gg@gordongregory.net – Page 16 – Gordon Gregory's blog

Dear Dr Gillespie: Don’t narrow the rural health agenda

Editor: Marie McInerney. Author: Gordon Gregory on 10 August 2016.

In the first of two articles for Croakey, the recently retired CEO of the National Rural Health Alliance, Gordon Gregory, outlines his concern that the initial agenda for the new Assistant Minister for Rural Health, Dr David Gillespie, appears to be narrow and medically-dominated.

In particular, he says the role of the new Rural Health Commissioner should look to the National Mental Health Commission as a model, rather than the role of the Health Department’s Chief Allied Health Officer, which was welcomed with much fanfare in 2013 but seems to have faded away.

The second piece will describe some of the other critical issues that Gregory says should be on the Minister’s agenda.

Updated: See at the bottom of the post for a response from the Department of Health on the status of the Chief Allied Health Officer.
narrow-path-croakey-first-piece Gordon Gregory writes:
The new Assistant Minister for Rural Health, David Gillespie, is a member of the National Party and has held the regional New South Wales seat of Lyne since 2013. So he knows about regional health services.

Dr Gillespie is a medical specialist (a gastroenterologist and consultant specialist physician) and grazier. Depending on how he uses them, those two things could either equip him well for his new job or be lifestyle contexts from which he must escape.

To win the confidence of health consumers and the majority of the health workforce, medical specialists need to continually demonstrate their understanding of, respect for and trust in other health professionals and in a teamwork approach to services.

And to be an inclusive and successful rural leader, a farmer must continually demonstrate that ‘rural’ means much more than ‘agricultural’.

Judging from what’s been heard around the traps, Dr Gillespie’s initial focus in his portfolio appears to be the Rural Generalist Pathway (a general practice training program) and action on the Coalition’s promise of a Rural Health Commissioner.

Both of these issues are important. But the first is not at all new, while, to be useful, the second needs to be well-resourced and empowered, like the National Mental Health Commission.

It would be a wasted opportunity if the rural health agenda was pared back to just these two elements.

The Rural Generalist Pathway – not just for doctors?
The Rural Generalist Pathway (RGP) has nothing but support from medical interests throughout Australia. Development of the pathway, led by Denis Lennox and others, has been underway in Queensland since 2007. A description of its history, purpose and first evaluation was outlined at the 13th National Rural Health Conference in a paper by Tarun Sen Gupta, Dan Manahan, Lennox and others.

For those not familiar with it, the Rural Generalist Pathway is now “a fully-supported, incentive-based career pathway for junior doctors wishing to pursue a vocationally registered medical career in rural and remote areas in Australia”.

It was originally designed to reverse the withdrawal of services that had long been provided by ‘procedural GPs’ in rural Australia, including birthing, anaesthetics and emergency medicine, and the deskilling of rural hospitals that resulted. The idea was to have a cluster of procedural GPs who could work together to cover anaesthetics, obstetrics and emergency medicine through pooling their skills.

With an expanded scope of medical practice locally, this model of service would require nurses, allied health professionals and midwives, for example. However, those other professions seem to have been left behind somewhat in the wash of the medical entity the RGP has become.

The Australian College of Rural and Remote Medicine (ACRRM) is now the standard-bearer for rural generalism and information about the RGP in all jurisdictions is available at its website.

It’s an idea whose time came some while ago. So well-developed and accepted is it that the concept is internationally recognised in the Cairns Consensus 2014 endorsed by 23 national and international medical organisations.

Both the Commonwealth and the States/Territories are involved with medical training. For a mature and settled Rural Generalist Pathway, the States and the Commonwealth will have to work together and presumably share its costs.

One of the questions that needs to be asked by the Minister is how the principles and lessons from the RGP can be used for the benefit of other (rural and remote) health practitioners.

Role and scope of the Rural Health Commissioner
Which brings us to the role and operational scope of the promised Rural Health Commissioner.

Judging from Fiona Nash’s June 2016 media release about the matter, the prognosis is poor for a broad, multi-professional and patient-focused approach to the work of the Rural Health Commissioner. The announcement implied a very close relationship between the Commissioner’s work and the Rural Generalist Pathway. Here are the key excerpts:

“A re-elected Turnbull-Joyce Government will develop a National Rural Generalist Pathway to address rural health’s biggest issue – lack of medical professionals in rural, regional and remote areas.

Australia’s first ever Rural Health Commissioner will be appointed to lead the development of the pathway as well as act as a champion for rural health causes.

Minister Nash said the Rural Health Commissioner will work with the health sector and training providers to define what it is to be a Rural Generalist. Importantly the Commissioner will also develop options to ensure appropriate incentives and remuneration for Rural Generalists, recognising their extra skills and hours and giving them more incentive to practice in the bush.

Extra recognition and financial incentives for Rural Generalists will help attract more medical professionals to the bush and help keep the ones we already have.

As a first order of business, the National Rural Health Commissioner will be tasked with developing and defining the new National Rural Generalist Pathway and providing a report to Government which lays out a pathway to reform.

The Commissioner will work with rural, regional and remote communities, the health sector, universities, specialist training colleges and across all levels of Government to improve rural health policies and champion the cause of rural practice.

The Commissioner will also lead the development of the first ever National Rural Generalist Pathway, which will significantly improve access to highly skilled doctors in rural, regional and remote Australia.

The National Rural Health Commissioner will be a champion of rural health, working with Government and the health sector to enhance policy and promote the incredible and rewarding opportunities of a career in rural medicine, Minister Nash said.”

Even more important than this apparent narrow focus is the question of whether the appointed Commissioner will be a single person within the Department of Health or the head of a Commission – being an agency with resources, including staff, and political support and authority.

The difference between these two models can be powerfully illustrated by comparing and contrasting the work done through two offices which, coincidentally, have both been filled by the same individual, David Butt.
One is the Department of Health’s Chief Allied Health Officer, the other the CEO of the National Mental Health Commission.

272fba5

When the position of Chief Allied Health Officer was announced by then Labor Health Minister Tanya Plibersek in March 2013 it was widely welcomed, in the belief that it would strengthen the role of allied health professionals in health, aged and disability care, lead allied health workforce initiatives, and facilitate better integration with medical and nursing services.

There is little evidence of such developments. Allied health is still the forgotten professional grouping in health policy matters, particularly at the national level.

This is reflected in the Department’s current Management Structure Chart. It lists one Chief Medical Officer, seven Principal Medical Advisers in various areas of the Department, two Senior Medical Advisers, and one Chief Nurse and Midwifery Officer. But the Chart has no reference to a Chief Allied Health Officer.

Look to Mental Health Commission as a model
In contrast to the apparent lack of political support or clout given for a Chief Allied Health Officer is the significant contribution of the National Mental Health Commission (NMHC), led by its Commissioners and its CEO (also a Commissioner).

The NMHC was established on 1 January 2012 as an independent executive agency, originally reporting to the Prime Minister. It now reports to the Minister for Health. It has high-profile Chair (Professor Alan Fels), Commissioners and CEO, and a staff complement of 14 positions (though nine were not filled as at 30 June 2015).

In 2012, 2013 and 2014 the Commission produced annual National Report Cards on Mental Health and Suicide Prevention. It advises the Government on how Australia can promote mental wellbeing, and prevent and reduce the impact of mental ill-health. And it collaborates with other agencies to influence positive change.

The Commission also drives a number of projects and initiatives, including the National Seclusion and Restraint Project, the Mentally Healthy Workplace Alliance, the National Mental Health Future Leaders Project, the National Contributing Life (survey) Project, the Mental Health Peer Workforce Capabilities Project and National Standards for Mental Health Services.

In 2014 the Commission undertook a national review of mental health services and programs across all levels of government and the private and non-government sectors. It received more than 2,000 submissions and consulted with individuals and organisations around Australia.

The report from the review, Contributing Lives, Thriving Communities, was released to the public on 16 April 2015. The Government’s response was released in November 2015.

Although some of the steam seems to have gone out of the endeavour, this is an important body of work – and it stands in stark contrast to achievements through the Chief Allied Health Officer.

It is imperative that Minister Gillespie sees the Rural Health Commissioner as a position akin to that of the Mental Health Commissioner.

And it is devoutly to be hoped that his view of rural health is not restricted to just the two matters discussed here. There is so much more than needs to be urgently considered in rural and remote health and on which his leadership is sought.

Croakey asked the Department of Health for information about the current status and past work of the Chief Allied Health Officer. Here is its response:

Yes, the role does exist. Mr Mark Cormack, Deputy Secretary of the Australian Government Department of Health, is the Commonwealth Chief Allied Health Officer.

In this role, Mr Cormack has engaged closely with allied health stakeholders to strengthen the contribution of allied health to the health system, including speaking engagements at Allied Health Professions Australia Board meetings, most recently 5 August 2016; National Allied Health Advisory Committee meetings, most recently on 6 June 2016; the 11th National Allied Health Conference in November 2015; and Australian Allied Health Forum meetings, in August 2015, and planned for later this month.

A short economic history of Australia from 1945 to the present.

Now that Australia has voted for “jobs and growth”, it will be useful to be reminded of its recent economic past. This piece (originally published in aggravations.org on 21 July 2016) explains the shift from woollen blankets to iron ore, and from Britain to China via Japan.

1945: the war ends. Industrialised nations switch from manufacturing munitions to the production of woollen blankets.

1952: Australian wool sells for a pound a pound. Graziers from the Western Division of NSW gather at the SCG for the final test against the West Indies. Richie Benaud takes his first test wicket.

1960s: increases in tariffs protect Australia’s industries and jobs, thus lowering the need for productivity improvements and innovation. Foreign investment therefore favours mining and agriculture because they are more exposed to international market prices and therefore more assured future profitability.

1962: Britain begins to flirt with Europe and abandons Imperial Preference in its trading relationships.

1966: Menzies retires.

1967: Japan overtakes Britain as the largest market for Australia’s exports.

1970: China accounts for 1 per cent of Australia’s total merchandise trade (imports and exports). Mineral and mining exports are 27% by value of the total.

1971: Wool prices are so low that all the pastoral zones are going to be emptied of people and properties. The crisis is so serious that economic historians from overseas are recruited to make sense of the situation.

1972: relationships with China are normalised. Its merchandise trade with Australia is valued at $100 million.

1974-75: Led by Lillian Thomson, Ian Chappell’s team regains the Ashes.

1982-83: Australia has the worst drought of the twentieth century. Someone suggests that instead of letting the inland blow away and blanket Melbourne (8 Feb. 1983) it could be dug up and sold to Japan. Australia’s mining boom is born.

5 March 1983: Bob Hawke breaks the drought and is rewarded by becoming Prime Minister.

1983-91: As Treasurer, Paul Keating hits upon some good ideas for the future of woollen blankets and mining exports. He reduces regulation and tariffs, floats the dollar and deregulates the banking system. The value of mining and minerals exports is 41% of the total.

1990: Norway establishes its Petroleum Fund “to counter the effects of the forthcoming decline in income and to smooth out the disruptive effects of highly fluctuating oil prices”.

May 1996 to May 2007: a series of Federal Budgets which trade on the world’s longest unbroken economic boom to give popular tax cuts to all, thus ensuring a structural budget difficulties for Some Time in the Future.

2006-07: the Ashes tests: Australia five, England nil.

2007-09: Howard and Costello leave and the Future arrives: the Global Financial Crisis sees Australia invest money it no longer has to successfully offset the employment effects of the GFC.

2011: Merchandise trade between China and Australia is valued at $114 billion – 25 per cent of the total.

2012: Australia’s mining boom ends prematurely.

2013-14: (It’s 5-0 again.) Mining and minerals account for 59% of Australia’s merchandise exports.

May 2014: Abbott and Hockey unearth a ‘budget emergency’ and plan to fix it with a Budget that not even their friends think is fair.

early 2015: Australia’s mining boom is not, after all, finished. It’s just ‘come off’ from its capital development and high prices phase to its production phase (greater volume of production but lower unit prices). As a result, the ‘budget emergency’ is no more.

later in 2015: But there is still a structural budgetary problem, since no government has been bold enough and sensible enough to expand the national tax base.

Monday 14 September 2015: PM Turnbull says there has never been a more exciting time to talk about new industries and jobs of the future, and innovation, agility, broadband and connectivity. Let’s hope he remembers that people outside the major cities need these things even more than those in the cities

May 2016: Norway’s petroleum fund has c$870 billion; is the largest stockowner in Europe.

Saturday 2 July 2016: It’s alright, don’t panic. We’ve gone for jobs and growth, jobs and growth, jobs a – –

Marriage equality and greyhounds

submarine

In the House of Commons on 11 November 1947 Winston Churchill famously used the words of an unknown predecessor when he said:
“Many forms of Government have been tried, and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed it has been said that democracy is the worst form of Government except for all those other forms that have been tried from time to time.…”

Churchill perhaps had in mind the original notion of ‘direct democracy’ – a system in which public policy issues, including proposed legislation, are determined by the entire body of the citizens voting on such issues; in effect, government by referendums.

In 1947 one of the arguments against ‘direct democracy’ would no doubt have been its logistical difficulty, sluggishness and cost – some of which would now be reduced by technological developments such as the internet, smart phones and social media.

Government by referendums is at one end of a spectrum of democratic possibilities, at the other end of which would be a system in which voters elect and entrust one person with the task of making decisions for them. (One is reminded of the Whitlam-Barnard Ministry of 1972.)

Towards the elect-and-entrust end of this spectrum is ‘representative democracy’, in which those entitled to vote elect a number of people to positions within an agreed institutional framework. In Australia the centrepiece of that framework is a Westminster system of government.

This framework is fixed and agreed in a Constitution. Such is the fundamental importance of the rules under which representative democracy is played out, that a referendum of those same entitled people is the only way in which the rules can be changed.

To alter those rules and institutions in Australia, a referendum on constitutional change must win the majority of votes nationally and also win in a majority of the states (a ‘double majority’). This is to safeguard the interests of the jurisdictions within the Federation, in particular to safeguard the interests of the States and Territories with smaller populations.

Since Federation there have been 44 proposals for constitutional change put to Australian electors at referendums. Eight have been approved.

These arrangements help explain the difference (in Australian terms) between a referendum and a plebiscite. The latter is a vote by eligible citizens on a matter of national significance that does not affect the Constitution. To pass, plebiscites only require a simple majority of electors’ votes. But whereas the outcome of a referendum is binding on the Government, a plebiscite is not.

What, then, are the sorts of issues on which the Government seeks the people’s advice through a plebiscite, rather than through the normal processes of representative government?

Why is the issue of marriage equality subject to a plebiscite but not the future of the NSW greyhound industry?

The Prime Minister’s rationale for the plebiscite seems to be in two parts. First, because his predecessor said there would be one. Second because marriage equality is an issue “based in faith or conscience”.

The first of these reasons is evidence of what we fear about Malcolm Turnbull: that he is not in command of his own Coalition; that he is willing to place political pragmatism above principle; and that he has lost some of his will to lead.

And what about the second reason: that it is an issue based in faith or conscience?

In Australia there is a strong tradition of state neutrality, or equal treatment, in dealing with issues of faith. Unlike the situation in the United States, Australia does not have a legally entrenched principle of the separation of church and state. But the tradition of church-State separation is strong enough and ubiquitous enough to mean that when there is a transgression, it leads to public notice. These issues of note and contention have included church-run employment agencies, the funding of schools, and matters of sexuality and reproductive science.

For Australia to continue to be seen as a successful multicultural nation, decisions on these matters need to be based on secular ethics and the national interest, not on religious belief.

After faith comes conscience. There is a belief in some quarters that a plebiscite is justified when a decision is one of conscience.

But the idea that there are only very few issues of this kind surely devalues the notion of ‘conscience’. The matter of marriage equality is critical in ensuring that some people in Australia can self-actualise to the greatest extent possible. But would we not say the same for access to meaningful work, home and shelter, and education and health services?

We elect parliamentarians to make decisions on our behalf. The corollary is that we are happy to have laws and policy proposals determined by them through debate and deliberation in the Parliament.

If the system of representative democracy is trusted to determine people’s access to food, education, health and shelter, it is also fit to be trusted on marriage equality.

Or, to use Bill Shorten’s words, we don’t need a non-binding, taxpayer-funded opinion poll on the matter.

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Don’t miss the upcoming Greyhound trilogy at aggravations.org. It’s a series you won’t want to miss, with pieces on greyhounds and marriage equality; greyhounds and leadership; and greyhounds and submarines. Give them a look, doggone it.

Tour Defiance 2016

For those who mist it, here is a summary of the exciting 19th stage of the Tour defiance. To save time, it was dictated through the speech recognition software I use. The stage featured rain, crashes and, among others, For Whom, Thomas Folklore, Vincent So Italy and Nevera Choirday.

Stage 19 of the Tour was carnage for many, including some of the leaders, as rain fell in the House.

tdf-in-the-wet-3 From Whom crashed but saw his overall lead grow as Romain Bardet won a damp, treacherous stage to Saint-Gervais Mont Blanc.

The stage began at Albertville in dry conditions, with Thomas Folklore (Direct Energie) soon establishing a break in typical mischievous fashion along the valley of the river Chaise. He was joined in the break by Daniel Technical High Note (Dimension Data) and Romanesque Never Doubt Us (Cannondale).

Once Folklore’s break was brought back another formed based around Status Claimant (I am Cycling), But Ours Was Asking (Bora-Argon), Great Than Other Might (BMC) and Tossed Against (Blotto).

While negotiating the hairpins of the 5.4 km climb to Queige, a number of riders got off the front, including Lose Inches (Long Grey), Roman Great Figure (Tinkoff), Tom Helter Skelter (Cannondale) and Chris and Kurt Sorensen (Fortuneo-Vital Concept). (It’s still a mystery why Tour Director Christian Prudhomme permits Chris and Kurt to share the bike when everyone else has to do it all themselves.)

index

The Tour leader’s crash came with 11km to go. His front wheel slipped on a white line on a left-hand bend shortly before the foot of the drop down from Megève to the valley before the final first-category ascent to the finish. He brought down Vincent So Italy (A Stunner) with him.

Team Buy responded to their leader’s crash with its usual efficiency, with From Whom taking over Giant Thomas’ bike and being brought back to the leaders by Mikel Naively, Dutchman White Polls and Sergio And Now.

From Whom’s recovery on Thomas’ bike was criticised by Matt White, Sporting Director of Team Orica-BikeExchange. “They pinched our idea,” Matt said wistfully.

For Whom made contact with the leaders as the final climb started, but remained near the back of the group as he tried to get used to the set-up of Thomas’ bike. “Now I know why he’s called Giant”, Chris said.

“Today showed exactly why the race isn’t over. A crash like that could have gone either way and I’m grateful that nothing is injured. Nevera Choirday on the Tour!”

In the confusion after From Whom’s crash, Bardet (Ag2R) escaped to link up with As a Visual (Francis To Ensure).

On the final climb to Mont Blanc the GC leaders attacked each other without any of them taking significant time. Ritchie Porte tried to dislodge his friend and former teammate For Whom but he had had to work hard on the descent from the super-category Montée de Bisanne after crashing, just as Vincent So Italy and his A Stunner teammates Channel Anger At and Local Folks Lang were piling on the pressure.

Bardet’s win was France’s first of this year’s race. So now the spell is broken.

stage-21

PS When they started their last lap on the Champs Elysées, did anyone ask Froome the Bell Tolls?

The tale of a cowslip

The tale of a cowslip, at aggravations.org (24 July 2016) – in which I reveal my love of cowslips (Primula veris or Spring primula) and a new-found admiration for civil engineering earthworks.

The substantial farmhouse and its outbuildings were separated from the village by the Bridgewater to Taunton canal. That’s the water in which I learned the thrill of the sudden disappearance of one’s float – white with a circle of orange paint – as an unsuspecting roach or perch tugged at the wriggling worm beneath.

I don’t recall whether the field on the far side of the bridge was part of our farm, but its significance lay in the fact that, occasionally, it was the location of a cowslip. As I remember it, just a solitary cowslip or two: small and erect, beautifully yellow with a little orange tinge, with a cluster of separate blooms at the top of a firm but succulent stem. (Succulent? Heavens: does that mean that at some stage I picked one?)

The field concerned was low-lying and slightly boggy, which I have therefore always taken to be the required growing conditions for cowslips. Primula veris. Spring Primula.

Wikipedia: “It may therefore be rare locally, though where found it may be abundant.”

Right.

Memories are vague but I recall the excitement of my occasional find and wonder whether I did not perhaps race back to the house clutching my little yellow treasure to be presented to my mother in front of the Aga. This would not have been a demanding journey, for we’re talking English farm distances here, not cut-lunch-and-water-bottle treks. I suppose from the cowslip field to the house might have been 450 yards.

50 years later, in 2011, it is April in Bath. Driving our rented car in search of David and Averil’s house, I spot one of those ceramic house numbers held up by a short stick planted outside the owner’s driveway. At its base is a very small cultivated area, as big as a dinner plate, in which grows not one but a small bunch of cowslips.

I haven’t seen one for 50 years.

At my insistence, we stop. A photograph is taken. My joy is strong and real.

A few days when later when driving west from Bath to Jackie and Tony’s place in Kentisbeare, we are driving through Shepton Mallet. I wonder whether Babycham still exists and is still made here?

On the way West we come to a roundabout. It is covered, literally bedecked, in hundreds upon hundreds of cowslips, sporting themselves liberally among a small flock of slightly stunted concrete sheep.

cow-and-sheep

At my insistence we circumnavigate this delicious tableau as often as the traffic will safely allow. Photos are taken. No cowslips are picked.

Wikipedia: “Additionally the seeds are now often included in wildflower seed mixes used to landscape motorway banks and similar civil engineering earthworks where the plants may be seen in dense stands. This practice has led to a revival in its fortunes.”

Bless!

Quad bike safety

There are around a quarter of a million quad bikes in Australia. They are now the biggest single killer on Australian farms, responsible for 15 on-farm fatalities in 2015. Between 2001 and 2012 there were more than 160 deaths associated with quad bikes, half of them resulting from rollovers.

Overall, thirty on-farm deaths were reported in the Australian media in the first six months of 2016, as well as 44 non-fatal incidents. Apart from quad bikes, the other major risks are tractors and other farm vehicles, unguarded machinery, animal handling and mustering.

Some people regard the results of research on the effectiveness of roll-bars on quads as inconclusive. Nevertheless Worksafe Victoria is tightening the rules so that they may be banned in workplaces unless appropriate rollover protection is fitted. Farmers will be required to fit crush-protection devices to quad bikes or face heavy fines if there is a rollover causing injury or death of an employee using such a vehicle.
The cost of a rollover protection system (about $700) will no longer be considered a reasonable excuse not to have the system installed.

quad-bike-accident

As with other issues of this type, it is not sensible to rely only on technical or engineering fixes. It’s also about behaviour and attitudes to risk. Many organisations, including the Rural Industries Research and Development Corporation’s Primary Industries Health and Safety Partnership (PIHSP), are urging farmers to attend training courses about safe riding, following manufacturers’ instructions and behavioural matters like wearing helmets.

There is a significant divide between what might be called ‘organisational work’ on this issue and the practical experiences and views of people in the paddock. Some of the latter were canvassed in a recent fireside chat I had at Sue’s place in Forbes.

By definition, many of the people involved with organisations working on such an issue are unlikely to be practising farmers. This raises concerns among farmers about whether those people have sufficient knowledge about what it’s actually like in the field.

The practical views expressed at the fireside by Tony and Michael included the following.

The mandatory wearing of helmets tends to make drivers feel they are ‘unbreakable’, thereby changing their perception of risk.

Banning kids from using bikes is impractical, given the pleasure and utility they provide and given the cultural history of kids learning to drive on farms.

Children will always play a vital role as labour on family farms – often from a young age. Much of what they do requires mobility, whether by bike, quad, horse or motor vehicle, all of which are potentially dangerous. In an area that is otherwise relatively well-researched, this is something that merits further specific attention.

However well-prepared and careful farmers and their immediate family members are, there are always the risks associated with visitors.

If there is any large-scale success in limiting the use of quad bikes, it would mean a return to motorbikes and horses – which are equally risky.

Access ladders on the outside of silos have to be high enough to be out of reach of children. But this means that the first step cannot be accessed by an adult’s foot, requiring an extension ladder which has to be locked in place out of a child’s reach. That means searching for a key – – !!

Drivers of livestock B-doubles may refuse to wear a harness when working on the top deck in the belief that, should they fall, their safety would be even more seriously compromised by being in a harness.

Worksafe agencies seem to be unwilling or unable to specify standards which must not be breached – but are never slow to take a farmer to task if something goes wrong. This is illustrated by developments in Victoria which are not simple and categorical (ie mandatory) but dependent on retrospective considerations if and when there has been an accident.

The equivocal nature of some of this regulation is demonstrated by the fact that It is apparently possible for a farmer to sign a stat.dec. with the worksafe agency to formally acknowledge that they are knowingly undertaking action beyond some specified limit of risk. (If true, this is bizarre.)

Because of the paperwork involved, the farmer may be discouraged from developing, updating and putting into operation a workplace health and safety plan.

It’s clear that the involvement of children and visitors are two of the greatest challenges.

Tony: “The farm people may have done the right thing and learned the right way but then city friends come to stay. When they arrive their kids, like young dogs, bounce out of the car looking for exciting things to do and riding the 4 wheeler is the top of the list.”

“Proposals for regulation need to be put to groups of practising farmers for input. Farmers need clear paths for teaching the safety aspects so that if an accident happens and leads to litigation, the farmer’s teaching methods are recognised.”

“Most farms have protocols that everybody signs and these need to able to be upgraded quickly and simply when there are new regulations.”

One of the take-home messages is that all parties involved need to have patience with each other, to listen carefully, to observe realities in the field, and by these means to strike the right balance between regulation and the practicalities of farm work.

Everyone agrees that 50 or 60 on-farm deaths a year is a tragedy we should work to avoid.

Note: Quad bike safety and the realities of farm life was originally published at aggravations.org on 20 July 2016.

For Leanne Coleman’s birthday (17 July)

Leanne Coleman: happy birthday!

Because of her industry, thousands of people know the name ‘Leanne Coleman’. It is the one at the foot of so many e-mails from the National Rural Health Alliance; the name to contact about the biennial conference; and one of those on the phone when enquiries are made.

Whoever you are – tinker, tailor, soldier, spy – be aware that today is Leanne’s birthday and spare her a thought.

Leanne has worked for the NRHA for nearly 2 decades and has been a critical part of its culture, its industry and its effectiveness. Whatever future the organisation has, credit and thanks should be given to Leanne for all she has contributed to its establishment and to its early life.

Leanne Coleman began her working career as an assistant to senior staff in the Department of Primary Industry. She first hit her straps as a member of the personal staff of John Kerin, who can still claim to be the longest and tallest Minister for Primary Industry there has yet been. It was probably in that role, “doing Kerin’s diary”, that Leanne’s natural courtesy and attention to detail first came to the fore. A Minister’s diary secretary stands like Horatius at the Bridge between a busy parliamentarian and all of those who seek his or her attention.

By these means, and thanks to her natural manner, Leanne learned to treat everyone with whom she came into contact as an equal and as someone deserving of her close attention. As a result, the NRHA has a well-deserved reputation for being open, responsive and egalitarian in its dealings with the world. It would have been Leanne who remembered to invite the Minister for Health as well as Branko and Anna, our long-serving office cleaners, to my farewell in Old Parliament House.

For many years Leanne was Office Manager at the NRHA and in this capacity learned a great deal about many things and a little about every thing relating to the organisation and its business. She then took over from Lyn Eiszele as Conference Manager and in this position has been the mainstay of the continued development of what is surely the NRHA’s best-known and highest quality service to the rural and remote health sector. (Leanne would be disappointed if I let this opportunity pass to remind you that the 14th is being held in Cairns next April: you have until 30 September to get your abstract in! http://www.ruralhealth.org.au/14nrhc/homepage)

Leanne is ‘quintessentially Queanbeyan’: modest, functional, still growing and of great service to the nation’s capital! (Message to ex-Mayor Overall: I am now available to the promotional activity of the new Queanbeyan-Palerang Regional Council. And I hope the boys will be playing with the Razorbacks again next summer?)

Leanne is a caring and assiduous daughter to Lionel who has not known her for many years now, but who still boxes on. She is a wonderful mother to Brad, Lizzie (21 last week) and James. And she is the best partner Lindsay could wish for, given his intention to bat on carefully and not risk dismissal. She loves her dogs, is a passionate advocate for social justice and proper remuneration, and a protector of nature and the natural world.

To me Leanne has simply been the best colleague imaginable. She sets high standards for herself and those around her, values work which has social and community utility, and is always willing to go the extra miles.

As well as all of the work at the Alliance with which her name is publicly associated, Leanne is also the one behind the organisation’s tweeting. Some of you might be surprised to know that “I taught her all she knows about Twitter over 10 years ago” (more on that another time!) but since then, behind the scenes, she has been the driving force in the Alliance’s adoption of social media.

It is therefore appropriate that I should thank Leanne for all she has done, and greet her on this special day, through this medium.

Happy birthday, Leanne Coleman, and love from all of us.

leanne-at-nrha-xmas-2013-127

Does the Brexit vote mean an end to the not-keeping-sheep industry under the CAP?

If the CAP fits it might be a Tam O’Shanter

Which breed of sheep is it best not to keep under the subsidies of the Common Agricultural Policy (CAP)? This and other intriguing questions are discussed in this piece published at aggravations.org on 9 August 2016.

One of the important questions arising from the Brexit vote in the United Kingdom is what will now happen to the system of subsidies (or transfer payments) made to UK farmers under the Common Agricultural Policy (CAP).

In 2015, UK farmers received almost €3.1bn in direct payments under the CAP, which is one of the cornerstones of the European Union (EU).

The CAP costs nearly 40 per cent of the EU’s budget – or €58bn a year. At €3.1bn, payments under the CAP represent an astonishing 55 per cent of the UK’s farm income.

The CAP provides financial support to 12 million farmers across Europe.
It was set up in 1957 to sustain the European Economic Community’s food supplies. It was so effective in boosting market prices that it led to over-production and the so-called ‘butter mountains’ and ‘wine lakes’ of the 1980s.

This in turn led to the introduction of production quotas on everything from milk to sugar beet, and to payments being made directly to farmers rather than to farm production. By this means farmers could be ‘rewarded’ for particular land use, which has been described as paying farmers for ‘producing countryside’.

Management of natural resources and climate action is now one of the three principal objectives of the CAP.

Following the Brexit decision, the question is whether the range of EC agricultural subsidies to farmers in the UK will be replaced by domestic transfers. If they are not, land prices will fall and some farmers will be forced out of business.

One of the most famous or infamous parts of the CAP was the set-aside scheme. Between 1988 and 2008 it, in effect, paid farmers to take some of their land out of production in order to help melt those butter mountains and drain the lakes of wine. (That’s one of the reasons why Chateau Dudley is not yet a household name.)

Set-aside also helped to reduce the damage to agricultural ecosystems and wildlife resulting from the intensification of agriculture

The benefits of the set-aside schemes were obviously greatest for farmers whose land was intrinsically low in productive capacity. These included those in the Scottish Highlands. (Might this help to explain the strong Scottish ‘remain’ vote in the recent referendum?)

This is what lies behind the critical – but dated – question of whether Scottish hill farmers will still be paid for not keeping sheep.

Secretary of State
Department of Agriculture
London

1 April 1990

Dear Sir

I have a friend who farms in the Scottish Highlands who has just received a cheque for £12,000 from the CAP for not keeping sheep.

My friend is very satisfied with the new business. He has been keeping sheep for nearly 40 years and the most he ever made was £6,500 in 1968.

So getting £12,000 this year for not keeping any is a good deal.

He suggested that I should join the not keeping sheep business so I am writing to you for advice.

What is the best size of farm for me to not keep sheep and does the amount paid per sheep not kept vary from one region to another?

I am keen to know which is the best breed not to keep. Are there any advantages in not keeping rare breeds such as the Greyface Dartmoor or the Leicester Longwool, or are there already too many people not keeping them?

Presumably I will need to keep records about the number and type of sheep I don’t keep. Can you recommend training courses for that?

My friend tells me that this year he has not kept 50 head. Will he get £24,000 next year if he decides not to keep 100?

I plan to operate on a small scale at first, but as I become more expert in not keeping sheep I plan to be more ambitious, perhaps increasing to 200 not kept in a year or two.

I understand that you also pay farmers for not growing crops. Will I qualify for payments for not growing crops to not feed the sheep I don’t keep?

Thank you in anticipation of your advice.
Yours faithfully
John Smith

English rugby: no longer Down Under

My father played rugby for England. He was a hooker who took the penalties and conversions. Straight on, with a toe poke – none of this fancy round-the-corner stuff.

He played for the Bs: Bath, Bristol and Blackheath – the last being the venue for the very first test between England and Australia in January 1909.

I was the youngest of four boys and didn’t hear much from him about his rugby experiences. For the best possible reason (wanting to do better for me than had been done for himself), I was sent away to boarding school when I was eight, limiting the time for shared reminiscences.

There was apparently a connection between that decision about the boys’ schooling and rugby. One RA Gerard played for Taunton and Somerset while still at Taunton School and he and my father went on to play for England together. (See the second picture down at: http://www.cliftonrfchistory.co.uk/1930s/1930s.htm)

As we were given to understand it, the evasiveness and grace of RA Gerard were tragically ineffective in his confrontation with a landmine in North Africa ten or so years later.

The only story I do recall from my father was of him being felled by a punch in front of the grandstand at Cardiff Arms Park by the Welsh hooker of the day. The point of the story was not the altercation itself but the fact that, even though that Welsh hooker was the best getting around, he was never chosen for his country again.

The England XV – GGG seated, second from left. RA Gerard seated, second from right.

The value of this story was perhaps rooted either in my father’s or in my own perceptions of ‘fair play’ and the extent to which some people would go to demonstrate it.

My brother David has in his possession a cutout part of a browning white shirt on which is a very wilted but still recognisable red rose. He also has a telegram addressed to GG Gregory which reads something like: “You have been selected to play for England against Ireland at Twickenham on Saturday. Be at the ground by 11am and bring your own boots and shorts.”

So I grew up with some sort of special love for rugby union but with no great talent, attributable not only to my diminutive stature but also to the fact that I had no great talent. I was probably the first and only captain of the school fifteen who agreed with the master in charge that, in order to improve the side’s performance, I should be dropped.

After leaving school I played a few games for Keighley in West Yorkshire – games of which I have absolutely no recollection, just a general sense that it was cold and wet.

I left behind some of that wet when I moved to Australia in 1971. I continued to play cricket and hockey, and even some clueless performances for the Uralla Wanderers AFL team, but never any more rugby. And I became a tragic follower of the Canberra Raiders rugby league team.

But the deep well of emotional association with English rugby seems never to have dried.

On the evening of 14 July 2016 I found myself in the Victoria hotel on Wagga’s main street. I cheered ecstatically and forgetfully as Jonny Wilkinson’s drop goal sailed over and only avoided being set upon by 120 cranky CSU students when Tad shepherded me into a safe neutral corner.

But that moment is only one in 1000 for an English rugby fan in Australia. Consider England’s record in test matches in Australia between 1971 and 2015:
Played 15, Won 2, Lost 13, Points for 195, Points against 467

Need I remind you of the games in Brisbane in 1998 (0-76 – eleven tries to nil!) and 2003 (15-51). One of England’s two victories in that period was in Melbourne in 2003. Perhaps that was a sign for English supporters to try a different winter sport.

So have a heart. Let us savour those true-blue English names Vunipola, Itoje, Ford, Brown – and Jones.
gg

How did rural people vote in the Federal Election?

electorates

This piece was first published at aggravations.org on 6 July 2016

Those of us interested in the differences between ‘city’ and ‘country’ in Australia might like to know how the recent Federal Election turned out in this respect.

The short answer is that there was a gradient from the electorates in metropolitan, to outer metropolitan and then to rural areas. On average, the more rural the electorate, the higher the swing from the Coalition and to the ALP.

It would be nice to know what caused this. Since this gradient accurately reflects so many other social and economic variables, which get worse with greater rurality, perhaps it reflects a general sense of alienation with governments that don’t seem to recognise the particular challenges and opportunities of life in rural and remote Australia.

Conveniently, the Australian Electoral Commission (AEC) has three categories in its classification of electorates. The first is comprised of the city electorates which between them constitute the capital cities. Next are electorates the AEC describes as ‘Capital City Surrounds’. This category only exists for the surrounds of Melbourne, Sydney and Brisbane. In Western Australia and South Australia electorates are defined by the AEC either as being in a capital city or rural.

‘Rural’ is in effect the third AEC category, although it should be noted that the AEC does not use that term for them.

A three-point classification therefore emerges from the AEC’s mapping: what might be called Metropolitan (for all capital cities), what we can call Metropolitan surrounds (for electorates around Sydney, Melbourne and Brisbane; and rural.

The first question to be answered is whether there were different average swings against the Coalition and to the ALP in these three distinct regions.

Analysis reveals that the answer is yes, at least in a political sense. I will leave it to others to determine the extent to which the differences are of statistical significance and, if so, at what level of probability.

A number of electorates were excluded from the analysis. Seven were excluded because, after the distribution of preferences, the result of this year’s election saw the first and second placed candidates being someone from one of the three major parties and a second person being a member of the Greens, the Nick Xenophon Team or an independent. In contrast, the election in 2013 saw head-to-head contests between one of the parties in the Coalition and the ALP.

These changed circumstances led to outlier or ‘rogue’ statistics ranging from a notional swing of 51.5% to the Liberals in Grey, where a candidate from the Nick Xenophon party came second; to a notional swing of 66.07% to the ALP in Grayndler where the runner-up was a member of the Greens.

The other five excluded on these grounds were Mayo (won by the Nick Xenophon Team), Warringah, Higgins, Cowper and Barker.

The other exclusions are those electorates in which a minor party was or had been successful in the 2013 election: Melbourne, Indi, Fairfax, Denison and Kennedy; New England where Tony Windsor, an independent, came second; and Murray, where the first and second where the candidates for the Liberal and National Parties.

For the purposes of the analysis, Solomon (Darwin) and Herbert (Townsville) were both considered to be Metropolitan electorates, in the case of Herbert because of the population size of Townsville.

Setting aside those 14 special cases, the analysis was then performed on 136 electorates: 74 Metropolitan, 31 Metropolitan surrounds, and 31 rural.

The analysis therefore measures the swing from the Coalition to the ALP in seats where the two of them finished first and second after the distribution of preferences in both 2013 and this year.

The average swing to the ALP in these three classes was:
⦁ 2.31 per cent in Metropolitan electorates;
⦁ 3.48 per cent in Metro surrounds; and
⦁ 3.82 per cent in rural electorates.

The analysis undertaken did not account for particular circumstances which resulted in specific swings, such as when a well-known and long-standing member retires.

Table: Average swings in 136 electorates from the Coalition to the ALP between the 2013 and 2016 Federal elections

Jurisdiction Metro. Metro. surrounds Rural
Av. % Av. % Av. %

NSW                    3.01                    4.68                                 3.26
Victoria              -0.13                   2.81                                2.90
Queensland        1.98                  3.13                                  3.24
South Australia 4.14                   –                               Wakefield 7.48
W.A.                    3.94                    –                                       3.17
ACT; Darwin       3.27                    –                                       –
Tasmania             –                         –                                     5.95

Total 2.31 3.48 3.82

Analysed this way, and given the caveats described, the overall average in the 136 electorates was a swing from the Coalition to the ALP of 2.92 per cent.

As can be seen from the table, the best performer for the Coalition was metropolitan Melbourne where there was actually a very small average swing its way. The best performer for the ALP (discounting single electorates) was Tasmania outside Hobart. In New South Wales the Metropolitan surrounds seats did particularly well for the ALP.

Hopefully this has piqued your interest in what politics might mean for rural people.