Category: Health

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.”

 

Sharp rise in youth homelessness shatters stereotypes

by James Farrell

The number of Australians who were homeless on census night increased by 17% to 105,237 in the five years to August 2011. When adjusted for population growth, the increase the increase is still worryingly high, at around 8%. It’s clear we need a stronger commitment to address this significant social issue.

The census data, released this week by the Australian Bureau of Statistics (ABS), continues to shatter the stereotype of homelessness: the middle-aged alcoholic or drug-addicted man sleeping in a park.

Rather, 60% of people experiencing homelessness were under 35 years old, and an incredible 17% were aged under ten. The ABS acknowledges that census methodology is likely to underestimate youth homelessness, so the number is probably higher than the estimated 44,083 Australians under 25 currently recognised as homelessness.

As subsequent research from the Australian Institute of Health and Welfare shows, these young people will be more likely to be involved in child protection and juvenile justice services, further entrenching their disadvantage.

Almost half (44%) of homeless Australians were women; with women and children the fastest growing group seeking assistance from specialist homelessness services. This number, however, does not include women and children remaining in unsafe housing and continuing violent relationships. The ABS recognises that data sources other than the census must be used to better understand the incidence of family violence and the consequences on housing security and homelessness.

In welcome news, the number of people “sleeping rough” (in improvised dwellings, tents or sleeping out) decreased from 7,247 in 2006 to 6,813 in 2011. But more people are sheltered in such substandard overcrowded housing as to warrant being classed as being homeless; this group increased from 31,531 in 2006 to 41,390 in 2011.

The homelessness rate grew by more than 20% in New South Wales, Victoria and Tasmania, with a gob-smacking 70% rise in the ACT. Meanwhile, the largest fall was in the Northern Territory, which still has (by far) the highest proportion of people experiencing homelessness (731 people per 100,000 population, compared with a national average of 48.9).

The ABS has acknowledged it has further work to do to understand and measure homelessness experienced by Aboriginal and Torres Strait Islander people, which goes a long way to explaining the NT’s massive homelessness rates.

The ABS report has been the subject of significant media coverage, much of it couched in terms of the failure of governments to reduce homelessness. But given the social and economic changes since 2006, it’s surprising that the growth wasn’t higher.

Rather than whacking governments, the ABS data shows a need for governments to continue their efforts to address homelessness.

 

 Committing to end homelessness

The Commonwealth’s 2008 white paper on homelessness, The Road Home, boldly aims to halve homelessness by 2020 and offer accommodation to all rough sleepers. Similarly, states and territories have introduced bold and targeted action plans to address homelessness.

These commitments have been underpinned by important agreements between the Commonwealth and the states and territories. The National Affordable Housing Agreement (NAHA) focuses on early intervention and prevention strategies, better assistance for people with multiple support needs, and providing ongoing assistance to ensure stability for clients post-crisis. The National Partnership Agreement on Homelessness (NPAH) outlines funding arrangements for specific projects and commits partners to addressing agreed outcomes through program delivery.

But these agreements end in June 2013, making the next few months a vital time for the agreements to be renegotiated. At his address to the National Press Club this week, Housing Minister Brendan O’Connor committed to providing half the funds required for another year while the NPAH is renegotiated.

The states are yet to meet this commitment and are seeking additional resources from the Commonwealth. Details will be discussed at today’s meeting of housing ministers in Brisbane.

In addition to resourcing, more work needs to be done to ensure homelessness services are sufficiently funded and effectively delivered. To achieve this, we need to establish a monitoring system with nationally consistent, evidence-based measures to assess the effectiveness of homelessness services. This will allow us to focus on the outcomes of people experiencing or at risk of homelessness, rather than just on the number of people being provided with services.

As the ABS figures show, homelessness continues to be a social crisis in Australia today. Governments, and the broader community, must redouble their commitments to address, and ultimately end, this significant social policy challenge.

James Farrell is currently a Director of the Council to Homeless Persons, Treasurer of the Federation of Community Legal Centres and the National Association of Community Legal Centres and a member of the StreetSmart Australia grants committee.

This article was first published 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

 

The power of control and reducing stress at work

For many, work means stress and as we all know, too much stress can lead to ill health. But research showing that people in positions of power are not very stressed, may hold clues for how workplaces can help reduce stress for all employees.

The difficult economic climate means many of us are being asked to “do more with less”, adding to the costs associated with the stress this creates. A critical challenge facing organisations then, is how to help employees effectively manage their stress, while maintaining optimal levels of performance and engagement.

One key strategy is enhancing psychological resources, such as control, social support, performance feedback, and access to information, which help employees meet their work demands. This issue is highlighted in a study published in the peer-reviewed journal PNAS that focuses specifically on the stress experienced by leaders.

Organisational leaders have demanding roles and face intense scrutiny of their performance. So it’s reasonable to expect them to experience the highest rates of work-related stress. But the authors of the PNAS paper demonstrate that leaders actually report lower levels of stress in comparison to other workers.

And they found this to be the case even after taking into account the sex, age, education, income, and mood of the study participants. Previous research has similarly established this counter-intuitive finding. So, why do organisational leaders report less work-related stress and ill-health?

The power of control

The authors of the study attributed lower levels of leadership stress to the greater capacity of leaders to exercise control over their work. They then conducted another study demonstrating that leaders who report a higher level of authority and have larger numbers of subordinates and direct reports, perceive a higher level of control over their work relationships. This sense of heightened control results in lower levels of stress.

These results are in line with research demonstrating that work-related demands are not uniformly stressful. And that facing more demands doesn’t necessarily equate to more stress. One of the key determining features of whether someone perceives a work demand as stressful or challenging is that person’s access to work-related and psychological resources, such as control, social support, feedback, and self-efficacy.

Indeed, research has consistently demonstrated that the highest levels of work-related stress are experienced by people who don’t have sufficient levels of control at work. In contrast, jobs that provide a positive environment and optimal health outcomes are not those with low demands, but demanding roles with sufficient access to control.

So while leaders undoubtedly face intense work pressure, greater responsibility, and a high-level of scrutiny over their work performance, they simultaneously possess a greater capacity to exercise control over their work environment. And control acts as a buffer against the otherwise adverse effects of high-level demands on work-related stress.

Intervention strategies aiming to increase control over how and when to undertake certain tasks and increase participation in decision-making are likely to reduce stress among workers. But sadly, increasing control and authority is neither possible nor desirable in many workplaces.

Protective forces

There are several other resources that are also beneficial for buffering against the adverse impact of job demands and for promoting positive outcomes, such as employee engagement, learning, and development.

Our research has demonstrated that support from supervisors and colleagues reduces burnout and psychological strain, while career-related support provided by mentors increases employee engagement over time.

People are also happier at work when they feel their organisation cares for and is concerned about its staff. They are more positive when good work by employees is adequately recognised, and when there are positive relationships between managers and staff.

Most significantly, the extent to which workers understand their organisation’s strategic priorities and their awareness of how their job helps the workplace achieve strategic objectives is linked with optimal employee outcomes, regardless of whether that person is a leader.

Leadership positions are naturally imbued with access to greater resources such as authority, control, support, and access to information. And leaders have greater capacity to influence the strategic direction of the workplace and shape their own personal roles to more effectively meet needs and manage demands.

Access to such resources for employees at all levels within an organisation is beneficial for managing work-related stress. And intervention strategies that focus on enhancing such access is likely to reduce the long-term economic and personal costs of work-related stress

Amanda Biggs is Post-doctoral Researcher at Griffith University

Originally published online at The Conversation

 


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