John Menadue

  • Mike Steketee. COAG and hospitals: look beyond the funding to fix our health system.

    Before Malcolm Turnbull and the states start haggling over hospital funding, it’s worth looking at why the system costs so much to run. Maybe it’s not just cash, but waste and inefficiencies that need addressing, writes Mike Steketee.

    Why do our hospitals cost so much to run? Like$55 billion a year and rising rapidly?

    It is the question worth asking before Malcolm Turnbull and the premiers start haggling at today’s COAG meeting over how best to pour more money into hospitals. Yes we are an ageing population and the health system is devising ever more clever ways to treat us.

    But that is not all that is going on. If you are 55 or over living in Fairfield in western Sydney, your chances of having knee arthroscopic surgery were 185 per 100,000 people in 2012-13. In Bunbury in Western Australia, the chances were more than seven times greater – 1319 in 100,000.

    Are there that many more dicky knees in Bunbury or at least ones that require hospital surgery? Or is it that many older people in Fairfield have been denied necessary surgery?

    Not likely on either front, according to the Australian Commission on Safety and Quality in Health Care, funded by federal and state governments. As it said in November:

    Despite the evidence that knee arthroscopy is of limited value for people with osteoarthritis and may cause harm, more than 33,000 operations were performed on this age group during 2012-13. Many of these people will have degenerative disease in their knees and will not benefit from this intervention.

    It added that, even if you argue the extremes distort the picture and take out the areas with the highest and lowest rates, hospital admission rates for arthroscopy still varied more than four times between local areas.

    The Commission found an overall variation of more than seven times for cataract surgery, which was performed 160,489 times on those 40 or over in 2012-13. Age differences between areas do not come anywhere near explaining variations of this size.

    For lumbar spine surgery for those 18 and older, the variation was 4.8 times. This included spinal fusion procedures, for which the Commission said there was limited evidence of its effectiveness for painful degenerative back conditions.

    And so on. Carried across a hospital system which saw 9.7 million admissions in 2013-14, this suggests that a great deal of money is spent unnecessarily.

    John Dwyer, emeritus professor of medicine at the University of NSW, has had a stab at estimating the waste generated by doctors across the whole health system and comes up with a figure of at least $10 billion a year. As they say, a billion here and a billion there and soon you’re talking serious money.

    A Productivity Commission research paper last year made a similar point:

    Governments and patients spend a considerable amount of money on health interventions that are irrelevant, duplicative or excessive; provide very low or no benefits; or, in some cases, cause harm.

    Despite all this, the Australian health system delivers some of the best outcomes in the world, other than for Indigenous people. But costs are rising rapidly, in part because of too little control over waste and too much emphasis on hospital treatment.

    Knees seem to be one particular problem. Knee replacement surgery was performed at the rate of 191 per 100,000 population in Australia in 2013-14 – 61 per cent higher than the average in 30 OECD countries.

    Overall, admissions for longer than day surgery in Australian hospitals are lower than some countries such as Germany but higher than those with which we often like to compare ourselves, such as New Zealand, the UK, the US and Canada. The last of these had a rate of admissions half of that in Australia.

    The Productivity Commission paper canvasses some of the weaknesses that apply across the whole health system but often culminate in expensive hospital treatment. It says governments subsidise many health treatments that have not been assessed for clinical and cost effectiveness.

    Often clinicians do not realise they are over-diagnosing patients, providing superfluous or harmful treatments or applying valuable treatments in the wrong way. Clinical guidelines … can be an effective way to promote high value medicine but they are often too complex, out of date, lack credibility or poorly implemented.

    Doctors are often resistant to change, including in acting on the findings of evidence-based medicine, arguing that their training equips them to know best the needs of individual patients. The way they charge – on a fee-for-service basis – is an incentive to provide more services than are necessary.

    The initiative announced by Malcolm Turnbull and Health Minister Sussan Ley on Wednesday to trial a different way of treating chronically ill patients, who often have multiple conditions, is an attempt to address some of these problems. At the moment, they said, such high users of the health system saw up to five different GPs a year, making it more likely they would fall through the cracks and end up in hospital.

    “Half of all potentially avoidable hospital admissions in 2013-14 were attributed to chronic conditions,” they added. Under the two year trial, one GP practice will co-ordinate the care of these patients and receive quarterly payments. This shifts the emphasis to improving the overall health of the patient, rather than charging for individual treatments.

    Turnbull and Ley hailed this as “one of the biggest health system reforms since the introduction of Medicare 30 years ago.” However, we shouldn’t get too carried away: various forms of co-ordinated care, including for chronic illnesses, have been tried for at least the last 20 years, with mixed results. Nevertheless, an increased emphasis on primary care – that is through GPs and including prevention programs – is crucial to keeping people out of hospital.

    These potential savings are before we even start talking about inefficiencies in administering the health system. With both the federal and state governments putting money into public hospitals, there is bureaucratic duplication on a large scale.

    Each level of government blames the other for deficiencies in hospitals. As well as blame shifting, each is constantly manoeuvring to shift costs on to the other. For example, hospitals, which are run by the states, are forced to keep elderly patients in beds costing $1200 a day because there are not enough places costing only $200 a day in nursing homes, which are funded by the federal government.

    Turnbull is right in suggesting this week that if the states raised more of their own revenue – for example, through his proposal to let them levy income tax – it would make them look more carefully at how money was spent. At the moment, it is much easier to beg Canberra for more money than to make voters cough up through taxes.

    It is just that experience suggests that the main effect of Turnbull’s idea would be to put even more pressure on hospitals. In most areas where they already have the power to raise taxes, the states have competed with each other to bid them down, such as through ever more generous exemptions for payroll tax and land tax.

    Of course, if Canberra stood firm on the states solving their own problems, it would force them to tackle some of the waste and inefficiency in their spending – either that or allow hospital and other services to run down and cop the wrath of voters. But then the states would just try to blame it on Canberra.

    Mike Steketee is a freelance journalist. He was formerly a columnist and national affairs editor for The Australian. This article was first published in The Drum 1 April 2016.

     

  • If we strike a deal with Japan, we’re buying more than submarines.

    In this article in the Melbourne Age, Hugh White comments

    ‘So before we decide whether to select the Japanese (submarine) bid, we have to ask if an alliance with Japan is good for Australia.’

    See link to full article below:

    http://www.theage.com.au/comment/if-we-strike-a-deal-with-japan-were-buying-more-than-submarines-20160314-gni3hl.html

  • Evan Williams. Eye in the Sky. Film review.

    I’d just come home from a screening of Eye in the Sky, Gavin Hood’s fine thriller about a terrorist cell in Kenya, when the news came through that Taliban suicide-bombers had killed more than a hundred people in Pakistan. Timely reminders of the reality of modern warfare and its distinctive horrors aren’t hard to find these days. A couple of weeks earlier we had the ISIS attacks in Brussels; before that it was Paris. Stories abound of Al-Shabah atrocities in North Africa, and the nightmare in Iraq and Syria shows no sign of ending. There’s still plenty of scope for filmmakers.

    But it’s not just its brutal topicality that gives Eye in the Sky such devastating impact. It’s a riveting suspense thriller, impeccably crafted with a clear moral dimension. We are forced to confront some troubling questions: Does individual conscience have a legitimate role in modern warfare? Are we justified in taking innocent lives in pursuit of a just and overriding military objective? Are drones an immoral weapon, as some have argued, because their “pilots” are immune from counter-attack? Hood’s film opens with an on-screen quotation of Aeschylus’s famous line: “The first casualty in war is truth.” But can there be any truthful answers to these questions?

    Eye in the Sky is fiction (the screenplay is by Guy Hibbert), but it’s rooted in real events. More than once in the film we are reminded that Al-Shabah bombers killed 67 people in an attack in Nairobi two years ago. Helen Mirren plays Colonel Katherine Powell, a US intelligence officer in charge of a joint British-American rescue mission aimed at capturing a radicalised British woman who has joined a terrorist cell. The woman has been traced (along with a radicalised American) to a safe house in a Nairobi suburb.  Powell’s orders are “to capture, not kill.” But when she discovers that the safe house shelters three suicide-bombers preparing another attack she convinces her superior officer, General Frank Benson (Alan Rickman), to launch a drone missile and blow the house to bits.

    All is ready to go. The drone hovers overhead, and far away – in some air-conditioned US base deep in Nevada or wherever – a finger is poised on the trigger. But at the last minute the drone’s spy camera detects the presence of nine-year-old Alia, a Kenyan girl selling home-baked bread on the street. Sitting at a little table outside the safe house, she would almost certainly be killed if the missile were launched. (According to the jargon, of which we hear much, it’s a case of “95 percent CDE” – an estimated 95 percent chance of collateral damage, ie, the loss of innocent lives.) Should Alia be sacrificed? The steely-eyed Colonel Powell argues that she should: many more children’s lives will be lost if the suicide bombers are spared. A nervous attorney-general sees no legal objection to the raid, but refers a decision up the line to the foreign secretary (Iain Glen), who has qualms of his own and wants the PM’s approval (not to mention that of the US secretary of state, who is playing ping-pong with Chinese officials in Beijing when the call comes through).

    Indecision and buck-passing are among the film’s main themes, and Hood pokes some gentle fun at the dithering politicos. For a moment I wondered if the PM would refer to the final call to Buckingham Palace, in which case we might once again see Helen Mirren playing Her Majesty (as she did so well in Stephen Frears’s film The Queen). But no such luck! Mirren has a big enough part as it is, and I doubt if she’s ever given a harsher and more intensely focused performance. There’s strong support also from Alan Rickman, whom many will remember as the sinister Severus Snape in the Harry Potter films, or (for those who are old enough) as the Reverend Obadiah Slope in the TV series Barchester Towers. (Rickman died last January and the film is dedicated to his memory.)

    The final moments are brilliantly suspenseful, and audiences may feel a little guilty for desperately hoping (as I’m sure they are meant to) that the deadly attack will be launched. Or is it that, addicted as we are to violent spectacle, we want a climactic big bang to round off the movie? It’s a fine film, but I wish I could say that all its moral issues are resolved. Perhaps they never can be. In 2006 I praised Hood’s film Tsotsi, also set in Africa, for its memorable portrayal of life in the impoverished black townships, the appalling contrast between the lives of the rich and the poor. I felt something similar with Eye in the Sky as I watched those political big-shots, in their elegant, softly-lit, wood-panelled chamber, plan their lethal raid while Kenyans are living in squalor.

    And when it comes to war, how do we compare numbers? Politicians had no qualms about the Allied carpet bombing of German civilians during World War II, when countless children were burnt alive. Nor did anyone lose much sleep at the time over Hiroshima and Nagasaki. But in Eye in the Sky our leaders agonise over the fate of a single child. This may well be a sign of moral progress, but somehow I doubt it.

    Four stars

    Eye in the Sky, rated M, is in national release.

    Evan Williams reviewed films in The Australian newspaper for 33 years. He is a Life Member of the Film Critics’ Circle of Australia for services to film criticism and the film industry.In 2015 he received the Geraldine Pascal Lifetime Achievement Award for critical writing.

  • Mike Steketee. Election 2016: Beware the (very) long road to ruin

    The risk with such a long election campaign is that unanticipated events can scuttle a party’s chances. And in the 2016 campaign it’s the Coalition that has everything to lose, writes Mike Steketee.

    Elections can throw up many imponderables and the longer the campaign runs the more likely they are to do so.

    After Bob Hawke won in 1983 against Malcolm Fraser, his personal popularity and that of his party kept rising. The drought broke – although not even Hawke claimed credit for that – and the economy was on the way back up after the worst recession since the Great Depression.

    Hawke called an election for December 1, 1984, only 21 months into his first term. Most prime ministers announce the election date close to the minimum time required by law, which is 33 days.

    But with the polls showing a swing to Labor, Hawke was so confident that he declared the date almost eight weeks before polling day. After all, voters loved him, and his opponent, Andrew Peacock, was a political pygmy whom he would cut down to size further during the campaign.

    Or so it seemed. But it did not turn out that way. Instead of a swing towards the government, there was a swing against it of 1.5 per cent after preferences. Its majority in the lower house was almost halved after taking into account an increase in the size of parliament.

    Hawke was reduced from political messiah to mere mortal. Paul Kelly records in his book The End of Certainty that Peacock started the campaign with a leadership rating of 19 per cent and finished on 54 per cent.

    Labor’s campaign director Bob McMullan said in his election post-mortem, quoted by Kelly, that:

    I believe it would be universally agreed that the election campaign period was too long … the party did not examine the implications of the length of the campaign for its strategy.

    This week Turnbull as good as announced the election almost 15 weeks before polling day, making the campaign nearly twice as long as in 1984. While the formal election period will not start until Parliament is dissolved, on the current assumption that the Senate will fail to pass the Australian Building and Construction Commission bill, Turnbull already has lost one advantage the system gives prime ministers – an element of surprise over the date of the election. With the election so far off but the date known, his opponents can ensure they are fully prepared.

    True, July 2 had been prominent in the speculation because of the mechanics of double dissolution elections. But long campaigns mean there is more time for things to go wrong. When British prime minister Harold Macmillan was famously (or apocryphally) asked the greatest challenge he faced as leader, he replied “events, dear boy, events”.

    Unanticipated events can damage or favour either side but the frontrunner, which is the government, has more to lose. The reason prime ministers generally call an election close to the minimum time required is to maximise the chances of a winning position holding until election day.

    One of the things that went wrong for Labor in 1984 is that the opposition set the agenda and the government spent much of the time on the defensive. Peacock seized on a theme and stuck to it: promising a Coalition government would abolish the assets test on pensions and the tax on lump sum superannuation, both introduced by the Hawke government, and running a scare campaign against a capital gains tax and death and gift duties, which he said Labor would bring in “as certain as night follows day”. (He was proved correct on the first but not on the others).

    Hawke countered with the promise of a tax summit after the election, which left Labor’s options commendably open – today’s political parties please take note – but also gave Peacock more ammunition for his scare campaign.

    Peacock repeated his core lines ad nauseum, to the point where he was ridiculed. But it proved the truth of the saying that once the political cognoscenti were completely sick of hearing the same message, voters were just starting to take notice.

    One consequence of firing the starting gun for an election is to raise the standing of the opposition leader. He or she is, after all, the alternative prime minister and the media provides increased coverage.

    In particular, the traditional leaders’ debate or debates will put Bill Shorten on an equal footing with Turnbull. Given their relative position in the polls, expectations of Shorten’s performance will be low so that, if he comes anywhere close to matching Turnbull, he will have gained.

    Then there are the policies. How will voters possibly be kept engaged over the remaining 14 weeks? Of course the answer is that they won’t. Undecided voters – the ones that election campaigns are all about – are making up their minds later and later – often in the last week or two. That is why in recent times the official election launch, one of the major media events, has been pushed closer and closer to the election date.

    Moreover there are more undecideds than in the past: major parties used to be able to rely on about 40 per cent of voters sticking with them through thick and thin. Now it is closer to 30 per cent, leaving a potential swinging vote of 40 per cent.

    But even when voters are not paying much attention, the election space has to be filled and the onus to do so rests more heavily on the government. Leaving a vacuum by having nothing much new to say for days or weeks is dangerous. It provides an opening for your opponents and it robs you of momentum. A government perceived to have run out of ideas can feed into a broader re-evaluation by voters.

    The polls suggest that there is a strong underlying sentiment that it is too early to bring back Labor and that it needs to do much more before voters are prepared to entrust it with managing the economy again.

    It does not even need the increased media attention of an election campaign for that to occur. Labor gained ground recently, at least for a while, by announcing a definite policy on taxation while the Government was dithering, as it still seems to be, over what to do.

    Turnbull has started by campaigning on the need for the building commission to police thuggery and criminal activity. The Heydon royal commission has provided him with plenty of raw meat with which to flail trade unions and Labor.

    But the Liberals have not gained a great deal of traction from union bashing in the past, perhaps because that is what voters expect the Coalition to do. Certainly Turnbull will need more arrows in his quiver to maintain momentum.

    The Government has the advantage of handing down a budget on May 3 – a major opportunity to seize the initiative and sell its wares. No doubt the Government will have a bag of goodies to deliver but how widespread will be their appeal is another matter.

    The latest in a numbing series of changes of thinking on tax policy is that the budget will not have much room for income tax cuts but will include a reduction in company tax as the best way of stimulating economic activity and higher wages. Humphrey Appleby would call that a “courageous” decision. It would be a tough sell, particularly with the stream of revelations about the creative accounting used by businesses to minimise their tax, not to mention screwing their customers.

    Besides, the budget will be two months before the presumed polling day. In election campaigns, that is an eternity.

    Elections can create their own dynamics and sometimes throw up completely unexpected outcomes – most recently the defeat of the first term Newman government in Queensland, despite its record majority, and before that Jeff Kennett’s loss in Victoria in 1999 and Paul Keating’s victory over John Hewson in 1993.

    Nevertheless it is rare for first-term governments to be defeated and in the end, none of the potential hurdles facing Turnbull may amount to much.

    In 1984, Peacock generally was judged to have won the campaign but he still lost the election. Currently, the polls suggest that there is a strong underlying sentiment that it is too early to bring back Labor and that it needs to do much more before voters are prepared to entrust it with managing the economy again.

    Turnbull’s task will be to keep those sentiments predominant in people’s minds.

    Mike Steketee is a freelance journalist. He was formerly a columnist and national affairs editor for The Australian. This article was first posted in The Drum on 25 March 2016.

  • Garry Woodard. Should Australia do more on the South China Sea?

    No. The Prime Minister’s statement in regards to the Middle East that this is not the time for gestures or machismo applies in spades to what we do in the South China Sea. Australia should act prudently and, though some will see this as a contradiction, transparently and after full parliamentary and public debate.

    Australia’s relative propinquity gives us an interest in the outcome of the territorial disputes between countries in the South China Sea, but will our interest in seeing a peaceful resolution be helped or harmed by introducing an Australian naval presence? As Australia already has a naval presence in the North China Sea, and northwest Cape supports intelligence collection there, are we not bound to see the China Sea as a strategic whole? Is this not the strategic perception of the US Seventh Fleet?

    Sir Arthur Tange wrote from close observation of ‘the US Navy’s global view and the nuisance they found in other people’s sovereignty’. If we put ourselves in China’s shoes would we not have the same strategic perception? Do we understand China’s thinking? What if the most recently reported militarisation of Woody Island is defensive, to improve intelligence gathering against a perceived threat, rather like the extensions built northward from the Great Wall to get better forewarning of the threat from the Mongols? If the strategic perception should be of the China Sea as a whole, the core problem is China’s unfinished reunification.

    Nobody who heard Deng Xiaoping on the subject could doubt the emotional pull of seeing Taiwan rejoin the motherland, even if in accordance with Mao’s timetable of 100 years.

    Australia, unlike greater powers, avoided involvement in the Chinese civil war. As Michael Fogarty described in a recent book review in Australian Outlook, had it not been for the skill of Australian diplomats it might have been an Australian warship instead of HMS Amethyst which was fired on in the Yangtze incident. The Chifley Government in 1949, unlike New Zealand, refused to send a warship to Hong Kong when the Chinese Communists took power on the mainland.

    Under Menzies, numerous attempts by the Americans to get Australia to share its residual responsibilities from involvement in the Chinese civil war for the security of Taiwan were deflected. Menzies went to Washington in an unsuccessful attempt to persuade Eisenhower that Taiwan should give up the offshore islands. In 1964 Menzies involved himself in de-escalating a crisis with Indonesia precipitated by the British sending a nuclear-armed carrier task force through the Sunda Straits: diplomatic good sense to precedence over asserting rights of innocent passage. Menzies had the confidence and stature to give Eisenhower a lecture on the danger of governments taking action which risked war without having public opinion behind them. That is not a long bow to draw in the broad context of addressing the current question. As Churchill said, and Hugh White is arguing, ‘better jaw jaw than war war’.

    Garry Woodard, former diplomat and Senior Fellow, University of Melbourne.

    This article was first published by the Australian Institute of International Affairs.

  • What a godsend politicians and journalists are to ISIS.

    In The Guardian, Simon Jenkins writes about the way that the ISIS recruiting officers will be thrilled at how things have gone since their atrocity in Belgium.  He points particularly to the ‘paranoid politicians and sensational journalists’ who have perhaps unwittingly provided great support for ISIS. Jenkins comments

    ‘The atrocities in Brussels happen almost daily on the streets of Baghdad, Aleppo and Damascus. Western missiles and ISIS bombs kill more innocents in a week than die in Europe in a year. The difference is the media response. A dead Muslim is an unlucky mutt in the wrong place at the wrong time. A dead European is front-page news. … Everyone involved in this week’s reaction, from journalist to politicians to security lobbyists, has an interest in terrorism. There is money, big money, to be made – the more terrifying it is presented, the more money.’

    Simon Jenkins is a journalist and author. He writes for The Guardian as well as broadcasting on BBC. He has edited The Times and The London Evening Standard.  See link to his article below.

    http://gu.com/p/4hzgx/sbl

  • Yang Razali Kassim. Will Mahathir and Anwar’s uneasy alliance unseat Najib?

    The unthinkable is happening in Malaysian politics. Former prime minister Mahathir Mohammad and his jailed former deputy Anwar Ibrahim have joined hands in a seemingly impossible alliance to unseat Prime Minister Najib Razak. Never before in Malaysian history have such sworn enemies buried their hatchets for a common cause.

    By launching his rainbow ‘core group’ of concerned citizens of various political stripes and leanings to ‘Save Malaysia’, Mahathir has once again thrust himself into the eye of the political storm. With Anwar still in jail, the disparate forces that opposed Najib over the 1Malaysia Development Berhad (1MDB) investment fund scandal have finally found someone of stature to rally around in a marriage of convenience. It is ironic that the man who crushed the opposition while in power has reinvented himself in retirement as the de facto leader of what in essence is a citizens’ revolt.

    Mahathir himself described this as a ‘very strange group of people’, brought together by a common goal of ousting the scandal-hit prime minister. By calling it a ‘core group’, Mahathir is indicating that this is only the beginning of more moves to come. What could emerge down the road is still hazy. But it is safe to say that a new era in Malaysian politics is unfolding with the key players jostling for a place in the shifting ground.

    Broadly speaking, politics and the people have become polarised into two groups. The first is pro-Najib, anchored around the ruling party — the United Malays National Organisation (UMNO). Opponents within and outside UMNO are being crippled or threatened one-by-one. The second group is basically the rest — the anti-Najib forces comprising of nearly 50 of the country’s public luminaries.

    As expected, Najib’s lieutenants have dismissed Mahathir’s latest strategy as leading nowhere. Some have even belittled Mahathir’s resignation from the UMNO — his second since he forced his successor Abdullah Ahmad Badawi to resign in 2008 — as something of a joke. Deputy Prime Minister Zahid Hamidi has painted Mahathir’s move as unconstitutional. And UMNO Youth have challenged the Mahathir-led movement to become a formal coalition and challenge the UMNO-led ruling coalition Barisan Nasional (BN) in a general election.

    But any misplaced sense of confidence on the part of UMNO could backfire. Mahathir’s second quitting may indeed not amount to much within UMNO, given that Najib has got the party effectively button-holed. But it would be foolhardy to take lightly what the 90-year-old warhorse is now doing. It may well lead to big changes in Malaysian politics. Although the UMNO-led BN won control of parliament in the last general election, it actually lost the popular vote. The people’s confidence has shifted towards the then Anwar-led opposition.

    Given Najib’s current scandals, which have been a lightning rod against UMNO, an election, if held today, could conceivably lead to the defeat of UMNO and the BN ruling coalition it leads. Mahathir’s son, Mukhriz, the deposed chief minister of Kedah state, said as much, noting that ‘the opposition could easily win the next general election’. The opposition says it has thrown its support behind Mahathir in a shared sense of urgency to save the country before more damage is done.

    Mahathir’s ‘core group’ could be variously described as having features of civil disobedience, a people’s power movement, even a de facto ‘new opposition’. Prior to its launch, there had been talk of similar and overlapping moves, such as Zaid Ibrahim’s initiative for a closed-door gathering of like minds on 27 March. There is also the plan by Wan Azizah, leader of the People’s Justice Party and Anwar’s wife, to convene national consensus talks. There is clearly a need for close coordination to avoid competing initiatives. Significantly, the Pan-Malaysian Islamic Party has not formally joined the anti-Najib alliance, although some of its leaders had supported Mahathir.

    So if Mahathir and his citizens’ movement can maintain their current momentum and the opposition recovers from its disunity, UMNO and BN could be in deep trouble in the next election, which is to be called by 2018. Should that happen, pressure would mount leading to two possible outcomes. The first may trigger a nation-wide awakening that could transform into an anti-Najib groundswell. The second is to push UMNO into the excruciating position of having to decide whose survival is more critical — Najib’s or UMNO’s? In that event, a pre-emptive move for a leadership change may become too tempting in order to avoid impending electoral defeat.

    And, if this trajectory holds, UMNO may be forced to explore two other options: vote Najib out, or craft unconventional strategies — such as allowing Najib to step down voluntarily. Face-saving compromises and ‘out-of-the-box’ solutions should not be ruled out, given the wide-ranging repercussions of potential political instability.

    Yang Razali Kassim is a Senior Fellow with the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University, Singapore.

    This article was recently published in East Asia Forum.

  • Evan Williams. ‘The Daughter’ film review

    The ads for the new Australian film The Daughter are proudly informing us that the film comes from the same producer who gave us The Piano and Lantana. And that’s some pedigree. Lantana and The Piano were both distinguished Australian films (though the Kiwis shared some credit for The Piano), but what’s this about the “producer”? With all due respect to Jan Chapman, the producer of The Daughter, producers don’t make films. They raise the money for them, hire the main players, acquire all the rights and turn up to collect any best-picture gongs on Oscar night, but they don’t make the movie. Sam Goldwyn was one of the great Hollywood producers, but he didn’t make The Best Years of Our Lives (that was left to William Wyler), and who remembers Goldwyn anyway for Roseanne McCoy or The Adventures of Marco Polo?

    I make this rather obvious point to make the equally obvious point that whatever we may think of The Daughter, credit or blame for the finished film must lie with Simon Stone, the director (who also wrote the screenplay). It’s a visually stunning work , finely acted by a remarkable cast, and set in an unidentified region of rural Australia. So full marks to the cinematographer, Andrew Commis, and actors of the calibre of Sam Neill (who starred in The Piano) and Geoffrey Rush (who starred in Lantana). Stone’s screenplay was “inspired” by Henrik Ibsen’s play The Wild Duck, which Stone adapted for a production at Sydney’s Belvoir St Theatre in 2011. Based on my dim memories of that occasion, the stage production departed freely from Ibsen’s play and the film version departs from it even further – which pretty much absolves Ibsen from any responsibility for the movie.

    There are some resemblances, of course. Put crudely, this is a film about a daughter and a duck, in which both have prominent roles and can be seen as complementary elements in the fabric of the story. The daughter is 16-year-old Hedwig (Odessa Young), whose mother Charlotte (Miranda Otto) teaches at the local school. The duck, which we meet in the opening scene, has been wounded by a bullet fired by Geoffrey Rush’s character, Henry, who owns the local timber mill and is about to marry his much younger bride and former housekeeper (Anna Torv). Everyone is gathering for a fancy wedding. The duck, meanwhile, is rescued and nursed back to health by Walter (Sam Neill), the father of Oliver (Ewen Leslie), who is married to Charlotte.

    I confess that the details of these relationships eluded me at first (narrative lucidity isn’t the film’s most obvious virtue), but we are left in no doubt that Walter is a nice guy. He lives in a splendid mansion that looks more like a colonial palace than a country homestead, and runs a sanctuary for wounded animals – a sort of “unofficial RSPCA”, as he calls it. (I doubt if Ibsen would have thought of that.) Hedwig, incidentally, is the only character whose name remains unchanged from Ibsen’s play, though I suppose it would seem odd if the horny-handed, bush-dwelling Aussies in the story went around with names Knut, Lars or Thor.

    Without trying to summarise all the film’s emotional conflicts, it’s fair to say that nearly everyone is miserable for one reason or another. The plot is replete with disappointments, infidelities, thwarted passions, buried secrets and skeletons in closets. All good, steamy stuff, well matched by the gloom of the surroundings. A mood of desperation is established early on when the timber mill is closed and hundreds of workers find themselves out of a job (timely echoes of recent events in Queensland, though Sam Neill comes across as a more sympathetic boss than Clive Palmer).

    Stone made his cinema debut with a miniature piece called Reunion, one of a compilation of 17 short films – or fragments of short films – that made up The Turning, based on a book of stories by Tim Winton. Written by Andrew Upton, Reunion was about a Christmas Day family gathering that gets absurdly out of hand. Praising it at the time, I called it one of the best pieces in The Turning and the only one of the 17 stories with a touch of light-heartedness. And how I longed for a touch of light-heartedness in The Daughter. Stone’s colour palette is unrelievedly dark, his cameras dwelling on rows of deserted shops, empty streets and grim forests of brooding trees, with more than one scene shot in a derelict factory.

    The acting honours must go to Odessa Young, who gives a performance of lacerating honesty and pain as the daughter. As for the duck, who is given the name Lucky, I think she shows great promise, and there is no more moving moment in The Daughter when she soars into the sky at the end, as if eager to escape the cauldron of misery and confusion engulfing the rest of the cast. A lucky duck indeed.

    Three stars.

    The Daughter, rated M, is in national release.

    Evan Williams reviewed films in The Australian newspaper for 33 years. He is a Life Member of the Film Critics’ Circle of Australia for services to film criticism and the film industry.In 2015 he received the Geraldine Pascal Lifetime Achievement Award for critical writing.

     

     

     

     

  • Jonathan Karnon. No-one should get dud hospital care.

    In 2013-14, Australian governments spent A$105 billion on health; A$44 billion of that was on public hospitals.

    The Commonwealth government is increasingly concerned with the size of the health budget and has acted to reduce the inappropriate use of Medicare benefits. But the Commonwealth government has less influence on public hospitals because the state and territory governments control their expenditure.

    State governments are facing tighter budgets as demand for heath care increases due to an ageing population, greater rates of chronic disease and more service use generally.

    The collection and analysis of data on the performance of our health-care system can be used to improve the quality of health services and maybe also reduce costs.

    At a national level, the clinician-led Choosing Wisely campaign is developing lists of specific tests, treatments and procedures that may be unnecessary and sometimes harmful for individual patients. Recommendations include reducing use of CT scans in the emergency department and not ordering x-rays for patients with uncomplicated acute bronchitis.

    But while improving the decisions made by individual doctors is important, there remain other causes of substantial variation in the safety and quality of care provided in Australian hospitals. This needs to be addressed.

    Varied quality and safety

    Efforts to improve the quality of care in hospitals have traditionally been left to individual hospitals and their managers. But we now have the data to compare different hospitals. We can identify the best and worst performers and, most importantly, determine how to boost the performance of the stragglers.

    Identifying and intervening to improve low-quality care requires financial investment. But there are significant potential long-term savings, due to improved efficiency and better patient outcomes.

    In New South Wales, the Bureau of Health Information has developed and tested methods for comparing the death rates within 30 days of treatment for heart attacks, strokes, pneumonia and hip fracture surgery.

    For stroke patients, ten hospitals had noticeably higher-than-expected death rates for these conditions. An additional 16 deaths were observed in every 100 patients treated at a low-performing hospital compared to a high-performing hospital.

    Clinical auditors and review panels should investigate differences in the care provided at the high- and low-performing hospitals and approaches to improve care quality.

    Other data show the costs of treating similar conditions varies dramatically. A Grattan Institute analysis shows the average cost of performing a hip replacement at different hospitals ranges from under A$10,000 to more than A$30,000.

    Further investigation may find the higher costs are due to the use of more expensive prostheses and to keeping patients in hospital for longer after surgery. Assessments can then be made about whether more expensive prostheses or extended lengths of stay produce better patient outcomes, which justify the additional costs.

    We have analysed hospital data to compare costs, outcomes and the care pathways of patients treated for similar conditions at the main public hospitals in South Australia.

    After adjusting for differences in the types of patients presenting at emergency departments with chest pain, seven in every 100 patients presenting at a particular hospital were readmitted or died within 12 months. This compared to four to five patients at the other hospitals.

    The same hospital spent up to A$669 more on each patient than the other hospitals. Over one year, these additional costs amount to almost A$1 million.

    Analysis of the care pathways showed that the hospital with the highest rates of re-admission, premature death and costs, discharged more patients from the emergency department. This hospital also kept patients who were admitted to an inpatient bed in hospital for longer than the other hospitals.

    This suggests some patients may have been inappropriately discharged home from the emergency department, while other patients could have been discharged earlier.

    Further investigation might look more closely at how and why decisions are made to admit patients from the emergency department and at what might be causing admitted patients to stay longer in hospital.

    Investing in improvement

    State governments are increasingly interested in improving quality. The Queensland government has set up an Integrated Care Innovation Fund to invest in initiatives to improve efficiency and value. NSW set up a similar Translational Research Grants Scheme. In South Australia, the Transforming Health initiative aims to improve the quality and consistency of health care across all metropolitan public hospitals.

    But while individual efforts to improve quality may have some effect, it is more likely that co-ordinated, systematic approaches will have a greater impact.

    Data should be analysed across hospitals on an ongoing basis to identify areas of clinical activity with the greatest potential for improvement, such as the examples above. Findings that quality could be improved should be fed back directly to hospitals.

    Specialist teams should be set up to work with hospitals to further investigate areas of concern and to develop and implement improvement strategies.

    Rather than going back to the drawing board on health reform, governments need to improve what we’ve already got and bring the poor performing hospitals and departments in line with their better performing peers.

    Jonathan Karnon is Professor of Health Economics, University of Adelaide.  This article first appeared in the Conversation on 21 March 2016.

  • Greg Barton. Out of the ashes of Afghanistan and Iraq: the rise and rise of Islamic State.

    Since announcing its arrival as a global force in June 2014 with the declaration of a caliphate on territory captured in Iraq and Syria, the jihadist group Islamic State has shocked the world with its brutality.

    Its seemingly sudden prominence has led to much speculation about the group’s origins: how do we account for forces and events that paved the way for the emergence of Islamic State? In the final article of our series examining this question, Greg Barton shows the role recent Western intervention in the Middle East played in the group’s inexorable rise.

    Despite precious little certainty in the “what ifs” of history, it’s clear the rise of Islamic State (IS) wouldn’t have been possible without the 2003 invasion and occupation of Iraq. Without these Western interventions, al-Qaeda would never have gained the foothold it did, and IS would not have emerged to take charge of northern Iraq.

    Whether or not the Arab Spring, and the consequent civil war in Syria, would still have occurred is much less clear.

    But even if war hadn’t broken out in Syria, it’s unlikely an al-Qaeda spin-off such as IS would have become such a decisive actor without launching an insurgency in Iraq. For an opportunistic infection to take hold so comprehensively, as IS clearly has, requires a severely weakened body politic and a profoundly compromised immune system.

    Such were the conditions in Goodluck Jonathan’s Nigeria from 2010 to 2015 and in conflict-riven Somalia after the fall of the Barre regime in 1991. And it was so in Afghanistan for the four decades after conflict broke out in 1978 and in Pakistan after General Zia-ul-Haq declared martial law in 1977.

    Sadly, but even more clearly, such are the circumstances in Iraq and Syria today. And that’s the reason around 80% of all deaths due to terrorist attacks in recent years have occurred in five of the six countries discussed here, where such conditions still prevail.

    An unique opportunity

    The myth of modern international terrorist movements, and particularly of al-Qaeda and its outgrowths such as IS (which really is a third-generation al-Qaeda movement), is that they’re inherently potent and have a natural power of attraction.

    The reality is that while modern terrorist groups can and do operate all around the globe to the point where no country can consider itself completely safe, they can only build a base when local issues attract on-the-ground support.

    Consider al-Qaeda, which is in the business of global struggle. It wants to unite a transnational ummah to take on far-off enemies. But it has only ever really enjoyed substantial success when it has happened across conducive local circumstances.

    The Soviet occupation of Afghanistan in the 1980s provided an opportunity uniquely suited to the rise of al-Qaeda and associated movements. It provided plausible justification for a defensive jihad – a just war – that garnered broad international support and allowed the group to coalesce in 1989 out of the Arab fighters who had rallied to support the Afghans in their fight against the Soviets.

    Further opportunities emerged in the Northern Caucasus, where local ethno-national grievances were eventually transformed into the basis for a more global struggle.

    The declaration of independence by Chechnya in 1991 led to all-out war with the Soviet military between 1994 and 1996, when tens of thousands were killed. After a short, uneasy peace, a decade-long second civil war started in 1999 following the invasion of neighbouring Dagestan by the International Islamic Brigade.

    The second civil war began with an intense campaign to seize control of the Chechen capital, Grozny. But it became dominated by years of fighting jihadi and other insurgents in the Caucus mountains and dealing with related terrorist attacks in Russia.

    In Nigeria and Somalia, Boko Haram and al-Shabaab now share many of the key attributes of al-Qaeda, with whom they have forged nascent links. But they too emerged primarily because of the failure of governance and the persistence of deep-seated local grievances.

    Even in Afghanistan, al-Qaeda struggled to transform itself into a convincing champion of local interests in the 1990s. After becoming increasingly isolated following the September 11 attacks on the US, it failed to gain support from the Afghan Taliban for its global struggle.

    But something new happened in Iraq beginning in 2003. The Jordanian street thug Musab al-Zarqawi correctly intuited that the impending Western invasion and occupation of Iraq would provide the perfect conditions for the emergence of insurgencies.

    Al-Zarqawi positioned himself in Iraq ahead of the invasion and deftly rode a wave of anger and despair to initiate and grow an insurgency that in time came to dominate the broken nation.

    Initially, al-Zarqawi was only one of many insurgent leaders intent on destabilising Iraq. But, in October 2004, after years of uneasy relations with the al-Qaeda leader during two tours in Afghanistan, he finally yielded to Osama bin Laden’s request that he swear on oath of loyalty (bayat) to him. And so al-Zarqawi’s notorious network of insurgents became known as al-Qaeda in Iraq (AQI).

    From the ashes

    Iraq’s de-Ba’athification process of May 2003 to June 2004, during which senior technocrats and military officers linked to the Ba’ath party (the vehicle of the Saddam Hussein regime) were removed from office, set the stage for many to join counter-occupation insurgent groups – including AQI.

    Without the sacking of a large portion of Iraq’s military and security leaders, its technocrats and productive middle-class professionals, it’s not clear whether this group would have come to dominate so comprehensively. These alienated Sunni professionals gave AQI, as well as IS, much of its core military and strategic competency.

    But even with the windfall opportunity presented to al-Zarqawi by the wilful frustration of Sunni interests by Nouri al-Maliki’s Shia-dominated government from 2006 to 2014, which deprived them of any immediate hope for the future and confidence in protecting their families and communities, AQI was almost totally destroyed after the Sunni awakening began in 2006.

    The Sunni awakening forces, or “Sons of Iraq”, began with tribal leaders in Anbar province forming an alliance with the US military. For almost three years, tens of thousands of Sunni tribesmen were paid directly to fight AQI, but the Maliki government refused to incorporate them into the regular Iraqi Security Force. And, after October 2008 – when management of these forces was handed over by the US military – he refused to support them.

    The death of al-Zarqawi in June 2006 contributed to the profound weakening of the strongest of all post-invasion insurgent groups. AQI’s force strength was reduced to several hundred fighters and it lost the capacity to dominate the insurgency.

    Then, in 2010 and 2011, circumstances combined to blow oxygen onto the smouldering coals.

    In 2010, the greatly underestimated Abu Bakr al-Baghdadi, a local Iraqi cleric with serious religious scholarly credentials, took charge of AQI and began working to a sophisticated long-term plan.

    Elements of the strategy went by the name “breaking the walls”. In the 12 months to July 2013, this entailed the movement literally breaking down the prison walls in compounds around Baghdad that held hundreds of hardcore al-Qaeda fighters.

    Islamic State, as the group now called itself, also benefited from the inflow of former Iraqi intelligence officers and senior military leaders. This had begun with de-Ba’athification in 2003 and continued after the collapse of the Sunni awakening and the increasingly overt sectarianism of the Maliki government.

    Together, they developed tactics based on vehicle-borne improvised explosive devices and the strategic use of suicide bombers. These were deployed not in the passionate but often undirected fashion of al-Qaeda but much more like smart bombs in the hands of a modern army.

    And the US military withdrawal from Iraq in late 2011, well telegraphed ahead of time, provided an excellent opportunity for the struggling insurgency to rebuild. As did the outbreak of civil war in Syria.

    A helping hand

    Al-Baghdadi initially dispatched his trusted Syrian lieutenant, Abu Mohammad al-Julani, to form a separate organisation in Syria: the al-Nusra front.

    Jabhat al-Nusra quickly established itself in northern Syria. But when al-Julani refused to fold his organisation in under his command, al-Baghdadi rebranded AQI (or Islamic State in Iraq) Islamic State in Iraq and al-Sham/the Levant (ISIS/ISIL).

    Then, a series of events turned IS from an insurgency employing terrorist methods to becoming a nascent rogue state. These included the occupation of Raqqa on the Syrian Euphrates in December 2013; the taking of Ramadi a month later; consolidation of IS control throughout Iraq’s western Anbar province; and, finally, a sudden surge down the river Tigris in June 2014 that took Mosul and most of the towns and cities along the river north of Baghdad within less than a week.

    IS’s declaration of the caliphate on June 29, 2014, was a watershed moment that is only now being properly understood.

    In its ground operations, including the governing of aggrieved Sunni communities, IS moved well beyond being simply a terrorist movement. It came to function as a nascent rogue state ruling over around 5 million people in the northern cities of the Euphrates and the Tigris, and defending its territory through conventional military means.

    At the same time, it skilfully exploited the internet and social media in ways the old al-Qaeda could not do – and that its second-generation offshoot, al-Qaeda in Arabian Peninsula (AQAP), had only partially achieved.

    This allowed IS to draw in tens of thousands of foreign fighters. Most came from the Middle East and Northern Africa, but as many as 5000 came from Europe, with thousands more from the Caucusus and from Asia.

    Unlike the case in Afghanistan in the 1980s, these foreign fighters have played a key role in providing sufficient strength to take and hold territory while also building a global network of support.

    But without the perfect-storm conditions of post-invasion insurgency, this most potent expression of al-Qaedaism yet would never have risen to dominate both the region and the world in the way that it does.

    Even in its wildest dreams, al-Qaeda could never have imagined that Western miscalculations post-9/11 could have led to such foolhardy engagements – not just in Afghanistan but also in Iraq.

    Were it not for these miscalculations, 9/11 might well have precipitated the decline of al-Qaeda. Instead, with our help, it spawned a global jihadi movement with a territorial base far more powerful than al-Qaeda ever had.

    Greg Barton is Chair in Global Islamic Politics, Alfred Deakin Institute for Citizenship and Globalisation; Co-Director, Australian Intervention Support Hub, Deakin University. This article first appeared in The Conversation on 3 March, 2016.

  • Peter Gibilisco. Disability support services – effectiveness and efficiency.

    Let me be frank. There are many stringencies that have to be faced in the provision of disability support services. We all know this whether we are recipients of in-home one-on-one support, residents, workers or management of disability support services, or even as officials of the Department of Health and Human Services (DHHS). We all are under the pump in an economic climate where there is widespread political anxiety about budget blow-outs and a possible collapse of our financial and economic system. We all know this. So when I make my professional contribution, as a resident of such a health-care facility, my recommendations and pleas are complex.

    Many of the problems in the disability support services arise because it seems that efficiency demands a certain generalized procedure. In this case “efficient” means something like: (a person) working in a well-organized and competent way.

    And when dealing with disability support, effectiveness  is also a crucial characteristic to be balanced against any “efficiency”. This is the meaning of “effectiveness”: the degree to which something is successful in producing a desired result; success.

    I would ask that readers appreciate that I too am a citizen, a member of this polity, one who has paid my taxes, one who has worked persistently to promote the common good. Yes, what I am about to say is framed in my own interest but it is not only that. I am just as much concerned morally as any other non-disabled professional person about the serious state of our disability support services. Unless that is understood then my point will not be appreciated.

    There have been developments at the level of Federal and State Government funding – negotiated through the Council of Australian Governments (COAG) – that have brought about significant changes to the delivery of human services more generally and disability support services in particular. I do not have access to a research facility to adequately assess and evaluate all of these. I regularly seek advice from those who may know but I do not want readers to presume that I have mastered all the details of all the complex agreements, contracts and policies that are now in place.

    In all this, within the political sphere dominated by neoliberalism comes the mechanism that can negatively impact on social decisions, and that is the way in which policies are freighted with a seeming over-riding criteria introduced by this question: but what is this efficient and effective procedure doing to enhance individual profit?

    Some social decisions, concerned with human-related social services are, and should be, unrelated to efficiency.

    But there are some gross inefficiencies, I believe, that are part of the disability support sector that have very little, if anything to do, with disability support. More likely is it the support of the organisational and managerial structure that claims to be supportive of disabled people that is benefiting. The management of service providers are required by their own charters to turn a positive result in their financial returns . There are some unscrupulous service providers in the not-for-profit disability sector, like my own, who charging me $647.54 per fortnight in rent, including some shared transport – if it be available – and for food. The provision of food money is allocated to certain support workers at approximately $14 per day for residents in this facility, even though in recent times, I have complained to management about their failure to disclose provision money in their accounts.

    Such not-for-profit enterprise will follow the model of service provision that I would call the neoliberal streamline model: to put it simply it interprets organisational and managerial reality in terms that instinctively require financial profit to have precedence over people’s welfare.

    One will ask, bewildered, why should a not-for-profit organization need to show a profit? We are a shared supported accommodation residence and we are said to be in the not-for-profit disability sector. Are we simply to roll over and allow an abstract efficiency with little or no room for effectiveness, to prevail? Are we really wanting a neoliberal perspective that affirms that efficiency means money saved, while effectiveness means costs and hence a challenge to ongoing future viability?

    This state of affairs prods me to drive home an ethical perspective about residents in shared supportive accommodation. In this house we have 9 individuals with high support needs. In other words what is required for  residents in shared supportive accommodation are processes and resources that overcome a lack of human support. There are a lot of funds paid and even more is required for unmet needs of disability support. But I have come to my matured and well educated perspective, having developed it over many years living in the face of a progressive disability for over forty years.

    My conclusion is this: the disability sector has lost its way being caught up in the self-interest of an overloaded pool of management. Instead of alleviating the need for support such a sector is in danger of exacerbating the need for greater assistance!

    But all is not doom and gloom. There is a plausible and workable solution within reach to many of the failures to provide efficient and effective disability support. Through the attainable cost savings people with disabilities can actually be empowered. This is evident from schemes of direct employment techniques that have been widely used to positive effect by both DHHS and the National Disability Insurance Scheme (NDIS).

    Direct Employment has just been formally introduced into Victoria. I was involved in the initial pilot program. This is a key reform with the Disability Services that many Individual Support Package (ISP) users should consider due to its numerous benefits. It is a person-centred approach to disability, being more positive in allowing one to contribute to the community, enhancing community inclusion.

    In July 2013, I was keynote speaker at the Disabilities Support Professionals Conference at the University of Sydney. There I spoke with my computer voice about; Cindy, a 46 year old lady with a severe intellectual disability. She is involved with Direct Employment, her self-planning carried out by family members. As a result Cindy lives a more inclusive life. She is supported by three workers whose rosters, pay, training and other work conditions are managed by the O’Loughlin family, with sister-in-law Christine and brother Darren managing the accounts and finances. Cindy, and her mother Lesley, take responsibility for the recruitment, training and day-to-day management of Cindy’s workers. Thanks to Direct Employment, Cindy is receiving the support she needs, she is happier and is living as an individual in the community the way she chooses to live. Cindy’s family are the professionals involved in her support.

    The encouragement of such forms of disability support derived from their logic with a focus upon social coherence.  It is important to ensure that this kind of arrangement is flexible enough to allow some changes in a day-to-day sense, even if complete change does not take place.  The aim is to re-build trust and flexibility in disability supports, thereby creating both community inter-dependence and independence.

    Direct Employment offers flexibility, allowing people with disabilities to choose the support staff they prefer, helping them lead their own lives and make decisions for themselves. Direct Employment is better suited to cater for individual needs and lifestyles: it is, after all, an important concern for people with disabilities. Hence it allows for a more personalised approach that is better suited to meet individual support needs than the efficiency-driven of not-for-profit organisations constrained to make a profit. As a person-centred approach, I believe Direct Employment is an important reform that will be the key to the future lives of many disabled people and their families!

    Let’s hope so.

    Special thanks to, Christina Irugalbandara, Bruce Wearne and Cunxia Li

    Peter Gibilisco, B Bus (Acc) Ph.D. (Melb), Honorary Fellow University of Melbourne.

    New Book: The Politics of Disability

  • Evan Williams. The Lady in the Van. Film Review

     

    Alec Guinness is remembered for playing seven different roles in the classic English comedy Kind Hearts and Coronets. In Nicholas Hytner’s film, The Lady in the Van, Maggie Smith goes one better. At different times she’s a crazy old woman, a street beggar, a nun, a belligerent suburban mischief-maker, a well-to-do motorist, an incarcerated lunatic, a kindly old biddy and an aspiring concert pianist – all embodied in the person of Mary Shepherd, the film’s formidable central character. It’s an acting tour de force for which Dame Maggie has received awards and much critical acclaim. It seems a pity to strike a critical note.

    The film is adapted from a play by Alan Bennett. Many consider the play a classic, but it’s well to remember Bennett’s own definition of a classic book – “one that everyone is assumed to have read and often think they have.” I won’t assume that everyone has seen Bennett’s play, but audiences love it and I have warm memories of the late Ruth Cracknell playing Miss Shepherd on the Sydney stage. But Maggie Smith has made the part her own: she was in the original London production in 1999 and in a radio version Bennett adapted for the BBC. Her character can be described as a seriously deranged version of the imperious countess and family matriarch she played in Downton Abbey. And everyone, of course, remembers Downton Abbey. To judge from early box-office returns for Hytner’s movie, especially in the US, Downton Abbey fans are flocking in great numbers to The Lady in the Van.

    As an opening title informs us, it’s “a mostly true story.” One day in 1984, a woman calling herself Mary Shepherd drives a battered old van into Gloucester Crescent, a street of grand Georgian houses in a posh part of north London. Filthy, unwashed, and clad in soiled rags, Miss Shepherd makes it clear that she intends to remain in her van and leave it parked in Gloucester Crescent for as long as she wishes – a prospect that hardly appeals to Bennett’s hoity-toity neighbours , who include a certain “Mrs Vaughan-Williams” (Frances de la Tour), who may or may not be the wife of the composer. Bennett (nicely played by a wonderfully look-alike Alex Jennings) feels a little sorry for the old girl and lets her park her van in his driveway. And here she remains for the next 15 years, venturing out for short walks, rides in a wheelchair, encounters with bemused strangers and one enforced visit to a local doctor.

    Like the play, the film is an uneasy mixture of comedy, pathos and sentimental kitsch. There are plenty of clever lines (this is an Alan Bennett script, after all), but the comedy consists largely in the spectacle of Miss Shepherd behaving like a graceless old ratbag. Much is made of her bodily odour. People are constantly recoiling from her presence with a disdainful twitch of the nose or wave of the hand, and there’s a brief moment in a cathedral when Miss Shepherd, apparently a regular worshipper, crosses the floor while a priestly voice intones: “The air freshener is behind the Virgin.” She may be a pious soul, but she isn’t above stealing holy water from the church to put in the radiator of her van. All reasonable requests from other s are parried with one of two impatient lines: “I’m a busy woman” (hardly believable), or “I’m a sick woman” (probably true). No thanks are offered for casual courtesies or even for the Christmas gifts brought to the van by neighbourhood children. Miss Shepherd is very hard to like, and for the film to work I think we need to like her rather more than we can bring ourselves to do.

    With a little research Bennett discovers that Miss Shepherd’s real name is Margaret Fairchild, a pianist and former pupil of the great Alfred Cortot, with whom she has studied in Paris. Committed by her brother to an asylum for the insane (as mental hospitals were once known), she somehow manages to escape, and while driving her van on a country road collides with a motorcyclist, who is badly injured in the crash. Fearing she will blamed for the motorcyclist’s injuries, she flees the scene, only to be blackmailed by a crooked cop (Jim Broadbent), who has discovered her secret and agrees to keep silent for a price.

    All very strange – and no doubt “mostly true.” But there are too many loose ends to the story. What happens to the motorcyclist? What has brought on Margaret’s illness – the trauma of her accident or the encroachment of age and dementia? She acts like a pauper but surely she has a source of income – how else to pay her blackmailer and afford to own, not one van, but two or three (the original being replaced by a gleaming and much bigger new model)? Bennett might have done more to enlighten us. Yes, it’s a comedy of sorts, if you enjoy seeing a devout young woman succumb to illness and the rigours of penury and squalor.

    Unlike Alec Guinness, Alex Jennings plays only two roles. He is both Bennett himself and Bennett’s identical alter ego – and often they’re together in the same frame. One of them, we are told, is the “real-life” Bennett, the other the writer tapping away on his typewriter while he tells the story. It’s an unnecessary gimmick concocted for the movie, but Bennett is such a mild and self-effacing character that his double-sided presence never feels overbearing. It’s just as well we don’t get two Maggie Smiths playing two Miss Shepherds. That would be overdoing things in a film already overdone.

    Two-and-a-half stars

    The Lady in the Van, rated M, is in national release.

     

  • Sam Bateman. Defence White Paper and the China threat.

    Australia’s flawed position on the South China Sea

    Australia’s 2016 Defence White Paper says a lot about the South China Sea, both directly and indirectly. It expresses concern about land reclamation and construction activities by claimants in the sea and about the possible use of artificial structures for military purpose. It also makes much of the importance of a rules-based global order to Australia’s security, with a clear message that some countries are not following these rules.

    While the White Paper does not name China, that’s how most commentators — and China itself — have interpreted these statements. As Benjamin Schreer has claimed, the White Paper ‘reflects the reality in maritime East Asia that China has moved to re-write the rules to fit its strategic preferences and historical narratives’. But what rules are we talking about?

    Despite the White Paper’s references to a rule-based global order, the reality is not quite that simple. For one, other countries besides China also don’t follow the rules. Australia’s major security partner, the United States, is not party to many important international conventions, including the 1982 UN Convention on the Law of the Sea (UNCLOS). Admiral Harry Harris, Commander of US forces in the Pacific, has said for example that, ‘We must continue to operate in the South China Sea to demonstrate that water space and the air above it is international’. But such statements ignore the carefully balanced regime of exclusive economic zones (EEZ) established by UNCLOS.

    The South China Sea is not international water space. It is comprised of the EEZs of littoral countries, which have significant rights and duties in that water space. Other nations operating in that space must do so with due regard to those rights and duties.

    Australia itself can also be accused of not conforming to the rules-based global order.One Australian commentary, which claims that China is trashing the rules-based order by refusing to recognise international arbitration over disputed islands in the South China Sea, conveniently overlooks the fact that Australia is taking a similar position to China in its maritime boundary dispute with Timor-Leste.

    The White Paper seems to make a subtle swipe at China when it observes that Australia opposes the use of artificial structures in the South China Sea for military purposes. But this further begs the question of who is militarising the South China Sea. The short answer is: everyone. China and the United States accuse each other of ‘militarising’ the South China Sea, but in reality both are guilty.

    Who you consider to be militarising the South China Sea largely depends on what you mean by ‘militarisation’. China’s construction of defensive military facilities is not the same as the militarisation implicit in increased military activity by the United States. China acknowledges that its reclaimed features have a military purpose, but describes the measures it has taken as ‘limited and necessary self-defence facilities’ consistent with ‘the right to self-protection’ afforded under international law.

    In contrast, the United States has also raised the military ante with its provocative freedom of navigation (FON) operations, increased naval exercises and its military support for the Southeast Asian claimants in the South China Sea. Such initiatives are seen by China as an attempt to contain it.

    China’s assertive actions in the South China Sea are cast as a growing threat to American interests, particularly by the Pentagon and the US Navy. But, conversely, instability in the South China Sea helps the Navy justify its budget, particularly as it’s the minor partner of the American Army and Air Force in both Syria and the Ukraine. For example, The South China Sea has become a major theatre of operations for the US Navy.

    Demilitarising the South China Sea should be a genuine objective of all stakeholders. To this end, China should clarify its claims in the South China Sea and refrain from activities that will be seen as assertive or aggressive. The US should step back from its current naval initiatives in the region, including its provocative FON operations. A bit of ‘give and take’ is required on both sides.

    Australia would do well to take a balanced approach. But in making a big play of the South China Sea, the White Paper falls in line with what Greg Austin has called ‘The Pentagon’s Big Lie about the South China Sea’. For Austin, the lie is the claim that China’s actions in the South China Sea threaten commercial shipping.

    The White Paper replays this sentiment. To justify Australia’s concerns, it notes that ‘nearly two-thirds of Australia’s exports pass through the South China Sea, including our major coal, iron ore and liquefied natural gas exports’. This figure is incorrect. The accurate figure is a little over 20 per cent and most of this is trade with China. The White Paper actually disproves its own estimate with the map in Figure 2 showing that most of Australia’s sea freight does not pass through the South China Sea. Nor does the map does show the busy trade route between eastern Australia, Japan and South Korea that passes to the east of the Philippines, rather than the South China Sea.

    There is much to like in the White Paper, particularly its focus on increased international defence engagement including with China. But policymakers need to be cautious of the White Papers’ exaggerations about how much China threatens Australian trade and security interests in the South China Sea.

    Sam Bateman is an adviser to the Maritime Security Programme at the S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University.

    This article was first posted in ANU East Asia Forum.

  • Richard Woolcott. The burning question – should Australia do more on the South China Sea?

    My clear response is ‘No!’

    China, as a major trading nation, now has the same rights as the US to protect its maritime and air approaches to its mainland.  Australia should avoid provocative statements and actions at sea or in the air.

    When we talk about the need to support ‘a rules-based global order’, we overlook the fact that this order was framed mainly by the US after World War II.

    The world has changed greatly over the last 50 years and rising countries such as China, India, Indonesia, Russia and Brazil will want to be involved in reshaping an updated international and regional order.  We should be involved in cooperative discussions with the US, the above five and all countries in the Asian region.

    The Australian Government and the ALP – and the factions in both major parties – need to acknowledge this or Australia will be left behind.

    Richard Woolcott was Australian Ambassador to Indonesia and the Phillipines and the High Commissioner to Malaysia, Ghana and Singapore. He was the Australian Ambassador to the UN and President of the UN Security Council. He was Secretary of the Department of Foreign Affairs and Trade from 1988 to 1992.

     

  • Kishore Mahbubani. The China threat! What happens when China becomes number one?

    In considering the Defence White paper, it is important as Hugh White has pointed out, that we consider carefully the growing power of China and its determination to be accepted as a strong regional and global power. In this article (reposted from 27 April 2015) by Kishore Mahbubani, he describes the likely consequences of China becoming the ‘number one’ regional and possibly world power in the decades ahead. Our Defence White paper discounts the significance of growing Chinese power and the need to accommodate it.  John Menadue

     

    ALBERT H. GORDON LECTURE BY DEAN KISHORE MAHBUBANI[1]
    AT THE GREEN ROOM, KENNEDY SCHOOL OF GOVERNMENT,CAMBRIDGE, MASSACHUSETTS, 8TH APRIL 2015

    In introducing this lecture, the Harvard Kennedy School said that for the first time in more than 200 years, a non-Western power, China, will have the largest economy in the world. China’s emergence will change our world order. To understand how China will behave when it becomes number one, this lecture by Kishore Mahbubani will introduce several questions: What are the priorities of the Chinese leaders? What impact have American policies had on China? Will China behave as America does when China becomes number one?

     It is truly a great honour to be invited to deliver the Albert H. Gordon lecture this year. The hardest part is deciding how to start. Asians always start with an apology. Americans always start with a joke. Sadly, I could not find a good joke, certainly not one as good as the joke that Richard Fisher started with when he delivered this lecture in February 2009.

    This is what he said: “Yesterday morning, as I got on the plane to fly up here, I turned to Nancy and said, “In your wildest dreams did you ever envision me following in the footsteps of Mikhail Gorbachev, George H. W. Bush, David Rockefeller and Ban Ki-moon in giving the Gordon Lecture at the Kennedy School?” And she replied, “I hate to let you down, Richard, but after 35 years of marriage, you rarely appear in my wildest dreams.” My wife Anne and I recently celebrated our 30th wedding anniversary in Greece just before coming here. I am sure she would say the same as Nancy. Anyway, as a good Asian, let me apologise for the fact that I have no joke.

    It is also no joke that we are probably living through the greatest transformation in human history we have seen. This was the underlying theme of my two most recent books, “The New Asian Hemisphere” and “The Great Convergence”. However, to illustrate this point more clearly, let me cite three spectacular recent developments whose profound implications have not been adequately noticed. In the spirit of the Albert H. Gordon Lecture series, let me pick three examples from the financial sector.

    We all know that the world experienced a global financial crisis in 2008-09. We also know that the Fed launched a series of unorthodox monetary policy measures, most notably quantitative easing (QE), to avert a deep recession. What few noticed was what the Fed’s decision meant for Beijing.

    Until the onset of the crisis, Chinese leaders were happy that the US and China had settled into a comfortable pattern of mutual dependence. China relied on the US markets to generate exports and jobs. The US relied on China to buy US Treasury Bills to fund US deficit spending. Tom Friedman, in his usual brilliant way, captured this interdependence with a simple metaphor. He said, “We are Siamese twins, but most unlikely ones – joined at the hip, but not identical.”

    This Chinese belief that the US government depended on China was further reinforced when President Bush sent an envoy to Beijing in late 2008 to request Beijing not to stop buying US Treasury Bills to avoid rattling the markets further. The Chinese leaders readily agreed and probably felt very smug as this confirmed that the US was also dependent on China.

    This smugness was shattered when the US Fed announced the first round of QE measures in November 2008. The Fed’s actions demonstrated that the US did not have to rely on China to buy US treasury bills. The Fed could create its own money to do so. This decision had profound implications for the world. Axel Merk, the president of the investment advisory firm Merk Investments said, “The US is no longer focusing on the quality of its Treasuries. In the past, Washington sought to promote a strong dollar through sound fiscal management. Today, however, policymakers are simply printing greenbacks.” Merk said that by relying on the Federal Reserve’s printing press, the US has effectively told other nations that ‘it’s our dollar – it’s your problem’.

    It was clearly a mistake for the Chinese leaders to believe that they had created a relationship of mutual dependence. When China decided to buy almost a trillion dollars of US Treasury bills, it had to do so from export revenues earned from the toil and sweat of Chinese workers. However, if the US wanted to repay this trillion dollars, all the Fed had to do was to increase the size of its balance sheet. This is why several leading economists have said that the US enjoys an “exorbitant privilege” in being able to repay its debts by increasing money supply. The term was coined by Valery Giscard d’Estaing and the French economist Jacques Rueff explained its workings. Barry Eichengreen famously wrote a book on the topic in 2010.

    Let me quickly mention the two other developments whose implications have not been fully noted. It is well known that in recent years, the US has prosecuted several foreign banks, including HSBC, RBS, UBS, Credit Suisse, and Standard Chartered. For example, Standard Chartered Bank was fined 340 million dollars for making payments to Iran. Most Americans reacted with equanimity to the fine paid by Standard Chartered Bank and thought it was just that the Bank was fined for dealing with the “evil” Iranian regime. However, few Americans noticed that Standard Chartered Bank, domiciled in the UK, had broken no British laws. Nor had they violated any mandatory sanctions imposed by the United Nations Security Council. However, since almost all international payments have to go through the United States payment mechanism, the Standard Chartered Bank was fined for violating American laws.

    To put it simply, what the US was doing in this case was to say that American laws applied to non-American citizens and non-American corporations operating outside America. This is called extra-territorial application of domestic laws.

    The third development was the threat of the US to deny countries access to the SWIFT system. Since all international payments have to go through the SWIFT system, any country denied access to the SWIFT is thrown into a black hole and denied access to any kind of international trading and investment. In a recent column, Fareed Zakaria described well the Russian reaction to the possibility of being denied access to the SWIFT system. In Western media commentaries, Putin is often portrayed as the bad guy and his successor as well as predecessor, Medvedev, is portrayed as the good guy. Yet, it was the “good guy” who went ballistic when he was told of this threat. This is what Medvedev said, “Russian response – economically and otherwise – will know no limits.”

    I begin with these stories for a simple reason. Events such as these will have a deep impact in determining the answer to the biggest question of our time: what happens when China becomes number one in the world? Clearly, the answer to this question will determine significantly the course of the 21st century. Hence, we should study this question carefully.

    Let me begin with what I hope you will agree are three incontrovertible facts. First, China will become the number one economic power in the world. Second, most Americans, like most Westerners, view China’s rise with great foreboding. Third, the role that China will play as the number one economic power has not been cast in stone. How the world, especially America, reacts to China’s rise will help to influence China’s behaviour in the future. If we make the right decisions now, China could well emerge as a benign great power (even though most Americans find this virtually inconceivable).

    This is why it is timely to address the topic of what happens when China becomes number one. It is always better to prepare for the inevitable than to pretend that it will not happen. So far, on balance, America has reacted wisely to China’s rise. However, it is always easier to be wise when a power assumes that it will be number one forever. When the reality sinks in that the number one power is about to become the number two power, it is conceivable that fear may replace wisdom as the dominant driving force in American policy towards China. It would be perfectly normal for this to happen. My goal in this lecture is to try to persuade my American friends to continue to react wisely to China’s rise.

    To achieve this goal, I will make a three-part argument. First, I will try to explain what I think are the goals and ambitions of China’s leaders as China emerges as number one. Secondly, I will explain how several wise American policies have so far managed to allow the relatively peaceful emergence of a new great power. Thirdly, I would like to conclude by recommending that America can protect its long-term interests by reacting even more wisely to China’s rise.

    Let me begin with the first question: what are the goals and ambitions of China’s leaders as China emerges as number one? Since China is still run by the Chinese Communist Party (CCP), it is conceivable that the goal of China’s leaders could be the same as the leaders of the Soviet Communist Party (like Lenin, Stalin and Khrushchev): to prove the superiority of the Soviet Communist System. As Khrushchev famously said on November 18, 1956, “Whether you like it or not, history is on our side. We will bury you”.

    One of the biggest sources of misunderstanding between America and China arises from China’s decision to retain the term “Communist” in the name of its party. This may clearly signify a commitment to Communist ideology. Yet, even a brief survey of China’s deeds rather than China’s words will show that China has effectively walked away from Communist ideology. Deng Xiaoping encapsulated this shift with his famous remark, “It doesn’t matter whether a cat is black and white. If it catches mice, it is a good cat.” Effectively, Deng was saying: “It doesn’t matter if the ideology is communism or capitalism. If it helps us, we will use it.” Effectively, China behaves more as a capitalist country rather than as a Communist country, but for complicated internal political reasons, it cannot abandon the term “Communist”.

    So if the Chinese leaders are not defending or promoting Communist ideology, what cause are they trying to achieve? The answer is simple and direct: they would like to revive Chinese civilization. If there is one thing that motivates China’s leaders, it is their memory of the many humiliations that China has suffered over the past 150 years. If there is a credo that drives them, it is a simple one: “No more humiliation”. This is why they want to make China a great and powerful nation again. Xi Jinping explained this goal well in his address to UNESCO on March 27, 2014. He said, “The Chinese people are striving to fulfil the Chinese dream of the great renewal of the Chinese nation. The Chinese dream is about prosperity of the country, rejuvenation of the nation, and happiness of the people. It reflects both the ideal of the Chinese people today and our time-honoured tradition to seek constant progress. The Chinese dream will be realized through balanced development and mutual reinforcement of material and cultural progress. Without the continuation and development of civilization or the promotion and prosperity of culture, the Chinese dream will not come true.”

    The revival of the great Chinese civilization is something we should welcome. If the CCP could change its name to ‘Chinese Civilisation Party’, it would do a lot to assuage Western concerns. It has already transformed itself into a meritocratic talent-seeking mechanism that is constantly searching for the best leaders to rule China. Despite the many ups and downs in the history of the CCP, this is what the CCP has become. If the Chinese have finally succeeded in finding the right mechanism to revive Chinese civilization, we should, in theory, welcome this development.

    In practice, it is a fact that the West will not rest easy till China transforms itself into a liberal democracy. The Economist, a leading Western magazine, reflects these views. The Economist said in its issue of September 20-26, 2014 that Xi “has become the most powerful Chinese ruler certainly since Deng, and possibly since Mao.” It then calls on Xi to use this enormous power for the greater good and change the system.

    The Economist assumes, as most Westerners do, that if China’s system is changed and a Western-style democracy emerges in China, this will be an unmitigated good. This is a dangerous assumption to make. A more democratic China is likely to be a more nationalist China. A more nationalist China could well be a more assertive and aggressive China. Such a China would launch a “popular” war against Japan and act in a far more belligerent fashion over territorial disputes, like those in the South China Sea.

    In this sense, the CCP is delivering a major global public good by restraining nationalist forces and voices in China. From time to time, it has to allow some of these forces to be expressed; it has to allow its people to vent nationalist sentiments. However, the CCP also knows when to draw back from volatile situations, as it did with Japan, India, the Philippines and Vietnam in recent years. The West should be careful about wishing for early democracy in China. Its dream could become a nightmare.

    At the same time, the West must recognise and respect that China is different; that it is not going to become “Western”. Therefore, the wisest course for the West to adopt would be to allow the present system to continue and to allow it to evolve and change at its own pace.

    This brings me to the second part of my argument. As I said earlier, wise American policies have allowed China to emerge peacefully. Some of this wisdom arose out of historical necessity. At the height of the Cold War, when America genuinely feared Soviet expansionism, it reached out to China to balance the Soviet Union. Indeed, America reached out to China when China had emerged out of one of its most brutal phases. Human rights was not a factor in American policy towards China then. This paved the way for Deng to use America as an example to persuade Chinese people to switch away from central planning to free market economies.

    In the 1990s, official US-China relations went through a series of ups and downs. Despite the efforts of President George H.W. Bush to keep the relationship on an even keel, the Tiananmen Square episode on June 4, 1989 assaulted American sensibilities and constrained his ability to improve relations. Tiananmen could have derailed US-China relations. When President Clinton took office in January 1993, after having described the leaders of China as the “butchers of Beijing”, one could easily have predicted a far bumpier road. Fortunately, Bill Clinton reacted wisely. I was present at the first Asia-Pacific Economic Cooperation (APEC) leaders meeting at Blake Island in November 1993 and saw with my own eyes how Bill Clinton and Jiang Zemin made an enormous effort to reach out to each other. By the end of the day, their mutual wariness was replaced by a significant degree of personal bonhomie. This episode demonstrated that the United States had been wise in welcoming China into the APEC in 1991. Such a move not only garnered the US diplomatic goodwill but also ensured that China adopted the membership of yet another international forum whose rules and regulations it agreed to abide by. Later, the US also worked with China in the East Asia Summit. In addition, the US and China collaborate daily in the UN Security Council to manage the “hot issues” of the day.

    The tragedy of 9/11 further solidified US-China cooperation. Apprehensions about the rise of China were replaced by a focus on the War on Terror. East Asia stopped being a priority for the United States for several years. This allowed China to rise peacefully and for the two countries to avoid the “Thucydides trap”.

    America made several wise decisions during this time. Firstly, America proceeded to admit China into the World Trade Organisation (WTO) in 2001. Although the admission was made on the basis of stiff conditions, these conditions ironically benefited China and forced it to open up to world trade – leading to its current pre-eminent position as the largest economy in the world in PPP terms.

    Another judicious call was to pay attention to China’s sensitivities on Taiwan. China had always regarded Washington’s policy towards Taiwan with suspicion, as they feared that the US could use the Taiwan issue as a means to destabilise China. Instead, America reacted wisely when in late 2003, the Taiwanese President Chen Shui-bian suggested that a referendum be held to assess the views of the Taiwanese people on independence. In response, President George W. Bush made it clear that the United States did not approve of his move. He said: “The comments and actions made by the leader of Taiwan indicate that he may be willing to make decisions unilaterally to change the status quo, which we oppose.” This was wise statesmanship, even if it was partly the result of Washington’s dependence on Beijing’s support for other more pressing issues, such as Iraq and North Korea.

    Some of these wise policies emerged out of America’s selfish interests, especially during the Cold War. However, it is possible that few Americans are actually aware how wise America has been. And even fewer Americans understand that it is in America’s national interest to continue these wise policies towards China. For example, since Deng Xiaoping opened up China in 1978 American universities have educated hundreds of thousands of Chinese students. In the years 2005 to 2012 alone, 788,882 Chinese students studied in American universities. This number has risen steadily – in the 2013-2014 academic year, 275,000 Chinese students were enrolled at American universities . This is an enormous gift from America to China. Future historians will be puzzled by this massive act of generosity as many of these students then return to China to build up the Chinese economy and to create innovations in many different spheres of science and technology that propel China forward in areas ranging from space exploration to defence.

    China has also contributed to the maintenance of friendly relations between the two countries. Firstly, China has “swallowed bitter humiliation” time and again and has reacted prudently to America’s mistakes. These mistakes included the bombing of the Chinese embassy in Belgrade in 1999 and the downing of a US spy plane in Hainan Island in China in April 2001. The tact and restraint demonstrated by China in both situations averted military action between the two countries.

    I have described these events in some detail as they help to explain a contemporary geopolitical miracle. Normally, when the world’s largest emerging power is about to pass the world’s greatest power, we should be seeing a rising level of tensions between the two (with the historical exception of one Anglo-Saxon power, the US, replacing another Anglo-Saxon power, the UK). It would therefore be perfectly normal to see rising tensions between the US and China today. Instead, we see the exact opposite: perfectly normal and calm relations between the US and China. This is a miracle.

    However, miracles are by definition historical aberrations. They don’t last. Soon, we will revert to the historical norm and competition and tension could rise between America and China. To prevent this from happening, both sides will have to make a special effort to continue on their extraordinarily wise courses.

    On the part of China, this means that it will have to learn lessons from the mistakes it has made in recent years in its dealings with its neighbours, especially Japan and Southeast Asia. For example, it completely mishandled an episode in which a Chinese fishing boat collided with Japanese Coast Guard patrols near the disputed Senkaku Islands on September 7, 2010. China unwisely demanded an apology from Japan after having publicly humiliated Japan into releasing the fishing boat. Similarly, China also mishandled the Korean crisis of 2010 by not condemning North Korea’s shelling of the South Korean island of Yeongpyeong. China also made aggressive statements and adopted more aggressive positions on the South China Sea in 2010 and 2011. When China submitted to the UN Commission on the Limits of the Continental Shelf a map including the nine-dotted-line territorial claim in the South China Sea on May 7, 2009, the Philippines lodged a diplomatic protest against China. Vietnam and Malaysia followed. Indonesia also registered a protest, although it had no claims on the South China Sea. In the face of this opposition, Chinese officials refused to back down.

    China has also made mistakes vis-à-vis its relations with ASEAN as a whole. The lowest point in China-ASEAN relations occurred in July 2012 at the ASEAN Foreign Ministers’ Meeting. Until then, for every year since August 1967, ASEAN had always succeeded in issuing an agreed joint communiqué after each Foreign Ministers’ meeting. However, in July 2012, for the first time in forty five years, ASEAN failed to do so. They failed because they could not agree on the paragraph referring to South China Sea. Nine of the ten countries agreed that ASEAN should reiterate the previously-agreed paragraph on this issue. However, the host country, Cambodia, refused to do so. It later emerged that Cambodia had come under heavy pressure from Chinese officials not to agree to these previously-agreed paragraphs on South China Sea. Clearly, China’s rise had made some Chinese officials arrogant.

    While China should learn from the mistakes it has made, America should study its own recent deeds through a simple lens: would it like China to replicate these deeds when China becomes number one? The reason for using this lens is that when China clearly becomes number one, it is likely to replicate abroad America’s deeds, not its words.

    Bill Clinton saw this coming long before any other American did. In a significant speech at Yale in 2003, he said the following:

    “If you believe that maintaining power and control and absolute freedom of movement and sovereignty is important to your country’s future, there’s nothing inconsistent in that [the US continuing to behaving unilaterally]. [The US is] the biggest, most powerful country in the world now. We’ve got the juice and we’re going to use it. . . . But if you believe that we should be trying to create a world with rules and partnerships and habits of behaviour that we would like to live in when we’re no longer the military political economic superpower in the world, then you wouldn’t do that. It just depends on what you believe.”

    Actually, as I document in The Great Convergence, Bill Clinton wanted to prepare his fellow Americans for the day when America becomes number two and China becomes number one while he was President. However, all his advisers firmly told him it would be politically suicidal for any sitting American President to talk of America becoming number two. Hence, he could only speak about it after he left office. Sadly, he has not said more on this issue after raising it in Yale. Hence, I fear that Americans are not psychologically prepared for the day when America will become number two.

    All this brings me back to the three stories that I began the lecture with. America was able to and could threaten to act unilaterally in all three cases because it is clear that America is still the reigning Emperor of the global financial system. Indeed, like many strong ruling monarchs, it enjoys absolute sovereignty in these areas and is not subject to any checks and balances.

    It unilaterally controls the global reserve currency, the US dollar. In theory, the US dollar is a global public good, but in practice, it is an instrument of American domestic and foreign policies. As former Treasury Secretary John Connally said in 1971, “It’s our currency but your problem”. Clearly, global interests are not taken into consideration when the US manages the US dollar. This is why many countries, besides China, were troubled by the QE measures.

    Similarly, America acted unilaterally when it applied its domestic laws in an extraterritorial fashion to foreign banks. Its threat to use SWIFT, another global public good, to unilaterally punish Russia could have had even more devastating consequences for the global order.

    And what would the devastating consequences be?

    To understand this, I hope you will look at my latest book The Great Convergence. One reason why the world has been remarkably stable and peaceful over the past few decades is that the rest of the world, especially Asians, who have been passive for almost two centuries, had agreed to accept and work with the Western-created family of global institutions, including the UN, IMF, and the World Bank. They agreed to do so because they believed that these institutions were serving global interests, not Western interests.

    This is therefore the big danger of the US using global public goods, like the US dollar, international banking transactions, and the SWIFT system, for unilateral purposes and ends. It will encourage the world, especially China, to work towards creating an alternative global order. If that happens, the world will become a far messier place.

    This is why I was happy to deliver this lecture at this time. We stand at one of the most important forks in human history. I hope America will continue its wise policies of strengthening a global order that serves global interests, not just American interests. If America does this, China will do the same. If this happens, nothing will change fundamentally when China becomes number one. We will continue to live in a safe and predictable world.

    Therefore the final question I need to answer is, “Will China emerge as a responsible stakeholder?” – to use the famous words of Bob Zoellick. My simple answer is this “China could emerge as a stakeholder that is as responsible as the United States”. Since America is still the number one power in the world, the big question that America should ask itself is a simple one: would it feel comfortable living in a world where China behaves just as America did when it was the sole superpower?

    Dean Kishore Mahbubani is Professor in the Practice of Public Policy, Lee Kuan Yew School of Public Policy, National University of Singapore.

    [1] Kishore Mahbubani, Dean of the Lee Kuan Yew School of Public Policy at the National University of Singapore, is the author of “The Great Convergence: Asia, the West and the Logic of One World.”

  • Carol Richards, Bree Devin. Supermarkets and food waste.

    In this blog on 25 February, I noted that the French parliament has voted to ban large food stores from throwing food away.  In the story below, Carol Richards and Bree Devin highlight the way powerful supermarkets in Australia push the cost of food waste onto suppliers and charities.  John Menadue

    At a time when one billion people globally experience hunger, as much as 50% of all food produced – up to two billion metric tonnes – is thrown away every year. In Australia alone, as much as 44 million tonnes of food is wasted annually.

    Last year, French supermarket chain Intermarché launched a highly successful campaignencouraging consumers to purchase “ugly” food. This year, France became the first country in the world to implement laws cracking down on food waste, with new legislation banning supermarkets from throwing away or destroying unsold food. Under this new legislation, supermarkets are required to donate any unsold food to charities or for animal feed.

    While there is no law in Australia requiring supermarkets to donate any unsold food, both Coles and Woolworths have aligned with food rescue organisations to donate unsold or “surplus” food.

    This surplus food is distributed amongst those experiencing poverty and food insecurity and is done voluntarily by the supermarkets under the banner of corporate social responsibility.

    But our research into the issue of corporate social responsibility and wastage of fresh fruit and vegetables has identified a number of tensions and contradictions, despite leading Australian supermarkets’ zero food waste targets.

    First, the strict “quality” standards required by the Coles and Woolworths duopoly means that a large volume of food does not reach the supermarket shelves. This is produce that does not meet size, shape and appearance specifications – such as bananas that are too small, or apples that are too red. If producers do not agree to meet these standards, they will lose access to approximately 70-80% of the fresh food market in Australia.

    Second, the two major food retailers do not take ownership of produce until it passes inspection at the distribution centres. It is here where suppliers, such as farmers and growers, are “invited” – under the supermarket’s corporate social responsibility initiatives – to donate rejected food to rescue organisations at their own cost, or otherwise pay for further transportation or dump fees.

    Thirdly, in an effort to reduce the high levels of food wasted at the farm gate, Australian supermarkets have followed France’s lead by marketing “ugly” food, (or what Intermarché termed “Inglorious Food”) – food that does not meet strict cosmetic standards, but is still perfectly edible.

    While a step in the right direction, this “apartheid” between beautiful and ugly food was criticised in this study for reinforcing values that perfection comes at premium and ugly food, which is often the way nature intended, should be price discounted. Growers are also concerned about the lower prices that “ugly food” attracts, and the flow-on effects to them in reduced profits.

    A final tension regarding food waste is “who is to blame”? Supermarkets attribute their high quality standards to consumer demands – however, consumers can only buy what is available at the supermarket. Supermarkets have also been criticised for marketing tactics that encourage household food waste, such as “buy one, get one free” campaigns.

    Despite the lack of transparency regarding food waste in the supply chain, supermarkets – with their powerful market position at the end of the supply chain – are in a good position to transfer the problem of waste elsewhere.

    They do this by setting cosmetic standards in the procurement of food which results in high level of wastage, not taking ownership of produce that does not meet their own interpretation of the standard, claiming corporate social responsibility kudos for donating to food rescue organisations (while at the same time saving on dumping fees) and differentiating between “beautiful” and “ugly” foods – reinforcing difficult-to-attain standards of perfection.

    Much of the food wastage and transfer of blame for food wastage can be attributed to the market power of the duopoly. Most significant, are the proprietor-driven private standardswhich require produce to be perfect.

    Although donating to food rescue organisations may be positive for people in need, it does not address the structural problems of the supply chain. This raises the question of state-led regulation, as with the case in France, to restrict food wastage at the retailer level. However, more is needed. Food waste is one symptom of excessive market power, something that needs to be addressed to steer mass food retail in a more sustainable direction in Australia.

    Carol Richards is Vice Chancellor’s Senior Research Fellow, Queensland University of Technology.  Bree Devin is Lecturer in Public Relations, Queensland university of Technology. This article first appeared in The conversation on February 29, 2016.

  • Rosemary Breen. Living Water Myanmar

    Five years ago, when I started this project of building large water tanks to collect water during the rainy season in the Dry Zone of Central Myanmar I had no idea how many lives would be changed because of this simple concept. To date 114 water tanks have been built for villages and schools due to the generosity of so many donors in Australia, the USA and the UK.

    As the Australian coordinator, I have given talks and shown a Powerpoint presentation to many groups in order to raise funds, while Saya Toe, the coordinator in Myanmar, organises the team of builders who go from village to village building the tanks with help from the local people. Each time I visit there are requests for tanks from the village headmen or head teachers of schools and seeing the poverty and great need, it is hard to refuse. There are over 650 villages in the Dry Zone and the government has done nothing over the last sixty years to alleviate the situation.

    In January, 2015 I visited a school and the head teacher showed me a small concrete container filled with brown water from the local dam (there were even leaves floating in it) It was the drinking water for the schoolchildren. She said simply: “Please help us – we are so thirsty!” When I returned in October, 2015, I was shown the same concrete container filled with sparkling, clear water which had been piped from the large tank built several months previously. It was a moving moment watching the children come and drink there.

    So once again I am making an appeal for these children and their families in one of the most impoverished parts of our world (a country which has been shut away from the rest of the world by its repressive military regime for many years) Any donation, however small, would be gratefully received and a tax-deductible receipt given.

    Living Water Myanmar partners with Global Development Group for Project J812N Living Water Myanmar. Donations can be made online (simply google Global Development Group) but it is really important to put the project name and number.

    Cheques can also be sent to GDG,

    56, Goorari St, Eight Mile Plain, Qld 4113 (with the project number and name on back of cheque.

    It is a great help if donors could also email me (rosemary.breen6@bigpond.com)

    Saya Toe has recently set up a Facebook page (Living Water Myanmar) for anyone interested to see some of the recent work. Each village or school which receives a tank is committed to planting ten trees to help the environment.

    Each time we have a drink of water, take a shower, flush the toilet, water the garden, turn on the washing machine or dishwasher, may we remember our brothers and sisters for whom clean water is a luxury and may it remind us to share generously with them.

    In gratitude,

    Rosemary Breen

  • Merriden Varrall. The Chinese elephant in Australia–Japan relations

    Earlier this month, Foreign Minister Julie Bishop visited Tokyo, where she outlined an increasing emphasis on security cooperation between Japan and Australia. The next day she was in Beijing, where she reportedly received a frosty reception. The two are not unrelated — Beijing is not thrilled about Australia’s growing security ties with Japan.

    Because Australia is concerned about China’s increasing assertiveness in the region, but at the same time benefits from China economically, we find ourselves in somewhat of a foreign policy pickle. In this very complex situation, it is critical that Australian policymakers respond with both immediate and long-term outcomes in mind. To understand the long-term implications for Australia’s interests of policies drawing Japan and Australia closer together, we need to understand how Chinese policymakers view the world and China’s role within it.

    Opinions of Sino–Australian relations in Australia are ambivalent and often sceptical. The 2015 Lowy Institute Poll clearly shows Australia’s ambivalence towards China. While most Australian trust the United States, they are far less certain about China. Australians have conflicting views about what China’s intentions are and what they mean for Australia. Of the respondents, 61 per cent felt that China wants to dominate Asia, and just over half thought that China’s growth into an important global power does not make the world more stable.

    At the same time, 67 per cent felt that the Chinese government aims ‘to create a better life for Chinese people’, and, compared to 2014, fewer Australians in 2015 felt that China is likely to pose a direct military threat to Australia in the next 20 years.

    Despite, or perhaps because of, these uncertainties, Australians appear eager to hedge their bets and play it safe with China. 73 per cent agreed that ‘Australia should develop closer relations with China as it grows in influence’. Fifty-two per cent believed that Australia should not join with other countries to limit China’s influence.

    The Poll suggests that Australians are not sure what the consequences of China’s growing global influence will be. All the same, there is a strong sense that Australia would be wise to be on good terms with China as it becomes more powerful. This was a view that underpinned Australia’s decision to become a founding member of the Asian Infrastructure Investment Bank, despite US disapproval.

    In comparison to China, Australians view relations with Japan more positively. In a thermometer measuring warmth of feelings towards other countries, Japan rated 68 degrees, to China’s lukewarm 58 degrees. While an overwhelming majority of 84 per cent said that Australia should remain neutral in the case of a ‘military conflict between China and Japan’, 11 per cent said Australia should support Japan, and only 3 per cent said it would be better to support China. This relative warmth towards Japan is reflected in Australia’s deepening security ties with Japan, as shown in its signing in February 2016 of an agreement on new joint maritime security and surveillance operations in the Pacific.

    China does not react positively to these growing Australia-Japan security linkages. Future security agreements between Australia and Japan need to take the worldviews of China’s policymakers into consideration. Failing to acknowledge how Chinese policymakers themselves see the world, and how China fits into it, can lead to policies that are ineffective, if not counter-productive, in the longer term.

    Several worldviews within which Chinese policymakers operate are particularly relevant to Chinese understandings of its place in the world, namely: the century of humiliation, a conception of national cultural characteristics as inherent and unchanging, the idea of history as destiny, and notions of filial piety and familial obligation that apply both inside China and to its neighbours. These four ideas add up to a foreign policy paradigm that assumes China will resume the central role it once played in regional and global affairs.

    Many Chinese policymakers feel that the United States and its allies are holding China back from its rightful leadership, and from the global benefits such leadership would bring. As such, rather than providing a disincentive from further ‘bad behaviour’, this kind of security cooperation creates the serious risk of further entrenching China’s sense of exceptionalism and exclusion from — and irrelevance of — the prevailing international order. China’s disapproval is in itself counterproductive, and serves to reiterate the uncertainty and tension that led to Australia and Japan seeking closer security cooperation.

    This negative cycle of mistrust is already having consequences for the security of the region. The call to understand Chinese perspectives when determining foreign and security policy is not an argument for simply accepting China’s view of the world as correct, or appeasing China. Rather, it is about clearly surveying the reality of the regional security situation, and taking long-term goals into consideration when making policy choices now. We should be aware that what may seem to be effective deterrence policy today may be creating more complicated security dilemmas in the future.

    Dr Merriden Varrall is the Director of the East Asia Program at the Lowy Institute. This article was first published in ANU East Asia Forum on 4 March 2016.

     

  • David Isaacs. As bad as Guantanamo

    If I liken the immigration detention centres on Nauru and Manus Island to the US facility on Guantanamo Bay, even passionate advocates for those seeking asylum such as human rights lawyer Julian Burnside dismiss my concerns: “Oh we’re not as bad as that.” I will argue that we are indeed as bad as that, possibly worse.

    Many people fleeing persecution to seek asylum have been subjected to psychological trauma in the countries they are fleeing and in the often highly traumatic journeys they take to reach ‘freedom’. However, people seeking asylum who are subjected to prolonged immigration detention are significantly more likely to suffer severe mental health problems than people seeking asylum who are not detained. Furthermore, the incidence of mental health problems increases with duration of incarceration. The United Nations defines torture as “…any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions”. Since prolonged detention without trial is unlawful under international law, Australia’s immigration detention policy clearly fulfils the key elements of the UN definition.

    Arguably what makes Guantanamo so bad is four things: lack of due process for imprisoning people there, lack of accountability (limited information, no transparency), indefinite imprisonment without due process (seemingly arbitrary legal processing, lack of clear end-point to imprisonment); and severe physical and mental maltreatment. Nauru and Manus share the first three characteristics with Guantanamo. Nauru and Manus, like Guantanamo, are ‘black sites’, out of sight and mind of the public, shrouded in secrecy, with severe restrictions on reporters. The Australian Border Force Act means employees including doctors, lawyers, teachers and guards who report the truth face two years imprisonment. Yet, for an Australian offshore detention policy to be successful in deterring people-smuggling, the stated intention, none of these four things are necessary. Therefore, even if you accept the Government justification for the Australian asylum seeker policy, the current treatment is unethical.

    Guantanamo is arguably worse in one respect: we know men are systematically tortured physically using techniques like water-boarding. However, Nauru is worse than Guantanamo in one hugely important respect: it includes children. When we surveyed Australian paediatricians, over 80% said immigration detention of children is child abuse. Successive Australian Governments have outdone the US Government in cruelty by torturing and abusing innocent children, all with the immoral aim of deterring other innocents.

    Furthermore, those imprisoned on Manus and Nauru are not terrorists; indeed, they are not guilty of any criminal offence, since seeking asylum is not a crime. Although the occasional innocent man was interned on Guantanamo, most knew what to expect when they went to war. In their autobiographies, Primo Levi and Nelson Mandela both astonishingly attempted without rancour to understand the motives of their captors; when they took up arms to fight injustice, they both knew the consequences if caught. On Nauru and Manus Island, in contrast, the injustice is being perpetrated against the very people seeking asylum. There can be few worse things than to be imprisoned unjustly and kept there indefinitely without right of appeal. Australia tortures innocent men, women and children who come begging for mercy. No wonder we are reviled internationally.

    When I worked on Nauru in December 2014, the predominant emotion was of utter despair and hopelessness. What would you do if you were imprisoned unjustly and indefinitely without right of appeal? In the current culture of victim-blaming, if you get depressed and self-harm or attempt suicide, you are accused by the Government of seeking preferential treatment. If you subsequently kill yourself, you had pre-existing mental health problems. If you get angry enough to riot, you are accused of violent ingratitude, with no mention of the extreme provocation that causes normally placid people to get angry enough to resort to violent protest.

    Gillian Triggs and the Australian Human Rights Commission have tirelessly and courageously exposed the harms done to children in immigration detention. The harm is also to adults, of course. But the very term ‘human rights’ implies an obligation, which risks being somewhat confrontational. Australia’s reprehensible treatment of people seeking asylum is as much a question of human decency as human rights. No civilised country should behave like this to fellow human beings. We treat refugees with respect and generosity. We treat people seeking asylum with contempt and cruelty. We talk of showing compassion, and in the same breath tell the meek to go back to where they came from. Australia is traditionally the land of the fair go, but in the words of president of the Australian Medical Association, Brian Owler, current asylum seeker policy is tearing at the moral fabric of our society. We, the public, need to prevail on all our politicians to listen to our pleas to find a new moral direction. Please help us re-discover our soul.

     

    David Isaacs is a consultant paediatrician in a University teaching hospital in Sydney, where he has run a Refugee Clinic since 2005, and is Clinical Professor at the University of Sydney

     

     

     

     

  • What has gone wrong with Malcolm Turnbull’s NBN?

    In a column in The Drum on the ABC, Paddy Manning comments that

    ‘Malcolm Turnbull’s version of the NBN is proving to be much more expensive to deliver than was originally hoped. Remember that the only merit of Turnbull’s “multi-technology mix” (MTM) was that it would be cheaper to build …’

    See link to article below:

    http://ab.co/1Sef8pS

  • Evan Williams. Oscars and other frivolities

    My vote for best performance by an actor in this year’s Oscars goes to Leonardo DiCaprio – not for his much-touted appearance in The Revenant, but for his rousing speech at the presentation ceremony. I don’t know if he scripted it himself – if he did he deserved a screenplay Oscar as well – but I rate it the most powerful contribution to the climate debate delivered from a public platform in recent memory. His passionate plea to “save the planet” drew cheers from the crowd. Yes, I know showbiz luvvies tend to be self-indulgent lefties and climate alarmists, but what an audience he had! By all accounts he was heard by 80 million people around the globe. What politician could wish for more?

    Speaking of politicians and great performances – and digressing for a moment – TV audiences the same evening witnessed rare footage of Malcolm Turnbull shedding tears on camera while recalling an encounter with an indigenous woman. It may not have been Oscar-winning material, but at least it showed Malcolm has a heart (as I suspect it was meant to do), and put Malcolm in the same lachrymose company as Bob Hawke, who famously shed a prime ministerial tear before the cameras while speaking of problems in his family. Cardinal George Pell made another TV appearance on Oscar night – this one from Rome – but I rate it the least impressive of the night’s offerings. No tears from George. Not yet.

    Getting back to the actual ceremony, I found DiCaprio a much more impressive performer than Chris Rock, the black comedian who hosted the evening and treated us to a seemingly endless harangue on the vexed issue of white actor bias in the Oscars. It’s not the first time the disparity has been noted. But could the reason simply be that, like it or not, more parts are written for white actors than black ones, or as we now say, for people of colour? It’s fanciful to suggest that the imbalance has anything to do with conscious racial prejudice. When actors of colour are called for, actors of colour are cast – witness In the Heat of the Night (1967), Gandhi (1982), The Last Emperor (1987), Slumdog Millionaire (2008), and 12 Years a Slave (2013) – all featuring great performances by actors of colour, and all of them Oscar-winning films. So there, I’ve had my say.

    What else? My vote for best costume design goes to Cate Blanchett for the frilly blue number she was wearing on the red carpet – the one with the non-existent neckline – which may be some consolation, I trust, for missing out on a best actress Oscar for Carol. Which brings me to the high point of the evening – those six gongs for Mad Max: Fury Road, a wonderful boost for the local industry. Admittedly they were only “technical” awards – best sound mixing, best hairdressing, makeup and the like, which most audiences couldn’t care less about – but when the film is revived soon in Australian cinemas, as it surely will be, “Winner of Six Academy Awards” is going to look great in the ads. It was the biggest Oscar haul by an Australian film since Jane Campion’s The Piano in 1993, which picked up best picture as well.

    Whether Mad Max deserved the best picture Oscar that many were hoping for is another question. Technical tour de force it may be, but for my money, The Big Short and Carol were both better films. And much as I hate to say it as a loyal, movie-going Australian, Mad Max: Fury Road strikes me as the apotheosis of today’s debased, spiritually exhausted, action-ridden cinema in which plot, character and dialogue are subservient to the hyper-kinetic demands of stuntmen and special effects designers. The film has almost no dialogue – though, as The Artist beautifully demonstrated in 2014, it’s possible for a silent film, even a silent film in black-and-white, to win the Oscar for best picture.

    But whatever you think of Mad Max: Fury Road, you have to feel sorry for George Miller. Six Oscars and he couldn’t crack it for best director. Bruce Beresford met a similar rebuff in 1989 with Driving Miss Daisy, which picked up four Oscars, including best picture and best screenplay, but no director’s gong for Bruce. And it was noticeable this year that Spotlight – of which more later – won both best picture and best screenplay but no prize for the director, Tom McCarthy.   All of which raises an old question: if you have a great script, how important is the director’s contribution to the final product? Well, of course, it’s important – some would say all-important – but not perhaps in ways that audiences care about. Alfred Hitchcock directed some the best films ever made, and no director in the 20th century was more widely admired and imitated. But Hitchcock never won an Oscar for direction. A few years before he died he was given an honorary one for lifetime achievement.

    And so to Spotlight – a fine film, an important film, though not, I think, a great one. To many people’s surprise it beat The Revenant for the best picture award. Reviewing it a few weeks ago, I wrote that it consisted of little more than a series of low-key conversations – which put it well outside the Mad Max class as an action movie. But it’s unfailingly gripping and well-crafted. This is the one about a team of reporters on the Boston Globe uncovering evidence of child sexual abuse in the Catholic Church in Massachusetts. The parallels with the church’s crisis in this country are obvious enough, which is no doubt helping at the local box-office.

    Tragically, clerical paedophilia has become a hot-button issue, and I suspect that Spotlight got its best picture Oscar at least partly on the strength of its topicality. When the Academy members were casting their votes, George Pell had yet to give his latest round of evidence to the Australian royal commission, but the scandal that rightly or wrongly surrounds him was already widely known abroad. Is it possible that George helped swing a few votes in Spotlight’s favour, perhaps clinching the Oscar for it? No doubt he would hate to think so, but at Oscar time, never underestimate the power of a cardinal.

    Evan Williams reviewed films in The Australian newspaper for 33 years. He is a Life Member of the Film Critics’ Circle of Australia for services to film criticism and the film industry.In 2015 he received the Geraldine Pascal Lifetime Achievement Award for critical writing.

     

  • Building Australia’s white elephant – cheap buy for white knight Telstra

    Tony Abbott gave Malcolm Turnbull instructions to undermine the NBN. As Minister for Communications it is apparent that that is what Turnbull did. As Prime Minister he could have reversed the damage to NBN. But he chose not to. In the following blog published by Paul Budde, he points out that both Infrastructure Australia and PwC  express major concerns about the value of the investment in the NBN if at some time in the future the Australian government decides to sell it. 

    See comments by Paul Budde below.

    John Menadue.

     

    Both Infrastructure Australia and PriceWaterhouseCoopers (PwC) have now weighed into the NBN debate.

    They have looked at the value of the NBN in relation to the future sale of the company.

    The eventual privatisation of the NBN is one of the few areas on which both sides of politics agree. That being the case then it would be prudent to build an NBN that maintains its value and will fetch a good price. Let’s say that it should at least cover the costs of the project at the time a sale is being considered. Because of the national interest it could be argued that simply covering the cost would be sufficient.

    However building a potential white elephant in the form of the multi-technology mix is certainly not going to deliver on this. There is global consensus that eventually the majority of the national fixed telecoms networks will need to be based on FttH. In Australia the NBN company is not building such a future-proof network – quite the reverse – it is using out-of-date technologies with no plan as to how to move on from this version to a robust network fit for Australia’s interconnected economy. Those who eventually might buy the NBN will have to make a massive investment in getting rid of the MtM and replacing it with FttH, not something many potential buyers will be interested in.

    In a recent assessment of the NBN, Infrastructure Australia also addressed, among other things, the potential sale of the NBN; and in order to prepare themselves for such a sale they stated: ‘To prepare for a future sale, it will be important that NBN Co does not “enmesh” different technologies in a way that cannot be separated later.’

    But that is exactly what the NBN company is building – a mesh NBN, even named by the government as such, a multi-technolgy mix (MtM).

    Neither the NBN company nor the government have revealed any plans on how they envisage moving the NBN beyond this technology mesh (or mess).

    When the original NBN was developed all of the elements that made up the plan made sense: a superior FttH network, Telstra moving out of the infrastructure business, wholesale-only structure and so on.

    With a superior FttH in place, all parties involved would benefit. Consumers and businesses would get superior services, telcos and ISPs would not have to invest in duplicating or overbuilding infrastructure (if you skip to a superior technology duplication would not be economically viable) and the government would build a good foundation for the Australian economy and society – a true national interest infrastructure for healthcare, education, government services, business, entertainment and so on.

    Since Tony Abbott’s plans to demolish the NBN, and Malcolm Turnbull’s subsequent second-rate proposal, we have warned that if you start to change the key principles of the NBN the whole venture will collapse like a house of cards.

    We are now getting a second-rate network and the first signs from customers, as we heard in a recent Senate Hearing, are not good. This is in line with our assessment. An MtM network, by its very nature a mesh network, will not be able to deliver consistently good quality services to all customers. Telcos and ISPs are not happy with the second-rate system and want to bypass the NBN with their own fibre and mobile services. And there has been dead silence from the government on the potential economic role the NBN has in relation to innovation, healthcare, education and so on. Belatedly the NBN company is now arguing that the NBN debate should move from politics and focus on what we, as a nation, want from it.

    From 2005 onwards I have time and again stated to both sides of government that before you technically design the NBN you will first of all need to have a plan for what you want to achieve with it. Only then can engineers come up with the right technical solutions.

    The white elephant scenario that the government is now pursuing will see the NBN fail, as it is not future-proof and consumers and businesses will want a better network. In other words, large parts of the $50 billion+ investment in the NBN will not be valued by the market at the time of sale – that is if the government relentlessly and single-mindedly pursues its MtM NBN.

    This is where the report from PwC kicks in, they stated that the value of the NBN, once ready somewhere around 2025, will not be worth more than $27 billion.

    We believe that there will be only one potential buyer for the mesh/mess NBN and that will be Telstra, one of the most successful and richest national telcos in the world. They will never pay the full price for the NBN and because of the NBN mesh it is highly unlikely that any other company will pay such a price for the infrastructure. It is even questionable if they will be willing to pay the price of around the $27 billion price tag.

    So it will end up in a fire sale and because of its wealthy and powerful position Telstra will be the white knight. It might pay a bit above the fire sale price and incorporate whatever it can use into an FttH network that it will then proceed to build for Australia.

  • Jeffrey Knapp. Big four accounting firms avoid scrutiny in multinational tax avoidance.

    The Senate Inquiry into corporate tax avoidance is due to hand down its final report by April. One of the lesser-mentioned groups appearing before 2015’s Senate hearings are Australia’s big four accounting firms.

    Multinational companies like Apple, Chevron, Google, Microsoft, and News Corp have dominated headlines, but little has been said of the role of PwC, KPMG, Deloitte and EY. After all, it is the big four firms that audit the accounts of leading multinational companies and render assistance with their taxation affairs.

    The big four firms claim they are supporters of transparency because it is fundamental to building public trust and confidence in the accounting profession.

    But when asked about the accounting practices of their multinational corporate clients during the November 2015 Senate inquiry hearings in Sydney, the big four firms were far from transparent.

    Senators questioned the firms about why at least 20 leading multinational companies had switched from general purpose accounts to special purpose accounts, resulting in fewer financial disclosures and lower transparency.

    The switching multinationals (with auditors in brackets) include Bupa Australia (KPMG), News Australia (EY), JBS Holdco Australia (KPMG), Serco Australia (Deloitte) and Johnson & Johnson (PWC).

    Whereas general purpose accounts comply with disclosure requirements across 40 plus accounting standards, special purpose accounts can follow as few as five standards. Special purpose accounts also allow multinationals to avoid audited disclosures of transactions and balances with related parties in foreign jurisdictions including tax havens.

    Why it matters

    Users that might rely on the information in general purpose accounts for making and evaluating resource allocation decisions are not limited to shareholders. It is reasonable to expect that other stakeholders of super-sized multinationals depend on general purpose accounts for decision-making.

    The operations of multinationals like Bupa, News, JBS, and Serco touch the lives of a significant number of Australians. Company stakeholders such as contractors, employees, customers and government agencies should have access to general purpose accounts.

    These multinational companies have dominant or powerful market positions with revenues and assets in the billions of dollars, government funding or contracts and creditors including thousands of employees. In switching to special purpose accounts, the companies and their big four auditors have undervalued two key indicators that general purpose accounts are required.

    The greater the economic or political importance of an entity, the more likely it is that there will exist users dependent on general purpose financial reports as a basis for making and evaluating resource allocation decisions. (Statement of Accounting Concepts SAC 1 paragraph 21)

    Financial characteristics that should be considered include the size (for example, value of sales or assets, or number of employees or customers) or indebtedness of an entity. The larger the size or the greater the indebtedness or resources allocated, the more likely it is that there will exist users dependent on general purpose financial reports as a basis for making and evaluating resource allocation decisions. (Statement of Accounting Concepts SAC 1 paragraph 22)

    No reason was given for switching to special purpose accounts. No disclosure was made of why fewer disclosures had become appropriate. The omission of this disclosure appears to be at odds with the following black letter requirement in accounting standards:

    When a voluntary change in accounting policy has an effect on the current period or any prior period … . an entity shall disclose: (a) the nature of the change in accounting policy; (b) the reasons why applying the new accounting policy provides reliable and more relevant information; (Accounting Standard AASB 108, paragraph 29)

    The unstated premise of the big four firms is that users who had previously relied on general purpose accounts were no more. In truth, there is no logical way to defend this vanishing because the super-sized multinational companies were still teeming with stakeholders.

    Consider the employees (shown in brackets) at Bupa (11,295), News (8,564), JBS (7,721), and Serco (6,000) when the switches to special purpose accounts occurred.

    Asked about the switches at the Sydney hearing, representatives of the big four firms stuck to the confines of their individual roles as tax partners. They claimed to be unable to shed light on the issue because it was dealt with in a different section of their firm – that is, audit and assurance.

    Not a single person in these leading multinational companies or the big four firms has subsequently presented a single cogent reason to explain the switching to special purpose accounts.

    At least the Australian Accounting Standards Board (AASB) made something of an effort to come up with an explanation at the Sydney hearing, albeit not a particularly salient one. AASB chief executive, Kris Peach said:

    “What we are saying is that there is an accounting concept which is a reporting entity concept. It is quite subjective in how it is applied… I do think that economic significance is important, but it is very hard to actually determine what economic significance is, and that is why there needs to be some good consultation around that . .. .Where we need to get to is that the end criteria are very objective.”

    Apparently, the concept is to blame for leading multinationals being less transparent. The concept is too subjective. The concept relies on substance over form and professional judgement. But aren’t accounting concepts supposed to be like that? What is an asset? Isn’t that subjective too?

    The truth is that there is nothing wrong with the existing user-based concept for general purpose accounts. The concept has applied since 1990. The switching to special purpose accounts by leading multinationals and their big four auditors is a relatively recent phenomenon.

    The accounting evidence at the Senate inquiry into corporate tax avoidance is cause for public concern. It gives an impression that the big four firms are prepared to overlook generally accepted accounting practice for multinational clients with deep pockets.

    The partners with gravitas at the big four firms need to take stock of the accounting practices that have emerged from their leading multinational clients. Priority number one should always be keeping faith with the concepts and standards of the accounting profession. Public confidence is not a trifling matter. Audits and auditors will soon be obsolete if standards are not maintained and enforced. Professional judgement of subjective accounting concepts is the key thing that auditors have done for time immemorial.

    In December 2015, the Parliament introduced new tax laws so that significant global multinational corporations must henceforth furnish general purpose accounts to the Australian Taxation Office. In effect, the Parliament had to bypass the AASB and the big four firms to get a better outcome.

    Most chartered accountants place great value in their designation and are careful to protect the legacy and reputation of the professionals that have gone before them. The big four firms are not immune from this vigilance. If the big four firms wish to remain prosperous over the long run, then they need to support transparency in what they do not just in what they say.

    Jeffrey Knapp is Lecturer/Accounting, UNSW.  This article was first published in The Conversation on 25 February 2016.

     

  • Kerry Goulston. Postcard from Vietnam. Health and medical cooperation with Vietnamese doctors and nurses.

    In 1998, Dr Phillip Yuile visited Professor Ton That Bach, Rector of Ha Noi Medical University, with a letter of introduction from Professor Kerry Goulston, Associate Dean of Medicine at the University of Sydney who had been appointed by the then Dean, Professor John Young, to explore possible links between the two universities. Subsequently Professor Ton That Bach invited Professor Goulston to Ha Noi to discuss a collaborative association between Sydney University and Ha Noi Medical University which had been established by the French in 1902..

    Professor Ton That Bach was highly respected by colleagues and beloved by his students, all of whom he knew individually by name. After he died suddenly in 2004 at Lao Cai he was given a state funeral and thousands paid their respects in the streets of Ha Noi.

    A meeting was held in Ha Noi in November 1998 between Professor Ton That Bach and Professors Kerry Goulston, Professor Bruce Robinson and Associate Professor Phillip Yuile from Sydney University. The purpose of the meeting was to formalize ties between the two institutions and to begin planning future activities. At an inter-country level this process was facilitated by the Australian Ambassador to Vietnam at the time, Mr Michael Mann. A warm relationship quickly developed with Professor Ton That Bach who stressed that he foresaw a continuing association centred on young doctors and nurses between the two Universities. He said that, although traditionally there had been medical linkages with France, he would like to see new links develop with Australia.

    Subsequently, in December 1998, an exchange program commenced with five students from the Sydney University Northern Clinical School spending an elective term in Ha Noi. Sponsorships were provided by the Sydney University Northern Clinical School, Ramsay Health Care, the Australian Returned Services League and private individuals.   In February 1999 the exchange relationship between the two countries commenced with Vietnamese doctors visiting Sydney hospitals under the auspices of the Sydney University Faculty of Medicine .

    In December 2001, Professor Ton That Bach, his wife Dr Nguyen Thi Nga, Head of the Blood Transfusion Service in Ha Noi and Dr Dang Van Duong visited the Northern Clinical School and the University of Sydney where Professor Ton That Bach was made an Honorary Fellow of the Faculty of Medicine and met with many academics and clinicians and signed a Memorandum of Understanding between the two Universities.

    Also in 2001, Hoc Mai, The Australia Vietnam Medical Foundation was established as a non-profit Foundation of the University of Sydney with Professor Marie Bashir, Governor of New South Wales, as Patron. The name “Hoc Mai”, meaning “forever learning”, was proposed by three young Vietnamese doctors, Trinh Binh Giang, Nguyen Van Bay and Ha Phan Hai An.

    Since 2001, over 300 Vietnamese doctors and students have spent time in Australia under the sponsorship of Hoc Mai. These have included postgraduate degree students, participants in short formal courses and doctors on short clinical placements.  In turn, over 200 Sydney University medical students have carried out their Elective Term in Vietnam under the supervision of Professor Dang Van Duong. There have also been numerous visits by individuals and teams of Sydney University academic clinicians who have lectured and taught short courses on a wide variety of topics in Ha Noi and at other centres in Vietnam.

    Further Memoranda of Understanding between Ha Noi Medical University and Sydney Medical School have been signed by Professor Nguyen Lan Viet as Rector of Ha Noi Medical University in 2005 and by Professor Nguyen Duc Hinh who was appointed Rector of Ha Noi Medical University in 2008. Professor Nguyen Duc Hinh has visited Sydney a number of times and has been made an Adjunct Professor of the University of Sydney.   He has cemented the longstanding close relationship between the two universities.

     Medical English

    In 2007 the first of many short courses in medical English was held at Bach Mai Hospital in Ha Noi. The aim of these free courses is to give Vietnamese healthcare workers who have basic English language competence the opportunity to hear conversational English spoken in a medical context and to assist them in speaking English. These interactive small group courses are intended to help with grammar, pronunciation, syntax, expression and medical vocabulary. Since 2007 many hundreds of Vietnamese doctors, nurses and other health care professionals have participated in these courses which have been held at several hospitals in Ha Noi. In 2011 this English language program was extended to include nursing students in the Ha Noi Medical University Advanced Nursing Program. These courses are held over four days in February and in September and are taught by Australian volunteer doctors, nurses and others who travel to and stay in Ha Noi at their own expense.

    New methods of medical teaching

    A one-day workshop was held  at Ha Noi Medical University in December 2009, attended by the Rector of Ha Noi Medical University, senior academic staff, clinicians and educators with the aim of determining educational priorities to which Hoc Mai could contribute. Four areas were identified: (a) teaching medicine and medical skills in English (b) defining learning objectives (c) introducing new teaching methods (d) introducing new methods of assessment. Subsequently, visits by Sydney Medical School academics helped to introduce new methods of assessment such as Scorpio and Mini-Cex for students and young doctors at Ha Noi Medical University and Ha Noi Hospitals.

    Advanced Course in medical teaching and research for talented Ha Noi Medical University graduates

    This course, which is conducted in English, is intended to provide a select group of outstanding recent Ha Noi Medical University graduates with ideas and tools to enable them to introduce and lead change in medicine and health care in Vietnam in the future. The course, which has been held yearly since 2010, was originally funded by Atlantic Philanthropy but in the past five years has been supported by competitive grants from AusAid and the Australian Department of Foreign Affairs and Trade and through the generosity of several private individuals.

    The course  has three components: (a) periodic four-day visits to Ha Noi Medical University by small teams of Australian clinical academics from a wide variety of specialties  (b) on-line interactive tutorials held approximately every 3 weeks (c) a four-week visit to Sydney involving two weeks of intensive tutorials and a two-week  clinical placement in Sydney hospitals.

    Each year, around 60 potential participants are chosen by Professor Nguyen Duc  Hinh, Associate Professor Ha Phan Hai An and Associate Professor Van Dang Duong on the basis of their academic record. All are then interviewed in Ha Noi by Australian Hoc Mai members using a structured interview to assess their ability to understand and speak English. Applicant’s curricula vitae and referees’ reports are also taken into account. Through this process around 20-25 are selected to attend the four-week immersion course in Sydney.

    The curriculum of the entire Advanced Course covers topics which are essential for future health care in Vietnam but which are not widely taught at present. These include but are not limited to: evidence-based medicine, communication skills, patient management plans, assessing clinical skills, effective clinical handover, medical ethics, professionalism, disability , leadership management, clinical errors and patient safety, child protection, pain management, hospital infections and hygiene, smoking cessation, health workforce, research methods, medical statistics, using the internet for clinical purposes, presentation skills, publishing a research paper and preparing a curriculum vitae.  Individual course components and the program as a whole are evaluated anonymously by the participants and reported to the teachers. At the end of the course, depending on the availability of funding, a number of participants are selected for an intensive four-week program of further teaching and supervised placements at Sydney Medical School and associated hospitals in Sydney. In addition to this program, Professor Owen Dent has conducted three day-long workshops on the use of the SPSS statistical computing package in clinical research and in February 2016 year a workshop on hospital management and leadership was held in conjunction with the February session of the Advanced Course in Medical Teaching and Research and the Medical English program. This was organised by Professor Huong and was attended by 140 participants.

    Kerry Goulston is Emeritus Professor of Medicine, University of Sydney.

  • Evan Williams. Film review ‘Spotlight’

    Evan Williams recently reviewed Spotlight. This film has now won the Best Film at the recent Oscars. This review is reposted below. Evan Williams will soon also write on the Oscar awards in general.  John Menadue.

    The other night I watched a DVD of Foreign Correspondent, Alfred Hitchcock’s wonderful thriller about a newspaperman on the trail of a secret spy ring. Nostalgic as I am for the glory days of print journalism, I love the moment when the paper’s editor yells from his desk: “Hold the front page!” You don’t hear that any more. Films about newspapers – those who own them and those who work for them – tend to be either very funny or very serious.

    And a surprising number are cinema classics. Lewis Milestone’s The Front Page was one of the wittiest comedies of the thirties. In Citizen Kane (still considered by many the best film ever made), Orson Welles brilliantly captured the power-hungry paranoia of his ambitious media baron. And two years after Richard Nixon resigned, Hollywood gave us All the President’s Men, recounting one of the great feats of modern investigative journalism – the unmasking of the Watergate scandal by two dogged reporters from the Washington Post. The film collected four Oscars and set a benchmark for the genre.

    Tom McCarthy’s Spotlight (rated M, on general release) is in the same exalted company. It’s gripping, it’s sordid, and it’s desperately sad. In 2001, four journalists from the Boston Globe were assigned by their paper’s newly-appointed editor to investigate allegations against a defrocked priest, John Geoghan, accused of molesting more than 80 boys in Massachusetts. After months of work, the Spotlight team – as they were known – uncovered a pattern of rampant sexual abuse within the Church and a systematic cover-up by senior prelates. It’s a familiar story. A closing title for Spotlight lists scores of cities around the world where similar evidence of abuse has been revealed. And here in Australia, thanks to Julia Gillard, a seemingly endless royal commission continues to enliven evening news bulletins with reports of sleaze and depravity in holy places, though in fairness it must be stressed that the horrors aren’t limited to the Catholic Church. Other religious denominations, high-profile schools, sporting bodies, the armed services – all have endured their share of ignominy. Our latest prime-time penitent was the hapless Peter Hollingworth, former governor-general and archbishop of Brisbane. making a ritual mea culpa for the TV cameras.

    With a screenplay by McCarthy and Josh Singer, Spotlight is little more than a series of conversations. There’s nothing you’d call action – except, perhaps, when some character or other breaks into a run while crossing the newsroom floor. That’s as fast as things get. All is slow, plodding, painstaking – and wholly engrossing – much, as I imagine, like the investigation itself. And what a frustrating business that must have been – with every possible difficulty encountered along the way – legal constraints, reluctant witnesses, ecclesiastical obstruction, privacy laws, confidentiality agreements, the Massachusetts statute of limitations (“That was years ago – these victims were kids!”), not to mention timidity and vacillation in the upper reaches of the Globe’s editorial hierarchy. No one wanted to take on the power and prestige of the church, especially in a city where 54 percent of the population (and no doubt a majority of Globe readers) were Catholic.

    In Spotlight, the Peter Hollingworth character – or dare I say, the George Pell character – is Cardinal Bernard Law (Len Cariou), head of the Boston archdiocese. There’s a telling early scene when Law is in intimate conversation with the Globe’s editor Marty Baron (Liev Schreiber), newly arrived from the Miami Herald. Baron has gone to the rectory to brief the cardinal on the Globe’s inquiries, and Law’s reaction – not surprisingly – is to urge caution in the interests of Boston’s good name and reputation. “The city flourishes,” says Law, “when its great institutions work together” – in other words, when church and press collude in keeping things quiet. Baron politely disagrees.   There are higher values than civic harmony – truth and justice among them. Challenging entrenched authority and tradition is never easy, but the Globe will stick to its guns.

    There’s an excellent cast at work here, even if everyone seems a bit downbeat, oddly colourless and subdued. There are no charismatic heroes in Spotlight, no dynamic crusaders, no star turns – just a bunch of hard-working, preoccupied journos doing their job – hitting phones, pouring over ancient church files and library records, searching through press cuttings and door-stopping interviewees while juggling pens and notebooks ( surely there were miniature recording devices in 2001). And everyone looks a bit scruffy. But it rings true. Years ago, when I started as a journalist on the Sydney Morning Herald, reporters were required to wear suits and ties and beards were verboten. Not on the Globe. To complicate things, everyone on the Spotlight team seems to have a Catholic background, including Robbie, the team leader (Michael Keaton), who is very much a part of Boston’s Catholic establishment. Working with him are Mike Rezendes (Mark Ruffalo), Sacha Pfeiffer (Rachel McAdams) and Matt Carroll (Byron D’Arcy James), all bothered by mixed feelings and divided loyalties.

    In a telling scene, an ex-priest, door-stopped at his home, readily and calmly admits to having abused boys, but insists that “I got no pleasure from it.” It’s an odd form of self-absolution. Audiences, I suspect, will get little pleasure from Spotlight, a shocking and angry film and a unique combination of detective thriller and modern morality tale. It is hard to know which is the greater calamity – the evil of paedophile clergy or the existential tragedy now engulfing the Catholic Church, if not the whole of Christendom. Perhaps, in the end, all great institutions survive. As Cardinal Law wryly observes: “The Church deals in centuries.” But what if it doesn’t survive? Can we imagine the headline,” Pope Quits And Shuts Down Vatican”? Hold the front page!

    Four stars.

    Evan Williams reviewed films in The Australian newspaper for 33 years. He is a Life Member of the Film Critics’ Circle of Australia for services to film criticism and the film industry.In 2015 he received the Geraldine Pascal Lifetime Achievement Award for critical writing.

     

     

  • David Armstrong. A journalistic career from Tharunka to Bangkok.

    David Armstrong has had a remarkable career as a journalist. From Tharunka at the University of NSW . His career includes The Bulletin, The Australian, South China Morning Post, and now business and semi-retirement in Bangkok. 

    In an interview with American writer, Kevin Cummings, David Armstrong speaks of his travels and career.  See following link:

     

    http://peoplethingsliterature.com/2016/01/25/david-armstrong-interview-5-decades-in-four-questions/

  • Renee Bittoun. Postcard from Hanoi. Smoking in Vietnam

    Unlike Australia today where the prevalence of smoking is about 15%, Vietnam remains a country where smoking is widespread. About 60% of the men smoke and about 5% of women. The burden of diseases related to smoking is therefore extremely high. On visiting a Hanoi hospital respiratory ward last week, most of the 100s of inpatients were patients with acute exacerbations of COPD (Chronic Obstructive Pulmonary Disease), and visiting the cancer hospital also showed that most of the cancers were also smoking related. There are efforts to reduce uptake of smoking however there is little supporting funding.

    Vietnam_SmokingMy role in the short week of visiting these sites was to teach the staff about smoking cessation. The medical and allied health staff were very keen and eager to learn about our approaches. However there was a great deal more to address. Cigarettes are very very cheap and readily available. The tobacco industry is local and tobacco is grown in Vietnam, with probable conflicts of interest for the government. The math has been done however that shows the enormous loss in health costs versus the gain in income.

    There are particular goals that might make a difference relatively quickly. Increasing the cost of tobacco and hypothecating the income to smoking related tobacco control and treatment services is known to have a significant effect on prevalence. Improving the awareness of health workers of the huge financial and health burden that smoking has on the well-being of the population would commence a trickle-down effect to the community. This along with a multifaceted intensive and prolonged anti-smoking media campaign would be very cost beneficial.

    There are things, however, we may learn from the prevalence of smoking in Vietnam. Most intriguingly it would be helpful to understand why so few women and girls smoke. It is highly inappropriate for Vietnamese women to smoke. A study of the cultural and environmental influences may show results that might be translated to other nation’s groups in order to reduce the prevalence of smoking elsewhere, and not just in women and girls.

    Renee Bittoun is Adjunct Associate Professor, Clinical School, Smoking Research Unit, Faculty of Medicine, Brain and Mind Centre, Sydney Medical School, University of Sydney.

  • Will Steffen. CSIRO and climate change: Making policy based on myths

    The recently announced cuts to CSIRO climate science have stunned the Australian research community and sent shockwaves through the international climate research system. Claims and counter-claims are flying around the media, the cybersphere, Senate estimates, and elsewhere.

    To cut through the claims that are being made in support of the CSIRO’s leadership to gut the Organization’s climate research capacity, a good round of myth-busting is required.

    Myth One: The science is settled and now we need to get on with the job of mitigation.

    The “science is settled” comment has been completely misrepresented by Larry Marshall, the CEO of CSIRO. It refers to the false claims made by deniers about the fundamental reality of climate change and its causes. Yes, THAT science is settled and has been for decades.

    We are dealing with arguably the most complex problem that humanity has ever faced. We are eroding the integrity of our own planetary life support system at an accelerating rate. However, the Earth is the most complex system that we have ever dealt with. There is much more that needs to be known about the responses of the Earth System to our expanding pressures so that we can make sensible decisions on how to cope with the mess we are creating.

    Cutting essential climate science now is like flying into an intensifying storm and ripping the radar, navigation instruments and communication systems out the plane.

    Myth Two: There are no cuts to CSIRO climate science; the money is just being put towards forecasting instead.

    There are clear cuts to CSIRO climate science capacity, in fact over 100 jobs are planned to be cut from the agency’s climate science staff. CSIRO needs this staffing capacity to undertake vital research like climate model development, improving sea level rise projections and their underpinning processes, understanding the carbon cycle, tracking how oceanic and atmospheric circulation is changing, monitoring the changing nature of extreme weather events, researching ocean acidification and regularly updating greenhouse gas data.

    Put simply, we can’t accurately or effectively mitigate or adapt to climate change without the most up-to-date climate science, which includes ongoing improvements in understanding how the climate is change through observations, process studies, analyses, model development, synthesis and integration, and tailoring knowledge to the needs of user groups.

    To be clear, in a rapidly changing climate where the nature of risks is constantly changing, ongoing research is required to continually improve our knowledge base. It is essential to understand and monitor how the climate is changing in order to ensure we understand the evolving nature and extent of the challenge facing Australia.

    This is why it makes no sense to say we can just ‘put money towards forecasting instead’. That would leave us totally in the dark, trying to respond to a problem without the constantly updating data and process understanding that we need to track and understand the problem.

    Myth Three: The Bureau of Meteorology (BoM) will just take on the workload. Climate modelling and climate forecasting are already performed by BoM and these results are shared between the CSIRO and BoM.

    BoM cannot take on the workload created by the CSIRO cuts, and should not be expected to do so. The CSIRO, BoM and the universities all contribute to climate science in different, complementary ways. They rely on each other to provide mutual support for the research effort.

    BoM focuses strongly on long-term observations of the climate and water systems, and provides short-to-medium range forecasting. The modelling framework that is used by BoM is essentially the same weather/climate model structure that is also used by the CSIRO for multi-decadal and century-scale projections.

    However, the modelling framework is continuously developed and improved primarily by CSIRO scientists, drawing on BoM observations and fundamental process studies carried out at the universities. It must be emphasised that CSIRO plays the leading role in model development and improvement.

    Scientific capacity in all three primary sectors of the Australian climate science community – BoM, CSIRO and the universities – has not been able to keep up with the demand for new understanding due to resource constraints, despite the urgent need for a better understanding of climate change. So there is absolutely no “slack” in the system that can take on the enormous workload that has suddenly appeared from the CSIRO cuts, either in BoM or in the universities.

    The CSIRO cuts represent vital capacity lost, not capacity that can be taken up elsewhere under existing resourcing.

    It has taken decades of hard work by dedicated researchers to build up CSIRO’s international reputation for world-class science that contributes to the wellbeing of all Australians. This capacity can be destroyed overnight. Apparently, Larry Marshall, the CSIRO leadership and the Australian Government are intent on doing so.

    Will Steffen is an Emeritus Professor at the ANU and a councillor with the Climate Council of Australia.

  • The benefits of migration.

    In this article in fivebooks.com, Ian Goldin speaks about the benefits of migration although those economic benefits are often widely and differently dispersed. He points to the disconnect between the benefits of immigration and often the political downsides where some communities feel disadvantaged. He notes that the business community often calls for more migrants and refugees when politicians are moving in the opposite direction. Ian Goldin is Professor Globalisation and Development and Director of the Oxford Martin School at the University of Oxford.

    See link below:

    http://fivebooks.com/interview/immigration/

  • Measuring the misery of those forced to flee.

    Robert Shiller, a 2013 Nobel Laureate in Economics says

    ‘Under today’s haphazard and archaic asylum rules, refugees must take enormous risks to reach safety and the costs and benefits of helping them are distributed capriciously . It does not have to be this way. Economists can help by testing which international rules and institutions are needed to reform an inefficient and often inhumane system.’

    For link to article in AFR, see below:

    http://www.afr.com/opinion/measuring-the-misery-of-those-forced-to-flee-20160126-gme8ch