It Is Hard To Argue With The Sentiment Expressed Here – This Vaccine Might Not Have Been Perfect But It Saved A Humongous Number Of Lives!

This appeared a few days ago along with a reminder a report on the whole saga is due in September this year:

The Observer Coronavirus

Analysis

AstraZeneca’s Covid vaccine is no more – but its remarkable success must not be forgotten

Robin McKie Science editor

Although dogged by controversy, the firm’s coronavirus jab saved the lives of millions and helped avert humanitarian crises in nations unable to access costly alternatives

Sun 12 May 2024 00.29 AESTFirst published on Sun 12 May 2024 00.26 AEST

Last week’s announcement that AstraZeneca would no longer market its Covid vaccine brings an end to one of the century’s most remarkable medical stories. Created within a year of the arrival of the pandemic, the AZ vaccine was cheap, easily stored and transported, and helped stave off humanitarian crises in Asia and Latin America, where many countries could not afford the more expensive mRNA vaccines that were being snapped up by rich western nations. It is estimated that it saved 6.3 million lives in 2021 alone.

Yet from the start the vaccine – created by research teams led by Professor Andy Pollard and Professor Sarah Gilbert at the Oxford Vaccine Centre – was dogged by controversy. It was linked to blood clots, US observers criticised protocols for its trials, and French president Emmanuel Macron claimed it was “quasi-ineffective” for people over 65. In fact, the vaccine is particularly effective for the elderly.

In very rare cases, the AZ vaccine can cause blood clots. According to the British Heart Foundation, one study in the BMJ showed that for every 10 million people vaccinated with AstraZeneca there would be a total of 73 extra cases of blood clots. By contrast 10 million Covid cases would trigger thousands of extra blood clot cases.

Many of the anxieties about the vaccine stemmed from national self-interests. However, others derive from the nature of vaccines themselves, and this raises issues that are likely to re-emerge with the arrival of any new pandemic in coming years, scientists have warned.

A vaccine is unlike any other type of medicine because it works by stimulating a person’s anti-pathogen defences, arming them in advance of a future infection. However, this preparation goes beyond helping one individual and can aid the general population, a point stressed by Professor Stephen Evans, of the London School of Medicine and Tropical Hygiene.

“If I take a preventative drug – such as a statin – then I am the only one who benefits,” said Evans. “However, there are people who cannot mount responses to a vaccine because they are ill or have a weakened immune system. They remain vulnerable. However, if you can build up herd immunity by ensuring the maximum number of people are inoculated, virus levels will drop and the vulnerable will be protected. If we believe we have responsibilities to help others, being vaccinated achieves that. There are moral concerns about being inoculated, in other words.”

Convincing the public – which has witnessed a rise in anti-vax propaganda in recent years – of this may not be easy. In addition, there is a second crucial difference between standard medical treatments and vaccines, added Professor Sir David Spiegelhalter, of the University of Cambridge. “We never know the identities of those who benefit [from a vaccine] – they are ‘statistical’ people – while those who are harmed can be named and their stories told.”

AstraZeneca’s Covid vaccine provides an example. We only know those who were harmed by it but cannot pinpoint those who benefited. Again, this makes it trickier to pinpoint a vaccine’s success and assure people of its efficacy. “To a certain extent, you can get round this and assess the impact of Covid vaccines by looking at the deaths of frontline workers in the health service during the pandemic’s early days,” added Evans. “Hundreds died, but if we had had a vaccine then it is now clear most would probably have survived.”

Most virologists and vaccine experts agree: when you look at the AstraZeneca vaccine from a global perspective, it probably benefited tens of millions of people, preventing deaths and reducing long-term consequences of Covid. It was a remarkable success, yet its passing has been marked by many who stressed its side-effects but never touched on its achievements.

“The paradox of vaccines is that people forget how important they are,” said Professor Adam Finn, of Bristol University. “They are like democracy. You enjoy it for a while and then forget how important it is to preserve it. It’s a problem.”

On the other hand, it is also clear politicians and officials will have to be careful about the claims they make, added Fiona Fox, head of the Science Media Centre. “Public trust in vaccines will come from open and honest communication. The benefits massively outweigh the risks as they did with this vaccine.

“But you won’t win any arguments by claiming that vaccines are 100% safe or running for the hills at the first reports of problems, which unfortunately too many government and NHS communications officers tend to do.

Downplaying risks is always tempting when you need people to take a mostly safe vaccine but it’s ultimately self-defeating because it erodes trust in the longer term.”

Robin McKie and science and environment editor for the Observer

Here is the link:

https://www.theguardian.com/world/article/2024/may/11/astrazeneca-covid-vaccine-jab-coronavirus-saved-lives-humanitarian-crises

If ever there was a case of perfection being the enemy of the very good this saga has to be it.

I remember the excited debate about how many side-effect related deaths were acceptable in the context of a pretty safe vaccine and a rising death toll from the virus way back then, Fortunately sanity prevailed with the at-risk populations until the Pfizer vaccine could be made and imported in adequate quantities.

Looking back it seems we could have steamed forward with A-Z and lost very few lives and saved a good few lives down the track.

Has anyone seen a decent review of the whole COVID-19 episode and the response. It would make interesting reading now!

This video will remind you of how we were thinking at the time:

https://www.youtube.com/watch?v=KtSz7w_TaEc&ab_channel=9NewsAustralia

Here is also a link to the Federal Government Inquiry which is due to report by September 2024.

https://www.pmc.gov.au/resources/commonwealth-government-covid-19-response-inquiry-terms-reference

Commonwealth Government COVID-19 Response Inquiry terms of reference

The purpose of the Commonwealth Government COVID-19 Response Inquiry (the Inquiry) is to identify lessons learned to improve Australia’s preparedness for future pandemics.

Scope

The Inquiry will review the Commonwealth Government’s response to the COVID-19 pandemic and make recommendations to improve response measures in the event of future pandemics. It will consider opportunities for systems to more effectively anticipate, adapt and respond to pandemics in areas of Commonwealth Government responsibility.

The Inquiry will adopt a whole-of-government view in recognition of the wide-ranging impacts of COVID-19 across portfolios and the community. Specific areas of review may include, but are not limited to:

• Governance including the role of the Commonwealth Government, responsibilities of state and territory governments, national governance mechanisms (such as National Cabinet, the National Coordination Mechanism and the Australian Health Protection Principal Committee) and advisory bodies supporting responses to COVID-19.
• Key health response measures (for example across COVID-19 vaccinations and treatments, key medical supplies such as personal protective equipment, quarantine facilities, and public health messaging).
• Broader health supports for people impacted by COVID-19 and/or lockdowns (for example mental health and suicide prevention supports, and access to screening and other preventive health measures).
• International policies to support Australians at home and abroad (including with regard to international border closures, and securing vaccine supply deals with international partners for domestic use in Australia).
• Support for industry and businesses (for example responding to supply chain and transport issues, addressing labour shortages, and support for specific industries).
• Financial support for individuals (including income support payments).
• Community supports (across early childhood education and care, higher education, housing and homelessness measures, family and domestic violence measures in areas of Commonwealth Government responsibility).
• Mechanisms to better target future responses to the needs of particular populations (including across genders, age groups, socio-economic status, geographic location, people with disability, First Nations peoples and communities and people from culturally and linguistically diverse communities).

The Inquiry will consider the findings of previous relevant inquiries and reviews and identify knowledge gaps for further investigation. It will also consider the global experience and lessons learnt from other countries in order to improve response measures in the event of future global pandemics.

The following areas are not in scope for the Inquiry:

• Actions taken unilaterally by state and territory governments.
• International programs and activities assisting foreign countries.

Independent Panel

The Prime Minister has appointed an Independent Panel of three eminent people to conduct the Inquiry. The Independent Panel will consult with relevant experts and people with a diverse range of backgrounds and lived experience.

Taskforce

A Taskforce within the Department of the Prime Minister and Cabinet will support the Independent Panel.

Public consultation

Public consultation will be completed during the Inquiry on the substance of the issues outlined in the Terms of Reference. The Independent Panel may invite and publish submissions and seek information from any persons or bodies. Consultation will take place across Australia with:

• Key community and other stakeholders reflecting a diversity of backgrounds
• Experts
• Commonwealth Government and state and territory government agencies
• Members of the public

Final Report

The Independent Panel will deliver a Final Report to Government including recommendations to the Commonwealth Government to improve Australia’s preparedness for future pandemics by the end of September 2024.

-----  End Quote:

This will make fascinating reading I am sure - and not all that far away! I wonder how 'warts and all' it will be?

David.

I Wonder What The Review(s) Of These Clinics Have Showed Or Have I Missed Them

This appeared a few days ago:

Prime Minister Anthony Albanese announces $227m cash splash to open 29 more urgent care clinics

Labor will expand its network of urgent care clinics to help keep bulk-billing alive and alleviate pressure off hospitals.

Ellen Ransley

May 11, 2024 - 10:00PM

NCA NewsWire

Labor will funnel $227m into opening 29 more urgent care clinics across the country, as part of a broader multi-billion dollar health package in Tuesday’s budget.

Despite a slow start to the rollout and ongoing concerns about opening hours, there have been almost 400,000 visits to the 58 bulk-billed clinics that have opened across the country since last July.

Designed to ease pressure on emergency departments, anyone with a Medicare card is able to walk in to see a doctor or nurse for urgent, non life-threatening ailments such as minor injuries and respiratory infections.

Health Minister Mark Butler said existing centres were working as designed, with about one in two presentations reporting they would have gone to an emergency department if they didn’t have the option of visiting an urgent care clinic.

“Medicare urgent care clinics are already fulfilling their promise by making sure Australians can walk in and receive urgent care quickly and for free,” Mr Butler said.

“Medicare UCCs are making a difference, for patients and for busy hospital emergency departments.

“More UCCs, in more locations, and all patients need is their Medicare card.”

The location of the new clinics have yet to be determined.

To date, about one in three visits have been for children under the age of 15, and over a third of visits have been after 5pm on weekdays or on the weekend.

But in the last round of Senate estimates, it was revealed the majority of those had fallen short of their objective of opening from 8am to 10pm, seven days a week, with only about 16 advertising that they met that criteria as of February 9.

Many clinics have opening hours of 8am to 6pm, or 8am to 8pm Monday to Sunday, while some clinics only offer 8am to 10pm during the week but not on weekends.

Others operate with reduced hours on the weekend, including the clinic in Albury in regional NSW, which currently advertises as only opening for four hours on Saturday and Sunday.

Meanwhile, the Devonport clinic in Tasmania currently operates between 2pm and 10pm, seven days a week.

Mr Butler confirmed the budget would have $8.5bn in new health investment, and would provide additional funding for clinics in regional, rural and remote Australia.

He said the government would continue to work closely with state and territory governments, and primary health networks, to roll out the clinics.

Currently, there are 14 clinics in NSW, 10 in Victoria, 11 in Queensland, seven in WA, five in South Australia, four in Tasmania, five in the ACT and two in the Northern Territory.

Here is the link:

https://www.news.com.au/finance/economy/federal-budget/prime-minister-anthony-albanese-announces-227m-cash-splash-to-open-29-more-urgent-care-clinics/news-story/ad5883d84c1fb054d938c88b9d23f735

You can find out about your nearest one here:

https://www.health.gov.au/find-a-medicare-ucc

(I note, in passing, that there is not a UCC within 20Km of me!)

You have to worry if the Government is trying to build an alternative GP network with all this money. Surely an incentive to practice in these underserved areas might achieve the same outcome?

It seems there are still considerable problems with the UCCs if my scan using Dr Google is to be believed. Many seem to have long wait-times or to be turning patients away.

I would be interested if any readers here have experience of their local clinic and how it has gone.

It seems a lot of money is being splashed around with not much evidence yo data, or have I missed it?

David.

This Generation Has Surely Shaped Where We Are Now And Probably How We Are Shaping Up Over The Next Decade Or So.

This appeared a couple of days ago, but seemed to make light of the health sector impacts – which I think will be pretty large and transformative, while covering so other useful ground! 

Boomers: the world wouldn’t be the same without ‘em

They came of age under the threat of nuclear obliteration paired with the promise of never-before-seen wealth and prosperity. What legacy will this much-maligned generation leave us with?

By Hugh Mackay

From The Weekend Australian Magazine

May 11, 2024

What a ride the Baby Boomers have had! The products of our highest birth rate since 1921, they were the beneficiaries of a post-war economic boom that ushered in an era of unprecedented prosperity. They became, up to that point in our ­history, our most highly educated generation, setting a ­pro-education example that subsequent generations have ­enthusiastically followed. They also established new records for international travel, for home ownership and for divorce. In their middle years, they were buffeted by the ­highest unemployment rate since the Great Depression. They had to contend with an often baffling ­information technology ­revolution that their children and grandchildren took in their stride. And they were the generation that took up the cry for women’s rights and fought hard to make it happen. Time after time, in so many ways, it has fallen to the Boomers to be social pioneers.

The members of the Boomer generation were born in the 15 years after the end of World War II, 1946-61. (That rather conveniently fits the 15-year span that demographers typically use to define a generation.) In 2024, the oldest of them are turning 78 and the youngest 63.

For reasons we are about to explore, the Boomers were dubbed the “Me Generation” by their parents and other observers of this feisty, rebellious, hard-to-ignore cohort. Later in life, Boomers often characterised themselves as the “stress” generation as they set new records for the use of tranquiliser and anti-depressant medication. Along the way, they’ve also been known as the “denim” ­generation (forever young, though it’s stretch denim these days), the “sandwich” generation (when they were simultaneously caring for elderly parents and dependent children) and the “keep working” generation (as they ­eschewed the idea of ­retirement as too ­ageing, and embraced the concept of ­“refocusing” instead).

-----

The Boomers’ attitudes and values were formed by two powerful but contradictory ­influences on their early development: the ­confidence and optimism generated by the post-war economic boom, and the anxiety and pessimism of the Cold War.

------

The optimism fuelled a big spike in the marriage rate after the end of the war. People were not only tying the knot and having babies in unprecedented ­numbers, but were doing it younger: by 1954, halfway through the boom, 60 per cent of women were marrying between the ages of 20 and 24 – roughly double the pre-war figure.

The marriage and birth rates had both ­increased steadily during World War II but ­exploded when the war ended. The baby boom, like the marriage boom, was a symbolic ­expression of the post-war spirit of energy and optimism. It signalled a return not only to peace, but also to the prospect of contented, ­stable family life. “Home and family” became the focal point of a society that was settling down to the serious business of making the dream of middle-class, suburban prosperity come true, and through the ’50s and ’60s that dream became a reality on a very large scale.

If the marriage boom was the demographic antecedent of the baby boom, then the economic boom was its cultural cradle. And what a boom it was! A housing boom, a construction boom, a manufacturing boom, a mining boom. Consumerism was born in an enthusiastic rush to buy all the goods and services flooding the post-war market: domestic appliances, kitchen gadgets, wall-to-wall carpets, cars (especially locally made Holdens), women’s fashions (the “New Look”, to match the new spirit of the times), confectionery, holidays and travel, even home phones (though many people in the ’50s were still walking to the end of the street – ­including the street I grew up in – clutching their two pennies to use the public phone).

Unemployment was hardly an issue. There was so much work to be done and so many ­European refugees looking to start a new life elsewhere that Australia began its massive ­immigration program. It was partly in response to the humanitarian crisis and partly to help supply the workers needed to fuel the economic machine that was now running at full throttle.

Having braced themselves for the long slog of post-war recovery, the Boomers’ parents were astonished by what actually happened: it seemed to them more like an economic miracle than a mere boom. But many of them said later in life that they had tried not to let it “turn their heads”: they maintained the values of prudence and restraint that the pre-war Great Depression and then the war years had taught them: save for what you want; stay out of debt; only buy what you need.

They had hoped to instil those same values into their offspring, but it was not to be. The siren song of materialism was too loud and too seductive! The Boomers became enthusiastic consumers from an early age; to them, it seemed that the future was rosy, and they would be borne into it on a constantly rising escalator of prosperity.

But all this economic jollity was coexisting with the other major post-war influence: the Cold War. The Boomers lived in the shadow of the atomic bombs that the US had dropped on Hiroshima and Nagasaki; nuclear weapons now represented a threat to human survival. This was not mere sabre-rattling – this was the threat of nuclear annihilation on a massive scale.

The Soviet Union and the US were both frantically stockpiling nuclear weapons, and the concept of MAD, or mutually assured ­destruction, had wide currency, even becoming the title of a satirical magazine that was a Boomer favourite. Its founders never claimed the name had been inspired by the Cold War acronym – that’s just my fantasy. (“Let’s get sex and violence off TV and back on the streets where they belong” was a typical MAD joke from the ’60s.)

Spending their formative years in a Cold War atmosphere, the Boomers were not only absorbing a kind of Armageddon mentality but were also being exposed to all the dark, dystopian material then being published in Cold War espionage novels and films. Spies, not soldiers, were the new heroes. This was a world of moral ambiguity, bleakly documented by writers like John le Carré (The Spy Who Came in From the Cold) and Len Deighton (The Ipcress File), and treated more flippantly by Ian Fleming’s James Bond novels and the TV series Get Smart.

One of the features of this period was the widespread fear that nuclear war could be precipitated accidentally, by someone misjudging a situation or simply pressing the wrong button. That fear was compounded by the belief that if the Cold War ever turned hot, it would be an unstoppable danse macabre of nuclear strike and counterstrike.

All of that led to The Big Boomer Question – more intriguing than any question we might raise about any of the generations that followed the boom: how would this rising generation of young Australians reconcile two such utterly contradictory formative influences? On the one hand, there was the promise of endless prosperity and material comfort; on the other was the real possibility of nuclear obliteration.

The answer to that question can be found in a slogan that became the Boomers’ generational catchcry: “We’re not here for a long time; we’re here for a good time.” That meant they were in a hurry to do everything, including marriage. Thirty per cent of Boomer women were married by the age of 20 – though they didn’t have nearly as many children as their parents’ generation had. In fact, they cut the birth rate in half, down to 1.8 babies per woman by 1984, the year that mid-Boomers turned 30. That reluctance to have children was a reflection of their deep misgivings about the future. Getting married was one thing; having children was a commitment of a very different order.

The Boomers’ enthusiasm for higher education transformed the university and TAFE sectors by their sheer numbers. They were in a rush to travel, too, creating an unprecedented “youth travel” market. They were in a rush to get a mortgage and buy a house. They were in a rush to ascend the employment ladder as quickly as they could.

And they were in a rush to embrace social change. They were turning their backs on their parents’ values and way of life. They wanted to be – and were – more radical in their thinking. They wanted the fruits of “women’s lib” to be seen now. Older Boomers wanted Australia out of the Vietnam War now. In 1972, those old enough to vote were keen to support the switch to the first Labor government in 23 years – most of them by then had lived under a Coalition government all their lives.

If you had to choose one word to capture the essence of the young Boomers, it would be ­“impatient”. And why not? Given those ­powerful but contradictory influences upon them, who could blame them for feeling some urgency about doing the things they wanted to get done?

They were devoted to the concept of instant gratification. They managed to combine a ­reluctance to save with an eagerness to spend. The credit card revolution that began in 1974 with the launch of Bankcard was heaven-sent for Boomers. They didn’t like to think of borrowed money as a boring “loan”: they preferred the spunkier concept of “credit”.

By the mid-’90s, when leading-edge Boomers were hitting 50, one of Australia’s most ­astute economic analysts, Phil Ruthven, said of them: “The Baby Boomers have been the shortest-term thinkers of probably any generation for over 100 years .... And they are our worst savers on record, in terms of saving as a percentage of income.” At the same time Arun Abey, then executive chairman of IPAC Securities, described Boomers’ reluctance to save with a charitable obliqueness: “Baby Boomers have a very strong cash-flow need.”

In essence, Boomers were acquiring a ­reputation for doing precisely what you’d ­expect people to do if they’d grown up with the expectation that all the rosy prospects beckoning from the future could be swept away in an instant, courtesy of The Bomb. How do you live with the simultaneous prospect of a bright future and no future at all? Answer: you run very fast, you play very hard, and you experience all the things you want to experience – sex, travel, prosperity, power – as early as you can. Their goal was not only to “have it all”, but to have it all at once.

Whoa!

It’s always hazardous to define generational characteristics because – obviously – there’s a huge range of individual differences in any age cohort. Yes, the Boomers shared some mighty powerful influences early on, but like any other generation they had plenty of diversity; they had different parents, grandparents and siblings; went to different schools; and had different personalities and temperaments. Over the years of my research into Boomers’ attitudes, I’ve often encountered Boomers’ own resistance to the idea of any generalisations being made about them. As possibly the most extensively studied generation in modern history, they are understandably sick of being under the microscope and then being discussed as if they are specimens. All understood. And it goes without saying that a 15-year span is quite a long time: in 1968, for example – the year of worldwide student uprisings with faint echoes in Australia – the oldest Boomers were 22, but the youngest were only seven. Still, I’m not ­retreating from the broad outlines of this analysis. The facts about the Boomers’ generational behaviour speak for themselves.

As time went by, Boomers were gradually forced to accept that, actually, they were here for a long time after all. And they realised – dammit! – they were not necessarily having the good time that the ’50s, ’60s and ’70s had promised. All You Need Is Love, adopted by many of them as a theme song, turned out not to be quite true. Or not true enough. Or not the whole truth.

Their children – some tail-end Gen Xers but mostly Millennials (previously known as Gen Y) – have certainly not followed their parents’ example, any more than the Boomers followed their own parents’, because the formative influences on them were so utterly different.

Some daughters of Boomers looked at their feminist mothers’ “liberated” lives and said: “I thought you didn’t want to be a doormat to your family, but you’re a doormat to your own liberation. If you’re free to choose, how come you’ve chosen to be so out-of-control busy? Yeah, maybe you can have it all, but what makes you think you can have it all at once?”

Now, as they look back on their lives, many Boomers – women and men – are asking themselves the same question.

Boomers are the way they are because that’s the hand Fate dealt them. But in general (warning: another generalisation coming up), they have continued to try to reshape the world.

They have their regrets (who doesn’t?) and perhaps we can also learn from those. Less ­materialism would have been good; less ­indulgence of children, and a combination of more time and more discipline would have been good; and less impatience would have been good – it’s probably better to live as if there’s a future.

Which leads us to ponder, what sort of ­leaders did Baby Boomers make? Here’s where any generalisations will be too dangerous, ­except one: they were impatient for power. (And perhaps a second: they will not go down in history as long-range thinkers.) Australia has had four Boomer prime ministers: Kevin Rudd (born in 1957), Julia Gillard (1961), Tony Abbott (1957) and Malcolm Turnbull (1954). They all came and went in the space of about ten years, a period marked by constantly simmering ­ leadership tensions as, one after another, the four aspirants for the top job lost patience with those who stood in their way.

The first, Kevin Rudd, was elected in 2007. Two and a half years later, he became the first Labor leader ever to be ousted in his first term when he was successfully challenged for the leadership by Julia Gillard. After the following election, when neither Labor nor the Coalition managed to achieve a majority, Gillard put ­together a government in coalition with the Greens, but before that government’s term was over Rudd’s persistent undermining of Gillard paid off and he defeated her in another party-room ballot. His second term as prime minister lasted a mere 83 days before Labor was ­defeated at the 2013 federal election.

On the Coalition side, a similar impatience for power was on display. Malcolm Turnbull, having weighed up the relative merits of the Labor and Liberal parties as his pathway to the long-cherished prime ministership, chose the Libs, entered parliament in 2004, and became their leader (in opposition) at his second ­attempt, just four years later. Before he could achieve his dream of becoming PM, however, he was ousted in a party-room ballot by ­another Boomer, the ever-eager Tony Abbott, who ultimately became prime minister at the 2013 election, promising a “kinder, gentler ­polity” (having mercilessly savaged Gillard throughout his time as opposition leader). Then, sure enough, Turnbull challenged ­Abbott for the leadership in 2015 and yet ­another sitting prime minister was gone.

It all seemed a bit breathtaking at the time, with such naked ambition and textbook Boomer impatience on display. (This was the period when it was said that paramedics could no longer check a dazed patient’s cognitive function by asking: “Who is the prime minister?”)

The Boomer PMs’ chaotic run came to an end when Turnbull’s dismal run of opinion polls led to another party-room ballot and his defeat by Scott Morrison. Turnbull became the fourth sitting prime minister to fall victim to ­internecine rivalries within eight years.

Like many other researchers, I have found Boomers endlessly fascinating, because their formative years were so utterly different from anything that had come before, and because the results of that formation have been on such public display. In fact, when you compare the young Boomers’ social, cultural and economic context with the contexts in which their parents and their children were raised, you realise just how swiftly our society has been changing. It’s almost as if those three generations represented three quite different Australias.

I once wrote that impatiens was the perfect flower for Boomers’ gardens, and stir-fry their perfect meal. I don’t know what the favourite flower of today’s rising generation of young adults might turn out to be – perhaps climate-proof cactus – but their favourite meal would be “home delivery”.

The Boomers’ story reminds us that, ­although family influence is always powerful, the wider world speaks loudly to us too. When children are fed a daily diet of ­information about the imminence of global ­destruction – by nuclear war, back then, or the effects of climate change today – anxiety about that message will lodge deep in their psyches and become an important part of who they are. In the Boomers’ case, all the talk of potential ­catastrophe was tempered – indeed, contradicted – by the promise of a rosy material future to come and by the exuberance of pop culture at the time.

It’s an interesting question for current and future researchers to study: will today’s children and adolescents be influenced even more profoundly than the Boomers were by the ­relentless bad news, because there’s no countervailing promise of a bright future? Some will respond with resignation, some with despair, some with deep-seated anxiety, some with anger and some with urgent activism, but which will be the dominant response?

Here is the link:

https://www.theaustralian.com.au/weekend-australian-magazine/hugh-mackay-on-the-making-of-the-baby-boomer-generation/news-story/67bdd4de5f7052f77f7d6f8b7f4f11bd

This is an excellent summary of the generation I am surely part of but I find it fascinating that we are yet to recognize just what a huge impact this now aging cohort is having on the health sector and how they are shaping the form of the health system through their demand for services and their intolerance of unavailability or access or lack of a “cure” for whatever ailed them!

The “Boomers” are a very considerable pull factor on how services are being delivered and are pretty intolerant of less than pretty well delivered and timely services.

They are also the generation that has seen the emergence of Digital and Digitally delivered services which have been more or less successful, and who have not tolerated some of the initial teething issues all that well! They are a generation that expect things to work, and to be intuitive in application! This has not always been achieved.

As they age the Boomers will push the health system pretty had in terms of both quality and availability and it will be interesting to see what changes occur. Digital service delivery will become more and more important as time passes I am sure.

This generation will, I suspect, want health services to just work and be available essentially ‘on demand’. I wonder how well those expectations will be met?

What do you think?

David.

AusHealthIT Poll Number 746 – Results – 12 May, 2024.

Here are the results of the poll.

Are "Protesters Who Seek To Wash Away The ‘Sin’ Of Their Own Privilege By Donning Keffiyeh" Pretty Separated From Reality And Should They Focus On Issues That Actually Matter?

Yes                                                                                9 (69%)

No                                                                                 3 (23%)

I Have No Idea                                                             1 (8%)

Total No. Of Votes: 13

A clear cut vote with so few votes it is clear most were annoyed / frustrated by the poll – probably feeling the whole thing was not appropriate on the blog! Sorry if you felt like that…. I clearly need to do better!!!!!

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

A very few votes indeed!. 

1 of 13 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted, as well as those who did not! 

David.

I Really Worry For Our Health Services As We Keep Running Huge Migration Arrival Figures!

This appeared last week:

Time to bust the migration paradox

· 12:00AM May 4, 2024

Australia has an economic model that depends on high immigration – and it is past time the flaws in this system were confronted as the Albanese government desperately tries to wind back our unsustainably record high migrant intakes in the post-Covid period.

The magnitude of Labor’s immigration misjudgment is alarming. Australia is a remarkably tolerant nation but its tolerance is being pushed to the limit.

In the year to September 2023 the increase in net overseas migration was 548,800 and this compares with our natural increase (births over deaths) of just 111,000 – so for the year in question immigration ran at about five times the natural rate.

The surge is a function of mistakes in the post-Covid period when an inflow of students and temporary workers was bound to take off. You can be a strong supporter of immigration but still grasp the current intake is untenable given the many downsides – economic, social and political.

For the above year the total increase in Australia’s population was 659,800 people, or an increase of 2.5 per cent, in just 12 months. The 548,800 overseas migration figure was a 60 per cent rise on the previous year. Unsurprisingly, Anthony Albanese has pledged to halve the net migration intake.

Home Affairs Minister Clare O’Neil says changes to reduce the intake have been put in place, notably in the overseas student intake and reforms to fix what she says is the “broken system” that Labor inherited.

Australia’s immigration policy faces two challenges – moving beyond the wild gyrations induced by the pandemic’s legacy and then, critically, deciding what normality looks like in the aftermath. It is no surprise that in this transition migration policy bipartisanship has been terminated.

But the old pre-Covid normality won’t do. Australia faces four conundrums in its population future. First, record low fertility, now 1.78 births per woman – well below population replacement at 2.1 – drives strong long-run momentum for immigration. Second, high immigration has become indispensable to economic growth and for more than a decade immigration has substituted for productivity in delivering the economic growth we need. Third, this substitution means Australia has growth without prosperity because the real income increase per person across a decade has been grossly inadequate (that’s when it avoids being negative), leading to public frustration and anger. Fourth, the fusion of weak income growth combined with high immigration and the rise of identity politics puts social cohesion on the long-run road to turbulence, as evidenced in other Western nations.

Jim Chalmers spent this week describing how Australia faces a world transformed – geostrategic risks, weaker global growth, the climate transition, technological disruption, huge industrial subsidies and the fusion of economics and security. But one event the Treasurer missed (not his job) is the unravelling of social cohesion courtesy of weak income growth, rampant inequality and the identity politics revolution that aims to terminate the principles of Western liberalism on which multiculturalism is supposed to be based.

The nation stands at a crossroads. Australia’s high immigration, low productivity, social cohesion model doesn’t work anymore. As part of the Chalmers’ old world scenario it is slated for extinction. Something has to give in this three-way contradiction. Take your pick. The denial in government and policy circles is near absolute – Australia is a country that can’t see what’s staring it in the face. We nurse our orthodoxies as they die before us.

Measured in per capita terms Australia has been struggling through a series of negative growth quarters – and weak productivity combined with high immigration is no long-run answer.

At the same time Labor seems convinced that the social cohesion from multiculturalism is ingrained in our character – rather than the unique product of remarkable forces.

On display today is the shredding of the multicultural principle – having one group of Australians preaching hatred against another group of Australians as political leaders stay silent or issue pious declarations under the misapprehension that the distress will be a passing phase.

In his recent Cook Society address, Liberal MP Julian Leeser named the two intellectual and moral poisons with the potential to destroy multiculturalism: “The first is the modern idea of privilege and the belief that certain races embody privilege. The idea of Jewish privilege has become the Protocols of the Elders of Zion for the 21st century. Its central premise is that if you want to tackle ‘white privilege’ you must start with ‘Jewish privilege’.”

The protests at universities and schools reflect a vision of the world divided into two groups – the oppressors and the oppressed – with people to be treated separately on this basis. The second idea is that Jewish Australians must be held to account for the actions of the state of Israel – when, as Leeser says, nobody holds the local Chinese community responsible for the fate of the Uighurs, the Russian community for Vladimir Putin’s violence or the Persian community for Iranian suppression of women.

Our leaders and our elites seem not to comprehend, maybe wilfully, that the attitudes being promoted in the protests have their origins within the academy and are founded in a moral concept and intellectual view of society that threatens the core of the liberal multicultural society. This is not just about Palestine; it is about us. Yet our elites engage in useless platitudes and our Labor government, sadly, seems intimidated by electoral politics and the Muslim vote.

This occurs in the context of a high immigration model no longer working properly, with the poor economic outcomes now beyond dispute and reinforced by huge generational divides in the housing market. Everyone talks productivity but productivity is the elusive ghost. No worries, the immigration intake is the easy fix.

The worst kept secret in politics is that the opposition under Peter Dutton intends to make immigration and social cohesion into a key issue at the next election. Nobody could miss this invitation.

Opposition immigration spokesman Dan Tehan tells Inquirer the public isn’t happy. “What the figures show, whether Labor is committed or not, is that a Big Australia is what they are delivering,” Tehan says. “They’ve brought to Australia well over one million people in the first term of the Albanese government. We’ve never seen numbers like that.

“The public is getting more and more concerned. The question that’s always put to me when I say they’re on track to bring in more than a million people is: Where are they all going to live? And the government has no idea.

“Immigration will be one of the key issues at the next election, a frontline political issue. Anthony Albanese gave every signal he wanted to keep migration low but then turned around and did another thing after he was voted in. He brought into the country the largest number of people in one term in our history.

“There will be a stark difference between ourselves and the Labor Party. We think immigration needs to be lower and sustainable. We are working on what we need in terms of skills and where we are with housing, rents and infrastructure. We will be running a much lower program.

“I believe the Australian people are concerned about the lack of social cohesion, it’s something that is raised with me more and more. Governments have a key role to play here. Yet we see a complete lack of leadership from the Prime Minister, with his unwillingness to call out anti-Semitism being the greatest example.

“We’ve also seen an unwillingness to lead when it comes to reassuring the community that the government is taking every step to ensure our communities understand the importance of social cohesion.”

O’Neil repudiates the Big Australia accusation. The Home Affairs Minister tells Inquirer migration is too high, fuelled by the catch-up in international students post-Covid and the strong labour market. “The problem with the migration system is not just the size,” she says. “When we arrived in office, the system was not strategic, not sufficiently selecting for the skills we need. Our migration strategy is a huge shift in thinking – to build a smaller, more strategic and better planned migration system.”

In December last year Labor outlined its reduction forecasts – net migration would be reduced to 375,000 in 2023-24 and then to 250,000 in 2024-25. There would be hardship in the process, since the 2022-23 outcome was a huge 510,000.

At the time O’Neil said of the reductions: “It’s not a target, it’s an estimate.” She warned: “It is going to take vigilance from me and Minister Giles to meet these numbers.” That’s an understatement. Migration experts predict the 375,000 forecast is a completely lost cause and that tougher decisions will be needed to reach 250,000. Significantly, O’Neil tells Inquirer “we are on track” to halve net overseas migration – that means meeting the 250,000 forecast. In any autumn 2025 election, that forecast becomes a non-negotiable political flashpoint – with immigration as an issue Labor cannot afford not to meet it.

The bigger issue, however, is Labor’s implication that 250,000 is the new norm. Certainly it will become the benchmark against which the Coalition pledges a reduced intake and, given Tehan’s pledge about a “stark” difference, that surely means a significant cut.

Tehan says: “Halving the number to 250,000 is still an incredibly high number historically. We need to deal with here and now, migration is still growing, that figure of 100,000 growth for February alarmed a lot of people. What confidence can we have in Labor managing immigration? None.”

Asked how he saw the immigration norm, Tehan says “it was about 180,000 in the previous decade” but figures provided by the government on net overseas migration show different results – taking the three years before the pandemic the annual average was 248,000 while taking the previous six years it was 220,000.

Independent economist Saul Eslake, in a recent assessment of global migration trends, found Australia, Canada and New Zealand have all experienced a migration surge – the most pronounced for more than 70 years – dominated by international students and temporary workers. In Australia the historical evidence is clear: migrants have made a net positive contribution to the economy and are likelier to be employed than the native-born.

Eslake tells Inquirer: “If you look at headline GDP growth Australia did much better than the OECD average from about the turn of the century to 2020. But that was only because our population growth also exceeded the OCED average. If you look in terms of per capita GDP growth, particularly in the decade ending 2020, we were actually slightly below the OECD average. And that’s now happening in spades.

“We have come to rely on immigration to drive economic growth. Part of why we do this is to cover up the failings of our education and training system. If our education and training system was producing people with the skills the economy needs, we wouldn’t need to rely so much on immigration and, in that situation, our productivity growth would be higher.

“This stands out in Victoria. It goes back a long time, pre-dating Daniel Andrews, with Victoria having come to rely on immigration more than any other state, particularly on international students. As a result Victoria has become a poor state. That’s something most Victorians don’t realise, as measured by per capita gross product or disposable income per head. Victoria is now in the bottom four states along with Tasmania, South Australia and Queensland, rather than in the top two.”

Eslake warns that in the coming world “immigration flows are likely to raise increasingly complex and difficult issues for high-income countries”. Many factors will come into play including climate change, the blurred distinction between economic migrants and asylum-seekers, security issues, wars and geo-strategic rivalry that will generate domestic tensions along racial, cultural and religious lines. This is now obvious in most Western nations including Australia.

Australia still possesses a major asset – being an island continent it can control its borders and the national government can determine the number and quality of legal migrants. But the task of maintaining public support for high immigration will get far more difficult. The pandemic along with the “new world” transformations identified by Chalmers guarantee this – any idea such defining events will leave immigration untouched is absurd.

Both O’Neil and Tehan say retaining public support for immigration is essential. But, whether Labor or the Coalition is in government, that demands far-reaching changes. The pandemic and the world of intense power rivalry will constitute a departure point in immigration management and attitudes. There will be no short-term solution to tensions from the generational divide in the housing markets.

Yet migrants will be increasingly needed in a range of expanding skilled areas, and notably in health, aged care and jobs the native-born refuse to do.

Eslake says: “Immigration levels over the past two years are not just unsustainably high but at that level they risk a much bigger anti-immigration political constituency than Australia has had traditionally. I would think an immigration level around 200,000 is probably about right at the moment.”

The depth of general support for immigration and multiculturalism is an Australian strength that needs to be preserved. But the cultural transformations under way will be challenging – the wide acceptance of identity politics, the ideology of “oppressed and oppressed” classes, the concept of a white privileged Australian ruling group and the rise of extremists, both far-right racist groups and Islamist extremists.

The conflict in the Middle East has likely entered a new plateau of greater intensity that will accentuate domestic divisions in Australia. The principles defining a multicultural society are being undermined almost daily, not at the margins but in our institutions, with plenty of examples – witness the Greens political party, the cultural sector and our leading universities.

In his Cook Oration, Leeser identified the corrosion of our once universal, equal and multicultural values. He says Jewish Australians are being typecast as symbols of privilege: “If you judge the actions of various state police forces, the Australian Human Rights Commission, and most of the equality, diversity and human rights apparatus that exists in this country, Jews – even when their physical security is threatened – are not worthy of any form of protection.”

We are witnessing a moral failure of elite leadership in Australia. Dutton was correct when he said this week the vilification of the Jewish community would not be tolerated if another group were the victims – Indigenous people, the Islamic community, Indians or Chinese.

As Leeser says, we now accept that racism is no longer treated as a truth, just a tactic to be deployed for political gain.

The tension between the Coalition and the universities is sure to deepen.

As Tehan says: “Our universities have a serious role to play in social cohesion, yet we see no leadership from them. We need to see the chancellors and vice-chancellors step up. There’s just a deficit of leadership on this issue.”

Here is the link:

https://www.theaustralian.com.au/inquirer/time-to-bust-the-migration-paradox/news-story/0c1e58dbaa60f2e928cc6d792c120fbb

I really wonder just what 250,000 to 500,000 permanent settlers are going to do to our various health services. Already we are seeing hospital, aged care and mental health services really struggling to cope and because of the time taken to stand up these services. It is going to get way worse before there is any improvement I suspect!

Skilled professionals in these sectors are in heavy demand around the world and that fact will surely not help solve the problem!

We need more skilled health migrants and we need to be training more health professionals here to keep up as well.

I fear this will be an issue for a decade or two at least.

David.