Monday 2nd of August 2021

facebook to the rescue...

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Scott Morrison has shrugged off critics of his government’s slow vaccine rollout and insisted plans are on track, again turning to Facebook to reveal critical information about the nation’s much-maligned inoculation program.

The Prime Minister has come under fire for giving vaccine updates via social media instead of in-person press conferences, but Health Minister Greg Hunt defended the decision by saying the government wanted to give out information about scrapping vaccination targets “in real time”.

Twice in two days, Mr Morrison has used his Facebook page – which only has 626,000 followers – to announce vital updates to the COVID vaccination program.

 

On Sunday night, he admitted the government had abandoned plans to set any sort of vaccination targets.

Then on Monday, he went live on Facebook in a 10-minute video address that appeared to be an attempt to quell Australians’ concerns about the troublesome rollout.

 

Read more:

https://thenewdaily.com.au/news/2021/04/12/morrison-facebook-vaccine/

 

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the health lobby...

 

By John Menadue

 

The major barrier to health reform is the power of providers - the health lobby. A succession of Australian health ministers Liberal and Labor for three decades have failed in any serious health reform. We have been going around in circles. It is very depressing. The new shadow minister Mark Butler could succeed as Minister if he can find a way to manage and neutralise the provider/lobbyists.But not otherwise.And don’t look the the Commonwealth Department of Health and Ageing for much help. It was State Premiers, State Health Ministers and State Health officials who drove the fight against the pandemic, not the Commonwealth and its agencies.

 

Aneurin Bevan who launched the UK NHS  in 1946, in my view the best health service in the world, knew a few things about health but more importantly, he knew much more about political power and how to exercise it in the public interest. He drew on the strong support of the community, a minority of doctors and the majority of nurses. He won the day by outflanking the main body of doctors.

In Australia, in recent decades there have been numerous sensible proposals for health reform but providers have invariably run them off the road.

The resistance of doctors, for instance, is often based on financial self-interest, but it also aligns with a general fear of change and professional conservatism. It is difficult for those who are “inside” a system – be they administrators, professional providers or policymakers – to conceive of other ways of delivering services.

Institutional inertia is a strong force. And in health care which is a very complex system, it is easy to lose sight of the fact that delivering services is not, in itself, the objective. The objective must be serving the community, not providers.

Vested interests dominate the public ‘debate’.  The public, patients and consumers are ignored.

The rent seekers are the same groups who so selfishly and ferociously led the opposition to Medibank in 1974. They are still with us today but in a different guise. The AMA has a long and dubious history in opposing key health reforms going back to its opposition to the Pharmaceutical Benefits Scheme in 1942.

These vested interests include the AMA, the Australian Pharmacy Guild, the Private Health Insurance funds and  Medicines Australia. They all have well-resourced lobbyists to promote their interests. Lees than 30% of doctors are members of the AMA but the AMA is still able to frighten ministers and seduce the media.

In addition, there is a general “pro-business” push to open up more aspects of health care to the private sector, particularly pathology and radiology. And the AMA is turning a blind eye to the growing corporate takeover of general practice and vertical integration into radiology and pathology.

In 2009 the Australian Society of Ophthalmologists had a bruising battle with Minister Roxon who proposed that the Medicare rebate for cataract surgery be halved in light of major technological advances that dramatically cut time for treatment and reduced costs. The result was that the eye surgeons with their dishonest campaign with media support won. Again. The Minister backed down. Many eye specialists continue to gouge patients.

More recently there was private discussion between some doctors and the Department of Health to move away from fee for service, often known as ‘turnstile medicine’, to remuneration based more on salaries and contracts to provide better care for the chronically ill. The result? It didn’t happen because it was opposed by the  Royal Australian College of General Practitioners. It was same old story The providers won again and the interest of patients were not even  represented at the table for discussions

Price gouging by many medical specialists continues. Their anti-social behaviour is being ignored. They are too powerful to challenge. Minister Hunt recently said that the fees of specialists would be set out on a departmental web site so that patients could make  more informed decisions. But even that modest attempt at transparency was thwarted by specialist doctors. The minister did not proceed with his plan

The Pharmacy Guild strongly defends the privileged position of pharmacists. It has the major political parties in its pocket. The Guild  promotes  many restrictions on competition – prohibition on pharmacies in supermarkets, prohibition on price advertising, restrictions on location and ownership of pharmacies and exclusive rights to sell many non-prescription medications.  It treats its members as shopkeepers rather than highly trained professionals.

Through lobbying, faint-hearted governments are also very vulnerable to foreign pharmaceutical firms  ( Big Pharma) who are able to exploit their power in patents. Medicines Australia, the body representing manufacturers and distributors of drugs, successfully lobbies the Commonwealth to pay very high prices for prescription pharmaceuticals, much higher than in NZ.

The Private Health Insurance companies are expensive financial intermediaries, benefiting from a $12b annual taxpayer subsidy through the rebate, and additional support in the form of the Medicare Levy Surcharge, which subsidises those with high incomes to hold PHI. Not even at the height of manufacturing industry protection were people actually given cash subsidies to buy Holdens and Falcons. PHI is a scam.

Before the 2007 election, Kevin Rudd secretly wrote to the PHI industry  assuring it that their taxpayer subsidies would continue under a Labor Government.  We learned about it years later. The industry never publicly defends its $12 b pa subsidy. It is too ashamed. Instead, it lobbies in private. The private providers win again and again. The public interest seldom gets a look in.

The $12b annual subsidy to PHI is the real privatisation threat that is aimed at the heart of Medicare.

In an economy where many traditional industries, from manufacturing through to print media, are facing huge competitive pressure and disruption, health care is seen as a high  growth sector, offering easy picking for business. A  whole gaggle of lobbyists work  to help providers protect and advance their interests in the large and growing health sector.

The record of the Rudd and Gillard governments was very disappointing. The got off to a bad start by appointing a senior executive of a major health insurance fund as the Chair of it’s Health and Hospital Reform Commission. After leaving politics Nicola Roxon went on to become Chair of BUPA.

The one major reform on the Rudd/Gillard Governments was plain packaging of tobacco products. But that was easy because the AMA and doctors generally backed the reform

Part of the problem lies in the Commonwealth bureaucracy. Commonwealth Ministers for Health are very dependent on the Department of Health and Ageing, particularly, as is often the case, when ministers are not across the issues and don’t have a clear policy program themselves.

DHA is ill-equipped for policy reform. Its objective is to keep the peace with provider lobbies. The Department is structured in ways that reflects the interests of providers such as doctors and pharmacists, rather than on the basis of community interests, such as acute care, chronic care or demography. It has expertise in administering existing programs but it has little economic expertise.

Public Service reports of its performance have been highly critical. In 2015 the Australian National Audit Office pointed to major concerns about DHA’s administration of the Community Pharmacy Agreement. Crikey on 8 April 8 2021 pointed to numerous DHA failures as follows:

A 2018 audit of the department’s administration of the Abbott government’s Indigenous Australians’ Health Program was riddled with problems and four years late in delivering its objectives. Its tender process for a National Cancer Screening Register was heavily criticised in 2017. Its implementation of the National Ice Action Strategy came under fire in 2019. It is also a department that, as a result of repeated rounds of funding cuts, is ever more reliant on consultants: its spending on consultants has ballooned from $38 million in 2013-14 to $66.1 million in 2019-20.

Then there is the aged care mess and now the bungled vaccine rollout...

 

READ MORE:

https://johnmenadue.com/john-menadue-lobby-land-the-power-of-the-health-lobby-health-ministers-may-be-in-office-but-they-are-not-in-power-an-up-date/

 

 

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marketing scumrot...

The conflicting, contradictory pressures on Scott Morrison’s government and his grasp on the prime ministership were graphically displayed these past seven days.

This week was indeed a long time in politics.

Morrison started his latest horror stretch by losing control completely of his signature, self-styled “one job” for 2021 – the seamless, successful and rain-making rollout of the coronavirus vaccine.

 

After deploying the usual suite of absurdist over-promising, self-congratulatory, look-at-me promises and targets, Morrison was left without a feather to hide his immodesty, let alone fly with, as everything that could go wrong did go wrong.

The big bet on black, also known as the AstraZeneca vaccine, went south following a trifecta of bad news, compounding the homegrown setbacks.

Production in Europe hit more hurdles than you’d find in the Grand National Steeplechase, the European Union got stroppy and imposed some selfish trade bans, while some inconvenient blood clots among a handful of those getting this jab sapped public and political confidence.

Meanwhile, people were not getting access at the speed they thought was implied by those Morrison boasts: “front of the queue”, “leading the world”, “four million jabs by the end of March”, “a million doses a day from CSL” and everyone with a needle in their arm by November 1.

Morrison quickly turned and played three of his favourite rhetorical cards: it had nothing to do with me; here are the others we can all blame, and let’s rally some usual suspects to help with the work and construct shared protection from further public anger.

Changing narratives

The Prime Minister is nothing if not unimaginative. He’s the political equivalent of the busted, $5 watch – he might be right twice a day but he’s useless the rest of the time.

So we’ve gone from “the head of the queue” last year to “we have to wait until Europe gets its act together” a few weeks ago, and from “this is not a race” in March to “we’re on a war footing” by mid-April.

No wonder the public are dialing back the rediscovered trust in politics and politicians that emerged through the “we’re all in this together” single purpose effort to confront and combat the global pandemic a year ago.

 

Talk about turning goodwill into waste water.

This failure at the “one job” Morrison listed for himself (there were four other big tasks but this was given primacy) at the end of January, came as the Prime Minister further disappointed people generally, and women in particular, as he again looked incapable of understanding the emotional or material needs of more than half the population.

As we noted here last week, Morrison constructed his own trap last October when he went too hard, too aggressively and too unthinkingly by attacking former Australia Post chief executive Christine Holgate for some ostensibly unremarkable corporate gift extravagance.

The bully’s pulpit

He made those matters worse by refusing to apologise to Holgate who, by the evidence of her own chairman, was treated appallingly in a shabby display of political and corporate bullying.

Holgate said she wanted an apology and would be happy if she got one. Plenty of Australia’s senior business elite felt the same, as did a few key political figures, including some with vital Senate votes.

Morrison, who hates to admit error, refuses to accept responsibility and stutters at the thought of the word ‘sorry’, dug in. He may stay stuck in his own mud but being in quick sand is not a fun place.

With this swirling in the background, the good news arrived for the government.

Employment growth jumped out of the ground, amazing politicians and economists, including those in the front line public sector roles of keeping the government informed about what’s going on.

Just over 70,000 jobs were added to the rolls in March, pushing the unemployment rate down to 5.6 percent, mainly on the back of particularly strong growth in part-time employment, which rose by more than 91,000 to 4.2 million Australians.

Dumb luck to the rescue?

To underline the real strength of this outcome, the percentage of working age people looking for work rose to a new record high of 66.3 percent, with a higher proportion of women wanting jobs than previously. Also, the keenly watched under-employment rate fell by more than half a percentage point.

As these real world results gave heart to a demoralised government, the parallel universe of the stock market was back at record, pre-pandemic levels, and consumer confidence had supercharged as a descriptor.

So, while the government and the Prime Minister’s fortunes have been pushed and shoved through a series of own goals and dumb errors, the economy is telling Australians we are indeed the “lucky country”.

This might be enough to save Morrison’s hide. He might not deserve it – as the great political philosopher Clint Eastwood said in the stellar western Unforgiven, “deserve’s got nothing to do with it” – but he could be headed for re-election.

At the moment, Morrison is doing everything to spoil his own chances and he is running out of options to distract from his own myriad messes.

He may well be one big stuff-up away from oblivion.

Morrison remarked in the middle of 2020 that a lesson he’d learned from previous prime ministers was that most of them didn’t make the same mistakes twice. He’s showing us right now, in real time, he didn’t learn that lesson at all.

 

Read more:

https://thenewdaily.com.au/news/politics/australian-politics/2021/04/17/scott-morrison-election-chances/

 

Read also: scomo goes twerking troppo...

 

 

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self-scumboof...

 

Life used to be much simpler for all of us when everyone observed a few basic "givens" in Australian politics.

These include that the Coalition parties think the public sector is an inefficient abomination in whatever form it manifests itself, and that Labor thinks the opposite.

Events of the past week show how topsy turvy that has all become.

A COVID-19 vaccine program was the one service delivery job the federal government gave itself in the current pandemic and it puffed long and hard about how it had all been planned with exceptional military precision.

That was until this week, when it turned out that neither the supply nor distribution of the vaccines seemed to be quite working out as planned and the federal government has, once again, had to turn to the states, to get it out of a service delivery bind.

 

Whatever the supply questions (and the question of whether there should have been more contracts signed is for another day), the vaccination of aged care residents was contracted out, the delivery of vaccines around the country — including to doctors' surgeries — was contracted out to DHL and Linfox (rather than Australia Post), and the vaccination of the general populous was going to be done through the quasi private sector capacities of the GP network.

What could possibly go wrong when the full resources of the private sector had been engaged? 

Well, apparently quite a lot. And it looks like the federal government will have to politely ask the states to help use their public resources to get us out of a jam, just as they did with quarantine facilities.

Cheap shots and blame games

All this sharp planning was going on more or less at the same time as the chief executive of one of the few arms of government that actually does still do service delivery — Australia Post — was effectively sacked by a Prime Minister under siege on various fronts, including a dodgy $30 million land deal done by his government.

And what was she sacked for? Rewarding four executives who secured a deal which — wait for it — secured the delivery of banking services to 1,500 communities who would otherwise not have any.

 

here's been the occasional tendency by the government in recent days to blame the Opposition for the fact that the Australia Post chief executive in question, Christine Holgate, was sacked.

That's because Labor had asked questions about the Cartier watches given to the four executives as rewards for securing the deal. 

And it is true that in the all outrage about the appalling treatment handed out to Christine Holgate, Labor has been lucky to escape much attention for taking a cheap shot.

The question from Opposition Leader Anthony Albanese that provoked such outrage from the Prime Minister last October, after the Cartier watches rewards had been revealed, gives a flavour of the politics.

How is it, Albanese asked, that on the Prime Minister's watch:

"in the middle of the worst recession in almost a century, with one million Australians unemployed, businesses collapsing and a trillion dollars of liberal debt, this government's taking no action against the liberal appointed Australia Post board, which spent $12,000 of taxpayers' money on Cartier watches?"

The watches were actually a reward given out two years ago — long before COVID hit — and you can see who the actual target of the question was: the board, not Holgate.

But Labor's role in all this was lost in the prime ministerial outrage against Holgate that followed.

Scott Morrison had been "appalled" by the revelations. "It's disgraceful," he stormed. "And it's not on, Mr Speaker." 

And who's on the board?

It seems no-one asked what the story was about before the Prime Minister publicly humiliated Holgate in the Parliament. 

An independent investigation into this "disgraceful" episode was outsourced to a legal firm, Maddocks. The report found "no indication of dishonesty, fraud, corruption or intentional misuse of Australia Post funds by any individual involved in the matters relating to the purchase and gifting of the Cartier watches".

But it did find quite a lot of confusion about corporate governance. For example, there were:

"varying levels of understanding of the current and former Board members who were interviewed with regard to: the obligations of Australia Post's Board as the "accountable authority" for the purposes of the [relevant act covering public sector enterprises]"; and the requirements of guidelines for all such bodies "with respect to board and corporate governance and accountability obligations". 

The report said there were contradictory reports about whether the former chairman, John Stanhope, had approved of the rewards (even though he had signed the cards that went with them) and the deal was apparently bad because the non-executive directors (who hadn't issued any guidelines on gifts) wouldn't have approved of the gifts if they had known. Which they didn't.

So who is on the board of this multi-billion dollar taxpayer asset, but who only seemed vaguely aware, according to Maddocks, of their obligations?

 

Christine Holgate, under questioning from Labor in the Senate inquiry, gave us a form guide this week.

It includes Tony Nutt, former Liberal Party director, member of the so-called Star Chamber that has determined ministerial staff in the current government, and apparently the board member who is supposed to represent the unions and the postal agency franchisees (who have apparently never met him, according to other evidence to the Senate inquiry).

There is Michael Ronaldson, a former Liberal senator and minister, Bruce McIver, former president of the Liberal National Party of Queensland, Mario D'Orazio, "a personal friend of Minister [Mathias] Cormann", according to Holgate, and Deidre Willmott, who Holgate told the Committee "worked for the Liberal Premier in Western Australia [and] Minister Cormann used to work for Ms Deidre Willmott".

How well is the board doing?

Australia Post was corporatised in 1989 — that is, its structure was turned into something more closely resembling a private sector company than a government instrumentality. 

Corporatisation has been fashionable in recent decades: designed to make public sector organisations more efficient and more accountable for how money is spent and, hopefully, put the pressure on to ensure they are self-funding rather than a drain on the taxpayer purse. 

And that was what was happening at Australia Post — despite the huge forces at play on its traditional services from the internet, the decline of snail mail and the rise of online shopping.

 

But the political story of Australia Post only seems to show how such corporatised bodies remain at the whim of the prime minister of the day and a haven of high paying board jobs for political associates.

Yet another consultant report, by Boston Consulting Group, was prepared for the incoming and current chairman, Lucio Di Bartolomeo, in 2019 at the cost of $1.38 million. 

It darkly predicted Australia Post would be running at a loss by now and proposed a cut back in its retail presence and in its staff, and the possible hiving off of its lucrative parcel service.

Holgate thought that was a terrible idea. Australia Post has done very well on its current model. But the question of how well the current board is doing, and where the current divide between private and public sector now sits, remain unclear.

 

Read more:

https://www.abc.net.au/news/2021-04-17/christine-holgate-australia-post-topsy-turvy-givens-politics/100075394

 

 

Read also: https://www.yourdemocracy.net.au/drupal/node/39852

 

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