Sydney and Melbourne.
The bank's central forecast for the Australian economy remained unchanged. GDP growth is expected to average a bit above 3 per cent in 2018 and 2019.
Lowering the threshold for high blood pressure to match the recently changed US guidelines would lead to a new diagnosis for 4.5 million Australians and double the proportion of adults classified as having hypertension.
Changing the Australian threshold from the current 140 millimetres of mercury for systolic blood pressure and 90 for diastolic mmHg to 130/80 mmHg, which the US adopted last year, could raise awareness of the crucial health indicator but would also likely lead to increased drug treatment, a new paper has found.
About 6 million Australians over the age of 18 have high blood pressure under the current measure, according to the Heart Foundation.
10% - Discounts of 2 per cent a year for a maximum of five years for under 30s
40 - Discount will expire after the policyholder turns 40
$2.25 - But premiums would only reduce by a relatively small amount per month
The federal government is being urged to scrap its plan to allow health insurance companies to offer discounts to young adults, with critics warning this will only increase the prevalence of low-value junk policies.
In its proposed overhaul of private health insurance last year, federal Health Minister Greg Hunt said the government would allow health funds to give discounts of up to 10 per cent on hospital cover to people aged 18 to 29 with the larger aim of improving affordability.
The number of people waiting for elective surgery in Victoria dropped to its lowest level on record last month, a result the state government has attributed to the dedication and hard work of health services staff.
More than 90 per cent of Victorians waiting for elective surgery were treated within the recommended time in the three months to June, new data from the Victorian Agency for Health Information shows.
In that time, 55,806 patients received their surgery, which was 2525 more patients than in the same three-month period last year.
The life-saving reason we need more female doctors
By Nikki Stamp
8 August 2018 — 11:30am
"Oh, a lady surgeon.” It may sound quaint, but this particular utterance makes me cringe. When I hear it, I know that the person who said it was expecting someone who fits the mould of a surgeon. Typically, that is an older, Anglo-Saxon man.
Why wouldn’t they? Statistically speaking, men make up the bulk of surgeons around the world. In medicine, a profession that exists to serve people of all walks of life, that stereotype holds true for surgery and other specialties but also for medical leadership and academic medicine.
For a number of years, at least half of graduating medical students have been female. Despite this, there is still significant under-representation of women. In Australia, just 12 per cent of surgeons are female and, in my specialty, around 5 to 6 per cent of heart and lung surgeons are female around the world. These are figures that we have been trying to change for quite some time because, well, equality is long overdue.
Medical procedures likely to have little clinical benefit are still being performed in Australian hospitals, wasting hundreds of millions of taxpayer dollars and thousands of bed days that could be freed up for more needy patients.
Despite doctor-led campaigns to limit unnecessary interventions and expense, research confirms some procedures have increased in recent years, undermining the work being done to ensure patients are treated appropriately.
A landmark study led by professor Adam Elshaug of the Menzies Centre for Health Policy at the University of Sydney has drawn attention to the high number of low-value procedures and significant variation between hospitals in NSW alone.
Two new strains of gonorrhoea resistant to different frontline antibiotics have been detected in Australia for the first time, emphasising the need for safe-sex practices to avoid an infection that is difficult for doctors to treat.
The latest six-monthly report for the National Alert System for Critical Antimicrobial Resistance also highlights the continued presence of a superbug known as CPE in the health system.
John Turnidge from the Australian Commission on Safety and Quality in Health Care yesterday said the ongoing presence of CPE, or carbapenemase-producing Enterobacteriaceae, demonstrated the need for vigilance.
Heroin overdose deaths in Victoria have reached a 17-year high with the inner-city suburb of Richmond still attracting drug users from other suburbs, the coroner’s court has found.
The Coroners Prevention Unit found 220 overdose deaths last year involved heroin, more than double the number in 2012.
This is the highest toll since the “heroin drought” of late 2000, when the supply of the drug on Melbourne’s streets plummeted.
A Senate inquiry into the mental health of first responders, including emergency service workers and volunteers, has been told of the challenge of facing trauma and difficult situations as part of the job.
The Senate education and employment committee is seeking to understand the issues in the sector better and help employers, governments and other organisations ensure first responders are protected and supported throughout their careers and beyond.
The inquiry comes amid ongoing efforts to ensure doctors, who are also at high risk of mental illness and suicide, are encouraged to seek treatment.
Rapid Response Tests Underway, Aiming to Halt Syphilis Spread
Rapid point-of-care testing is underway across three high-risk regions of Northern Australia, as part of the Australian Government’s $8.8 million surge response to the syphilis outbreak.
8 August 2018
From today, rapid point-of-care testing is underway across three high-risk regions of Northern Australia, as part of the Turnbull Government’s $8.8 million surge response to the syphilis outbreak.
“These tests are a critical weapon in the fight to curb and control the spread of syphilis,” said Indigenous Health Minister Ken Wyatt AM.
“Previously, it could take up to a fortnight for results of traditional blood tests to be returned, leading in some cases to problems locating patients who had moved on after giving blood samples.
An Australian medical ethicist who spent decades observing euthanasia in Canada has called on the Senate to reject a bill that would clear the way for voluntary assisted dying to be legalised across Australia.
Bioethics Professor Margaret Somerville, from the University of Notre Dame's school of medicine, said the international experience demonstrated that euthanasia was being used as a cheaper alternative to psychiatric and palliative care.
"It's a societal tragedy if we allow this," she said.
The federal Senate will this week debate a private member’s bill brought by Liberal Democratic Party senator David Leyonhjelm, which would enable the ACT and Northern Territory to make their own laws on voluntary assisted dying.
A new government-backed service is boosting transparency around medical fees.
Private Patient Connect is in trial mode with 300 specialists doctors.
Patients with a GP referral letter can request a quote from hundreds of doctors.
It was at a family gathering a couple of Christmases ago when Tess van der Rijt confronted first-hand a large gap in the health system and set about closing it.
"My uncle needed a surgery on his bladder and we were in the country, and even though we're a family of doctors and health professionals, we couldn't find a specialist working over Christmas who could see him," she said.
To Donald Trump it seems as though the "Deep State" has arisen from the depths of the dismal swamp of Washington to torment him. He sees a cabal of his political enemies – foremost the men who have led the Federal Bureau of Investigation, the National Security Agency, and the Central Intelligence Agency – as a cryptocracy operating under the cover of the constitutionally established government, an immense conspiracy, a dark force seeking to destroy him. The president awakens to tweet thunderbolts against it before Fox & Friends signs on at dawn. (To wit: May 23, 2018, 6:54 AM: "the Criminal Deep State. They go after Phony Collusion with Russia, a made up Scam....")
Standing next to Vladimir Putin in Helsinki on July 16, he was asked if he believed the unanimous conclusion of his intelligence services that Russia tried to sway the 2016 election. Trump sided with the smirking autocrat: "They said they think it's Russia. I have President Putin; he just said it's not Russia. I will say this: I don't see any reason why it would be." Senator John McCain called it "one of the most disgraceful performances by an American president in memory."
UK Trade Minister Liam Fox sees 60-40 odds there'll be no Brexit deal by March
British trade minister Liam Fox said "intransigence" from the European Union was pushing Britain towards a no-deal Brexit, in an interview published by the Sunday Times.
With less than eight months until Britain quits the EU, the government has yet to agree a divorce deal with Brussels and has stepped up planning for the possibility of leaving the bloc without any formal agreement.
Updated 5 August 2018 — 9:03pmfirst published 4 August 2018 — 8:52am
The US economy continues to expand at a strong pace with relatively moderate inflation pressures, a key reason why the yield on the 10-year Treasury note has failed to push convincingly through the 3 per cent level.
The July payrolls report showed that employers hired 157,000 people last month, compared with an average monthly gain of 203,000 over the previous 12 months, according to the Bureau of Labor Statistics.
China has threatened to impose retaliatory tariffs on US$60 billion worth of goods from the United States, ranging from liquefied natural gas to aircraft.
'Fire season just beginning': Massive California fire grows by another quarter
By Dan Whitcomb
6 August 2018 — 8:06am
Los Angeles: A massive, out-of-control Northern California wildfire that destroyed 68 homes and forced thousands to flee has become the fifth largest in state history, officials said on Sunday, as crews battled high temperatures and strong winds.
The Mendocino Complex Fire, made up of two separate conflagrations that merged near Ukiah, north of Sacramento, exploded by 25 per cent overnight and had blackened more than 1000 square kilometres as of Sunday morning, local time, the California Department of Forestry and Fire Protection said.
"The Mendocino Complex fire has charred more than 254,000 acres [101,000 hectares], making it the fifth largest blaze in California's history," AccuWeather said on its website. "Firefighters will continue to face local gusty winds and building heat this week."
Donald Trump reimposes stiff sanctions on Tehran, limiting gold and $US purchases
by Nasser Karimi and Ian Deitch
The United States reimposed stiff economic sanctions on Iran Monday (Tuesday AEST), ratcheting up pressure on the Islamic Republic despite statements of deep dismay from European allies, three months after President Donald Trump pulled the US out of the international accord limiting Iran's nuclear activities.
Iran accused the US of reneging on the nuclear agreement, signed by the Obama administration, and of causing recent Iranian economic unrest. European allies said they "deeply regret" the US action.
London: The European Union is about to re-activate an old law to try to persuade businesses to defy US sanctions and continue to trade with Iran, in an attempt to salvage the nuclear treaty.
The European Commission’s high representative Federica Mogherini, in a joint statement with the foreign ministers of France, Germany and the UK, said they will activate a ‘blocking statute’ on Tuesday morning, local time, in direct defiance of the sanctions which will be imposed at the same time.
London: UKIP is back. The nationalist anti-immigration party, which had sunk almost into irrelevance, has polling numbers with a pulse after a long flatline.
Perhaps not coincidentally Boris Johnson is ridiculing women in burqas, a convicted far-right troll has somehow become a poster boy for free speech, and a bunch of thugs wearing ‘Make Britain Great Again’ caps stormed a socialist bookshop in London, shouting “we love Trump”, harassing staff and customers and (reportedly) ripping up magazines.
Only one other president has ever acted so desperate, and it ended badly
By William D. Ruckelshaus
7 August 2018 — 6:57pm
President Donald Trump is acting with a desperation I've seen only once before in Washington: 45 years ago when President Richard Nixon ordered the firing of special Watergate prosecutor Archibald Cox. Nixon was fixated on ending the Watergate investigation, just as Trump wants to shut down the special counsel's investigation into Russian interference in the 2016 election.
A lesson for the president from history: It turned out badly for Nixon. Not only could he not derail the investigation, but also, 10 months later, he was forced to resign the presidency.
In fact, in some ways, Trump is conducting himself more frantically than Nixon, all the while protesting his innocence. Nixon fought to the end because he knew that what was on the tape recordings that the prosecutor wanted would incriminate him. We don't know what Trump is hiding, if anything. But if he is innocent of any wrongdoing, why not let special counsel Robert Mueller do his job and prove it?
New York: The Trump administration has deepened its trade war with China by announcing a new round of tariffs worth $US16 billion ($22 billion), a move the Chinese government has warned will trigger another round of retaliatory tariffs on US exports.
The tranche of 25 per cent tariffs - which covers 279 products including electronic parts, plastics, chemicals, batteries, tractors and railway cars - follows $US34 billion worth of tariffs announced by the US government in July.
The Office United States Trade Representative (USTR) announced the tariffs in a statement released on Tuesday afternoon US time. They will take effect on August 23.
US sells record $US26b worth of 10-year Treasury notes
by Liz Capo McCormick
New York | Investors scooped up a record $US26 billion 10-year Treasury auction Wednesday, showing that swelling US government issuance has yet to put pressure on the nation's long-term borrowing costs.
The sale of 2028 notes was $US1 billion larger than the Treasury's May offering, which matched the previous record set in 2009. But a gauge of demand was above the average for the last four quarterly refunding auctions. The sale drew a yield of 2.96 per cent, in line with where the new security was trading in the minutes before the auction, signalling that investor appetite at around the 3 per cent level continues.
The unprecedented size comes as America's deteriorating fiscal outlook and ballooning debt load are moving onto investors' radar. The refunding sales this week, which also include Tuesday's three-year auction and a 30-year offering Thursday, will tally $US78 billion. That's the largest hit of new supply for a quarterly refunding since 2010.
How Taiwan's online democracy may show future of humans and machines
Co-founder of the Taiwanese government's Public Digital Innovation Space explains what the future of democracy may look like.
By Shuyang Lin
9 August 2018 — 9:02am
Taiwanese citizens have spent the past 30 years prototyping future democracy since the lift of martial law in 1987. Public participation in Taiwan has been developed in several formats, from face-to-face to deliberation over the internet. This trajectory coincides with the advancement of technology, and as new tools arrived, democracy evolved.
The launch of vTaiwan (v for virtual, vote, voice and verb), an experiment that prototypes an open consultation process for the civil society, showed that by using technology creatively humanity can facilitate deep and fair conversations, form collective consensus, and deliver solutions we can all live with.
It is a prototype that helps us envision what future democracy could look like.
A MAJOR new war is looming — and this one sits worryingly close to home.
Asia is at risk of descending into a region-wide crisis with global implications, a leading expert in Asia-Pacific affairs has warned.
Dr Brendan Taylor, Associate Professor at ANU Coral Bell School of Asia Pacific Affairs, argues Asia is at a dangerous crossroads in his new book The Four Flashpoints: How Asia Goes to War.
US Space Force launched at Pentagon as a separate armed service
By Tom Vanden Brook
10 August 2018 — 6:46am
Washington: US Vice President Mike Pence announced on Thursday that the Pentagon has begun planning to create a Space Force, embarking on an effort to create the first new armed service since 1947.
In June, President Donald Trump called for the establishment of a sixth armed service, the Space Force, to join the Air Force, Army, Marine Corps, Navy and Coast Guard.
US Vice President Mike Pence says the time has come to create a new, sixth branch of the US military by 2020 known as the 'Space Force.'
Recep Tayyip Erdogan opts for economic suicide: Mark Gilbert
by Mark Gilbert
Asking your citizens to search under their pillows for foreign banknotes and gold to convert into domestic currency isn't much of an economic strategy at the best of times. When your currency has lost more than a third of its value against the dollar this year and is trading at a record low, it amounts to economic suicide.
Any investors who'd been hoping for some semblance of standard economic theory taking hold and reversing the Turkish lira's freefall got scant comfort from Friday's speech by Turkish President Recep Tayyip Erdogan. "Turkey won't surrender to economic hitmen," he said, accusing detractors of hatching an "interest rate plot" that is "no different than a military coup attempt".
Unfortunately, US President Donald Trump took to Twitter to feed Erdogan's conspiracy theories, announcing a doubling of tariffs on steel and aluminium and cheering on the lira's collapse.
'Reckless escalation': Trump embraces market pain with little concern for contagion
By Justin Sink
11 August 2018 — 7:22am
President Donald Trump is embracing financial-market pain to get what he wants around the world, showing again the penchant for turmoil that is his trademark in US politics.
His decision Friday to double steel and aluminum tariffs on a Turkish economy already reeling from a currency crisis came just days after imposing new sanctions on Russia, creating market havoc in both countries. Most Asian markets ended down for the week amid the US-China tariff war.
Rather than worrying about US markets becoming infected by selloffs elsewhere, Trump is cheering on the economic losses suffered by the targets of American tariffs and sanctions.
Turkey's President Recep Tayyip Erdogan warned the US its decades-long alliance with the country is at risk after rising political tensions between the two nations erupted and helped stoke a financial crisis that shook global markets.
Erdogan, in an editorial Friday in The New York Times, cited Turkey's cooperation with the US dating back to the Cuban missile crisis and the Korean War as evidence of a long-standing partnership between the NATO allies. But he added more recent disputes over a failed 2016 coup, the conflict in Syria and sanctions imposed this week against top Turkish officials and the country's steel industry were straining that alliance to its breaking point.
"Before it is too late, Washington must give up the misguided notion that our relationship can be asymmetrical and come to terms with the fact that Turkey has alternatives," Erdogan wrote. "Failure to reverse this trend of unilateralism and disrespect will require us to start looking for new friends and allies."
Shanghai | China's state media has continued a barrage of criticism aimed at the United States as their tit-for-tat trade war escalates, while seeking to reassure readers the Chinese economy remains in strong shape.
Commentaries in the People's Daily, China's top newspaper, likened the US to a bull in a China shop running roughshod over the rules of global trade and said that China was "still one of the best-performing, most promising and most tenacious economies in the world".
The commentaries come as trade tensions between the two countries intensify. China said this week it would put an additional 25 per cent tariffs on $US16 billion ($22 billion) worth of US imports in retaliation against levies on Chinese goods imposed by the US.
The Turkish lira fell sharply to its lowest level ever on worries about Ankara’s stability, sending tremors through Europe and emerging markets amid renewed jousting between the country’s leader and President Trump.
The lira dropped as much as 17 per cent against the US dollar, extending a tumble that ranks as one of the steepest in world markets this year.
President Recep Tayyip Erdogan defended his unorthodox policies in two speeches on Friday, vowing to prevail in what he called an “economic war.”
Mr Trump said he would double steel and aluminum tariffs on Turkey, a move that would prevent Turkish exports from becoming cheaper with the lira’s fall and exacerbating worries of a prolonged trade spat between the two NATO allies.
The Bartone Ultimatum: – “Fix The My Health Record”
09 Aug 2018
During a private twilight meeting in Melbourne three weeks ago, AMA President, Dr Tony Bartone, put a strong demand directly to Health Minister Greg Hunt – fix the privacy provisions of the legislation or the My Health Record (MyHR) will remain in limbo for years to come.
Dr Bartone had made public his intentions a week earlier at the National Press Club in Canberra when he declared to journalists that he would do ‘whatever it takes’ to force the Government to take action to make the privacy protections of health information as watertight as possible in the digital health age.
The new AMA President stayed true to his word.
With the blessing and support of the AMA Federal Council, Dr Bartone, a Melbourne GP, took a four-point shopping list to the Minister – amend the Act to ensure health data is not disclosed without a warrant or court order; ensure that people who opt-out do not end up with a permanent MyHR; run a public information campaign; and extend the opt-out period.
The Minister, wanting the controversy to end, and ultimately wanting the MyHR to succeed, agreed to all the items and, after obtaining a sign-off from the Prime Minister, he issued a media release to publicly confirm the actions to be taken.
Minister Hunt said the Government will strengthen privacy provisions under the My Health Record Act, and the legislation will be strengthened to match the existing Australian Digital Health Agency (ADHA) policy.
“This policy requires a court order to release any My Health Record information without consent,” Minister Hunt said.
“The amendment will ensure no record can be released to police or government agencies, for any purpose, without a court order.”
Dr Bartone told ABC Radio AM that “we can now move forward and have certainty around the protections to the privacy of those medical records that our patients expect when they confide their information with us”.
“The assurance that people who opt-out will have their records deleted will hopefully appease concerns in that area,” Dr Bartone said.
“The privacy protection of our records and the security protection of our records is of considerable and paramount importance to us.
“We have protocols and procedures in place. We work with our IT providers to ensure that everything is in compliance and in the utmost preparedness for any cyber attack that we can envisage,” Dr Bartone said.
The AMA will examine the amended legislation carefully to ensure that patient, community, and professional concerns are addressed satisfactorily.
Dr Bartone said that the AMA remains committed to the potential clinical benefits of an electronic health record, but the future of the record depends on getting the security and privacy settings right.
“It would be a tragedy if, after more than a decade of development, we have to go back to square one in building a secure and workable electronic health record.”
Despite Minister Hunt’s announcement, the Labor Opposition is calling for the My Health Record system to be suspended until privacy concerns can be allayed.
Shadow Health Minister, Catherine King, raised concerns that non- custodial parents could create records for their children and use them to locate their children and estranged partners.
“The Government needs to deal with this issue,” Ms King said.
This claims that with the universal agreement of an AMA Council (those who has let this omnishambles run on uncritically for six years) he has arranged that all the issues surrounding the myHR were going to be fully addressed and that the bemused and confused populace could now nod off back to sleep, and I simply don't believe that to be true.
I think it is also fair to say earlier AMA Presidents don’t quite see it that way with one putting it thus and suggesting much more is needed:
This provides a flavor:
AMA 'monumentally' wrong to back My Health Record: Professor Kerryn Phelps
The AMA and RACGP should have been less enthusiastic before offering their 'breathless support', she says
The AMA and RACGP’s public support for My Health Record has been a monumentally bad idea, says former AMA president Dr Kerryn Phelps.
Her comments follow Minister for Health Greg Hunt’s promise to redraft the legislation so that clinical records on the system are covered by the same legal protections as those held by doctors.
Under the current My Health Record Act (2012), the Australian Digital Health Agency can hand over a patient’s medical records to law enforcers and government agencies without a warrant, providing it “reasonably believes” the request is necessary to prevent a law being breached.
But Dr Phelps said the slack privacy protections showed it was a “monumentally bad idea” for the AMA and RACGP to pledge support for the billion-dollar system in the controversial compacts signed with the Federal Government last year.
The federal government's My Health Record system is capable of storing genomic information, such as a person's genetic risk of developing cancer, which could turbocharge medical research but has intensified privacy and security fears.
Fairfax Media can reveal Sydney-based whole genome sequencing company Genome.One developed “necessary infrastructure” in order to upload highly sensitive genomic information onto My Health Records.
The Australian Digital Health Agency (ADHA), which for weeks has been deflecting privacy and data security concerns, handed the for-profit company $40,000 in September last year to support the development of the software.
Genome.One, a wholly-owned subsidiary of The Garvan Institute of Medical Research, can sequence an individual's entire genetic information and identify genetic variations which may increase the chances of developing a particular disease.
An RACGP e-health expert has poured cold water on fears that genomic data will not be safe if uploaded to My Health Record.
Chair of the RACGP Expert Committee – eHealth and Practice Services (REC–eHPS) Dr Nathan Pinskier believes recent reports that genomic data would be uploaded to the government’s health data repository should not trigger concerns.
‘[Genomic data] is the same as other pathology tests. It goes to My Health Record based on consent. They’re not uploading the DNA, but just a summary of findings,’ Dr Pinskier said.
‘Consumers have control. They can upload or not upload – it’s up to them. If they want to remove the data afterwards, they can.
‘I’d argue a consumer would like a place to keep this information, rather than having to go back to the laboratory all the time.’
Precision medicine – using insights obtained from genomics and other "big data" analysis – enables treatment and prevention strategies to be customised, potentially revolutionising healthcare. The government has committed financially to precision medicine. Genomic pathology testing is an increasingly important tool in the diagnostic arsenal. The inclusion of genomic testing results in the My Health record is consistent with inclusion of other pathology test results, increasing the amount of clinically useful information available to healthcare providers in My Health, but also contributing to a valuable research dataset.
But genetic pathology test results are fundamentally different from other pathology results. The shared nature of genetic material – received by individuals, along with their siblings, from their parents, and in turn transmitted to their children – means that information about the genetics of a patient necessarily reveals, or allows educated inferences about, the genetics of other people not the subject of the My Health Record.
Dr Wendy Bonython is an associate professor in the School of Law and Justice at the University of Canberra. She has a PhD in Molecular Medicine, and post graduate qualifications in law. She researches in regulation and ethics of biotechnology law.
This is rather better informed than a GP from a group spruiking the myHR. It clearly warns care was needed. As someone with biological science and medical degrees I know who I am likely to take notice of. You really do have to pick your experts very carefully these days or become very confused!
Loath though I am to say it, overall the information campaign being run by the ADHA is looking more and more like fake and distorted news as every day goes by. They have been caught out and now seem to be flailing about with increasing angst and less concern for the precise truth.
You should be able to rely on these medical entities (among others) and the ADHA to be fully informed, reliable, trustworthy and unbiased. I don’t think I am seeing that. What do you think?
CATHERINE KING MP SHADOW MINISTER FOR HEALTH AND MEDICARE MEMBER FOR BALLARAT
SENATE ADOPTS LABOR’S PLAN FOR AN INQUIRY INTO MY HEALTH RECORD
The
Senate has agreed to Labor’s proposal to subject Malcolm Turnbull’s My
Health Record fiasco to a comprehensive inquiry amid significant ongoing
privacy and security concerns.
We remain deeply concerned that the Government’s bungled rollout of the
My Health Record opt-out period has severely undermined public trust in
this important reform. That’s why we proposed an inquiry on Tuesday.
Labor has long supported an electronic health record system. We believe
it has the capacity to revolutionise health care delivery, but we also
recognise it needs a high degree of public support in order to be
successful.
While the Government has agreed to a number of changes demanded by Labor
and doctors’ groups, including an extension of the opt-out period and a
new public information campaign, more needs to be done.
We are disappointed the Greens did a dodgy deal with the Government to
truncate the inquiry but Labor’s terms of reference remain intact.
We’re also surprised the Government ended up supporting the inquiry
referral despite Greg Hunt yesterday dismissing Labor’s proposal as “a
stunt”.
This will be a wide-ranging inquiry that will review all the laws, regulations and rules that underpin the My Health Record.
It will examine the Government’s decision to shift from an opt-in system
to an opt-out system and whether it adequately prepared for this
fundamental change from Labor’s system.
It will examine a range of privacy and security concerns, including the
adequacy of the system’s log-in procedures and default settings. It will
also consider issues raised in the public domain around domestic
violence and workers’ compensation.
The inquiry will look at the adequacy of the Government’s public
information campaign, and the potential that commercial interests –
including health insurers – could be given access to My Health data.
We encourage everyone with a view on the My Health Record to make a submission to the inquiry.
Labor remains of the view the Government should suspend the My Health Record rollout until this mess can be cleaned up.
