As noted, the Victorian abortion law reform bill has sailed through the (lower) house, and Archbishop Dennis Hart is throwing a massive tanty about it:
CATHOLIC hospitals might close their maternity and emergency departments if a proposed new abortion law is passed in Victoria next month, Melbourne Archbishop Denis Hart has warned….”Catholic hospitals cannot be part of any abortion. That has to be respected in the community. Even providing a referral is a co-operation in evil, and that impacts very strongly on us as Catholics,” he said.
Lauredhel has summed up the Bishop’s position quite succinctly: he’s prepared to let women die for his anti-abortion beliefs. Charming, and, as she says, all the more reason for the bill to be passed.
What I’d like to know is what the actual medical practice in Catholic hospitals around Australia. Does the Archbishop’s hardline position (which, as I understand it, is in line with the Catholic Church’s official position) actually get followed in Australian hospitals?
The Victorian Parliament is preparing to debate legislation to decriminalise abortion, and the Federal Senate is soon to debate Guy Barnett’s regressive proposal to abolish Medicare funding for abortion performed after the fourteenth week of pregnancy.
In this context, the BBC World Service’s interview with Dr. Susan Wicklund is indeed timely. This interview should be required listening for all Victorian MPs and Federal Senators over the next few days.
Other perspectives from Susan Wicklund on the realities of abortion and of women’s reproductive choices can be found here.
P.S. The first minute or so of the audio is not the Susan Wicklund interview but the tail end of the news bulletin which preceded it.
A couple of comments on the thread about reforms to Victoria’s abortion laws suggested that it’s likely to come down to a few votes in the Legislative Council (the state Upper House). If so, success in passing the legislation is likely to require persuading waverers with moral qualms about abortion to pass the bill. While trying to persuade such people is not completely novel (for instance, the overturning of the RU486 ban a couple of years ago), it’s not something I’m sure either side of the debate has a huge amount of experience in.
For instance, Leslie Cannold, as the head of Pro-Choice Victoria, recently published an op-ed in The Age. As an essay in the abstract, I think it’s a useful contribution to the argument. But, as a gut reaction, I don’t know whether these arguments are ones that are going to work on the fence-sitters.
But then, I’m not particularly sure what arguments are likely to be persuasive with people who are conflicted on the upcoming vote, and I’d like to have a better idea before I put pen to paper to write to my MLCs on the matter. Any thoughts?
Jim Edwards, over at BNet, has noticed a change of tone in GSK’s blog for weight loss drug Alli.
Why does a drug need a blog anyway?
Sold as Xenical in Australia, Alli is a fairly notorious drug; it last made news here in 2006 when Xenical advertising run during Australian Idol was criticised for targeting teenage girls. A complaint from Choice Magazine very nearly cost the drug its over-the-counter status, and the TGA revoked Roche’s ability to advertise the drug direct to the consumer in Australia.
The marketer of the over-the-counter version of the drug in the US, GlaxoSmithKilne, have a blog devoted to the “wonders” of the drug. As Edwards points out, a change in sales management has lead to a very a distinct change of tone; away from a chatty style with a focus on health and nutrition (albeit with a strong sideline in “buy our drug”), and on to a much more aggressive “if you’re fat and ugly (you know—anything larger than a size 10), you’ll feel better if you take our drug.”
Continue reading ‘Ask me how!!!’
ABC News reports:
The Victorian Government has introduced a Bill to State Parliament to decriminalise abortion.
The Bill allows unrestricted abortions in the first 24 weeks of pregnancy, but termination would have to be approved by two doctors after 24 weeks.
Currently, abortions are illegal unless a woman can show she is at risk of harm by continuing with a pregnancy.
Essentially, this is Option B from the Victorian Law Reform Commission report on the decriminalization of abortion. Most pro-choice advocates were advocating for Option C, which would have removed abortion from the scope of the criminal law entirely.
Continue reading ‘Abortion reform finally reaches Vic Parliament’
I’m not quite sure what it was, but there must have been one, because the AGI health checks on indigenous children in the NT last year did not record a single case. (Update: this claim of zero cases of trachoma recorded, taken from the post linked to below, has been contradicted, although the rate recorded is still extraordinarily low.)
Fred Hollows must be causing a scene around the Pearly Gates in the way he’s kicking himself for missing such a simple and effective solution to a common cause of blindness that was a special concern to him due to Australia’s central desert regions having the highest incidence of trachoma in the world.
The crucial ingredient in miraculously eradicating trachoma appears to be (drumroll) the recruitment primarily of recently-graduated doctors from urban and coastal regions (who’d never seen a case of trachoma before) to do all the health checks in a region where the condition is endemic. Voila! No cases of trachoma recorded! The previous incidence rate of 45% reduced to zero in one strike! Marvellous (and who knows what other medical conditions may also have been eradicated by this daring initiative?). Think of all the funding for blindness programs that can now be re-allocated because there are no more cases of trachoma in the central desert!
I suspect that this miraculous eradication method could quite possibly be effectively adapted elsewhere. What say you?
Update: some of you need your sarcasm meters recalibrated. Yes, the “miracle cure” is pure snark.
Update July 3rd: the Medical Board has now approved the registration of the recruited doctor. Now they just have to get him sorted with a Medicare provider number and he can start providing care to Dorrigo.
* * * * *
From today the two doctors who service the population of Dorrigo are on strike, and at least one of them has resigned from the local hospital as part of their protest: they will continue to attend life or death emergencies and to provide palliative care for the dying, but anyone else in need of medical attention who can make it down the mountain alive to the hospital in Coffs Harbour will be sent there.
Their reason? After finally successfully recruiting a third doctor to alleviate their horrendous workload and provide better services for the Dorrigo community, their overseas-trained recruit (now an Australian citizen) has not been able to gain approval for his registration as a General Practitioner, without which he cannot come and practise in Dorrigo. This final piece of paper was originally supposed to be issued in April when he passed his Board assessment with flying colours, but there has been bureaucratic delay after delay, based on a (ETA) compulsory and arguably inappropriately rigorous assessment of his English competency when he has been working in hospitals here effectively for the last 6 years.
Dr Herb and his colleague just heard that the approval of the registration application has been further delayed until at least the 2nd of July. Unsure of whether this will merely be delayed again, they have declined to renew the lease on the accommodation they had secured for their recruit and his family, as they have been paying hundreds of dollars a week on an empty house since March while waiting for the paperwork to be sorted out, and are unwilling to keep on doing so with no promise of a timely resolution. Suitable accommodation is difficult to find in Dorrigo, and they now don’t know whether, when their recruit is finally approved for registration to practise, they will be able to secure him appropriate accomodation at that time.
In utter frustration, they have decided to go on strike.
Below is the press release from Dr Horst Herb, which was forwarded to me privately by a third party. (I have contacted Dr Herb to ensure that this is definitely from him and that I have his permission to publish it.)
Continue reading ‘Dorrigo doctors on strike over bureaucratic delay in registration of an overseas-trained recruit to overloaded rural medical centre’
Much and all as their antediluvian internet access policy is annoying, if you want to be kept informed about important issues you pretty much have to read the Fin. Today, for instance, there was a report (brief summary here) indicating the difficulties the states and the federal government were having in implementing e-health. Apparently, plans to introduce universal electronic medical records - that is, storing your entire medical history in a centralized electronic database - have been delayed until 2012. 2012? 2009? I wasn’t even aware that a formal plan to introduce such a thing exists, let alone by 2009.
As previously noted here, there are very serious privacy and security concerns about such systems, as well as great potential advantages. If they get it wrong, there’s considerable potential for it to blow up in the government’s face.
So here’s my little question. Before we get to the stage of spending billions - rather than the $150-million odd already spent around the country on such projects - it would be nice if the privacy and security issues were thrashed out. At the very least, it might save a lot of money in redesigns after media pressure forces hasty changes. Are we going to have a public discussion of these issues, or are we going to get another departmental omnibus program that, like the Access Card, is going to be so flawed that the only thing to do once it’s announced to fight is kill it off? Maybe a discussion paper or two to kick things off the discussion, perhaps?
There’s nothing that annoys me more than science reporters who don’t understand that correlation doesn’t imply causation.
Then again, psychiatrists - heck, the whole medical profession - aren’t particularly good at statistics. Take this study
Stress from high housing prices and sporting failures is shrinking Sydneysiders’ brains, compared to those of their counterparts in Melbourne, an imaging study shows.
Royal Melbourne Hospital neuropsychiatrist Dennis Velakoulis and his team scanned the brains of 20 Sydneysiders and 20 Melburnians to look for differences in brain structure.
Did the researchers responsible control for the most obvious factor causing brain shrinkage in Sydney - excessive exposure to Ray Warren? Or was this taken into account, and the reporter simply omit to mention it?
Either way, what a joke…
Today’s Australian:
A NATIONAL system of registration for doctors is being finalised by federal, state and territory governments, which will help prevent cases such as that of Jayant Patel in Queensland and the “Butcher of Bega” in NSW.
Federal Health Minister Nicola Roxon yesterday said the Council of Australian Governments was expected to sign off soon on a national registration system for health professionals.
“It will make a difference to ensure high standards across the whole country,” she said on ABC television. “It’s no solace to the people who are victims of the treatment for now but it needs to be proceeded with.”
The current system for registration of health professionals is done by medical boards in each state and territory. The COAG proposal is to replace this with a national process overseen by nine separate boards for all the different health professions.
Ms Roxon’s comments were made in relation to the so-called Butcher of Bega, deregistered former doctor Graeme Stephen Reeves, who allegedly performed unnecessary and sometimes horrific gynaecological procedures at Bega and Pambula hospitals on the NSW south coast over several months in 2002.
Self-regulation in most professions has been problematic, so it’s beyond time to have an external oversight system properly put in place for the health professions. It’s only shameful that it took a case as full of blatant system failures as that of Dr Reeves to finally get some action.
Interestingly, I hadn’t heard this before in all the recent coverage (emphasis mine):
The board maintains Mr Reeves was able to dodge the restriction because he moved from Sydney to take up a new post in Bega and at the time legislation prevented the board from passing on details of the ban to his new employer.
Really?
Kudos also to the NSW Government for planning to institute a system of mandatory reporting for medical personnel of medical misconduct by their colleagues. Such systems have been recommended by watchdog groups for years (decades?) of course, and who knows how many unnecessary harms could have been avoided if such systems had been in place for all that time, but at least it’s finally happening.
Next: regulating the specialist medical colleges so that they can no longer unreasonably inflate their incomes by maintaining an artificial scarcity of medical specialists. Isn’t competition meant to be healthy?
Crossposted from Hoyden About Town (related post by Lauredhel)
With the news that the Commonwealth Treasury has flipped the switch to looking after our wellbeing, it might be timely to take another look at the Affluenza crew. The “less is more” perspective, associated in this country with Clive Hamilton, has its international incarnations - and indeed it must be a deliberate choice to eschew the vulgarity of intellectual property in book publishing that accounts for so many titles being published with the name “Affluenza”. I was going to have a rant about this (and I was going to rant, among other things, about the irony of economists of all people - exponents of the “dismal science” - being in the business of calculating what makes us happy), but perhaps fortunately for LP readers, Brendan O’Neill of spiked.com got there first in a recent book review in the New Statesman - his text being Oliver James’ The Selfish Capitalist: Origins of Affluenza.
Like O’Neill, I’m of that perhaps antiquated stamp of person who believes that the aim of the left should be to secure liberty through maximising equality in solidarity with one another. Call me an Enlightenment tragic, if you will, but the founders of the American constitution were quite right to describe “the pursuit of happiness” as a constituent principle of liberty - not state diktats about what will make us happy. Being on the left, I think that that pursuit is best pursued collectively, but some sort of quasi-Fabian and neo-puritan arbitration on individual choice should not be the core of the left’s purpose, still less the narrowing of the affective register in favour of a “therapy culture” and the creation of a brave new world of shiny, happy people. But, I appear to be ranting, so here’s O’Neill. (See also this review in spiked.)
Continue reading ‘Against herbal tea socialism’
For a different perspective on Australia’s health system, some fascinating American research about death rates from conditions treatable with good-quality healthcare, such as complications from surgery, certain cancers, heart disease, and the like, across 14 developed countries. Over the fold, a couple of charts that summarise the key findings: Continue reading ‘Australia’s health system OK, by world standards’
Why is the number of medical specialist geriatricians in the USA declining so sharply at a time when the population is aging so rapidly? (And is the same thing happening here in Australia, and elsewhere in the affluent West?) Below is an excerpt from a fascinating lecture by Atul Gawande, Harvard Professor of Surgery, about “What makes a good doctor, and how do the best hospitals work?”, broadcast on Radio National’s Background Briefing (this is from near the end of the transcript).
Kirsten Garrett: A member of the audience asked about a recent article written by Professor Gawande in The New Yorker magazine, in which he had discussed among other things, the decline in specialists in geriatrics in America. And the need for patients themselves to ask for good care in old age.
Atul Gawande: One of the reasons why I went into such excruciating detail about how your teeth start to age, and what happens is your hair roots start to lose their cells, is that I wanted people to grasp the difference between recognising that we are ultimately going to die and having the fantasy we all have that well maybe we can somehow live forever. And what it comes down to is the idea of the geriatrician.
Does anybody clamour for geriatricians? We’ve had a drop from 1998 to 2004 in the number of geriatricians in our country, by one-third. At a time when the number of elderly are increasing enormously. In just a decade we’re going to be a 20% of the population being over the age of 65.
Now part of the reason people don’t clamour for the geriatrician is what the geriatrician does. What the geriatrician does is they don’t make your life longer, they help figure out how to be attentive to your nutrition, and whether your toenails are clipped and whether you have good balance and whether your strength is there, and whether you’re exercising, and whether your eyes are doing well. All the things that you need in order to stay independent, to have control over your life.
Continue reading ‘But if we value it, we actually would transform what it’s like to age’
Been wondering what’s happened to “values” and the culture wars in this campaign? So have I, and I’ve had a stab at an answer to the question over at the ABC’s election op/ed site Unleashed.
Originally posted at LP in Exile.
In our last big discussion on problems in the public health system (regarding the Coalition plan to initiate a revamped hospital training program for new nurses) a lot of us pointed fingers at the bean counters as the reason why hospital nurses no longer have time to provide patients with the emotional support that used to be a core feature of nursing, a support which patients - sorry, should I use the bean-counters’ preferred term, clients? - regularly complain about no longer receiving.
In all the discussion of last week’s hospital scandal about the woman who miscarried in the Royal North Shore Hospital (RNSH) Casualty toilet area while waiting for obstetrical assessment and a bed, people (including the NSW Health Minister Reba Meagher with her knee-jerk directive which has no funding or staffing attached to implement it, and Federal Health Minister Tony Abbott’s Fantastic Voyage advocating the olden days of competing and duplicative local boards) seem mostly upset about the reported lack of sensitivity and emotional support shown by the staff in the system. With all the sympathy in the world for the woman’s ordeal and the couple’s emotional trauma, I think this focus misses some key points about the fundamental reason that ER departments regularly have unacceptably extended wait times, which is not just about understaffing and overwork in the ER itself.
Continue reading ‘Capacity, utilisation and peak demand’
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