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"...public opinion deserves to be respected as well as despised" G.W.F. Hegel, 'Philosophy of Right'

good governance « Previous | |Next »
September 28, 2007

Whilst I was at the Australian Psychological Society's annual conference in Brisbane this week, I noticed that Joe Hockey, the federal Minister for Employment, was giving an address athe Brisbane Press Club in the Brisbane Exhibition and Convention Centre where the conference was being held. I didn't attend, and so I don't know what Hockey said but this op-ed in the Sydney Morning Herald can stand in its place.

In it Hockey argues that:

Good governments should be in the business of building opportunity, not imposing its views on others through overt regulation.....And the best foundation upon which to build opportunity - whether it be social, environmental or individual - is a strong economy....Significant government polices do not operate in isolation. Indeed, a government bolstered by a strong economy is better able to implement them. Tackling problems such as the water crisis or climate change is not cheap.


Shouldn't governments be concerned about a healthy population. Providing an opportunity is a means to wellbeing not the end of government policy. Hocky implies that a strong economy is the end of governance, and this can be reinterpreted to meaan prosperity. So Hocky understands wellbeing as prosperity.

Being wealthy equals quality of life, in other words. This view is contested by Lindsay Tanner,the Opposition finance spokesman, who argues that:

time is the currency of relationships. We use money to buy goods and services, but we use time to build and sustain relationships.The pressures of modern life are eating into our time and making it harder to lead a balanced, fulfilling life. Everywhere you look, you will see battles about time at the heart of contemporary political controversies. ...In contemporary politics, relationships are an afterthought. Everything revolves around measures of material wellbeing. The health of our relationships is just as important, but it's harder to measure. So it's usually ignored.

He adds that material wellbeing is at the centre of Labor and Liberal traditions and that it has taken decades for environmental sustainability to come to prominence. It has with climate change.

| Posted by Gary Sauer-Thompson at 1:29 PM | | Comments (12)


the Wilcox cartoon refers to a report about the Royal North Shore Hospital in Sydney---- Jana Horska was found in a toilet at the hospital on Tuesday covered in blood and holding a live foetus between her legs after waiting in acute pain for two hours to be seen. Another woman, Jenny Langmaid, told the Herald she miscarried in a toilet in the hospital's emergency department two years ago, and was forced to pull her 14-week-old foetus out of the bowl on her own.

It is being claimed that the State Government is underfunding the hospital to such an extent that it is "having to rob their own building funds just to keep treating patients". Around 30 per cent of beds had been closed at the hospital in the past 20 years, putting enormous strain on doctors and nurses.

things are pretty crook in Sydney. The NSW branch of the College for Emergency Medicine has called for an urgent ministerial taskforce to deal with a staffing crisis after several hospitals lost their training accreditation due to a lack of senior specialists to supervise junior doctors.

With an 81 per cent increase of medical graduates over the next seven years, the severe shortage of emergency specialists to train recruits had reached crisis levels. the hospital's director of trauma, Tony Joseph, said he had complained of a lack of beds and had constantly asked the Government for improvements to overstretched services to no avail.

women don't need to give birth in hospitals. In Australia women can receive personalised care from the same midwife throughout their pregnancy and birth journey.

This model is cheaper, safer, more effective and very popular with women.However, it is unavailable to 98 per cent of Australian families.

the problems bedevilling emergency departments in Sydney and elsewhere go well beyond failure to deal with miscarriages.

In Canberra, the ACT Health Services Commissioner has reported a 28 per cent increase in complaints about health services in the ACT, many of them directed against the emergency department at Canberra Hospital. These included instances of "serious misdiagnoses", including one case where an individual suffering fractures was sent home with a packet of painkillers.

One of the regular commenters over at Blogocracy signs off comments with "I live in a society, not an economy".

Hospitals are among the services that contribute to the well being of the society, as opposed to the economy, which have been allowed to deteriorate in favour of the user-pays ideal redefined to suit privatisation. Bad luck for the government that stories like these are proliferating right now. Bad luck as well that the professionals generally won't play into the blame-the-states argument.

Joe Hockey's statement as published echoes the wider view of the Howard Government and sounds suspiciously like the old 'protestant ethic', which roughly translates as -God rewards the good on earth with financial prosperity and goods/property.
Ergo, those who have to rely on the public health system are the undeserving poor.
The Australian Constitution imposes responsibility for health and dental care on the Commonwealth. Despite the Commonwealth having farmed out this responsibility to the States, it is not absolved of its moral responsibility in these areas.
As a footnote, an 89yr old frail-aged pensioner with a fractured spine was recently scheduled for an afterhours hospital discharge, only 24 hrs after the accident. This was alledgedly due to lack of bed space. Only his primary carer refusing to accept this situation saw him remain in hospital to receive appropriate medical care and a reasonable discharge plan.

one can agree with the Coalition pointing the finger at the NSW Labor Government for the problems at the Royal North Shore Hospital, where Jana Horska miscarried, without buying Tony Abbott's inference that those who want to see how federal Labor might run things should look at how state Labor ran them.

The point that is being made the reputation of the NSW Labor Government in running hospitals is appalling is a reasonable one. It applies to the other State Labor governments as well.They are a bloody disgrace in terms of doing very little to prevent the deaths that occur in the public hospitals.

That is the main reason why Kevin Rudd has promised to move towards a Commonwealth takeover of hospitals if the states do not agree to improve the way they are run.

public hospitals screwed down in Sydney NSW by a state government indifferent to investing in public infrastructure is an example of the private affluence and public squalor argument.

I cant see that hospitals run by the commonwealth would be any better than ones run by the state.What would be the difference? Besides any government that takes over the hospitals federally will automatically be voted out of office at the next election because every problem then becomes their problem. Thats why Abbott was told to shut up when he first started throwing the idea around. So Howard wont do it because he can blame Labor for the mess and Rudd wont do it because it will only end in tears.
So it wont happen.

But something needs to be done quick smart at Wagga hospital because it is currently run by Chimpanzees


Yes, it is a reasonable accusation. I wrote that last sentence then went off on a thought tangent about how it doesn't matter which level of government does stuff as long as it gets done. From there to what we think it's reasonable to expect compared with what it's reasonable for those in less fortunate countries to expect and endlessly off topic.

Our local paper carried a story today about another woman left to miscarry in a hospital without attention. I think Nan has a good point. Midwives are perfectly capable of dealing with these sorts of things and in my experience are better at the empathy bit that's needed at such a time.

There are alternative services for pre-natal and ante-natal care that we're just not making the best use of. These, along with patients who can't get into nursing homes, are using resources we don't have to spare.

The sad facts of the hospital situation is that most of these errors are occurring in the public system not the private system. That point needs to be made clear and I am sure that we would all agree on that. I am guessing that for the numbers of births in both systems the numbers of complications developing in the publics would be most likely double. I think it is much likely more but say double. Without sounding too Nazi it really is simple genetics and simple poor health choices that cause these complications and that can be attributed to other health areas.
You see that while home birthing and midwifes can be successful with mothers that are healthy in lots of cases they simply aren't qualified to be performing serious emergency procedures.
Blaming staff at hospitals is not the answer. My advice would be for those that poo poo the public system is to go and sit in the P.A emergency for a couple of hours ( my wife worked there) and it really is a battlefield.

Gary, I participated in a number of aspect of NSW Patient Quality or Risk managemet programs. Probably now they have other names. They were at a very high level and spread through the whole system incuding to Visiting Medical Officers who are also GPs. The quality effort has gained momentem over the last ten years. It has long way to go. It is very difficult to turn around an entreched culture shifting the blame on individual institutions or people to an analysis of the system when things go wrong. By the way where is the evidence that the private healyh sector has no quality problems. Some of the same medical people work in both places!
No one can escape the fact that much of the problem in public hospitals comes from the feds with holding money for hospitals. Couple that with the shortage of trained people and you get crowded emergency wards. Many peolpe are there because thay cannot get in to see their GP.Remember in rural areas the VMO and the GP are one and the same!
Another thought. GP services and pharmaceutical services are open ended financially
Hospital services are capped financially. Patients requiring services are not capped. You need the service you get it no matter how long you have to wait. It stands to reason with more people needing help you will get the problem we see today. It all need a rethink. That is what Labor is offering. Liberal are offering more of the same.