Category: Accountable Government

Tony Abbott’s $100 Million Broken Promise on Westmead Hostpital

The Abbott Government has broken its promise not to cut hospital funding by slashing funding for Westmead Hospital by $100 million.

Treasurer Joe Hockey also slashed $12 million in funding for St George Hospital, $10 million in funding for Nepean Hospital and $6 million for a new MRI at Mount Druitt Hospital.

The $100m for Westmead Hospital was funding the first stage of redeveloping Westmead Hospital. The total redevelopment would include

a new six or seven story ‘stack’ to consolidate the complex and critical care unit;

  • an expansion of outpatient and ambulatory care;
  • refurbishment of existing infrastructure; and
  • the repositioning of the front of the hospital.

Tony Abbott’s broken promise will hurt families who rely on Westmead Hospital and the critical services it provides.

Before the election, Tony Abbott promised not to cut hospital funding – now he has cut $100 million from Westmead Hospital and other hospitals in Sydney.

These health initiatives were axed by the Abbott Government on Tuesday:

In yesterday’s MYEFO, the Abbott Government confirms the funding cut on page 104.

COMMUNITY OUTRAGE AT O’FARRELL DECISION TO DUMP RADIOACTIVE WASTE AT KEMPS CREEK

At a public meeting in Penrith last night, Western Sydney residents have expressed alarm at Barry O’Farrell’s decision to dump 5000 tonnes of radioactive waste at Kemps Creek – a stunning breach of his promise before the 2011 election.

“Barry O’Farrell is ploughing ahead with taking radioactive dirt from Hunters Hill and dumping it on the people of Western Sydney,” Shadow Environment Minister Luke Foley said today.

This is a broken promise of epic proportions.  Mr O’Farrell assured the community that this transfer would never happen – yet tonight he dispatched his bureaucrats as the fall guys for his broken promise.

  • “To dump it in Western Sydney is stupid, it’s a threat, and it’s not the way any government ought to be behaving.” Barry O’Farrell, October 2010

Last month, the O’Farrell Government issued its Final Environmental Assessment for the waste transfer – confirming local residents’ worst fears:

  • “During the proposed Remediation Works, there exists the potential for some groups of people to receive an increase in radiation exposure.” (page 124, 8.1 Radiological Hazards)
  •  ”The half-lives of the radionuclides present in the impacted soils at the site are long, and radioactivity may not attenuate for hundreds of years. As a consequence, any waste management solution would need to be effective in the very long term.” (page 148)
  •  ”In the short term there would be some environmental impacts which would require mitigation [including] …risk of ingestion/exposure to contaminated material containing radioactive tailings and chemical compounds.” (page 233)

“The Premier’s own experts have confirmed that this soil is so toxic it will need to be monitored for radioactive decay until at least the 24th century AD.  Mr O’Farrell is condemning the people of Western Sydney to 300 years of risk from radioactive material sitting within metres from streets and homes. This decision says it all about Barry O’Farrell’s real attitude to Western Sydney.”

Penrith Labor councillor Prue Car said: “Barry O’Farrell is putting the local community last. The Government can hold public meetings until it is blue in the face – the blunt truth is Mr O’Farrell misled us.
“If this soil isn’t dangerous why not keep it in Hunters Hill?  ”If it is dangerous – none of us in Western Sydney want a bar of it.”

 

Spotlight back on PPPs as BrisConnections falters

by Flavio Menezes

News that BrisConnections, which operate Brisbane’s Airport Link M7, has suspended trade on the ASX as it continues to talk with its debtors is likely to again lead to a debate about the role of Public-Private-Partnerships – or PPPs – in providing government infrastructure.

PPPs have been criticised in the wake of several high profile failures including Sydney’s cross-city tunnel, Brisbane’s Clem 7 tunnel and the consortium building the Ararat prison in Victoria, as well as the high cost to the public of PPPs undertaken in the 1980s and 1990s.

Supporters will argue that the PPP model works because ratepayers will be protected if the company that built and operated the tunnel fails.

Both sides are mistaken. Economic research suggests that PPPs can deliver better outcomes than traditional procurement but often governments choose PPPs for the wrong reasons and fail to take key steps to ensure their success.

Under public procurement, the government finances the construction phase of the infrastructure, tendering the construction to private parties. The operation and maintenance of the infrastructure also may be contracted to private parties.

Under a PPP, a government tenders a “bundle” consisting of financing, construction and operation to private parties. The contract is usually for a fixed period at the end of which the asset reverts back to the government.

An important advantage of PPPs is the potential efficiency gains from bundling the construction and operations/maintenance.

When bundling occurs, the winning firm minimises the total of construction and maintenance/operating costs. So design and construction are undertaken in a way to minimise the total cost of the project over its lifetime.

Another potential advantage from the involvement of private financing under a PPP is in avoiding the construction of politically motivated white elephants. Private parties will find it difficult to obtain financing for a project that is not commercially sound. Arguably, the PPP failures reported above could be related to the particular structure of those PPPs rather than the underlying economics of the projects.

There are also, however, wrong reasons for selecting PPPs over traditional procurement. For example, governments may favour PPPs over public tendering to alleviate its budget constraints. This argument is clearly wrong when PPPs involve direct government transfers, such as minimum income guarantees or other types of payments. It is also wrong to the extent that the PPP project is financed by user fees — a revenue stream which the government gives for the duration of the PPP contract.

Governments can be also attracted to PPPs because they perceive this model shifts the demand risk from the government to the private parties. This argument for choosing PPPs is erroneous for several reasons. Firstly, the private parties bearing demand risk do so in exchange for a risk premium. To the extent that they cannot influence demand, the government may be the best party to hold the risk. Secondly, the upshot of the financial difficulties with projects such as the M7 Airportlink is that it will be very difficult to find investors willing to finance similar ventures in the future.

Third, in a number of cases in Australia and overseas, governments have bailed out failed projects, for example, by renegotiating payments or taking equity stakes. In such cases governments ended up bearing at least some of the demand risk.

There are ways in which PPP tenders can be modified to allocate risk appropriately. For example, research developed over the past decade suggests a tender process that allocates risks appropriately. The key idea is to run a least-present value of revenue tender. The winner of the tender is the firm that has submitted the lowest required revenue (expressed in present value terms). The innovation of this process is that the duration of the concession is variable.

The contract only expires when the winner of the tender recovers the amount of revenue bid. This type of tender allocates the demand risk to the government, reducing financing costs and ensuring that the benefits of PPPs over public tender are realised. This approach has been successfully tested in Chile.

In the past decade, we have learned a lot about what works and what does not in PPPs. To avoid previous mistakes with PPPs, governments need to ensure that there is a robust process for evaluating PPPs. Moreover, closer attention needs to be paid in the design of PPP tenders and contracts, as suggested by both economic theory and international practice.

Flavio Menezes is a Professor of Economics and currently the Head of the School of Economics at the University of Queensland.

A longer version of this article is at Australian Policy Online.

Media, unions and political parties seen as Australia’s most corrupt institutions

by Sunanda Creagh

The media, trade unions and political parties are seen as Australia’s most corrupt institutions but fewer than 1% of people have had recent direct experience of graft, a new poll shows.

The survey, titled Perceptions of corruption and ethical conduct and produced by the Australian National University’s Research School of Social Sciences, surveyed 2020 people aged 18 years and over by phone between August and September this year, with a response rate of 43%. The results were adjusted to represent the national population.

“Satisfaction with democracy in Australia remains high by international standards, although it is lower in 2012 than at any time since 1998,” the study said, with most concerns related to the quality of government.

“There is a widespread perception that corruption in Australia has increased, with 43% taking this view and 41% seeing corruption as having remained the same,” the report said.

The police and armed forces were seen as most trustworthy while the media, trade unions and political parties were seen as most corrupt.

“The media one is interesting because it confirms a finding across 25 EU countries earlier this year about the pillars of integrity in our community – the media again came down near the bottom,” said study author, Professor Adam Graycar.

“We’ve seen a number of media stories recently globally — the Murdoch scandal in the UK. There have been issues with talk back radio and the cash for comment allegations. This poll was done before the latest talk back controversy. But it’s a global phenomenon and the implications are important because of the very important role the media has in transparency,” he said.

While less than 1% of respondents said they or a relative had experienced corruption directly, “where corruption exists, it does have a serious and deleterious effect on government, on the delivery of our services and infrastructure,” said Prof Graycar.

While political parties were seen as corrupt, more than half of respondents see ‘almost none’ or ‘a few’ federal politicians as being corrupt and public scepticism of politicians’ motives has been stable since the 1990s, the study said.

Professor Mark Findlay, Deputy Director of the University of Sydney’s Institute of Criminology, said public perceptions on crime “often have very little to do either with personal experience or factual knowledge.”

“It is particularly interesting that police corruption is no longer viewed in the serious end (when, in fact, instances of such corruption, particularly in some states such as Victoria, see no sign of abating),” he said.

“This may be explained by things as tangential as new series of ‘Underbelly’ in this viewing season, or in more concrete variables such as a desire to believe in our institutions of public security in a political climate of border protection and prevailing concerns about local and national security.”

The loss of confidence in politicians and trade unions is troubling but consistent with a worldwide disillusionment with conventional institutions of representative governance,“ Prof Findlay said.

“What is more troubling is the belief in media corruption when, in other circumstances, the media is relied upon to expose public sector corruption. Maybe all this could be put down to the recent political scandals and degenerating level of political debate, and the biased and irresponsible role of individual media personalities in fuelling this state of affairs.”

Overall, respondents were mostly satisfied with the direction Australia is headed in, with the economy, immigration and employment topping respondents list of most important issues and concern for the environment on the wane.

Respondents were only asked about perceptions of corruption in public institutions, not private businesses or corporations.

Darren Palmer, Associate Professor in Criminology at Deakin University said the poll showed anti-corruption agencies needed to boost their profile.

“One of the most interesting and also somewhat surprising results is that almost half of the respondents indicate they would report suspected corruption to police. This flies in the face of the major restructure of mechanisms for dealing with corruption, whereby all jurisdictions have invested heavily in various anti-corruption agencies, including those dealing with allegations or suspicion of police corruption,” he said.

“More needs to be done by these agencies to enhance public awareness and access to their complaints processes.”

Sunanda Creagh is the Editor of  The Conversation.   Additional reporting by Bella Counihan.

This article was first published by The Conversation at www.theconversation.edu.au

 

Censoring public health in Queensland – a dangerous precedent?

Beyond the recent publicity around cuts to health and other portfolios, something deeply disturbing – even sinister – is occurring in Queensland.

The state government is implementing health policies on the run and cutting health jobs and services. This has happened before around the country and will eventually be turned around, albeit not before a deal of harm has been done.

Even this week, there is news of yet more cuts to prevention programs. But more disturbing still, and a move that should send alarm bells ringing around the country, is the Queensland government’s decision to gag health organisations, health professionals and public debate on health issues.

A number of of Queensland Health’s recent problems – from Bundaberg to payroll disasters – followed historical underfunding of key control processes, and came to light in part because concerned people had the courage to speak out.

There is a long history in public health of measures that were initially resisted or opposed, speedily becoming accepted as part of a modern, civilised society. We would not be one of the world’s longest-lived populations without advances in public health such as sanitation and safe water, safe food, safe environments, immunisation, control of infectious diseases, screening, speed limits, seat belts, random breath testing, and tobacco control.

Each of these advances met initial resistance. None of them – not a single one of the public health advances we now regard as vital – would have been implemented without public health advocacy.

A troubled history

There is nothing new about opposition to public health advocacy. When sanitary reforms were being debated in England in the 1850s, led by the pioneering epidemiologist John Snow, the London Times thundered, “We prefer to take our chances of cholera and the rest than be bullied into health by Mr. Snow”.

But Snow persevered, achieving changes that led the way to advances there and elsewhere. Since then, we have seen a plethora of public health advances because of pressure from health groups, whether professional organisations such as the Australian Medical Association (AMA), or issue-based non-governmental organisations (NGOs), such as the various cancer councils and the Heart Foundation.

These external pressures are often encouraged by health ministers who need help generating support for action in Cabinet and the community: after legislation or other action, they frequently express their appreciation to the organisations concerned.

It is reasonable and normal for governments to expect that public servants follow conventional protocols in relation to public comment. It is also reasonable to expect that NGOs engaged in advocacy do so in a sensible and civilised manner. It is, however, unreasonable and dangerous for governments to gag health NGOs, and to take action that will specifically preclude them from advocating for change.

Gagging order

Health departments traditionally fund large numbers of NGOs to carry out crucial work in the community. Queensland Health Department contracts with these NGOs will now be subject to censorship. Any NGO receiving 50% or more of its funding from the state will be precluded from advocating for state or federal legislative change – even from providing website links to other organisations’ websites that do so.

NGOs justifiably fear that the 50% figure is just a starting point, and that this censorship may ultimately apply to any funding. Many now dare not speak out. Even those not currently in receipt of funding but thinking of applying will feel constrained.

The condition relating to websites means that funded NGOs may not be able to provide links to organisations such as Cancer Council Australia, the Heart Foundation, or even the AMA and the World Health Organization, all of which advocate for legislative change.

Government-funded NGOs are often also funders of research, which may conclude that legislation or regulation is appropriate. The new Queensland Health approach will preclude reputable health organisations from even discussing the implications of such research.

An important 2007 paper showed that there was already cause for concern about suppression of information in the health sector. It noted international precedents where exposure and comment from outside government were crucial in preventing further public health catastrophes, such as the 1980 Black Report in the United Kingdom, the Chernobyl disaster in the Soviet Union, the SARS outbreak in China, and harmful mercury blood levels in the United States.

But why?

So what justification has the Queensland Government offered for its descent into the dark ages?

First, they assert that NGOs should focus on their “core activities”, not advocacy. But seeking action that will protect the health of the community is the most fundamental core activity for public health organisations. Even if they cannot understand this, it is outrageous that a government providing only some of an organisation’s funding should prohibit action carried out with funding from other sources.

Second, they state in relation to funded groups that “we would expect that organisation to conduct itself with the political impartiality of any other government sector.” This verges on the bizarre, given that by definition NGOs are not part of the “government sector”.

A third rationale now offered is that this condition will prevent abuses, such as the “Fake Tahitian Prince” scandal, and funding of NGOs to pursue political agendas. But any concerns in these areas should be addressed by protocols common to all governments (and indeed other funding agencies) about proper, well-monitored use of funds.

The fourth rationale is that the government is seeking “health outcomes, not political outcomes or social engineering outcomes”. The government is entitled to seek health outcomes from activities that it funds: but that is no justification for gagging the non-government sector.

It is desperately depressing that any health minister should use pejorative phrases such as “social engineering” to describe the aims of health organisations, and, by implication, the aims of his own and other health departments around the country.

The Queensland government’s approach has already met with some success. It has created a climate of fear. Beyond the AMA, whose Queensland president, Dr. Alex Markwell, has shown herself to be a true health leader, and some courageous public health academics, few in the state are willing to speak out, lest they be victimised and lose their funding.

These are dark days for public health in Queensland. The public health advocacy that has made our community so healthy will be hard to find. By contrast, commercial interests – in areas such as alcohol, tobacco, gambling, junk food, even firearms – are free to pressure governments at will.

Queensland, of all states, should have learned that gagging people in health from speaking out is a recipe for disaster. Censorship is the hallmark of a totalitarian regime; censorship in health sends out the signal loud and clear that the government neither understands public health nor cares for the future health of the community.

Other governments should condemn the Queensland approach though the Standing Council of Health Ministers; the Federal Government should bring all possible pressure to bear; and health professionals around the nation should use every available opportunity to make clear their distaste for this fundamentally unhealthy approach to public health.

Public health has been described as the conscience of the health system. It should be a matter of great concern for the entire community that any government is seeking to silence our conscience.

Mike Daube is Professor of Health Policy at Curtin University.

This article was first published online at The Conversation

 


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