Category: Politics

  • John Menadue. Regional cooperation on refugees, Bali and a Track II Dialogue.

    I attended a Track II Dialogue in Bangkok recently to try to help develop a framework of shared responsibility to manage in a humane and efficient manner, displaced people movements in the region.

    There is concern that the Track I Regional Dialogue at government level has not been particularly fruitful. So much of the response to asylum seekers, refugees and displaced people in the region has been ad hoc, fragmented and political.

    The Track II Dialogue included a range of government officials in their private capacities, refugee experts, international agencies and people from think-tanks. The Dialogue was initiated by the Centre for Policy Development in Australia. It now has many additional conveners and supporters including from Mahidol University in Thailand, ISIS Malaysia, the Sydney Myer Fund, the Planet Wheeler Foundation, the Vincent Fairfax Family Foundation, Qantas and Corrs Chambers Westgarth.

    Australia’s successful participation in the Indochina refugee program would not have been possible without the cooperation of regional countries. There were several key elements in that cooperation ,one being that  regional countries would hold Indochinese asylum seekers in safety and facilitate processing. That commitment from regional countries was backed by a broad agreement that countries such as the US, Canada, France and Australia would assist in resettlement. This basic pact between regional countries and settlement countries was messy around the edges, but it worked. My experience with the Indochina program is the reason for my contention over many years that we need to build a regional framework or architecture to manage the flow of displaced people into and within our region.

    But whilst the principles of that earlier pact over the Indochinese outflow are still valid, it is also obvious that no two situations are the same. Most of the asylum seekers from Indochina into South East Asia were in direct flight from Indochinese countries. Many asylum seekers in the region now are not in direct flight but are in transit. There are also many economic migrants in the region who are not asylum seekers but seek improved economic opportunities for themselves and their families. In many ways these displaced economic migrants bring an economic benefit to host countries but their status is irregular and precarious.

    These regional countries face far greater problems over irregular movements than we do. For example in 2015 Malaysia had 272 000 people of concern to the UNHCR, Thailand had 625 000, Indonesia 13 000, Bangladesh 233 000 and Myanmar 1.5 m. Australia had 58 000 people of concern to the UNHCR.

    So the situation faced by regional countries today is different from the situation faced by those countries at the time of the Indochina outflow.

    But there is another major difference. A key to the resettlement of asylum seekers in regional countries in the aftermath of the Indochina war was that relatively wealthy countries were prepared to accept large numbers of refugees for resettlement. The US did the heavy lifting with other countries such as Australia, France and Canada. But now, regional countries cannot rely on this same degree of outside help in resettlement. As regional countries, we have to collaborate and address our problems together. That is not a bad thing but it means building a new framework of regional cooperation.

    Amongst other things Track II seeks to build on the ‘Bali Process’ which was established in 2002 at the initiative of the Australian and Indonesian governments.   Australia then faced an earlier flow of boat arrivals mainly as a result of wars in the Middle East that we involved ourselves in at the request of the US.

    There are now 45 member countries of the Bali Process, including key countries Australia, Indonesia, Malaysia and Thailand. Australia and Indonesia are co-chairs of the Bali Process at both ministerial and official level.

    The Bali ‘process’ has been cumbersome, ad hoc and fragmented. Australia has been a fair-weather friend to the region on refugees. When the Indochina program closed down in the mid 1990s, we left regional countries with responsibilities for many handicapped and disadvantaged Indochinese asylum seekers. After the Bali Process was initiated in 2002, we lost interest when boat arrivals to Australia fell away. In the recent Andaman Sea crisis, when many asylum seekers from Myanmar were stranded at sea, the response from ‘Bali’ was very slow. Many souls died of starvation and dehydration. The Australian government was asked whether it was prepared to help and Tony Abbott infamously said ‘Nope, nope, nope’. This was despite the fact that our Minister for Foreign Affairs was and still is co-chair with Indonesia in the Bali Process. Eventually the Thai government stepped in with support from Malaysia and Indonesia and the desperate people stranded at sea were allowed to land.

    There is quite a way to go in the Bali Process to build a framework of cooperation. It is very clear for Australia and for other regional countries that we cannot manage this problem on our own. There must be shared responsibility and burden-sharing. We need to build trust and a structure that will provide dignity and protection for vulnerable and displaced people.

    The recent Track II Dialogue in Bangkok made the following recommendations to the Bali Process Ad Hoc Group. 

    The Track II Dialogue recommends the Bali Process Ministerial Meeting authorise senior officials to:

    (a) review the response to the 2015 Andaman Sea situation, the resulting caseload, and ongoing maritime movements there and in the Bay of Bengal, within the commitments and principles outlined in the Regional Cooperation Framework (‘RCF’), to share those lessons among Bali Process members and work to implement necessary improvements; and

    (b) Take a broader focus and, drawing on the RCF, make any recommendations necessary to improve national and regional contingency planning and preparedness to enable more predictable and effective responses on forced migration, utilising existing capacity such as in ASEAN, IOM, UNHCR and civil society. Recommendations should reflect the principles that effective policy responses require shared responsibility and distributed capacities.

    The Dialogue offers to support the Bali Process in these endeavours to develop a more effective regional architecture over time.

    These recommendations are made with a view to upcoming fora relevant to the Bali Process, including the UN High-Level meeting on ways to address large movements of refugees and migrants on 19 September 2016. 

    The Bali Process Ad Hoc Group Senior Officials responded positively to the recommendations made by the Dialogue at their meeting in Bangkok on 2 February, agreeing to submit them to Ministers next month in Bali. The Co-Chairs of the Ad Hoc Group Senior Officials released a statement following their meeting, and referred directly to the Dialogue in paragraph [12]:

    The Meeting welcomed an update from the Co-Chairs on the recent meeting of the Track II Dialogue on Forced Migration, held in Bangkok on 29-30 January 2016, and noted recommendations sent by the Dialogue conveners to the Bali Process Co-Chairs. Members agreed to recommend to Bali Process Ministers that officials be tasked to conduct a review of the regional response to last year’s irregular migration events in the Andaman Sea, and share the lessons among Bali Process members. It will also identify recommendations to improve national and regional contingency planning and preparedness to enable more predictable and effective responses on forced migration. Members reaffirmed the importance of engagement with the Track II Dialogue and other civil society, and agreed that the Co-Chairs continue such efforts to engage with key civil society stakeholders.

    Government and non-government members of the Track II Dialogue in Bangkok all showed strong commitment to the overall process and to maintaining involvement to build an architecture of regional cooperation to manage and assist people displaced in the region.

    The next two meetings of the Track II Dialogue will be held in Malaysia in September 2016 and Indonesia in early 2017.

    The Track II Dialogue is already providing a flexible, sustainable and credible platform for regional cooperation and for influencing government policy. Good progress has been made, but a lot of work remains to build a regional framework/architecture.

    What is critical is not the process of consultation but practical and humane outcomes.

    Further information about the Track II Dialogue and its second meeting in Bangkok is available on the CPD website here.

    https://cpd.org.au/2016/02/secondadfmmeeting/

  • John Menadue. Part 2. How we deliver healthcare is as important as the funding of healthcare. Medicare has degenerated into a payments system.

    In Part 1 I focussed on the importance of improving the delivery of health care and not just funding.

    In Part 2 I will focus on specific areas where costs should be reduced.

     

    Part 2

    Getting costs down

    • The government should abolish the subsidy for private health insurance which costs all up about $11 billion p.a. This welfare subsidy is one of the fastest growing areas of Commonwealth government health expenditure. We have never had high income welfare recipients on such a scale before .PHI is the Damocles sword hanging over our health system. PHI is the reason for the disastrous American health system. High levels of private health coverage in Australia are achieved not through the attractiveness of the products on offer but mainly through the carrot of the tax subsidy and through the stick of penalising the uninsured. The subsidy favours the wealthy, is inefficient, has underwritten rising specialist fees through gap insurance, has not taken the pressure off public hospitals and has weakened Medicare’s ability to control costs. PHI discriminates against country people where there are few private hospitals. The immediate abolition of this subsidy would do more to improve our health system than anything else. This is welfare big time- far more than the welfare we used to pay to the motor industry. The abolition of the $11 b. subsidy would more than fund a universal dental scheme. Alternatively, say $5 b. of the saving by abolishing the subsidy could be paid directly to private hospitals through an activity based funding arrangement. It is absurd that public funds should be churned through high cost private health insurance rather than being paid directly to hospitals. Before the Howard government, Commonwealth government funds were paid directly to private hospitals, but this was discontinued. Direct Commonwealth funding for both public and private hospitals would also substantially improve the integration of hospital care. But private hospitals would oppose this because they find it much easier to twist the arms of private health insurance companies. And some of the major hospital groups, particularly Ramsay, are generous donors to the Liberal Party.
    • We need a more productive workforce. Health is the largest and fastest growing sector in the Australian economy. Despite all the talk of improving productivity in Australia no-one has been game to take on the entrenched privileges in the health workforce.Where is the honesty and consistency here? The blue collar workforce is fair game but not doctors and lawyers. We need expanded roles across the board particularly for nurses, pharmacists, allied health workers and ambulance officers. The Productivity Commission in its February 2007 report estimated that a 5% improvement in the productivity of health services would deliver savings of about $3 billion p.a. This is a very conservative estimate. The health sector in Australia is rife with demarcations and restrictive work practices. eg 5 % of normal births in Australia are delivered by mid wives. In the Netherlands it is 70%, in the UK 50% and in NZ 95%. We have a few hundred nurse practitioners when there should be thousands. The work practices in most industries are light years ahead of the work practices in the health sector.
    • Fifteen years ago 45% of doctors were GP’s. It has fallen to about 35% yet we know that care is most equitably and efficiently delivered by GP’s. Specialists are reactive and we all know they have become very expensive thanks to gap insurance provided by private insurance companies.
    • We could save about $2 billion p.a. in drug costs if we paid drug suppliers the same prices that are paid in NZ. We also pay a high price for the protection of pharmacists through the 5000 limit on the number of community pharmacies and the restrictions on where new pharmacies can be located. Pharmacies cannot be established in supermarkets.
    • We need to raise productivity in our hospitals. The Productivity Commission suggests that the productivity gap in best practice in public hospitals ranges from 3% to 89%. In private hospitals the range is 22% to 37%. There are major governance problems in many hospitals with a dis- connect between management and clinical functions. Running hospitals is very difficult with clinicians coming and going from private practise like the cottage industries of old.
    • The Commonwealth/State fragmentation in healthcare results in blame-shifting, the evasion of responsibility and higher costs. If for example the Commonwealth Government or a joint Commonwealth/State body had responsibility for all health care funding in a state or region, there would be a clear incentive to focus on treatment in the community and in homes to ensure that the high cost hospitals are really a last resort. The National Health Performance Authority found that in 2013/14 over 600,000 hospital admissions for 22 conditions could have been avoided with timely interventions in the community, mainly by GP’s. But the problem in doing this is that the Commonwealth government funds general practice and state governments operate hospitals.
    • The real elephant in the room in health care cost reduction is avoidable mistakes, including deaths. They are euphemistically called “adverse events”. But Ministers, clinicians and managers do their best to avoid the issue. Based on earlier surveys in NSW and SA I estimated, very conservatively the cost of avoidable mistakes in our health sector at $5b pa (see my blog of June14, 2013). Despite a great deal of money and effort there is no sign of improvement. Insiders won’t solve the problem Good people are caught in a bad system.
    • Only last week, Medibank Private said that $800 m. p.a. could be saved if a reference pricing system with Australian and global benchmarks was introduced for prostheses such as for hip and knee replacements, plates and pacemakers. Medibank Private said that prices for identical products could be 45% lower in the public system compared with the private system. With differentials like that it is no surprise that private health insurance premiums have increased at three times the rate of inflation.

    The quality of our health care is generally good but waste and inefficiency is deep and widespread.

    We need to address waste and costs in a measured way. We should not panic, but we should get it done. Australian healthcare costs are 9-10% of GDP. This is not high by world standards. It is below the OECD average. A major reason why we have been able to do better than others is that we have Medicare as a public insurer. One lesson is clear all around the world. The countries that have high levels of private health insurance, like the US, have high costs.

    A fundamental problem in the health sector is the way we deliver healthcare. But we keep focusing only on funding. We have a horse and buggy health delivery system that is unfit for the 21st Century. Medicare takes that horse and buggy delivery system as a given.

    I have almost given up hope that the ALP will restore Medicare to what was intended, a single payer and a strong public insurer.

    The vested interests don’t want change in the way we deliver health care. They must be delighted to see how gutless the ALP is.

    More and more money will not necessarily improve the delivery of health care and neither should we expect it to. It will mainly entrench a lot of bad habits and the position of vested interests.

     

  • John Menadue. Privatising Medicare’s payments system and the erosion of Commonwealth Public Service capability.

    The government has apparently accepted the advice of the Commission of Audit that Medicare’s payments system should be reviewed with the possibility of privatisation. The payments system includes Medicare, the Pharmaceutical Benefits Scheme, Aged Care Services and Veterans’ Affairs.

    It sounds like another expression of neo liberalism, that only the private sector can be efficient and cost-effective.Let us see whether that is so through market testing. I remain sceptical.

    As a regular user of Medicare services and payments, I am not aware of problems in the payments system. But if there are problems, the government should fix them.’.

    This proposal on privatizing Medicare payments is part of the continuing trend to degrade government capability in both policy and administration of programs. The Australian Public Service is becoming short of senior people who understand the complex world of business strategy and those things required in commissioning the delivery of services or planning infrastructure investments and their delivery. In social policy it is not at all clear that the Commonwealth now has the people who understand the big systems that are so essential to a large part of what the public sector does.

    In between jobs, the new Secretary of PM & C put the problem this way in an interview with Laura Tingle in the AFR in May 2015. He said:

    ‘I think our institutions are being eroded in their capability and eroded in public trust. … Over time large parts of the public service have lost their policy development edge.’

    He has been replaced in Treasury by John Fraser, most recently a banker. Yet much of the governments’ deficits around the world have occurred as a result of governments having to bale out the banks for poor decisions and poor risk management.

    The problems that we apparently have with Medicare are common to many agencies. Good accounting in government has been abandoned and replaced with narrow financial metrics. Outside a few agencies, there just isn’t the capacity to do proper cost/benefit analysis. Many decisions are made on the run on the basis of cash outlays over four years.

    This failure of government administration suits private providers who exploit ministers’ and bureaucrats’ lack of analysis capacity and the domination of short-term cash outlays in the public presentation of the budget.

    It also suits neoliberals to get as much off the budget as possible even if the community is worse off. This is happening in the health sector. Some government expenditure is relieved by pushing business towards private health insurance, but we know that administrative costs of private health insurance are three times higher than Medicare. Furthermore we know that the growth of private health insurance makes it harder for Medicare to control fees. So whilst the budget may look a little better, the community is much worse off.

    We have had glaring examples of how government policy, capability and operations have been run down to the benefit of accounting and consulting firms who come and go with projects and their ‘economic models’, but there is little building of intellectual capital in the process.

    Staff numbers in the Australian Taxation Office have been cut back at a time when we have record tax avoidance and hundreds of our major companies paying no tax at all.

    I have rarely seen a root-and-branch criticism of a department as we saw with the Australian Public Service Commission Capability Review of the Department of Health and Ageing last year. The Secretary of the Health and Ageing at the time is now Secretary of Finance.

    The Department of Immigration and Border Protection has become securitized with a focus on border protection and control at the expense of nation-building and humanitarian programs. Senior and competent people with knowledge in nation-building and refugee programs have left the department. We see the result most graphically in the snail-pace response to settling 12,000 refugees from Syria. Less than 10 have arrived! Canada has put us to shame.

    The Attorney General’s Department failed to tell security agencies about the risk of Mann Haron Monis weeks before he entered the Lindt Café. The Attorney General’s Department has carriage of the policy and implementation of ‘meta data’ through the Data Retention Act. We were told at the time it was urgent because of the terrorist threat. But the policy cannot be introduced until the end of 2017at the earliest because of flawed implementation. AG’s department has just not been up to the job.

    One reason for the pink batts problem was the loss of  implementation capability in the Department of the Environment. That same department has bungled the approval of the Carmichael mine.

    The Department of Defence is subject to very little effective checking of its very expensive capital projects. It keeps making the same mistakes. As John Stanford put it in this blog on 11 December last year

    ‘Our defence acquisitions keep repeating the mistakes of the past, from mixing and matching systems inappropriately and accepting excessive risks, to allowing political judgements to override efficiency considerations and the proper regard for the public purse. In the new submarine acquisition, we seem to have learned nothing from the Collins Class procurement’.

    When the new submarines are delivered China and India will have nuclear submarines.

    The Department of Defence has a one-line budget appropriation which effectively denies rigorous examination of mega-dollar projects by the Department of Finance and others.

    The sorry story continues with the mega funding of roads. As Mike Keating and Lucas Fraser pointed out in the policy series in last year’s blog

    ‘A reasonable projection of planned road expenditures indicates that the accumulated stock of debt to FY 2023-24 could be of the order of $114 b. When added to the already accumulated debt, this amounts to a total accumulated road-derived public sector debt of $140 b. within a decade, a matter than until now has been entirely unreported’. Where is the Department of Transport or Infrastructure Australia when we have such gigantic and wasteful expenditures on roads”?

    There is a dismal and concerning story about how the capital of government is being deliberately eroded.

    We are paying a very heavy price for neoliberalism and the down-sizing of government that goes with it. The selling of Medicare’s payments system may be another step along this path.

    The coinage of the Australian Public Service is being seriously devalued. Can the threads of good policy development and administration be recovered? It is getting late.

  • John Menadue. Part 1. How we deliver health care is as important as the funding of health care. Medicare has degenerated into a payments system

    Part 1 of these articles will focus on the inefficient way we deliver health care, the many perverse incentives and the power of vested interests to resist reform in health care delivery.

    Part 2 will focus more particularly on examples of waste and inefficiency in health care delivery

    Part 1

    We have been told many times that our health system is unsustainable.

    To justify its case for an increase in the GST, the government was telling us that an increase was necessary because of rising costs in health and education. Now the GST is apparently off the table as Malcolm Turnbull retreats on yet another issue.

    Some premiers and commentators suggested that an increase in the Medicare levy was best because it was fairer than an increase in the GST. And we will hear a lot more from the premiers about health because the Abbott Government said it would cut $ 80 b from grants to the states for education and health over the next decade commencing in 2017

    But what is being avoided in all this confusion about budget repair and health costs is that there is no real discussion about the waste, inefficiency and low productivity in our health sector. We continue to focus on the funding of our health sector, but refuse to debate how the delivery of care – its cost and safety – can be improved. Medicare is overwhelmingly discussed in terms of funding only. It should also be about how those funds are spent to improve the delivery of health services. Basically Medicare funds an existing system of health care delivery. That needs to change.

    There are three main reasons for our failure to address the delivery problems in health care.

    The first is the power of the vested interests. These vested interests fight doggedly and selfishly to maintain their privileged position in health delivery. The principle vested interests in health are the AMA, the Pharmacy Guild of Australia, Medicines Australia and the private health insurance sector. In an earlier blog I said that the Health Ministers may be in office, but they are seldom in power. The vested interests –the providers- are really in power.

    A second reason for the failure to focus on delivery of health services is that politicians are afraid of the vested interests – doctors, pharmacists, pharmaceutical manufacturers and suppliers, and the private health insurance sector.

    The third reason is the failure of economists and other commentators to consider efficiency in the delivery of health services. These economists talk continuously about the need for appropriate incentives, but in the health sector many of the incentives are quite perverse – such as fee for service.

    As Ross Gittins put it in a recent SMH article, ‘Like so many of the interest groups, econocrats are obsessed with funding education and health rather than ensuring both systems are working in ways that have found a good trade-off between fairness and efficiency, and effectiveness.’ … See link to article.

    These economists that we hear and see so often in the media are mainly employed by the banks. They have little or no knowledge or interest in health economics. They tie themselves in knots over the need for IR reform and improvements in productivity in the workforce generally. But over the years I have never heard any of them address the appalling work practices and demarcations in our health sector which really go back to the 19th Century. Yet our health and welfare sectors employ 13% of our workforce, the largest sector by far. It is also the fastest growing. At its worst, our waterfront never had the appalling work practices and demarcations that still persist across our whole health sector. Clinicians justify our archaic work practices on the grounds of safety when it is really territory they are defending.

    Economists are yet to grasp that health consumers have little power over prices or quality of care. Power is with the providers-doctors, pharmacists, drug distributors and private hospitals. That is why a strong public insurer is essential to counter the power of providers. If there is not a strong public insurer we will follow the disastrous path of the US that has the most expensive and unfair health system in the world. But our economists who say they believe in markets will not recognise the failure of the health ‘market’.

    On 4 Corners several months back, Norman Swann suggested that waste in health expenditures could be as high as 30% of our total health expenditures. I think that estimate may be on the high side, but it is clear that there are excessive costs. – see link to article ‘Four Corners: No wonder we’re wasting money in health care – we got the incentives wrong’ by Jennifer Doggett, Ian McAuley and John Menadue.

    In a paper in July 2007 I estimated that there was at least $10 billion in possible savings and productivity improvements in health. That represented about 10% of our total health costs in that year. I think it would be nearer 20 % or $ 30 b per annum. I have spoken and written extensively on this matter.

    The lack of accountability in health

    Despite the rapid increases in costs and escalating demand in the healthcare industry, there is no accountability in any meaningful way for what the health industry delivers. Doctors are accountable for malpractice but not for their overall performance particularly in general practise. Accountability is patchy in many private hospitals. Taxpayers have a legitimate reason to ask – ‘Are we getting value for money particularly when we pay 80 % of doctor’s incomes.’ In a survey several years ago by the Health Council of Canada, 97% of over 1,800 senior respondents said that healthcare providers should be required by law to reach certain service benchmarks in such areas as patient outcomes , the use of preventive strategies like screening and waiting times. There is the same lack of accountability in Australia.

    The Council also asked the group ‘Do you believe healthcare in Canada will improve if the government spends more money on healthcare?’ 58% said ‘no’.

    Managing the demand for health services

    The demand for health services is increasing rapidly across all age groups and not just among the old. We are over-diagnosed and over-treated. In 1984-85, medical services per head were 7.1 per annum. In 2007-08 they were 13.1 per annum – about double. The trend continues.

    • We must accept that we cannot have all that we want in health and that governments, in consultation with the community, have to set priorities. Can we afford continuing existing levels of funding for IVF and end-of-life treatments at the expense of funding for mental health and indigenous health?
    • We need to rationalise our co-payments to make them efficient and equitable. We all should take more responsibility for the way we use health services, particularly as we are now much wealthier than we were 30 years ago when Medicare was introduced. A universal health scheme does not have to be free. But it must be fair and efficient. But co-payments are a dog’s breakfast! We pay about 18% of health costs out of our own pockets, but there is very little rhyme or reason in how this is done.
    • The best way to curb the long-term growth in health spending is through prevention in such areas as alcohol, smoking, junk food and obesity. Our sporting, alcohol and junk food sectors are in a joint enterprise to promote poor health. But the first action of the Abbott Government in its first budget was to abolish the Australian National Preventive Health Agency which was focussing on lifestyle risk factors.
    • We need to change the perverse incentives, such as fee-for-service, which is associated with bulk-billing. Clinicians are rewarded by the number of transactions rather than health outcomes. It promotes what is called ‘turn style medicine’ FFS is particularly inappropriate for chronic care, mental health and services with high fixed costs and low variable costs, such as imaging. The government should move away from fee for service and set budgets for general practitioners when they prescribe drugs, order pathology tests or imaging services. We need more doctors on salaries and capitation payments for caring for patients-not on a service by service basis. Hopefully, the Medicare review will grasp this nettle.
    • We need to tackle the wide variations in the incidence of clinical practice across the country, e.g. caesarean sections and cataracts. In the Australian Atlas of Health Care Variations the Australian Commission on Safety and Quality in Health Care found ‘substantial variations in health care use in areas such as antibiotic prescribing, surgical, mental health and diagnostic services’ Medicare should be much more proactive in exposing and limiting very expensive and inexplicable variations in clinical practice. .It also needs to publish the enormous variations in doctors fees and particularly the fees of specialists. Better public data for greater transparency is essential.

     

     

     

  • Laurie Patton. Utopia: the professor, the public service, and the need for change.

    In an article in The Mandarin former Secretary of the Prime Minister’s Department, Professor Peter Shergold, is quoted urging public servants to adapt and to show courage.

    http://www.themandarin.com.au/60090-adapt-die-peter-shergold-manifesto-public-service-transformation

    Shergold is spot on. But before things can change we need to be willing to accept that mistakes are made, even by the best of people.

    Last week it was revealed that the team responsible for the Data Retention Act received a Secretary’s Award for “excellence”. To anyone familiar with this fetid exercise that must sound like a scene from the satirical television series Utopia.

    As Internet Australia told a parliamentary inquiry the Act’s drafting is “fundamentally flawed” and clearly written by lawyers with insufficient knowledge of how the Internet works. The result is a flawed implementation process that has the industry up in arms. Even Telstra has demanded 18 months grace to become compliant. Imagine how the 400+ smaller ISP’s are getting on.

    The data retention scheme was presented as an urgently needed weapon in the fight against terrorism. According to official timelines now being provided to the industry it will be a full two years from the date of Royal Assent before the Act is in force. And even then it is unlikely to achieve its purported purpose. When he was communications minister, Prime Minister Turnbull amply demonstrated, in the media and in private, that there are so many ways to work around this law.

    If we must have data retention then surely we should aim to have legislation that might work? Legislation that doesn’t send Internet service providers broke or result in increased access fees for Internet users.

    Internet Australia has called on the Government to bring forward a review due in 2018. It is time for the Attorney General’s Department to accept the true situation and recommend that this take place. That would be a good start to achieving the lofty ambitions proposed by the good professor.

    Laurie Patton is CEO Internet Australia. 

  • John Thompson. Fiona Nash and private health insurance for rural Australians

    Screen Shot 2016-02-11 at 4.04.29 PM

    A few nights ago on Q&A, the Minister for Rural Health, Fiona Nash, undertook to drop out of private health insurance while she was in office. Ms Nash lives in Crowther, a small town about midway between Wagga Wagga and Bathurst. Foregoing private health insurance makes a lot of sense for her because, like most rural and regional people, she pays a large amount to private insurers and has very limited access to private hospitals and related private services in her area.

    The map above shows why rural people are especially short changed with the private health system. The brown markers indicate public hospitals and the private hospitals are shown by purple markers. Crowther is almost in the middle of the map – 180 kms from Wagga Wagga and 141 kms from Bathurst.  There is one private hospital in Wagga Wagga and one in Bathurst, and neither has an emergency department. [On my count, there are about 30 public hospitals in this area. JM]

    The private health system is one of the most expensive Commonwealth Government programs.  In 2016/16 direct outlays by the Commonwealth Government will be $6.3 billion and income tax foregone will amount to $4.2 billion, a total of $10.5 billion for the year.

    Ms Nash, as a Nationals Party representative, should recognise that the private health system is particularly costly for her rural constituents because they are getting such a very raw deal. They are paying large sums directly to the private insurers and similarly large sums in taxation to support those insurers.  And they are getting very little in return.

    Rural Australians should ask themselves what they are getting for the large sums they are paying, both directly and through their taxes, to private insurance companies, and perhaps follow the lead of their elected representative, the Minister for Rural Health.

    John Thompson is an economist with an interest in health policy.

  • Jim Bowler. Mungo Man needs help – to come home

    It’s time for funds and a plan to preserve and commemorate this visitor from Ancient Australia, writesJim Bowler, the geologist who discovered Mungo Man’s remains.

    Forty-two years ago, on 26 February 1974, I first encountered the remains of Mungo Man eroding out of the desiccated shores of Lake Mungo. He had been ritually buried over 40,000 years earlier – at a time when the lake was full – by an ancient community that thrived in the fertile environment. The re-emergence of Mungo Man has changed the way we understand Australian history. Together with the earlier (1969) discovery of Mungo Lady, these burials provided the foundations on which the Willandra Lakes World Heritage area was defined and accepted by UNESCO in 1981. That region stands today as Australia’s richest legacy of early occupation. Yet forty-two years later, after decades of constant calls for the return of Mungo Man, none of the responsible state and federal ministers have committed to caring for these sacred remains.

    In November last year, a repatriation group of Indigenous representatives took the first step towards Mungo Man’s return. The 40,000-year-old human remains, along with the more fragmentary remains of some ninety other individuals from the Willandra Lakes area, were transferred from the Australian National University to the interim storage of the National Museum of Australia. After years of frustration, the traditional owners of the Willandra Lakes area – the Mutthi Mutthi, Ngiyampaa and Paakantji tribal groups – reluctantly decreed that unless appropriate keeping arrangements were made by the end of 2017, they will dispose of all Willandra remains, with the possibility of complete reburial. The possibility that the remains of Mungo Man may not be laid in a formal place – an underground sacred crypt with above-ground recognition of the dead, perhaps, in memory of deceased Elders and of those thousands who fought in defence of their lands – should stir the nation’s conscience.

    Mungo Man is acknowledged worldwide as the centrepiece of our evidence of ancient Australia. He has featured in documentaries, novels, histories and scientific papers, and he has given us an insight into life in ancient Australia through paleopathology, DNA analyses, and studies of isotopic bone and teeth structures. Moreover, the ritual nature of his burial has changed our understanding of the time-depth and complexity of Aboriginal culture. The body was coated (or heavily sprinkled) with rare ceremonial ochre – the blood-red symbol of life – which had been imported from distant sources. His grave was associated with a nearby hearth, from which smoke might have drifted over the assembled mourners on the lakeshore. The discovery stands without equal on the global stage. Politicians who frequently claim occupancy with members “of the world’s oldest continuing cultures” are denying a keeping place to the very person who provided the historical substance of that claim. The Australian nation awaits his return home.

    In Mungo Man, the interaction of climate and people come together. The cultural implications of his burial reflect complex relationships with his environment. The central function of ochre, the association with fire, and the careful details of the grave emplacement combine to define a community with connections to the land they loved. Such evidence resonates with Aboriginal connections to country today. There is great dignity here in that people–land relationship. Exemplified today in the Dreaming, song lines and creation stories, it remains of central importance in helping define traditional people’s identity with and connection to the place they call home. White Australians have something important to learn from our Aboriginal cousins.

    Stan Grant’s passionate reminder of our shameful treatment of Aboriginal Australians, and subsequent discussions of our national identity have touched new sensitivities in the fraught relationships between Aboriginal and white Australia. Two centuries of failure to acknowledge the magnitude and pain of dispossession have come back to confront us. The neglect of the human remains of Australia’s oldest identity, Mungo Man, adds yet another dark stain to our relationships with the first Australians. We now must seek new opportunities to restore fractured bonds, to help heal at least part of the pain inflicted on the original occupants of this land.

    This year marks the centenary year of the Somme and we honour the memory of those who died on the Western Front during the first world war. It is where my father spent two harrowing years navigating duckboards and dodging shell holes in Amiens and Villers-Bretonneux. A century later, the deaths of the tens of thousands of Aboriginal men and women who died in defence of their land await their memorial occasion. The continued absence of facilities in memory of Mungo Man and all he represents pales against the $100 million Villers-Bretonneux Educational Centre Tony Abbott unveiled last year. While the honouring of our war dead is essential, what is sacred in France demands equality at home.

    Unless immediate steps are taken to ensure adequate accommodation for sacred items that amplify and help define the meaning of human occupation of this continent, the iconic figure of Mungo Man could be lost forever. We have but eighteen months to ensure safe passage. The repatriation process needs realistic funding and a discretionary commitment to World Heritage management to ensure it takes place. Without state and federal assistance, the Indigenous repatriation group will be forced to rebury the remains of Mungo Man instead of preserving them for future generations in a sacred keeping place.

    We are dealing here not just with an assemblage of ancient bones, but with the dignity and cultural richness of our Aboriginal brothers and sisters. As a nation, we need to seize this opportunity to release Mungo Man from his custody. The return and celebration of Mungo Man will set us on a course to heal those bleeding wounds Stan Grant so eloquently defined. It is an act of recognition to Indigenous Australians of the nation’s debt to their ancestral history.

    Jim Bowler is a professorial fellow at the University of Melbourne’s School of Earth Sciences. This article was first published in Inside Story on 9 February 2016.

  • Reversing the Flight to Private Schools Depends on Reforming Australia’s Incoherent and Unfair Funding System

    New school enrolment data show that the long-term shift of students to private schools has stopped in recent years. But, whether it will be sustained is uncertain given school funding trends that massively favour private schools.

    Figures released by the Australian Bureau of Statistics this month show no change in the share of enrolments between public and private schools over the past three years. Public schools enrolled 65.1 per cent of all students in 2015, the same as in 2013 and 2014. Prior to this, private schools had regularly increased their share since the 1970s.

    The figures show different trends in primary and secondary school enrolments. Public primary schools increased their share of enrolments from 68.9 per cent in 2011 to 69.5 per cent in 2015, with small increases each year.

    However, the shift to private secondary schools has continued at much the same rate as in previous years, although it did slow markedly in 2015. The public school share fell from 60.3 per cent in 2011 to 59.2 per cent in 2015. The year-on-year growth in private secondary school enrolments has averaged about 0.3-0.4 per cent since 2010, but in 2015 it was 0.2 per cent, the smallest increase since 2009 and 2010.

    The shift in primary school enrolments to public schools came largely at the expense of Catholic schools. The share of Catholic school enrolments declined from 19.4 per cent in 2011 to 18.9 per cent in 2015. The Independent school share fell only in 2015, down from 11.8 per cent in 2014 to 11.6 per cent.

    The Catholic share of secondary school enrolments fell slightly in 2015 for the first time in decades, from 22.6 to 22.5 per cent. The Independent school enrolment share increased from 17.7 per cent in 2011 to 18.3 per cent in 2015.

    While it is important not to read too much into small changes, the figures do suggest a significant change in trend in primary school enrolments. Families now seem to be more inclined to enrol their children in public schools than for many years.

    There appear to be a couple of factors behind the change.

    One is that there has been a significant slowdown in average weekly earnings growth in the past few years and some families may be finding it harder to pay fees at private schools. Wages growth has been at historically low levels over the past three years – increasing at about 2 per cent a year compared to 3.5-4 per cent in the decade before.

    The slowdown in wages growth has probably more affected the ability of Catholic school families to pay fees than those in Independent schools who tend to attract better off families. When families are feeling the pinch, their first option is likely to be reduce expenditure on primary schooling rather than secondary.

    The second is that over the past few years there has been increasing awareness in the community that there is little academic advantage in attending private schools. Public schools achieve similar results to private schools for a given socio-economic background of parents. Research findings consistently show that students from a given socio-economic background achieve similar results in public and private schools. Increasing awareness of these findings may be affecting decisions about whether to enrol in private schools.

    There can be no certainty that the change in trend will be sustained as the long-term shift to private schools has been fuelled by increasingly skewed government funding. Between 1998-99 and 2013-14, government funding (Commonwealth and state/territory) per private school student, adjusted for inflation increased, by 39 per cent compared with only 17 per cent for public schools.

    The situation has been even more dire in recent years. Real government funding for public schools has decreased while funding for private schools continued to increase. Between 2009-10 and 2013-14, public school funding per student fell by 3 per cent but private school funding increased by 10 per cent.

    Many private schools serving the most privileged sections of Australian society continue to receive large funding increases while many schools serving the most disadvantaged communities have received only small increases and, in some cases, reduced funding.

    For example, government funding of Korowa Anglican Girls School in Melbourne, with 83 per cent of students from the highest socio-economic status (SES) quartile and 1 per cent from the lowest quartile, increased by 38 per cent between 2009 and 2013. In contrast, funding for Northern Bay P-12 College in Geelong, with 73 per cent of students from the lowest SES and 1 per cent from the highest quartile, had its funding cut by 18 per cent.

    In Sydney, government funding for Ravenswood Girls School, with 85 per cent of students from the highest SES quartile and none from the lowest quartile, increased by 28 per cent while funding for Punchbowl Boys HS, with 63 per cent of students in the lowest SES quartile and only 2 per cent in the highest quartile, had its funding cut by 3 per cent.

    Given this, it is a big call to expect that public schools can hold or increase their share of enrolments. Australia has a distorted, incoherent and unfair school funding system in which privilege trumps disadvantage.

    The Gonksi plan promised change. However, it was sabotaged by the refusal of the Abbott and Turnbull governments to fund the last two years of the plan when some $7 billion was due to flow to schools, including $5.8 billion to public schools.

    At least Labor has given voters a clear choice on education by promising to restore a large part, though not all, of its original commitment made when it was in government. It offers hope that disadvantaged schools and students will finally get some justice and that public schools will be able to reverse the enrolment shift to private schools over the longer term.

    Trevor Cobbold is National Convenor of Save Our Schools

    http://www.saveourschools.com.au

    https://twitter.com/SOSAust

     

     

     

     

  • Michael Gracey AO. Grappling with the Indigenous health gap.

     

    By most recognised markers of socio-economic status, Indigenous Australians fare badly compared with their non-Indigenous counterparts. This is certainly the case where health standards are concerned. For example, rates of infections and hospitalisation for these and many other illnesses are much higher; chronic diseases like heart disease, stroke and diabetes are more prevalent; and hearing loss and blindness rates are increased as are a multitude of other disabilities. Illnesses and deaths linked to alcohol and drug abuse, and accidents and violence are more frequent, as are disorders associated with psychosocial stress. Death rates are increased across the life span and Indigenous people tend to die younger and have a life expectancy which is somewhere between 10 and 17 years shorter than that of other Australians. The statistics are stark and this situation represents one of Australia’s worst embarrassments internationally.

    But we need to understand how this situation evolved, what has and is being done about it, and whether these inequities in health and wellbeing are being corrected. It may come as a surprise to readers aged below 50 to realise that the divide between health standards among Indigenous and other Australians became generally recognised and acknowledged only within their lifetimes. The earliest reliable reports about poor Aboriginal health appeared in the mid-1960s after it was recognised that Aboriginal infants had very high rates of gastroenteritis, malnutrition and high death rates and that the life expectancy of Aboriginal people was much shorter than for other Australians. When the media reported these findings there was a public outcry and a quick but poorly organised political response was provoked to try to fix the problem. By then this was labelled the “Aboriginal Health Problem”.

    The late 1960s and early 70s brought many rapid changes into the lives of Indigenous Australians. These included: the 1967 Referendum which allowed the federal parliament to enact laws relating to Indigenous people and to include them, for the first time, in the national census; the federal court decision to grant “equal pay for equal work” for Indigenous workers; the establishment in Sydney of Australia’s first Aboriginal Medical Service in 1971; the gradual relaxation of restrictions on access to alcohol by Indigenous adults; and a rapid shift of Aboriginal people in rural and remote areas into towns and their fringes. In 1979 a federal parliamentary committee acknowledged the poor standards of Indigenous health and identified their root causes as being in deprived socio-economic circumstances and sub-standard living conditions. By that stage almost two centuries of marginalised living and social exclusion had reduced the original inhabitants to being an under-class in Australian society; the late Professor Rowley called them “Outcasts in White Australia”. This group of people by then had an entrenched core of ill-health, chronic disease and premature deaths which would be extremely difficult to correct.

    The social determinants underlying the patterns of ill health that affect Indigenous Australians must be addressed before significant and sustained improvements in health and wellbeing will occur. These contributing factors include poverty, overcrowding, unhygienic living conditions, low education standards, under-employment, social stigmatisation and marginalisation, disengagement from mainstream society, and their inadequate participation in decision-making processes which affect health and wellbeing. It must be appreciated, also, that some of the factors which have strong negative impacts on Indigenous health are trans-generational. For example, prenatal under-nutrition and impaired growth can adversely affect pregnancy outcomes over multiple generations; this means that those negative effects may take 50 years or more to be eliminated.

    In 2005 Tom Calma, then Aboriginal and Torres Strait Islander Social Justice Commissioner, released a report which called on Australian governments to commit to achieving equality for Indigenous Australians in health and life expectancy within 25 years. The Federal Government then made a formal Statement of Intent in 2008 to ensure that Indigenous people would have ”equal life choices”. The target date of 2030 was set for the various goals to be reached. This ambitious strategy and program was warmly received but within a year it was being questioned whether the targets were achievable in the time allotted; in particular, the goal of removing the life expectancy gap between Indigenous and non-Indigenous people was considered to be “probably unattainable” (https://www.mja.com.au/system/files/issues/190_10_180509/hoy11300_fm.pdf . These reservations were soundly based. By then there were many thousands of Indigenous people with long-standing chronic diseases like diabetes, chronic respiratory and cardiovascular diseases, late-stage kidney failure, irreversible visual and hearing loss and a range of other permanent disabilities. Added to that formidable burden was the increasingly heavy load of illnesses, social and stress-related disorders, and premature deaths associated with cigarette smoking, alcohol and drug abuse, in Indigenous people as well as those linked to accidents and violence. Quite clearly this wide-ranging and massive range of illnesses, disabilities and premature deaths would have no simple, single solution as, for example, could be applied to successfully control or prevent an infectious disease outbreak by a community-wide immunisation program.

    Yet, despite the timely and nationally published cautionary advice cited above, the Close the Gap Strategy and program continued. Each year a formal report has been released in parliament outlining progress towards the stated targets. There have been some improvements in Indigenous health over the past decade or so but it is difficult to attribute them to this strategy alone. For example, improved pregnancy outcomes such as heavier birth weights, suppression of childhood infections by immunisation, and lowered infant and maternal mortality, were achieved largely by other programs based on sound public health principles; that work began well before the Close the Gap initiative began. Annual report cards have mostly shown what is often officially called “mixed outcomes” – this usually means that the reporting agencies and their bureaucrats could find little that would attract a favourable headline in the press. This is disappointing because most Australians, black and white, want to see Indigenous people share the high levels of health which most of us take for granted. These mixed results in health, wellbeing, living standards, education, employment and productivity among Indigenous people have left them feeling let down. When the seventh annual Close the Gap report was presented by Prime Minister Abbott in February 2015 he acknowledged that the results were “bitterly disappointing”. Why didn’t he grab the nettle then, acknowledge that the strategy was failing, indicate that it had been introduced by former Prime Minister Rudd, and then ditch the policy and start again? That opportunity was lost and yet another year passed until the next Prime Minister, Turnbull, reported this month that the results of the eighth annual report were “mixed”.

    One of the key targets of the Close the Gap program all along has been to equalise the life expectancy of Indigenous and other Australians. However, the 2016 report acknowledged that the improvements that have occurred so far are not happening fast enough for that target to be reached within the next 20 years. Even in some instances where improvements seem to have been encouraging, closer scrutiny of the details exposes otherwise hidden obstructions. Take infant mortality rates for example. While the rates of Indigenous children dying in their first 12 months of life have dropped substantially over the past 15 years, the rates among non-Indigenous infants have also been dropping. When the relative rates, that is Indigenous compared with non-Indigenous rates, are examined it is evident that Indigenous infants are dying at about double the rate of other infants before their first birthday. Prime Minister Turnbull conceded that achieving the target to close the life expectancy gap by 2030 remains “a significant challenge” (ABC News item, 10 February 2016). Regrettably, other aspects of the 2016 Close the Gap report which have significant impacts on health were also disappointing; they include educational attainments, employment rates and housing standards.

    Repeated and protracted disappointments like these leave people feeling angry and frustrated, particularly the Indigenous community who have so much at stake for themselves and their future generations. Nationally prominent Indigenous leaders like Patrick Dodson have said recently that the Closing the Gap initiative is doomed to failure unless it is radically reformed. He added that the Prime Minister has not yet put his stamp on Indigenous affairs and has not paid sufficient attention to these issues.

    Resolving the inequities in health between Indigenous and other citizens must be done with an all-inclusive approach to all of the inter-related issues that are involved. Providing better and more accessible and appropriate health and disease care can only be part of the solution. Strategies and programs that are aimed at promoting and improving wellness as well as treating illness must be given more prominence in the clinical approaches towards better Indigenous health outcomes. A crushing disappointment for clinical carers of all types who work in this field has been to see the substantial improvements in health which have occurred over recent years, much of it in children, be undermined by high-risk attitudes and behaviours in later life which result in preventable premature deaths. Examples are the serious illnesses and deaths due to tobacco smoking, physical and mental damage and deaths from alcohol abuse and other addictive drugs, vehicle accidents and other forms of violence, and the long-term consequences of overweight and obesity including diabetes and cardiovascular disease. The gains that have been made in reducing infant and young child deaths should lead to improved life expectancy but this is being thwarted by the continuing wastage of lives in adolescence and early and mid-adult life. Much of this wastage is preventable. This is where responsibility for personal, family and community-based health must become part of the equation. Indigenous acceptance of responsibility and participation must become an essential element of this process in order for real progress to occur.

    A recurring theme in the continuing debate about trying to achieve equity in health and wellbeing between Indigenous and other Australians is the need for increased participation of Indigenous people in the activities and social circumstances which affect them. Not only is there a place for enhanced Indigenous involvement in these issues, there is a real need for this to happen. Examining the way health and clinical services are currently provided to Indigenous people shows that three main sectors are involved:

    • federal and state government services
    • the specially developed and independently-run Indigenous Medical or Health Services, and
    • private or other non-government providers of clinical and related services

    If these three sectors had been working cooperatively and effectively over the past thirty or more years, Indigenous health should not be in its present sorry state. Despite past failures there is still goodwill among the wider Australian community to see that this situation is corrected. I have previously called for a fourth sector to be organised to help bring this about (Refer to earlier Gracey blog on ‘What is need to fix Aboriginal health?’ here). This new sector would be established as a community-based organisation representing ‘grass roots’ Indigenous people who are currently sidelined from the process of policy development and making decisions about running programs at the community level to suit their own needs and aspirations. Adding this new dimension would show at last that local Indigenous communities have a real contribution to make in the health improvement process. This is not being achieved by regional Indigenous Medical or Health services although they claim to be ‘community-controlled’. In fact, members of local Indigenous communities have very little or no say in the selection of such regional bodies; in effect they are voiceless. The emergence of this fourth dimension would demonstrate that local communities and their members are prepared to accept this responsibility to contribute to planning and delivering health care for their own people. Such a development should help answer the repeated calls by Indigenous leaders from different parts of Australia for their people to play a bigger role in improving health and wellbeing of the Indigenous population.

    It is time for the issues surrounding Indigenous health to be thoroughly and objectively reviewed. This would help to ensure that the mistakes of the past are not repeated and perpetuated. Australia must be able to do better. The health needs of Indigenous people are, indeed, more demanding than for other Australians. But more funds, more doctors, nurses, clinics, hospitals, and related services cannot alone provide the solution. There must be a wide-ranging approach to all of the infrastructure services and other factors which influence the determinants of wellness and illness. Education, employment, housing, hygiene, access to affordable nutritious food as well as avoidance of unhealthy lifestyles must all be part of the equation towards better health. The media often sensationalise negative factors in society that contribute to the continuing poor state of Indigenous health. While many mistakes have occurred in the past and marginalisation of Indigenous people has had serious negative impacts on their wellbeing, it is time to look to the future and take a more positive outlook. Present problems should be seen as opportunities or challenges to put things right. To focus repeatedly on racism or negative stereotyping as the root cause of this continuing dilemma could be counter-productive and tend to separate Indigenous and other Australians even further. Instead, we should try to reach a situation where Indigenous people are given better chances to accept responsibility for their own health. Encouragement and cooperation will foster trust between them and the wider society and its representatives, namely governments and their agencies and bureaucrats. But all sides must accept this will be a “two-way street” where flexibility and patience will be keys to ultimate success.

    Michael Gracey AO is a paediatrician who has worked with Indigenous children, their families and communities for more than forty years. He was Australia’s first Professor of Aboriginal Health and for many years was Principal Medical Adviser on Aboriginal Health in the Western Australian Department of Health. He is a former President of the International Paediatric Association.

  • Michael Keating. An Update on Tax Reform

    The Prime Minister seems to have been encouraging speculation that the Government has decided not to consider any reform of taxation that involves an increase in the GST. If true, hardly a courageous decision, given the support he has received from some State Premiers. But this posting is concerned about the consequences.

    First, in the absence of any extra GST revenue, it now is almost certain that the Australian Government will not give the States any more money. Instead the States will have to wear the $80 billion cut to health and education funding that the Commonwealth has already imposed on their budgets.

    Of course, the Commonwealth will say that the States should find the savings or tax more themselves to ensure that vital health and education services are maintained. But on any stretch of the imagination, it cannot be expected that the States will raise the missing $80 billion by increasing land tax or payroll tax, and any other State taxes are inherently inefficient as well as not raising much revenue.

    As for expenditure savings, the reality is that as readers of this blog know, there are opportunities for savings in the health budget. However, these savings will take time, and more importantly many of the savings opportunities in health are in areas of Commonwealth responsibility. For instance, long run savings could be made by more effective public health systems aimed at prevention and by keeping people out of hospital, but the relevant programs are mainly the responsibility of the Commonwealth and not the States. Indeed, the funding of hospitals, which is the principal State government health care responsibility, is now based on the efficient cost of individual services, and the principal savings have already been obtained.

    Similarly, although there are opportunities for savings in education, there is equally a need for more investment in tertiary education, and for improving the funding in disadvantaged schools. This extra expenditure has a very high benefit-cost ratio, and so it is the antithesis of “reform” if any education savings are not reinvested in better education programs.

    The second major consequence of not increasing the GST is that the Australian Government then has only limited capacity for what it deems to be “tax reform” as measured by lower personal and corporate income taxes. Instead, the only significant way of increasing the revenue to finance lower income taxes would be to broaden the income tax base, by removing or reducing some of the tax concessions. A number of such possibilities have been floated, including:

    • A fairer and less generous form of taxing superannuation contributions and earnings,
    • Reducing the possibilities for claiming deductions of interest costs through negative gearing, and
    • Reducing the taxation concession for capital gains.

    The problem with all these types of proposals is that they don’t raise much money; in fact a lot less than their proponents imagine. For example, the superannuation tax concessions have received a lot of publicity lately, and based on the Treasury Tax Expenditures Statement, some commentators have sown the idea that as much as $30 billion might be raised by abolishing these concessions. However, it all depends upon what is the standard against which these concessions are being measured. So on closer examination savings of around only $6 billion is a much more realistic figure.

    Similarly, reducing the capital gains discount and the opportunities to claim interest payments by negative gearing might eventually raise an extra $10 billion in each year. However, there would be grandfathering provisions as part of any such adjustment, so that this amount of extra revenue would not be realised for the best part of another ten years. In the short-term, these proposals could even cost the Budget, if people adjusted their investments in between the announcement of the changes and the date that they would take effect.

    In addition, a proposal to abolish claims for work expenses in return for lower taxes has also been floated. This could reduce the amount of irritating form filling, but the amount of revenue gained would hardly finance much of a tax cut. In addition, would people feel better off if it didn’t, and what they gained in one hand was taken away from the other.

    In sum, the amount of extra revenue available in the next few years from reducing concessions is likely to be not much more than $10 billion, slowly increasing further over time.

    So what should be done with this extra revenue, on the bold assumption that it is actually realised? Arguably the first call should be repair of the Budget deficit, for which according to the latest official estimate, the underlying cash deficit will be as much as $35.4 billion in the current financial year and still $33.7 billion next year. Clearly this is quite a lot more – indeed three times more – than any extra revenue, now on the horizon from likely/possible “tax reform”.

    Furthermore, the present projections of the Budget deficit rely quite heavily on fiscal drag as people move into higher tax brackets as their incomes increase, if only in line with inflation. Thus the Budget for this year was based on a projection that over five years, revenue would rise by 2.4 percentage points relative to GDP, while expenditure would only fall by 0.2 percentage points relative to GDP. Clearly revenue is expected to do almost all the work of closing the Budget deficit, and 1.7 percentage points of the 2.4 percentage points increase in revenue (or 70%) is due to fiscal drag.

    The Treasurer, Scott Morrison, has implied that his highest priority is to neutralise this fiscal drag by redrawing the tax scales, and personally I find it hard to disagree. But if the Treasurer wants to do that he will not have enough revenue to finance the necessary tax reduction, and he will add significantly further to the Budget deficit, especially as so much of the projected reduction was reliant on maintaining the fiscal drag.

    Of course, there will be some cheery souls in right wing think tanks, who have never had to depend on the state, who will then draw the conclusion that expenditure should be cut further – indeed by as much as the 5 percent of GDP necessary to achieve their agenda. But no government has ever embarked on such a draconian savaging of expenditure programs. Not even the Hawke Government cut by this amount, and although it did achieve very large expenditure reductions, the opportunities for savings were much greater then. Thus the Hawke Government savings were principally realised through more targeting and user charging, but those opportunities have now been taken up, and cannot be implemented twice.

    Indeed, the only realistic scenario is that in this election-year the Turnbull Government will not repeat the first Abbott/Hockey Budget of 2014, which was rejected as being very unfair. So we are essentially stuck with a continuation of existing policies, no tax reform worth boasting about, continuing reliance on fiscal drag, and negligible progress towards fixing the nation’s finances.

    Furthermore, it is hard to see how this situation will change until we face up to the real fact that the number one priority is to find an agreed way to increase the overall tax take by a couple of percentage points relative to GDP. On this critical issue, Jay Weatherill and Mike Baird have been absolutely right and so far federal Labor has been absolutely wrong.

     

  • Frank Brennan SJ. The Taxpayer’s Liability for Long Term Detention on Nauru (and Manus Island)

    As the Commonwealth Government contemplates what to do with the Bangladeshi woman in the recent High Court asylum case and her baby born in Australia, it will be relevant to consider the possible civil liability of the Commonwealth for its participation in her detention on Nauru for six months at a time when the Commonwealth Parliament had not specifically authorised the Executive Government to take action or make arrangements co-operating in such detention with a refugee processing centre (RPC).

    Last year the Immigration Department advised the Senate:

    It was originally planned that the RPC would operate as an ‘open centre’, comprising ‘community living institutions’ with minimal security, from which asylum seekers would come and go with relative autonomy, and engage with the local community. In ensuing consultation with the Government of Nauru, the model ‘evolved’ such that from its conception the centre operated as a closed facility, with movement outside the RPC only allowed on an escorted basis. On 25 February 2015, open centre arrangements were introduced at the RPC for certain cohorts of asylum seekers. The department advised that this was being ‘incrementally expanded to include all eligible asylum seekers’.

    The High Court decided that ‘the Commonwealth did not itself detain the plaintiff’. But that was not the end of the matter. French CJ, Keifel and Nettle JJ said that ‘the plaintiff’s case concerns the participation by the Commonwealth and its officers in the detention by Nauru of the plaintiff. It is that participation which is required to be authorised.’

    It is that participation which might found an action in tort for wrongful detention.

    French CJ, Keifel and Nettle JJ said, ‘It may be accepted that the Commonwealth was aware that Nauru required the plaintiff to be detained. In order to obtain Nauru’s agreement to receive the plaintiff, the Commonwealth funded the Centre and the services provided there in accordance with the Administrative Arrangements. The Commonwealth concedes the causal connection between its conduct and the plaintiff’s detention.’ Equally it may turn out that Nauru was aware that the Commonwealth required the plaintiff to be detained, or that the Commonwealth and Nauru reached agreement that the plaintiff should be detained. But why?

    The Commonwealth Parliament passed retrospective legislation authorising the detention regime. But just before the case commenced, the Nauruan government announced that they would no longer detain asylum seekers within refugee processing centres.

    French CJ, Keifel and Nettle JJ said: ‘If the regional processing country imposes a detention regime as a condition of the acceptance of UMAs removed from Australia, the Commonwealth may only participate in that regime if, and for so long as, it serves the purpose of processing.’ Did the six month detention of the plaintiff serve the purpose of processing, given that Nauru no longer requires the detention of asylum seekers while processing them, given that Nauru originally intended to process asylum seekers without detaining them, and given that the Nauruan decision to detain asylum seekers ‘evolved’ through discussions with Commonwealth officials?

    Justice Bell said that the Commonwealth brought about the plaintiff’s detention ‘in a practical sense’:

    The Commonwealth did not seek to have Nauru detain persons taken to it for regional processing. Nonetheless, by applying for an RPC visa in the plaintiff’s name and by taking the plaintiff to Nauru, in a practical sense the Commonwealth brought about her detention under the regime that applied in Nauru. The Commonwealth parties accept so much.

    Justice Bell said, ‘As a condition of its acceptance of a transferee from Australia, Nauru required that the transferee be detained in custody while any protection claim was processed and while any arrangements were made for removal from Nauru in the event the transferee was found not to be in need of international protection.’ Her Honour concluded, ‘The Commonwealth parties brought about the plaintiff’s detention in Nauru by applying for the issue of an RPC visa in her name without her consent.’ Justice Bell accepted that the plaintiff’s detention in Nauru ‘was, as a matter of substance, caused and effectively controlled by the Commonwealth parties’. Justice Bell said, ‘If a transferee were to be detained for a period exceeding that which can be seen to be reasonably necessary for the performance of those functions, the Commonwealth parties’ participation in the exercise of restraint over the transferee would cease to be lawful.’

    Given that Nauru originally intended to process people without detaining them, and given that Nauru is once again committed to processing people without detaining them, the question arises: what was the purpose of the six months detention of the plaintiff? Was she detained for a period exceeding what was reasonably necessary to effect the processing of her claim?

    Justice Gageler said that the focus had to be on the capacity of the Executive Government of the Commonwealth ‘to procure or enforce a deprivation of liberty’.   He concluded that the Commonwealth’s contractor Wilson Security staff ‘exercised physical control over the plaintiff so as to confine her to the Regional Processing Centre’.

    He concluded ‘that Wilson Security staff exercised that physical control over the plaintiff in the course and for the purpose of providing services which the Executive Government of the Commonwealth had procured to be performed under the Transfield contract’.

    Justice Gageler said that the Commonwealth Parliament’s retrospective law was directed at ‘nothing other than conferring statutory capacity or authority on the Executive Government to undertake action which is or might be beyond the executive power of the Commonwealth in the absence of statutory authority.’ Most significantly, he insisted, ‘The section has no effect on the civil or criminal liability of the Executive Government or its officers or agents under Australian law or under the law of a foreign country. The lawfulness or unlawfulness of Executive Government action under Australian law or under the law of a foreign country conversely does not determine whether or not that action falls within the scope of the statutory capacity or authority conferred by the section.’

    Gageler J found: ‘The requisite connection with that role would be broken were the duration of the detention to extend beyond that reasonably necessary to effectuate that role or were that role to become incapable of fulfilment.’ He thought that the plaintiff’s claim ‘that the Commonwealth and the Minister acted beyond the executive power of the Commonwealth by procuring and enforcing her detention at the Regional Processing Centre between 24 March 2014 and 2 August 2014 was well-founded.’ Thus the need for the Commonwealth Parliament to pass a retrospective law validating the Commonwealth action in 2015.

    There is no doubt that the Commonwealth’s involvement in the six month detention of the plaintiff was unauthorised when it occurred. Prior to the plaintiff’s detention, Nauru saw no need to detain asylum seekers in order to process their claims. Now, Nauru sees no need to detain asylum seekers in order to process their claims. It could be a live issue for a court to investigate how the model of processing evolved to warrant detention. If there be evidence that the long term detention of the plaintiff and people like her contributes nothing to the efficacy of the processing of their claims, then the Commonwealth’s participation in a scheme aimed at effecting and financing the detention would arguably create a civil liability regardless of the retrospective Commonwealth law permitting the Commonwealth Executive to effect and finance detention but only for the purpose of processing.

    Mr Dutton has a lot to think about. As Treasurer, Mr Morrison might also continue to have a few worries about the long term detention of persons on Nauru which he participated in when Immigration Minister.

     

     

     

  • Ian McAuley. The only unifying thread in the Liberal Party is a compulsion to keep Labor out of office.

    There is a German saying “The less the people know about how laws and sausages are made, the better they sleep at night”.

    In his book Credlin & Co (Black Inc 2016), an exposé of the political relationship between Tony Abbott and his loyal Chief of Staff, Peta Credlin, Aaron Patrick of the Financial Review takes us inside Abbott’s sausage factory.

    At one level it’s a story that’s been around for 500 years, which is when Machiavelli warned about the folly of the prince who surrounds himself with a protective guard to flatter him and protect him from his critics. When at Oxford Abbott must have skipped over that part of The Prince.

    But at another level it’s about the dysfunctional nature of the Liberal Party. Patrick describes the party’s factions and alliances, and the values some of its power-brokers hold strongly – social conservatism, a dogmatic faith in the intrinsic virtue of “small government”, loyalty to the Queen of England, a belief that’s what’s good for “business” is good for Australia, and denial of climate change, to name a few.

    Reading Patrick’s work it’s apparent that the only unifying thread in the Party is a compulsion to keep Labor out of office. To the Party’s members it’s an imperative akin to protecting Australia from smallpox – so self-evident that it needs no explanation or justification.

    And that’s where Abbott excelled, from the day in late 2009 when he knocked off Malcolm Turnbull as Opposition Leader. Abbott and Credlin were faithful to the Party’s mission – and understandably they would be resentful at being turfed out after having been so true to the Party’s mission.

    Patrick exposes a party that’s so arrogant and sure of itself that it attributes any setbacks or defeats to a failure to get its message across. If only Abbott and Hockey had explained the 2014 Budget it would been far better accepted. If only they had handled the Senate cross-benchers better they could have succeeded in cutting age pensions and raising university fees. If only Campbell Newman had been a better political strategist the LNP would not have suffered its humiliating defeat in Queensland.

    Patrick acknowledges that Abbott went overboard on terrorism, and that awarding a knighthood to an already honour-overladen prince from one of Europe’s offshore islands was rather stupid, but by and large he does not suggest that there was anything wrong with Abbott’s t policies.

    Apart from criticising Abbott’s ineptitude, Patrick’s account is largely non-judgmental. His book flows easily (journalists can write well when sub-editors don’t mangle their work .) I doubt whether he set out to expose the Liberal Party’s weaknesses. He tends to take the Party’s policy justifications at face value.

    What he exposes, inadvertently perhaps, is a party that cannot learn from its policy mistakes. Abbott and Credlin cut themselves from the rest of the Parliamentary Party, but that is similar to the way the Liberal Party has cut itself from the Australian people. Abbott and Credlin are scapegoats for a malaise that affects the whole party – a paternalistic “born to rule mentality”.

    No politician, however canny, could have “sold” the 2014 budget to the Australian people. Those who are skilled in political leadership can convince people that when economic times are tough some short-term shared sacrifice is necessary for the common good, but almost anyone can see through a policy that imposes costs on the most vulnerable while protecting the privileges of rent-seekers. The problem for the Abbott Liberal Government was that people did understand its policies.

    The Liberal Party’s strongest manifestation of paternalism is in its “small government” obsession. Although we have the smallest public sector and are the most lightly-taxed of all prosperous developed countries, the Party is unwavering in its idea that “small government” is good for us. Indeed, its articulation of beliefs says “businesses and individuals – not government – are the true creators of wealth and employment”. That statement is grossly offensive to every doctor in a public hospital, every teacher in a government school, and every cop on the beat, as well as being just plain stupid economics.

    So, when people demand more funding for health, education, urban transport, and environmental protection, the Party’s response is to disrespect people’s preferences, and to assert, paternalistically, that the Party knows better.

    Nowhere is this paternalism more evident than in privatisation. It’s reasonable that people should object to paying high prices for their electricity or public transport when those businesses become featherbeds for overpaid and underworked trade unionists. But that doesn’t mean they want these same utilities sold to the private sector so that high prices are subsidising overpaid executives and shareholders. They want their utilities – the utilities in which they have invested their taxes – to be run well, not sold off to opportunists. Privatisation is a lazy substitute for reform.

    Even if people haven’t studied the economics of market failure, they understand that certain matters – health insurance, school education, energy and water utilities, roads – are far better handled by governments than by the private sector.

    And people know what is meant by “business interests”. Patrick points out that the Abbott Government had lost the support of the “business community”, as if that was unquestionably a bad development. But there is a fuzzy line between “business friendly” economic policy and cronyism. If we were to find the ACCI and the BCA – lobby groups that speak mainly for corporate executives and (largely foreign) shareholders – were 100 percent behind any government’s policy, we should be truly worried that the government has lost sight of the public interest.

    For anyone interested in seeing inside the sausage factory – at least the Liberal Party section of the factory – Patrick’s book is an excellent exposé. Readers may find it hard to swallow his uncritical approach to the Liberal Party’s paternalism, and statements such as his claim that the ABC and the Fairfax media are on the “left”, but that is the world view of one who has been close to the Liberal Party powerbrokers, and it’s the world view into which Australians are slowly drifting.

    More important, in exposing the Liberal Party’s weaknesses, it should be a guide for a confident Opposition, ready to engage in a mature and honest way with the electorate.

     

     

  • David Isaacs. Secrets and lies and bad morality: Australia’s policy on people seeking asylum

    The latest episode in the long, sorry saga of how badly we can treat people seeking asylum was played out in the High Court in February 2016. Long because the story started in 1992 when the Paul Keating Labor government introduced mandatory detention ‘as a temporary measure’ in reaction to a handful of people arriving in leaky boats from Cambodia. And I use the term ‘people seeking asylum’ advisedly, because the term ‘asylum seekers’ dehumanises the people and has been shown to cause Australians to switch off. The High Court found it is legal for the Government to send babies born in Australia and children and adults transferred to Australia for mental health and other problems back to Nauru. This decision was predictable because the Government passed retrospective legislation making it legal. As the human rights lawyer Daniel Webb put it so eloquently, the law is complex but the morality is simple. Bad Governments pass bad laws to allow them to do things that are morally wrong. I am a doctor not a lawyer, so I am not qualified to say at what point the High Court has a duty to make sure our Government does not exact really heinous legislation, but this is pretty bad. Excising Christmas Island from the mainland and sending people into detention centres on Nauru and Manus Island is our Guantanamo. These are ‘black sites’ where people can be severely mistreated under a veil of secrecy: out of sight and out of mind.

    To argue that people are now free to come and go from the detention centre on Nauru is disingenuous. They are not safe if they leave the detention centre and they are not safe in the detention centre. Their visas to stay on Nauru are restricted to 5 years, so their future is as uncertain as ever. Nauru is their prison. Mr Dutton has stated that the hospital on Nauru is comparable to Australian hospitals. I did a clinic at the Republic of Nauru (RON) Hospital in December 2015 and it is far, far worse than any Australian hospital I ever visited. Furthermore, the staffing is as important as the facilities and the RON Hospital struggles for qualified staff. Of course, Mr Dutton will argue things have changed in the last year. Verifying the truth is impossible when the only journalist allowed in for years was a single Murdoch Press Government sympathiser and doctors who speak out risk two years in prison.

    Ethics can be defined as ‘how we ought to behave’ and medical ethics as how health professionals ought to behave. I recently published a paper (available on request) in the Journal of Medical Ethics (http://jme.bmj.com/content/early/2015/12/20/medethics-2015-103066.abstract) in which I argue that prolonged immigration detention fulfils all the criteria for torture. I then argue that doctors and other health care professionals are conflicted: they have a duty to their patients to help them but they also have a duty not to condone torture. The US Central Intelligence Agency (CIA) argues to this day that water-boarding prisoners in Guantanamo and Abu Ghraib was not torture because the technique was devised by psychologists and supervised by doctors. The doctors would presumably argue that the water-boarding was going to happen anyway and they were ensuring the prisoners did not drown. Highly respected colleagues and lawyers have said to me “Nauru is not as bad as Guantanamo”. Is it not? Are we to have degrees of torture? There have been unconfirmed (probably unconfirmable) reports by a guard of water-boarding and ‘zipping’ being inflicted on people in immigration detention in Nauru (http://www.abc.net.au/news/2015-08-14/guard-tells-parliamentary-inquiry-asylum-seekers-tortured-nauru/6699162). Why would the guard lie? Mr Dutton denied it, but he would wouldn’t he.

    The harms we are inflicting on adults to punish them for having the temerity to flee persecution in their homelands are immoral. We treat innocent adults worse than we do convicted criminals. But the public are more likely to sympathise with the argument that children are innocent victims. Gillian Triggs realised this, which is why her Forgotten Children enquiry is so powerful. Alison Light, in her wonderful book “Common people”, describes how the 19th century English workhouses were intended to punish men who did not want to work, but the biggest victims were women and children. I was struck by the parallels with immigration detention centres. I am proud that increasing numbers of paediatricians and paediatric nurses have decided to speak out against what is being done to children by our Government in our name. Alanna Maycock, Hasantha Gunasekera, Karen Zwi and Josh Francis have all risked imprisonment for telling the truth.

    What should happen? The Government mantra, ‘We’ve stopped the boats’, means the immigration detention centres are redundant. Keeping people imprisoned can only be to deter other desperate people from seeking asylum. Europe, struggling with a far bigger immigrant problem, has not resorted to such vulgar deterrent policies, although extreme right wing European groups cite Australia as an example to follow. We should allow the derisory number of children to remain in Australia with their parents. We should close the detention centres on Nauru and Manus, which are not only immoral but hugely expensive (it costs over half a million dollars per year for each person kept on Nauru). Mr Turnbull committed his Government to a tough stance on border control. If that stance includes continuing to torture innocent people we should hang our heads in shame.

    Professor David Isaacs is Senior Staff Specialist, Department of Infectious Diseases and Microbiology and Clinical Professor of Paediatric Infectious Diseases at the University of Sydney. He works at the Children’s Hospital at Westmead.

     

  • John Menadue. The collapse of the Malaysian Arrangement has led to the depravity of Manus and Nauru.

    Having done its best in Opposition to wreck the Malaysian Arrangement in 2011, the Turnbull government is now seeking the help of Malaysia over detainees in Manus and Nauru. For political cynicism, this is hard to beat.

    In May 2011, the Australian and Malaysian governments announced an ‘in principle’ arrangement that up to 800 boat arrivals would be transferred from Australia to Malaysia for their asylum claims to be heard. In response Australia would be prepared to accept 4,000 refugees from Malaysia. The arrangement with Malaysia was signed on 25 July 2011. The UN High Commissioner for Refugees gave it qualified support. At that period, boat arrivals were running at four to six per month.

    The Gillard government introduced legislation to give effect to the arrangement with Malaysia which was necessary as a result of a High Court decision on the transfer of people. That legislation was bitterly opposed by the Coalition and others in an evenly divided House of Representatives. The legislation failed in September 2011 when boats were running at only four in the month.

    In this opposition to the Malaysian arrangement, the Coalition was actively supported by the Greens and some key NGOs.  The Greens and the NGOs wanted more than was on the table and finished with nothing – or something worse – Manus and Nauru. NGOs need to be politically astute and consider government’s responsibilities on security, economy and society. Or as Gough Whitlam put it pungently in another context. ‘Only the impotent are pure’.

    Failure to pass the legislation to implement the Malaysian Arrangement opened the door for people smugglers to really get to work. As a result of the failure of the Malaysian Arrangement, boat arrivals rose from about four or five a month to 48 in July 2013. Tony Abbott and Scott Morrison were not interested in stopping the boats. Their political objective was to stop Labor stopping the boats.

    Having helped defeat the legislation in the parliament, Tony Abbott and Scott Morrison seized every opportunity to bash Malaysia’s human rights record and ‘canings’.

    But now we find that despite this history, the Turnbull government is now discussing with Malaysia ways to resolve the Manus/Nauru mess, a situation which no-one believes is sustainable. Consistent with what I have heard in the region, Laura Tingle in the AFR on February 4, 2016, said

    ‘Now it emerges that we are once again talking to Malaysia – the country with whom the Labor government was doing a deal … which was supposedly so abhorrent to the Coalition and the cause of human decency. ‘

    We have gone cap in hand to the Cambodian government and paid it over $50 million to resettle four refugees from Manus/Nauru. Our government has also been in discussions with the Philippines and Kyrgyzstan but without success. Now the government is talking again to Malaysia which Tony Abbott and Scott Morrison reviled in 2011.

    Tony Abbott helped to keep the door open for people smugglers by successfully but unscrupulously contributing to the defeat the Malaysian Arrangement.

    The Malaysian Arrangement was not ideal, but it would have significantly helped manage the flow of desperate people. It would also have been a building block for a regional framework which is necessary to manage displaced people in our region.

    I will be writing further about the importance of this regional framework.

    The result of the failure of the Malaysian Arrangement is the depravity of Manus and Nauru. Political cynicism has been exposed but at great cost to very vulnerable people.

    We have become a pariah in our treatment of asylum seekers.Even if we are stuck with Manus and Nauru for a while yet, there is no excuse for the Australian Government allowing detainees being treated so inhumanely.

    See link to earlier articles, Parts 1 and 2,  I wrote with Peter Hughes on this subject ‘Slogans versus facts on boat arrivals. Part 1’. See also post ‘Slogans versus facts on boat arrivals. Part 2’.

     

  • John Menadue. ‘We don’t have a revenue problem, we have a spending problem’.

    Treasurer Scott Morrison has been expounding the above philosophy of his for months. But he couldn’t be more wrong. Unfortunately the Secretary of Treasury has now followed up with nonsense that Australia should have a ceiling of 25% of GDP on government spending (I assume he is referring to Commonwealth Government spending).

    Michael Pascoe (Michael Pascoe on Page 21 of February 03, 2016 issue of Sydney Morning Herald) nailed the ideological clamour and suggestion that lower levels of government spending result in improved economic performance and that Australia has a high level of government spending that should be reduced.

    In the article, Pascoe says ‘What can be clearly shown is that there is no correlation between relatively low government spending and the very best possible credit rating.’ Pascoe produces the latest figures from the ‘right wing’ Heritage Foundations 2016 Economic Freedom Index, which compiles all government spending – federal, state and local. This article points out that Australian Government spending is running at 35.6% of GDP. He adds that almost all countries with AAA status from Standard and Poor’s, Moody’s and Fitch, have higher government spending as a proportion of GDP than Australia: Australia 35.6%, Canada 40.7%, Denmark 57.1%, Germany 44.3%, Hong Kong 17.6%, Luxembourg 43.6%, Netherlands 46.8%, Norway 44%, Singapore 18.2%, Sweden 53.2%, Switzerland 33.5%.

    These figures make it clear that high levels of government spending do not necessarily result in poor economic performance. Pascoe concludes ‘It turns out that having markedly higher government spending isn’t so necessarily disastrous after all.’

    In a submission to the Senate Select Committee into the Abbott Government’s Commission of Audit, Jennifer Doggett, Ian McAuley and I contend that the problem is not that government expenditures or that the public sector is large in Australia compared with other countries. We contend that the problem is a short-fall of revenue and that on international comparison, our tax revenues are low.

    In our summary to the Committee we say …

    The Commission of Audit’s brief is based on assumptions that Australia is burdened with “big government” and that taxes are an impediment to business investment and workforce participation.

    There is no evidence for either assumption. The trend in Commonwealth expenditure has been downwards since the mid 1980s, falling from a peak of around 28 percent of GDP to a range of 24 to 26 percent of GDP in recent years. In comparison with similar prosperous countries Australia has one of the smallest public sectors.

    The problem a body such as the Commission should address is our inadequate tax base, which is the main reason the Commonwealth has had a structural deficit for most of this century. We aren’t collecting enough revenue to fund the public services needed if the economy is to thrive.

    We should not shy away from raising taxes. Evidence from international comparisons and from surveys on competitiveness suggests that reasonable levels of tax do not impede countries’ economic performance. In fact, countries which compete on the basis of low taxes do so to compensate for competitive weaknesses, such as inadequate infrastructure and poor standards of education – in other words impoverished public sectors.

    Such evidence, however, seems hard to convey to those gripped by a zeal to cut spending and taxes. Even in a “small government”/low-tax country like Australia it is possible to find areas where private funding and provision of services can displace public funding and provision.

    But such displacement is usually at high economic cost, simply to achieve an arbitrary fiscal objective. There is no point in reducing taxes if the private costs are greater than the saving in taxes, with no improvement (and in many cases a deterioration) in the services provided. We illustrate this in the case of health care funding. This is an area of significant public outlay and where, because of ongoing growth in demand, there are voices – often the voices of self-interest – calling for a shift from public to private insurance. Such a shift would be costly on all economic criteria – technical efficiency, allocative efficiency and equity.

    The rushed and secretive processes of the Commission are not the path to good public policy. There may be areas where a change in the public/private mix is justified on economic grounds, but these are not one-way towards the private sector as implied in the Commission’s brief. Because we already have a small public sector it is likely that a proper process, with research and consultation, would find a need for a net expansion of Australia’s public sector. By shutting off that possibility those who drafted the Commission’s brief are imposing a constraint which may be contrary to the community’s wishes and sound economics.

    The full submission to the Senate Select Committee can be found by going to my website. Click on ‘John Menadue Web Site’ top left of this blog page.

     

     

  • Stephen Duckett. Health in 2016: a cheat sheet on hospitals, Medicare and private health insurance.

    We start 2016 as we started 2015 – with big challenges for the health system and uncertainty as to how governments will meet them.

    The health care headaches in 2016 are, in fact, the same ones we faced a decade ago, albeit different in severity and symptoms. They include population growth, ageing and the rise of chronic disease; inequality in access to care and health outcomes; technological change (the good, the bad and the expensive) and the seemingly inexorable rise in health costs.

    Circling for landing are three major reviews on private health insurance, primary care, and low-value care. Their recommendations, and the government’s response to them, are very much up in the air.

    Adding to the uncertainty is the broader review of federalism and its consequences for public hospital funding, along with speculation around the 2016 federal election date and what each party’s Santa sack of election promises might contain.

    Private health insurance

    The number of people with private health insurance continues to creep up but the market is not in good shape.

    The rebate is one of the fastest growing areas of government health expenditure and complaints about the product abound. High levels of coverage are being achieved throughcarrots (the rebate) and sticks (penalties for the uninsured) rather than genuine consumer appeal.

    One solution being floated is for the whole subsidy framework to be thrown out. Instead of subsidising private insurers, which pay private hospitals, the government could subsidise private hospitals directly.

    Government advisers are impressed by the efficiency gains that activity-based funding (paying hospitals per procedure rather than a lump sum) brought to public hospitals and believe similar improvement can be brought to the private sector.

    The mechanism to achieve this could be a Hospital Benefits Schedule which, like the Medicare Benefits Schedule, would prescribe a schedule fee for private hospital care, based on existing Commonwealth payments for public hospital services under activity-based funding. The same schedule may later be used for public hospitals, replacing grants to the states.

    However, it will only be politically palatable if it is cost neutral for consumers or comes with reduced private health insurance sticks.

    The devil is in the detail of a new policy such as this. Will payment be to the hospital or surgeon? Will it cover the surgeon’s fee, as in public hospitals? Will it cover diagnostics? Without this information it is impossible to forecast the impact of the shift.

    Public hospitals

    This will be a challenging year for public hospitals. Major reductions in Commonwealth funding for hospital admissions – which continue to grow – will kick in from 2017, and states are likely to start the belt-tightening early.

    The cuts far exceed the productivity gains that can be made, so a reduction in services is certainly possible. Efficiency may be improved somewhat by the ongoing expansion of activity-based funding to mental health and “sub-acute” care such as rehabilitation and palliative care.

    The possible changes to private health insurance and a Hospital Benefits Schedule may be one way to put money from the federal government back into the system, but there is no sign that Treasurer Scott Morrison is keen to loosen the purse strings.

    Hospitals will also be under pressure to lift quality. Hospitals face increasingly stringent “quality standards” with tougher monitoring covering a broader scope of issues, including access and timeliness.

    Meanwhile, the increasing array of publicly available data is putting variation in hospital performance under the spotlight more and more, with commensurate calls for greater accountability.

    Medicare

    Two independent reviews of Medicare are expected to land sometime in 2016.

    The first examines primary care. It could address any number of challenges, including chronic disease management, “six-minute medicine”, co-payments, frozen rebates, and the growing corporatisation of general practice.

    Management of chronic diseases such as diabetes, heart disease and cancer poses the main challenge. The rise of chronic disease is imposing big costs on a system that wasn’t designed to provide the complex, continuous and coordinated care now needed.

    The government will have to consider far-reaching reform with only limited and equivocal evidence to draw on. Options on the table include a shift in the balance of payments to practices, with less emphasis on payment for attendances (fee-for-service) and more emphasis on payment for care over the episode of illness or year (capitation payments).

    There may be other changes in payment structures. The government’s long-standing desire to reduce perceived incentives for six-minute medicine may see a minimum consultation time imposed on the standard (level B) fee.

    If sense prevails we won’t see a resurrection of the GP co-payment policy zombie. We should, however, see an end to the freeze on medical rebates; the only question being when and with what trade-offs.

    A further issue to be addressed is the shift toward practices owned by corporate chains that profit from referrals to and provision of diagnostic services, such as blood tests and X-rays. The implications of changed ownership structures for practice are not at the forefront of practice payment redesign but should be.

    The second review looks at quality and cost-effectiveness of items on the Medicare schedule. The review got off to a rocky start with wild claims about 30% waste in the system, and release of its first list of items targeted for delisting in the sleepy period between Christmas and New Year.

    The work on modernising the schedule will come to fruition in 2016. There will be individual and group losers in this process who undoubtedly will scream loudly with varying levels of effectiveness.

    What should you expect?

    It isn’t yet clear whether Health Minister Sussan Ley’s appetite for reviews portends massive reform to the sector, or simply a politically judicious preference for treading water in a portfolio still reeling from tumultuous management by her predecessor. However, the auguries are good for the former.

    The scene for change has been set, at least with the medical profession. Respectable leaders are engaged and leading some of the review processes. Hopefully this will be the year the health system rises to meet the big challenges of 21st-century health care.

     

    Stephen Duckett, Director, Health Program, Grattan Institute.  This article first appeared in The Conversation on February 1, 2016.

     

  • Bruce Duncan. Australia’s moral crisis: shipping babies and families off to Nauru

    How has it come to this, that the Australian government is poised to send back 37 babies, 54 children and their families – 267 in all – into the traumatic conditions of Nauru?

    Only a few years ago many Australians would have considered it inconceivable that our governments should have imposed such shocking treatment on people who fled to our country seeking asylum as refugees.

    What has brought matters to a head is the government’s cynical manipulation of the law to prevent the High Court of Australia ruling in favour of a Bangladeshi woman who had been brought from detention in Nauru to Australia because of complications in her pregnancy in 2014. She brought an action in the High Court to prevent her being returned to Nauru.

    The government responded by rushing new legislation through both houses of parliament on 24 and 25 June 2015, changing the migration act to justify any action taken by the government to support its regional processing policies. The law came into force on 30 June 2015, but was backdated to take effect from 18 August 2012. Only one judge, Justice Gordon, dissented from the judgment of the other six judges of the High Court.

    As Professor George Williams wrote in the Sydney Morning Herald on 3 February, by sending people back to Nauru, Australia was washing it hands of responsibility. ‘There is no requirement that children are well treated or that their best interests are safeguarded. There is also no need for asylum seekers to be treated fairly, such as by having their claims promptly and properly assessed.’ http://www.law.unsw.edu.au/news/2016/02/asylum-seekers-nauru-are-legal-black-hole

    Waleed Aly in the Age of 5 February was more trenchant. ‘Nauru has become a screen behind which we hide our own culpability; its sovereignty a charade, really – a sort of legal fiction we use to obscure the consequences of our own policy’. We had descended into a ‘world of make-believe’ and become adept at ‘lying to ourselves’. https://theconversation.com/sending-children-back-to-nauru-risks-creating-a-generation-of-damaged-people-54115

    The issue has provoked a crisis of conscience among many people, including politicians and decision-makers, about where the logic of deterrence of asylum seekers has led us. Undoubtedly many politicians are conflicted about the dilemma they face. Labor member for Fremantle and a former lawyer at the United Nations, Melissa Parke, insisted that Australia’s laws were ‘certainly a serious violation of our international legal obligations and are utterly repugnant in a moral sense.’ http://www.abc.net.au/news/2016-02-03/labor-mp-melissa-parke-hits-out-at-immigration-laws/7137508

    On the one hand, we all want to prevent asylum seekers arriving by boats, resulting in hundreds of people drowning at sea. To stop the boats, Australia established the deterrent of indefinite detention in harsh and remote detention on Nauru or Manus Island.

    On the other hand, church, human rights and medical authorities http://www.abc.net.au/news/2016-02-03/mental-health-children-detention-darwin/7137858 , and https://theconversation.com/sending-children-back-to-nauru-risks-creating-a-generation-of-damaged-people-54115

    are protesting vigorously that our policies are driving hundreds of detainees into mental illness, especially children. It is unprecedented that Fairfax papers have given their front pages in early February to photos of many babies about to be sent back into detention with their mothers or families.

    Growing protests against treatment of asylum seekers

    Various Anglican and Uniting churches http://www.baptistcareaustralia.org.au/documents/item/965 have invoked the ancient right of sanctuary to prevent these children being carted back to Nauru, an island of 10,000 people with a barely functioning government, weak policing and very limited resources. Church leaders harbouring these asylum seekers could themselves face arrest.

    Significant protest marches and meetings have been held in cities throughout the country, attended by many mainstream voters, as well as church and community groups. Mums and dads are undoubtedly moved by the thought of what harm such detention in the conditions on Nauru would do to their own children.

    Morally it is repugnant to punish current detainees on Manus Island and Nauru in order to deter other asylum seekers who might think of arriving by boat, by demonstrating how harshly they will be treated, and keeping in indefinite detention with no prospect of settlement in Australia.

    New Zealand offered in February 2013 to take 150 of the asylum seekers each year for three years, but Australia turned down the offer lest the refugees gain NZ citizenship after five years’ residence and then enter Australia. With the migrant crisis in Europe and the Middle East, few other countries will accept them. A handful has gone to Cambodia at a cost of $55 million to our government, which has also approached Kyrgyzstan and the Philippines. A small number of refugees has also tried to settle in Papua New Guinea and Nauru. However, most of the asylum seekers are in despair, and face years in detention.

    What is to be done?

    Many people are appealing to Mr Turnbull that the limited numbers of newborns and their families can be allowed to remain in Australia without reviving the boat arrivals. Church, community and academic http://opcvoice.com/index.php/news/item/45-letter-to-prime-minister-malcolm-turnbull-open-letter-to-prime-minister-calling-for-release-of-children-in-onshore-detention-and-on-the-nauru-opc and medical groups have been particularly prominent.

    In Melbourne, Bishop Vincent Long, spokesman for the Australian Catholics bishops and a former refugee himself, urged Prime Minister Turnbull and Immigration Minister, Peter Dutton, to show compassion and not cause more harm to these people. He called on the government to ‘ensure that no child is subject to an unsafe and harmful environment’ and that no one be returned to face ‘physical, psychological and sexual violence and harm.’ He said the Catholic Church opposed mandatory and detention and offshore detention. http://mediablog.catholic.org.au/media-statement-from-bishop-vincent-long-ofm-conv-australian-catholic-bishops-delegate-for-refugees-regarding-the-high-courts-decision-on-offshore-processing/ Thirty years ago Long set out from Vietnam, drifting at sea for seven days before spending 16 months in a refugee camp.

    Robert Manne in The Monthly also appealed to Mr Turnbull. ‘The idea that allowing a few children out of detention in Australia would act as an international signal that would see the return of the people smuggling trade was insane.’ https://www.themonthly.com.au/blog/robert-manne/2016/03/2016/1454477557/how-has-it-come

    Fr Frank Brennan in Eureka Street argued that turning back the boats has stopped the arrival of unauthorised asylum seekers; the harsh deterrent policies of Nauru and Manus Island were no longer needed, and hence they could be closed. Most immediately, the children in Australia should be allowed to remain here with their families, he wrote. http://www.eurekastreet.com.au/article.aspx?aeid=45948#.VrSD-E9yK4M

    One of Australia’s most respected journalists, Michelle Grattan, saw some hope in Mr Turnbull’s cautious response that each case needed to be considered individually and that he wouldn’t ‘send children back into harm’s way.’ https://theconversation.com/governments-tough-reaction-to-high-court-judgment-contains-just-a-little-wriggle-room-54129

    Public opinion on these most vulnerable of refugees has shifted decisively, as the latest appeals from state and territory government leaders in Victoria, Queensland, New South Wales and the ACT indicate. It is no longer seen as a party-political issue, but as a matter of human decency. All eyes will now be on Prime Minister Turnbull to recast our policies on refugees and asylum seekers and end this moral blight on the conscience of our country.

    Bruce Duncan is a Redemptorist priest who lectures in social ethics at Yarra Theological Union within Melbourne’s University of Divinity. He is one of the founders of the ecumenical advocacy network, Social Policy Connections.

     

     

  • How long can we keep lying to ourselves.

    In the SMH on February 5, 2016, columnist Waleed Aly says ‘The history of asylum seeker policy in Australia will be remembered as a story of how successive governments legislated their lies to justify a world of make-believe borders and imaginary compliance.’

    See link to article below:

    http://www.smh.com.au/comment/nauru-how-long-can-we-keep-lying-to-ourselves-20160204-gml6or.html

  • Frank Brennan SJ. High Court not the answer to Nauru depravity

    The moral depravity of Australian funded and orchestrated holding of asylum seekers, including children, on Nauru and Manus Island is to continue.

    On Wednesday the High Court made clear that it is in no position to question the retrospective law passed by the Commonwealth Parliament on 30 June 2015 authorising the Australian Government to do whatever it takes to assist countries like Nauru with the detention of asylum seekers sent there by Australia as of 18 August 2012.

    The court ruled by six to one that offshore detention and processing of asylum seekers was valid according to this law authorising the Australian government to enter into agreements with other governments and contracts with corporations to provide ‘garrison and welfare services’ in offshore regional processing centres such as Nauru and Manus Island.

    The sole dissentient was the newest judge, Justice Gordon.

    The case arose out of a claim by a Bangladeshi woman (categorised as an ‘unauthorised maritime arrival’ or ‘UMA’) who had been intercepted on 19 October 2013 on a boat headed for Australia seeking asylum. She was transferred to Christmas Island the next day. Three months later she was transferred to Nauru where she was held in detention at a refugee-processing centre for over six months.

    Because of medical complications with her pregnancy which could not be treated adequately on Nauru, she was transferred temporarily back to Australia where she gave birth to her child on 16 December 2014. Not relishing the thought of taking her baby to the hellish conditions of Nauruan detention, she applied to the High Court questioning the legal validity of the offshore detention and processing regime.

    The Commonwealth’s lawyers obviously thought she had an arguable case. On 30 June 2015, the Commonwealth Parliament enacted the Migration Amendment (Regional Processing Arrangements) Act 2015 (Cth), which inserted s 198AHA into the Migration Act, with retrospective effect to 18 August 2012. This law authorised the government to take any action or ‘make payments, or cause payments to be made, in relation to the arrangement or the regional processing functions’ in other countries.

    Presumably the Nauruan government lawyers and political advisers also thought there might be some problems. On 2 October 2015, just days before the High Court hearing, the Government of Nauru announced its intention ‘to allow for freedom of movement of asylum seekers 24 hours per day, seven days per week’ from 5 October 2015 and to introduce legislation to that effect at the next sitting of the Nauruan Parliament. The High Court was duly informed of these developments.

    It is fair to say that prior to October 2015, the Commonwealth expected Nauru to detain these people, and with that expectation being realised was prepared to remunerate Nauru very handsomely, with retrospective parliamentary endorsement.

    With the air of unreality reserved to the highest courts (and perhaps some religious authorities) three of the judges observed that ‘the Commonwealth could not compel or authorise Nauru to make or enforce the laws which required that the plaintiff be detained’ and thus the Commonwealth was not legally responsible for the detention.

    These three majority judges did concede some limit to Commonwealth complicity in Australian funded detention of asylum seekers by another country: ‘If the regional processing country imposes a detention regime as a condition of the acceptance of UMAs removed from Australia, the Commonwealth may only participate in that regime if, and for so long as, it serves the purpose of processing.’

    Another of the majority judges, Justice Keane, said ‘the plaintiff’s submission that regional processing is punitive because it is designed to have a deterrent effect on the movement of asylum seekers must be rejected. A deterrent effect may be an intended consequence of the operation of regional processing arrangements, but the immediate purpose of s 198AHA is the facilitation of the removal of unauthorised maritime arrivals from Australia.’

    I daresay none of these judicial niceties will bring much comfort to the Bangladeshi mum who might feel that her baby is being punished by being taken to Nauru where both of them could remain for up to ten years should they be found to be refugees, pending resettlement in Cambodia or any other participating third country.

    If the Australian Constitution contained provisions similar to the human rights protections contained in the Nauruan Constitution, the High Court may have been able to offer some relief. But the High Court made clear that the detention of asylum seekers on Nauru was detention by the Nauruan government authorised by the Nauruan parliament, and thus it would be a matter for the Nauruan courts to determine if such executive action and legislative authorisation were constitutional.

    The Nauruan Constitution, unlike the Australian Constitution, sets strict limits on the government’s and the parliament’s power to detain persons and to deprive them of their liberty. Australia just happens to fund and facilitate the arrangements authorised by the Nauruan government and parliament, whether or not those arrangements are constitutionally valid.

    Justice Gageler rightly observed: ‘Their detention at the Regional Processing Centre has been under the authority of Nauruan legislation, the validity of which under the Constitution of Nauru is controversial.’

    Justice Gageler, our strongest civil libertarian judge (having been the Commonwealth Solicitor-General during some of the more difficult years of Australian asylum policy), considered that ‘the plaintiff’s central claim (that the Commonwealth and the Minister acted beyond the executive power of the Commonwealth by procuring and enforcing her detention at the Regional Processing Centre between 24 March 2014 and 2 August 2014) to have been well-founded until 30 June 2015, when s 198AHA was inserted with retrospective effect’.

    If returned to Nauru, presumably the plaintiff and her baby will no longer be detained, given Nauru’s newfound commitment to liberty for asylum seekers transferred from Australia. That then raises the fundamental political and moral question: why do we still want to transfer people like this (including babies) to countries like Nauru, Manus Island and Cambodia?

    Just after Malcolm Turnbull became prime minister, I wrote to him and Opposition Leader Bill Shorten suggesting a bipartisan announcement at the opening of parliament this year. I suggested that each address the Parliament reconfirming their commitment to stopping the boats and turning back those who are not in direct flight from persecution in Indonesia. I urged the announcement of an agreed date for the closure of the facilities on Nauru and Manus Island.

    I conceded that immediate closure of these facilities might allow unscrupulous people smugglers to ply their trade again with the message to asylum seekers in Indonesia that the appointment of a new Australian Prime Minister warranted renewed attempts at gaining access to Australia. I wrote, ‘But after an appropriate delay, you could negate that possibility and you could close these facilities without any risk of asylum seekers thinking that Australia was once again a possible boat destination.’

    Neither Turnbull nor Shorten was interested, repeating the mantras about preventing people smuggling, saving lives at sea and maintaining the integrity of Australia’s borders. But all this can be done without sending this mum and her baby to Nauru. We’re now told it can be done without actually detaining anyone on Nauru.

    In the past, we were solemnly assured that it was necessary to detain these people in order to send a message to other asylum seekers waiting in Indonesia. The boats have stopped. They will stay stopped. Any boats that try to get here will be turned back provided only there can be the assurance that no one on board is in direct flight from persecution in Indonesia.

    The people smugglers and their prospective clients now know that people are no longer held in detention on Nauru. It is no longer the hellish or uncertain conditions (with or without detention) on Nauru that deters people from getting on boats. It is the vigilance of our intelligence and military personnel which does that. The door is locked.

    All major political parties are agreed on the need to stop the boats. The heads of the Australian defence force are now confident that the boats have stopped and that any future boats will be stopped or turned back. This is a very different situation from four years ago.

    When Prime Minister Gillard failed to have her Malaysia solution implemented, she set up an expert panel chaired by Air Chief Marshall Houston. In August 2012, the Houston panel told the government that ‘the conditions required for effective, lawful and safe turnbacks of irregular vessels headed for Australia with asylum seekers on board are not currently met in regard to turnbacks to Indonesia’.

    So they looked for other short-term measures. Having studied Prime Minister Howard’s 2001 Pacific solution, the panel concluded that ‘in the short term, the establishment of processing facilities in Nauru as soon as practical is a necessary circuit breaker to the current surge in irregular migration to Australia’. Four years on, the Houston assessment of turnbacks would appear to be outdated and there is no longer a need for a circuit breaker. There is no surge; the boats have stopped.

    Before becoming Prime Minister, Turnbull insisted that our treatment of asylum seekers on Nauru and Manus Island was ‘harsh, but not cruel’. Now that there is no purpose to be served by maintaining the facilities on Nauru and Manus Island, the treatment of those persons is cruel as well as harsh.

    A prompt resolution of the matter is required unless Australia is to be left with a legacy of shame which will be sure to be disclosed at a future royal commission with plaintive cries from our past leaders and retired public servants: ‘We didn’t know the trauma caused to children and others fleeing persecution by being placed in such uncertain, isolated hell holes.’

    There is no joy to be found in our High Court applying a Constitution even more bereft of human rights protections than the Nauruan Constitution. It’s time for our politicians to address the political and moral question: what purpose is actually served by sending this mum and her baby back to Nauru, given that the boats have stopped and will stay stopped regardless of where we now place this mother and child and others like them?

    It’s time to walk and chew gum at the same time. It’s not an either/or proposition. There is no longer any need for a circuit breaker. The circuit is permanently cut. We can prevent people smuggling, save lives at sea, maintain the integrity of our borders and deal decently with the residual caseload of asylum seekers including this mother and her child.

     

    Frank Brennan SJ is professor of law at Australian Catholic University and Adjunct Professor at the Australian Centre for Christianity and Culture. This article was first published in Eureka Street on 3 February 2016.

     

  • John Menadue. What has happened to the 11,990 Syrian refugees?

    After telling us for months that Australia would not take additional Syrian refugees, Tony Abbott announced on September 9 last year that the government had ‘agreed to settle 12,000 Syrian refugees … one of the world’s largest (intakes) to date’. We were told that the first refugees would arrive by Christmas and the 12,000 by June 2016. State governments, community groups and churches then geared up to respond.

    But to date, after five months, only about ten Syrian refugees have arrived.

    We should contrast our performance with the generous and efficient response of the Canadians. The Canadian government website reveals that at the 31 January 2016, 15,157 Syrian refugees had landed in Canada since November 4. That number of arrivals was made up of 8,767 government-assisted refugees, 1,049 blended Visa-Office-Referred refugees and 5,341 privately sponsored refugees. By the end of January 165 Canadian communities had welcomed Syrian refugees. There had been 57 government organised flights.

    In Canada, at the 31st December 2015 there were 13,881 applications in progress, with 6,381 applications finalised but the refugees had not yet travelled to Canada.

    For this generous and efficient response the Canadians put us to shame. Why? I suggest there are several reasons.

    The first and most important reason is the political leadership and will of the new Canadian Prime Minister Justin Trudeau. What a contrast with Abbott, Morrison, Dutton and now Turnbull.

    The second is that our ‘Immigration’ Department has been changed dramatically and is no longer adequately equipped to handle a movement such as this with expedition and efficiency. Senior and experienced people with expertise in the area have left the department. The ‘settlement’ function which has been so critical for managing newcomers to Australia has been transferred out of the Department of Immigration to the Department of Social Services. Furthermore, just as our foreign policy has become securitized, so our refugee and immigration programs have been overwhelmed by border control and border protection. We even have a military style Operation Sovereign Borders. The Department is not really involved in nation-building any more. It is about border control and we saw an example of this in the Melbourne fiasco late last year. Once upon a time Australia had a well-managed ability to move people quickly who are in need of resettlement. Ministers Scott Morrison and Peter Dutton have participated in the crippling of that ability.

    The third and a more specific problem is the delay in the large backlog of cases that are waiting ASIO checking. This is despite the fact that ASIO in recent years has received a substantial increase in personnel and other resources. Checking is necessary but the fear of foreigners that has been promoted by ministers has effectively thrown the weight of effort into control rather than a humanitarian response. There are always risks in the speedy movement of large numbers of desperate people but in the past we have been able to manage that efficiently – and reasonably quickly. And the lesson of terrorism in France and elsewhere in recent months is that it is mostly young people born to earlier arrivals rather than new refugees that have turned to terrorism.

    Canada has shown us a better way to help Syrian people in great need. The Canadian Government web site puts it this way. ‘Resettling refugees is a proud and important part of Canada’s humanitarian tradition. It reflects our commitment to Canadians and demonstrates to the world that we have a shared responsibility to help people who are displaced and persecuted.’

    In Australia we also used to have that humanitarian tradition of shared responsibility to help people who are displaced and persecuted. The Coalition and the ALP are trashing our proud tradition.

    We should make amends by increasing our Syrian intake to 25 000 and really applying ourselves to the job. The Canadians have shown us the way.

     

  • John Menadue. Tax reform and vested interests.

    We are in the midst of a misleading campaign on tax and budget reform.

    Large corporations and high income groups are pressing the government to increase the GST in order to reduce company tax and taxes for high-income groups. I have seldom seen such a blatant and self-interested campaign by vested interests. And they seriously suggest that it is in the name of tax and presumably, necessary budget reform. Even Mike Baird has joined in this nonsense.

    We are told by these vested interests that the benefits of tax advantages for the powerful and wealthy will ‘trickle down’ to the rest of us, including the disadvantaged and the poor. These stories about trickle-down have been with us for years. It is claimed that the ‘trickle down’ from the wealth would encourage ‘growth’ and ‘jobs’. But there is no empirical evidence anywhere to back up this argument. Scott Morrison continues in the same vein, that if only there were more tax incentives, we would ‘work, save and invest’ more.

    See an excellent article on this issue by Ross Gittins in the SMH on February 1, entitled ‘Business-led tax “reform” won’t fly’.

     

     

     

     

     

  • John Menadue. ‘Balance’ and the ABC

    The ABC has a mistaken notion of media balance.

    It has become clear that Nick Ross, a Senior Technology Editor at the ABC, could not publish a story critical of Malcolm Turnbull’s NBN unless he also published an article critical of Labor’s NBN. To add to this bias by ABC management he was told that Labor’s plan was dead because Labor couldn’t win the next election. The ABC management was desperate to be onside with the new Coalition government.

    The ABC was making a political judgement and refused to allow a professional judgement of policies. The ABC continually ties itself in a knot over this issue.

    I recall that in the name of ‘balance’, Gough Whitlam was effectively denied access to the ABC in the 1960s. He was not allowed to appear on ABC current affairs programs unless there was a Minister to provide ‘balance’. By refusing to have a Minister appear, the ABC in effect allowed the government, to veto Gough Whitlam’s appearance. Fortunately Talbot Duckmanton, the General Manager of the ABC was persuaded that the government should not veto appearances of opposition leaders.

    We now have the ABC resuming its old veto policies, saying in effect that it will not have an article critical of Malcolm Turnbull’s NBN unless there is an article critical of Labor’s NBN.

    In the name of ‘balance’ professionalism and honesty is being forfeited.

    We have had a ludicrous so-called debate about climate change and the media’s attempt to provide balance. The media have given equal prominence to skeptics who are really a small and declining fringe. The nonsense from the skeptics has been given the same sort of coverage as the professional advice of thousands of eminent scientists around the world.

    The most grievous offender in this, of course, in Australia has been the News Ltd publications. The ABC should however re-examine what it means by ‘balance’ and the implications for its professionalism and duties to the whole Australian community.

    The ABC continues to give its former Minister and now Prime Minister an arm chair ride.

     

     

     

     

     

  • Ian McAuley Private health insurance – does the lady protest too much?

    Sussan Ley, the Commonwealth Health Minister, has hit out at private health insurers’ bid for a six per cent price increase.

    In view of the strong support the Coalition has always given private health insurers, such public criticism from a Liberal Party minister may surprise us. As one-time Prime Minister Tony Abbott said “private health insurance is in our DNA”.

    It would be reassuring to believe that the Sussan Ley has come to recognise private health insurance (PHI) for what it is – a high-cost financial intermediary that does nothing to take pressure off public hospitals and that has been largely responsible for diverting scarce health care resources away from areas of need.

    As John Menadue, Jennifer Doggett and I have pointed out in conference papers, submissions to enquiries and a major study published by the Centre for Policy Development, PHI is an expensive, inequitable and inefficient way to share health costs. It does at high cost what Medicare and the Australian Tax Office (collecting taxes to fund Medicare) can do far better.

    Its bureaucratic overheads are high: only 86 cents in the dollar of insurers’ premiums are returned as benefits, compared with 95 cents for Medicare.

    It fails in its main avowed purpose to relieve pressure off public hospitals, because in channelling funds to private hospitals it has attracted resources – nurses and specialists – away from public hospitals. All it has done is to shuffle queues for access to limited resources, bringing insured patients to the front of the queue and pushing everyone else back.

    It fails to keep providers’ costs and patients’ usage under control. That’s because of what economists know as “moral hazard” – the tendency for people to over-use a service when it is free at the point of delivery. A single funder such as Medicare can control moral hazard through use of well-structured co-payments to impose some pricing discipline and through hospital staff allocating services on the basis of need. By contrast, when there are multiple insurers they necessarily have to be permissive in meeting the demands of service providers, particularly highly-paid medical specialists.

    That’s why PHI premiums have been rising at an average of 5.5 per cent a year since 2000, while general inflation has averaged only 2.9 per cent. Insurers claim that they are simply passing on costs incurred in hospitals, without acknowledging their own role in driving price inflation and over-usage in health care.

    Insurers may claim that in marshalling private funds for health care they have kept demands on the Commonwealth budget and therefore taxes in check, but even if this is the case, there is no virtue by any economic criterion, “right” or “left”, in substituting what is essentially a privatised tax (PHI) for an official tax. It’s a weird ideology that would find benefit in saving taxpayers $1.00 in official tax at the cost of their having to pay $1.10 or even $1.50 for the same or inferior service, because for most people the incentives for holding PHI come near to compulsion.

    Young people are cajoled into PHI through the penalties in “lifetime community rating”, and people with moderate and higher incomes are cajoled into PHI through exemption from the Medicare Levy Surcharge. While official taxes can incorporate progressivity, PHI, in its regulations designed to achieve “community rating”, builds in many injustices. For example, those who rely on PHI for private hospitalisation or dentistry are subsidised by the taxpayer up to 40 per cent, while those who pay from their own resources get no support.

    We don’t know the reasons for Susan Ley’s criticism of health insurers. Maybe it’s just clever politics, to distance herself and the government from another round of premium increases. Maybe it’s about her own constrained budget: because of the direct subsidies to PHI every one per cent premium rise means there is $60 million less for other health priorities. (In fact the total fiscal cost of supporting PHI, often reported at $6 billion a year, is more like $11 billion a year once tax expenditures (revenue forgone) are taken into account.)

    Or perhaps she realises that there are better ways to support private hospitals than channelling funds through PHI, and that scarce funds for health care are best directed at primary care and prevention, rather than subsidising the lifestyles of medical specialists and the well-off to jump the queue.

    (On my website are several papers on PHI. Those wishing to go further into the issues, or to find sources for the points covered in this article, will find a major study John Menadue and I conducted for the Centre for Policy Development in 2012. Late last year Jennifer Doggett and I made a submission, incorporating updated costing and other data, to a Departmental inquiry into health insurance.)

     

  • Ian Webster. Alcohol and Sport.

    The facts about alcohol should stop politicians in their tracks. But they are unmoved.

    A quarter to a third of the work of a general hospital is alcohol-related. On Australia Day one in seven ED attendances were caused by alcohol; in some EDs it was one in three. The Senior Australian of the Year, Gordian Fulde, time and time again, has described the carnage at St Vincent’s Hospital’s ED late on Thursday, Friday and Saturday nights; as many as 70 percent of cases at peak periods are intoxicated.

    That’s only part of the medical story. The alcohol load is massive in the trauma, orthopaedic and burns units and manifestly over-represented in suicide attempts, mental health, brain injury and in the general medical and surgical wards. Twenty to 40 percent of patients in general practice have had a serious alcohol problem at some time in their life. Globally, alcohol is the third most modifiable risk factor to prevent disability and death. Alcohol overshadows most contemporary public health problems.

    In the social story, alcohol outstrips the impact of other substances. One third of child protection cases, 40+ percent of domestic violence, 40+ percent of homicides, 45 percent of assaults attended by police and up to 60 percent of suicides – the list could go on. The police, courts and welfare agencies are tied up dealing with the consequences. Alcohol’s social impact dwarfs the anxieties about ICE and cannabis.

    It’s not that we can’t tackle alcohol; it’s the countervailing forces which stop us. Dealing with the health and social harms of alcohol is not straightforward public health as the strategies to reduce harm competes with commercial interests and politics.

    In the recent holiday period, the cricket season was awash with alcohol advertising, for all to see. Loopholes in legislation allowed alcohol advertising to subvert the measures designed to protect young minds. When alcohol is linked so convincingly to sporting success and peer-acceptance, young minds are too easily persuaded that being a drinker is OK.

    Since ancient Greece, sporting activities have celebrated athleticism, skills, teamwork and playing by the rules. Sporting heroes have been role models for youth. But the role models of today are seduced into colluding with the alcohol industry – for celebrity, money and power. The once noble traditions have been corrupted by the dollar.

    This collusion is not for the common good. With apologies to former US President Dwight Eisenhower, the alcohol industry and organised sport have established a powerful ‘industrial complex’ along with their bedfellows – the gaming and PR industries. The asymmetry of power and political influence, compared with the proponents for public health means that effective strategies such as reduced late-night trading hours for alcohol-outlets and evidence-based alcohol taxes struggle for a place in government policy.

    Michael Thorn, referring to the alcohol industry, wrote last week (Pearls and Irritations, 23/01/2016), “It’s an industry built on identifying, targeting and exploiting its best customers, and ensuring they continue to misuse and abuse alcohol.” He observed that 20 percent of Australians aged 14 years and above consume 74.2 percent of all the alcohol consumed in a year. As far back as 2006, a US study showed the alcohol industry’s revenue in that country was dependent on heavy and disordered drinkers (‘sick’ drinkers) and underage drinkers. (1) A degree of exploitation redolent of the gaming industry’s dependence on problem and addicted gamblers.

    Professor Robin Room and Dr Michael Livingstone, internationally recognised alcohol policy researchers from Latrobe University, and Michael Thorn, CEO, Foundation for Alcohol Research and Education, have said recently, that the alcohol industry’s interests run in the opposite direction to public health and effective alcohol policy and the industry should be excluded from alcohol policy decision-making. On the evidence, who can disagree?

    It is also in the community’s interest to warn sporting organisations, that partnership with the alcohol industry undermines sporting values and risks the health of future generations.

    ___________

    1. Foster SE, Vaughan RD, Foster WH and Califano JA Jr. Estimate of the commercial value of underage drinking and adult abusive and dependent drinking to the alcohol industry. Archives of Pediatric and Adolescent Medicine. 2006 May; 160(5): 473-8.

    Ian Webster is Emeritus Professor of Health and Community Medicine at UNSW and patron of the Alcohol and Other Drugs Council of Australia. He was formerly a National Mental Health Commissioner and Chair of the Australian Suicide Prevention Advisory Council.

  • John Menadue. Royal commissions – partisan politics or public interest.

    Australia has had a string of politically inspired and often useless royal commissions. The fiasco surrounding Dyson Heydon’s acceptance of an invitation to speak at a Liberal Party dinner made it even more likely that his enquiry into trade unions would be quickly discounted, except for those who wanted to pursue a political agenda against trade unions and by implication, their association with the ALP.

    In response to the Trade Union Royal Commission report, Malcolm Turnbull identified himself with business and the political ‘right’ rather than the public interest or the middle ground. He is consistently taking an ambivalent approach whether it is on climate change, coal mining, gay marriage the republic or the NBN. In response to Heydon’s report, he was not as hectoring as the Employment Minister Michaelia Cash. That is not his way with words, but in substance he followed along.. It was the same on his visit to the US. The tone was different but not the substance. We could do with ’more matter and less art’

    We have had a long list of royal commissions into trade unions. In 1976 the Fraser government had a Sweeney Royal Commission into the maritime unions. In 1982 the Fraser government received a report on bribery and corruption by the building unions. In 1984 the Costigan Royal Commission dealt with racketeering by the Ship Painters and Dockers Union. In 1989 Heydon and Meagher recommended that trade union officials should have the same fiduciary duties and responsibilities as company directors. In 2001 John Howard commissioned the Cole Royal Commission to investigate the conduct of industrial relations within the building industry.

    Despite this plethora of royal commissions, very little resulted.

    Perhaps aware of this record, Dyson Heydon in his final report decided that he had to call to his aid a former High Court Chief Justice, Sir Harry Gibbs. In his report, Heydon said

    ‘Sir Harry Gibbs was universally admired for probity. Near the end of his long life, much of which had been devoted to controversies about the meaning of the constitution, he concluded that it did not matter much for the health of the nation what the constitution meant, so long as one condition was satisfied. That was the inherent decency of the Australian people continued.’

    Mystified as anyone would be by this comment about Sir Harry Gibbs. Richard Ackland in the Australian Guardian commented

    ‘The relevance is mystifying as is the decision to propel Sir Harry (Bill) Gibbs onto the field of battle in this context. Gibbs, while a judge in Queensland, conducted a royal commission into allegations that the National Hotel in Brisbane was the centre of a call-girl operation sanctioned by the Queensland Police. After ruling heaps of available information as inadmissible and accepting an amount of perjured testimony, he could find no evidence of police corruption. This finding was so disastrous that it is credited with empowering the rotten apples in the Queensland police for another 23 years – until the Fitzgerald Royal Commission came along. Why on earth would Heydon launch his trade union report by citing a conservative judge whose name is the kiss of death in the pantheon of royal commissions?’

    Tony Abbott established a royal commission headed by Mr. Hanger on the Home Insulation Program, or pink batts as it was better known. In his report Hanger criticized the commonwealth government for having relied on the states to implement their own occupation and health laws, their own employment training programs and their own building regulations. He said

    ‘To rely on the states and territories to police their own respective workplace health and safety laws seems to have been misguided.’

    What a remarkable thing to say! As even the most ignorant would know, the states have clear responsibility in these areas which they jealously guard. To say nothing of the responsibility of employers. Yet Hanger decided to try and pin responsibility on the commonwealth government and let the states and employers go free. For a political beat-up that is hard to better. It is not surprising that we have heard little further about the first of Tony Abbott’s royal commissions into the previous Labor government’s administration. But it gave Tony Abbott and News Ltd an opportunity to attack.

    Then we had Dyson Heydon on Julia Gillard. In his interim report, Heydon said that Ms Gillard’s ‘intense degree of preparation, her familiarity with the materials, her acuteness [and] her powerful instinct for self preservation made it difficult to judge her credibility.’ In the same vein as Mr Hanger’s report on pink batts this was also an amazing thing to say. Was Heydon really saying that Julia Gillard was too smart for him? Would he have preferred her to be unprepared and ignorant about the material on which she was questioned?

    And despite the royal commission grilling over several days and the media frenzy, Bill Shorten got home free.

    The royal commission into trade unions and the Liberal Party favour corporate style regulation of the unions. They fail to acknowledge that corporations exist to advance the profits of shareholders and in this they get enormous advantages through ‘limited liability’. But trade unions are community organisations established to protect the rights of workers in a marketplace that is heavily biased against them. Union activity in Australia has been largely decriminalized since the 19th Century. Unionists should be penalized for taking action for personal gain but they should not be penalized for acting in the course of an industrial dispute to support their members.

    This royal commission into trade unions was designed to weaken trade unions. Yet trade unions have been a continuing feature of Australian political, economic and social life that protects vulnerable people in the workplace. When asked in 2014 what Australia had done right to defend the economy against chronic inequality that had occurred in the US, Nobel Prize winning economist, Joseph Stiglitz said ‘unions’. Republican presidents and business interests have bitterly attacked the role of trade unions in the US. That is one reason why there is now so much alarming inequality in that country.

    It is not surprising that there are strong unions in our maritime, construction and mining industries. Dangerous workplaces will inevitably produce strong unions to ensure workplace safety. Tough work produces tough union leaders. Every ten days there is a workforce death in the construction industry. It is dangerous work. In his cossetted world does the royal commissioner really understand how dangerous construction work can be?

    The royal commissions on pink batts and trade unions have been politically partisan. There are other areas of major concern that would have been a more appropriate focus for royal commissions and transparency. Why did almost 600 of our major corporations pay no tax in 2013-14? That included such companies as Transfield, News Group and Exxon. People damaged by conflicted advice from financial planners in our banks were refused a royal commission. There has been systemic exploitation of workers by such companies as 7-Eleven and labor hire companies. But again, no royal commissions in these far more serious areas. And the one royal commission that we should have had above all others was a royal commission on the flimsy and manipulated information that led us into the Iraq War and tragedy for millions of people, a tragedy that is still unfolding.

    The HSU and the CFMEU are fair game, but the big end of town that funds the Liberal Party is left to run free.

    There is certainly no room in Australia for unionists that are ‘louts, thugs, bullies, thieves, perjurers …. ‘as the royal commissioner described some of them. Laws should be exercised or stronger laws introduced to address these problems. But why be so partisan and allow really big offenders to go scott free just because they are closely aligned to the Liberal Party.

    At the urging of the big end of town who want him to intervene on the side of capital to the detriment of labour, will Malcolm Turnbull over-reach on industrial relations as John Howard did on Work Choices?

  • Chris Bonnor. Labor goes back to the Gonski future.

    The ALP’s commitment to funding Gonski for the full six years has created interest and even excitement, being welcomed by the three main school sectors, but panned by the Coalition.

    So why do I just feel that we’ve been here before?

    It could be because everyone welcomed Gonski’s findings and recommendations in 2012, but what followed was one disappointment after the other. Key players in the the non-government school sector soon disappeared behind closed doors to argue the details, especially the weighting given to student needs. It was probably academic: after the 2013 election the Coalition abandoned Gonski funding plans for the vital last two years of the six year period.

    But let’s share the blame around. As education minister and as prime minister Julia Gillard dragged her heels in setting up the Gonski review and then in acting on its findings. When the 2013 election loomed Labor created and jumped into a trench, ready to do battle with Abbott around school equity and Gonski funding. Abbott and Pyne then declared a ‘unity ticket’ on funding and Gonski disappeared as a significant election issue.

    Fast forward and we have another ALP leader facing an election from well behind a reinvigorated Coalition. Malcolm Turnbull and Simon Birmingham have nailed their colors to the masthead, having recently abandoned any idea of funding Gonski for the full six years. A door has opened for Bill Shorten.

    Like Gillard, Shorten is keen to get on the front foot in anything which will define a difference with the Coalition. When Abbott was around the ALP showed little inclination to talk about Gonski funding. Their conversations about school education policy seemed to focus on anything but. Now Shorten is on fire, taking a leaf from Gillard’s 2013 strategy – and on current form, heading for the same outcome.

    Labor’s announcement included separate funding for students with a disability, even though no one seems to know how many students have a disability and where they go to school. Years ago Gonski recommended that we find out. Disability funding has created a few headlines recently and both sides of politics want to be seen to be responding.

    Shorten also mentioned that the distribution of future funding would be “sector neutral”. Whatever that means, it sounds new – but was more likely a misuse of words. Gonski’s distribution was to be sector-blind, in effect funding on need without school sector being a consideration. Sector neutral suggest making sure everyone gets a slice of the funding pie, regardless of need.

    Meanwhile the lofty goals of yesteryear have been dragged out again. Gillard wanted Australian kids to be ahead of Shanghai by 2025. Shorten wants something along those lines and a 95% retention to Year 12. This time around Labor has stressed that there will be strings attached to the money – as indeed there should be. Kate Ellis has  stipulated the need for a strong evidence base to where the funding is to go. Another good move.

    Simon Birmingham has predictably responded by complaining that spending more money doesn’t improve results. He needs to revisit this script: it seems that the best evidence to support this assertion comes not from struggling schools but from high-fee non-government schools. NSW Minister Adrian Piccoli guardedly welcomed Labor’s new commitment. From opposite sides of the fence the AEU and the Independent Schools Council of Australia seem happy – as they were in 2012.

    Here we go again, maybe.

    Chris Bonnor is a Fellow of the centre for Policy Development and a Director of Big Picture Education Australia

  • Niall McLaren. A case for ‘armed neutrality’

    In its short history, Australia has been among the most aggressive nations on earth, regularly engaging in wars that, on any objective basis, have nothing to do with us. These military adventures cost us dearly in men, material and credibility without ever showing the slightest evidence that they improve our security. Malcolm Fraser argued that we graft ourselves to foreign military powers in the hope that they will come to our aid in an emergency but that this has never benefited us. At present, our military is fully enmeshed with the American war machine at all levels, to the extent that Australian officers serve in command posts in US sectors. However, there is no reason to believe that the US would ever go against its interests in order to rush to our defence.

    Most scenarios envisage that, in future conflicts, our most likely enemies would be either Indonesia or China. Bearing in mind that, by its control of the Strait of Malacca, Indonesia has us and the huge economies of North Asia in a stranglehold, picking a fight with them seems the height of folly, especially as everything says the US would not endanger its relationship with Indonesia in order to help us. China is now our biggest market and supplier so squabbling with them would take especial folly. But there is another problem to bear in mind: with the looming Trans-Pacific Partnership, Australia’s industrial capacity will be further downgraded. Very soon, we will be unable to manufacture any of the most basic requirements for fighting any sort of war. That is, we will be rendered essentially defenceless. I don’t believe this is in our interest.

    My case is that we should immediately begin to move to the defence stance known as “armed neutrality,” meaning we would build our defence capacity to the point where we would be “too prickly” to attack but would have very limited offensive capacity. There is very little reason to believe our northern hemisphere “allies” would be happy with this, because at present, they have the best of all possible worlds. We don’t, and it could easily get very much worse, meaning we would be on our own.

    Niall (Jock) McLaren is a psychiatrist with extensive experience in remote area, military and post-traumatic psychiatry. His politics and interests are humanist, rationalist, socialist and poking fun at the self-righteous.

  • John Tulloh. Middle East: The Arab Spring becomes the Arab Winter.

    ‘Arabs have rarely lived in bleaker times’. The Economist. 

    An impoverished Arab would have been been flabbergasted at the consequences of his single, desperate protest five years ago. It precipitated the ousting of his country’s ruler and two other Arab leaders, the greatest upheaval and carnage of this century in one country, protests in others, a war in another and now acute anxiety in other Arab capitals that the same might happen to them. The Arab was Mohamed Bouazizi, a vegetable market trader in Tunisia who immolated himself in protest at harassment by local officialdom.

    His case sparked local demonstrations – the Jasmine revolution – which led to the downfall of Tunisia’s long-time leader, President Ben Ali. Emboldened, neighbouring Libyans rallied against the dictatorial rule of Muammar Gaddafi. He did not last long, thanks in part to NATO intervention. Egyptians then brought down their long-time leader, Hosni Mubarak. It became the Arab Spring. Syrians tried in vain to do the same with their leader with its terrible consequences as we all know. The protest ripples spread to Bahrain and Algeria, but they were crushed. Now the seismic effect has hit Yemen where the bloodshed is what Time called ‘the worst crisis the world isn’t talking about’.

    What the world is talking about is Saudi Arabia and Iran and the ancient Sunni/Wahabist and Shia divide. Saudi Arabia will face ‘divine intervention’, said Iran’s Supreme Leader Ali Khamenei earlier this month following the execution of a Shia cleric and 46 other people. The sacking of the Saudi embassy in Tehran by Shiite protesters led to the rupturing of diplomatic relations. The two countries are flexing their authority in a proxy war in Yemen where Iran is actively supporting the Shia Houthi rebels who’ve captured the capital, Sanaa, and other parts of the country. Saudi Arabia has sent in troops and bombers, but to little avail 10 months on apart from causing more of the ungodly death and misery which today we associate with the Middle East more than anywhere else in the world.

    Iran and Saudi Arabia have reached a critical stage in imposing their authority and influence. The long-established political order in the Middle East may never be the same again. Iran, fresh from new respectability following its US-sponsored nuclear deal, is now revelling in freedom from most of its sanctions. Billions of frozen dollars have been released and oil exports allowed to resume for what that’s worth in today’s depressed market caused mainly by its foe. Quoted in the Australian, Fawaz Gerges, a Middle East expert at the London School of Economics, says Iran interests the U.S. both politically and economically. ‘There is a new relationship based on a new understanding of Iran’s pivotal role in the region – that Iran is here to stay’, he says.

    As a result, Saudi Arabia no longer has the undivided attention of the Americans with the thawing of relations between the ayatollahs and the Great Satan. Its once powerful economy is depressed with austerity measures imposed. Youth unemployment is steadily increasing just as it was in prompting Tunisians to take to the streets five years ago. Riyadh was reported to be short of money and considering selling shares in Saudi Aramco, the state-owned oil company said to be the most valuable firm in the world. There were reports last year of dissension among the ruling royals.

    ‘Saudi Arabia feels with good reason more threatened than any time in its modern history’, John Jenkins, the former British ambassador there, wrote in the New Statesman. Apart from the declining oil revenue and the spread of jihadism, one reason was ‘the sustained ideological and material challenge of Iran’. Iran looms just across the Persian Gulf from Saudi Arabia’s oil-rich Eastern Province where the majority of the country’s minority Shiites live. The Saudis fear Iran will foment unrest there as well as in the nearby emirates. They did not help their cause by the execution of the prominent Shiite cleric earlier this month.

    Nor did the Iranian foreign minister, Mohammad Javad Zarif, try to ease tensions. He had a blood-curdling column in the New York Times. He wrote: ‘Saudi Arabia seems to fear that the removal of the smoke screen of the nuclear issue will expose the real global threat: its active sponsorship of violent extremism. The barbarism is clear. At home, state executioners sever heads with swords as in the recent execution of 47 prisoners in one day…Abroad, masked men sever heads with knives’.

    Meanwhile, there are unofficial reports that Saudi Arabia has told Israel that it is free to use its air space if it wants a short cut to bomb Iran’s nuclear facilities. Whatever next?

    It is very difficult to interpret the intentions of Iran and Saudi Arabia with their traditional intrigues and devious policies. Iran is under the sway of ayatollahs who have to combine religious beliefs with practical politics. It is the same with Saudi Arabia except it is ‘one of the least transparent regimes in the world’, according to Anthony Bubalo of the Lowy Institute. Their foreign ministers are due to come face to face this month if agreement can be found about whom to invite to the talks on Syria’s future. It is difficult to envision a settlement when Iran is helping prop up Syria’s President Bashar al-Assad in return for transit rights for supplies to the Shiite Hezbollah in neighbouring Lebanon. For Saudi Arabia, al-Assad, from the Alewite sect, is a villain and has to be replaced by someone representing Syria’s Sunni majority.

    If there is one matter Iran and Saudi Arabia agree on, it is routine executions. The New York Times says 700 people were put to death in Iran in the first half of last year. Figures for Saudi Arabia are hard to come by. But human rights groups claim that ‘at least 157 people were beheaded last year. Apostasy is a capital offence. The punishment for adultery can mean being stoned to death. Other misdeeds can lead to a public lashing.

    The U.S. and Britain remain restrained in their observations about human rights. After all, Saudi Arabia is a prime market for their arms trade. It spends a bigger portion of its economy on defence than any other country – 11% of GDP as against 3.5% in the U.S and 1.5% in Australia. Last month, the Saudis signed a US$29 billion deal to buy 84 F-15 fighters from the U.S. and now intends to spend another US$11 billion to buy four littoral combat ships. Saudi Arabia also is home to five U.S. military bases. For Britain, it is the most lucrative customer of all for its arms companies. Iran is a potential major customer if the sanctions are eased altogether. It wasted no time in ordering 114 European airbuses to replace the state airline’s ageing fleet.

    The Middle East must be the most thankless region in the world when it comes to making political deals. Its map is fractured more than ever by opposing groups jostling and fighting for power and mostly with an Islamic undertone as exemplified by Daesh (Islamic State). Then you have Israel and the Palestinians. They have been talking for decades without success except they maintain a relatively harmonious co-existence compared with elsewhere in the neighbourhood. Just as the ancient texts of the Koran are never far away in Arab disputes, so, too, have been the even older teachings of the Torah in the Israel/Palestinian imbroglio. They can be anything but helpful when it comes 21st century political negotiations.

    If there is the faintest glimmer of optimism, it is the 2015 Nobel peace prize. It was won by a coalition of Tunisian unionists, employers, lawyers and human rights activists for helping to prevent the original local Jasmine revolution from descending into chaos like the uprisings in the other Arab countries.

    FOOTNOTE. Spare a thought for the war in Yemen. Not only does it have what the New York Times in November called ‘a chaotic stew of government forces, armed tribes, terrorist groups and militias at war in the country’. It now has mercenaries from Colombia, Chile, El Salvador and Panama – presumably mostly Christians – fighting on behalf of the government, according to the same paper. They were sent by the United Arab Emirates as part of the campaign led by a jittery Saudi Arabia to curb further Arab revolutions.

    John Tulloh had a 40-year career in foreign news.

     

     

     

     

     

     

     

     

     

     

  • John Menadue. Australia Day doing well, but could do better.

    The following repost is from Australia Day 2014.

    I wonder what indigenous people thought when they saw Captain Phillip with his ships come uninvited and sail up Sydney Harbour in January 1788. There does not seem any doubt that despite their concerns they were less hostile than we are to boat people 226 years later.

    Succeeding generations came by boat in their millions, including my ancestors who came from agriculturally depressed Cornwall in SS Northumberland to desolate Port Willunga in SA in 1847. Migration has never stopped. It has dramatically changed Australia, mainly for the better.  I don’t think any country has done it as well. It has brought vibrancy and greater openness If I could be more precise, I think Australia has benefited most from refugees.  Whilst the first generation of refugees may often lack skills and education, they more than make up for it in enterprise, courage and risk-taking.  That enterprise and high aspirations are often expressed through their children who often outperform others in education.  Refugees are by definition risk-takers who will abandon all for a new life.  They select themselves much better than a migration officer can ever select them.

    We have seen the benefits of migration refugees and multiculturalism, but seem hesitant about new people.  But this hesitancy and sometimes hostility to newcomers, in time gives way to acceptance and pride in our common achievements.  This has been our experience with waves of newcomers.  Irish Catholics were initially depicted as different and perhaps disloyal.  We were prejudiced against Jewish newcomers.  German migrants, particularly in the Barossa Valley, were harassed for decades. We were sceptical of balts, reffos and dagos We were initially wary about the Indo-Chinese and what damage they might cause to the Australian way of life.  But over time, it changed.  Even the early Afghans who built the transport links in Central Australia now have a train, the Ghan, named in their honour.

    Whilst Australians are invariably hesitant about newcomers, what gives me confidence is our pragmatic acceptance.  That seeming contradictory response is shown consistently in opinion polling and over long periods.  We are favourably impressed with the personal experience we have of the neighbour or shopkeeper who is Italian, Chinese or Vietnamese.  Is there something in the casualness and our easy-going acceptance that overcomes ideological and philosophical opposition?  We eschew the extremes and don’t get too excited by ideologies at either end of the spectrum.  If November 11, 1975, couldn’t even provoke a general strike, what could?  Insurrection is rare.  There isn’t much blood on the wattle.  We bump into each other, but we don’t cause a great deal of hurt

    One important reason for our successful integration of newcomers has been our settlement programs, particularly English language training. Unfortunately the Abbott Government has now taken these settlement services out of the Department of Immigration which is now focussed on border protection rather than settlement and nation building.

    As the host, Australia has particular responsibility to provide opportunities for newcomers. But it is not a one way street. The leadership of the new communities also carries responsibilities. Most have provided that leadership. Some have obviously failed both their own communities but also the wider Australian community. There is a lesson to be learned here.

    I believe that we do not place sufficient emphasis on citizenship, not in the jingoistic way of the United States but as a symbol of our unity. There must be strong commitment to Australia and new comers must place that ahead of loyalties to former homelands. Australian residents or citizens who go to fight in wars in their former homelands must be dealt with very firmly.

    We welcome diversity but not for its own sake. Diversity must be of benefit to the common good. For example we fought too long and hard for the separation of church and state to be prepared to give way to sharia law. We have built a superstructure of enriching diversity. But that diversity has been built on a strong substructure of shared institutions and values…our constitution, the rule of law, parliamentary democracy, freedom of speech and religion, English as the national language and tolerance and equal opportunity.

    In addition to time healing differences, we have also had leaders who have inspired the best in each of us or ‘touched the better angels of our nature’ (Abraham Lincoln).  Ben Chifley overcame public opposition in allowing Jewish refugees after World War II.  Robert Menzies, on coming to office, continued the acceptance of the displaced people of Europe.  Harold Holt skilfully, but in defiance of public opinion, commenced the dismantling of White Australia.  John Gorton and Gough Whitlam continued the process.  When Malcolm Fraser responded to the anguish of the Indo-Chinese people, he knew that he was acting contrary to public opinion.  Bill Hayden and then Bob Hawke supported him.  Yet no-one today would argue that these leaders got it wrong.  We applaud their courage and leadership. John Howard and Tony Abbott were the first post war leaders to break from that bi partisan tradition and engender fear of newcomers.

    Border protection is clearly necessary to maintain public confidence in migration and refugee intakes.  But it is possible to do that, as Malcolm Fraser showed without dividing the country and punishing the most vulnerable people on earth.

    What gives me confidence, is the Australian people.  I know of a Jewish refugee boy who went to school in inner Melbourne after World War II.  He told me his story.  His sister and he were called before the headmaster. As they were leaving his office, the headmaster asked them whose photo it was on the wall.  They didn’t know, but surmised that it might be head of the police or the head of the military.  The headmaster told them who it was, but the name meant nothing to them.  They then asked their schoolmates and were told it was Don Bradman.  That Jewish man said to me recently ‘I knew then that we were safe’.  If the most important public figure for the headmaster was a famous sportsman, there was little to fear and a lot to be looked forward to in Australia.

    Our nation will always be dynamic .It will be work in progress. The Australia of today is vastly different to the Australia of my childhood with its widespread racism and sectarianism. It was socially suffocating. For those changes I am very grateful. There is a lot that we can be proud of.  No country has integrated newcomers as well as we have. But there have been failures and remedial action yet to be taken. We are yet to be reconciled to our indigenous brothers and sisters who watched the European boat arrivals in 1788. We are yet to take our share of responsibility for the displaced and persecuted people of the world.

    Fear holds us back from expressing the generosity we all possess.

  • Cavan Hogue. Mr Turnbull goes to Washington.

    Despite one welcome outburst of independence by refusing a request for more troops on the ground in the Middle East and a generally less sycophantic approach than most of his predecessors,the Prime Minister’s visit to Washington had all the usual hallmarks of a client presenting tribute to the Emperor.  The fact that Australian and American comentators felt the need to sound surprised at the refusal of a US request is instructive.

     The stress on shared values is interesting. Certainly we share many values with many Americans but do we endorse their gun culture? Do we share the values of Trump and his very many supporters? The USA is a complex country with many different cultures and values.When our leaders go to Japan they criticise the Japanese about the rights of whales and when they go to China about the rights of humans but they never criticise the Americans about human rights abuses in Guantanamo or their failure to conform with the the Nuclear Disarmamant Treaty (NPT).

    Do we accept the view that the USA is somehow exceptional and that it has a manifest destiny that gives it rights internationally that others don’t have? Quite possibly we do! President Obama, a liberal and moderate President who generally does represent those sections of American society with whom Australia has some affinity, has felt it necessary to boast of America’s economic and military might. The conflict between the USA and China, and Russia, is not really about values but about great power competition. Each of these three powers believes it has some kind of special destiny which makes it different from the rest of us so we should not be surprised if they all want to be supreme globally or at least within their traditional sphere of influence. Mr Turnbull made it clear that we are allied with one of those powers which suggests we will end up getting into more wars we should keep out of.

    However, Mr Turnbull’s approach was echoed by the mainstream Australian media response which in turn reflects Australian fear of the outside world and our need for a protector.True independence is not an Australian value.

    Cavan Hogue was former Australian Ambassador to USSR and Russia.