February 21st, 2008
Attending to the basics is the key to hospital reform in NSW
I agree with much of what John Dwyer has to say (”Hospitals’
health depends on reform - and dollars”, February 6), particularly
that “the last thing NSW hospitals need is months of delving into
[their] problems”, since we already have years of data. Where we
fundamentally disagree is in what needs to be reformed and how it
should be done.
Not all our problems relate to doctor shortages. There are 13
per cent more doctors working in Australia than in 2001, and most
of the increase has been in NSW. There has also been a rapid
expansion in the number of students, which is yet to be reflected
in graduates.
No one will argue that all services must be available in all
places, particularly where those services - such as radiotherapy
bunkers - are large and infrequently used. But are we honestly
saying that, with more doctors per head of population than ever
before, we should set standards so high that even the largest
hospitals in our biggest city cannot meet them?
Maybe people are right to get angry when the availability of
services is restricted because we cannot meet a standard that is
nonsensical to begin with. Far more Australians die due to lack of
access to services than have ever died through access to silver
standard services instead of gold.
The ideas that small hospitals (regardless of location) should
be restricted in their services and that role delineation is an
“essential” aspect of quality and safety fly in the face of the
evidence. Obstetric outcomes during the past 20 years have been
consistently worse in large metropolitan units, yet low birth
volume is the most common rationale for downgrading smaller
units.
Professor Dwyer’s claim that there are too many episodes where
“the clinical needs of a patient are not met by skilled staff”
reeks of similar discrimination. This promotion of skills creates
expectations far in excess of the population’s true needs. Everyone
should see a GP at least once every two years, and 95 per cent of
Australians do. Many will never need to see a specialist. Yet while
specialist numbers have grown by 16 per cent since 2001, GP supply
has fallen by almost 6 per cent.
If we are serious in our quest for health reform, why not start
by talking to people whose experience is in the areas where
outcomes most need to change - such as those who work in
disadvantaged, rural, and Aboriginal health. They probably won’t be
professors, or names you would recognise. They may not even be
doctors. But they are the ones I would trust to say where the
reinforcements should go.
Dr Sue Page Lennox Head
Don’t create more dramas for Utzon’s masterpiece
As an employee of the Sydney Opera House from 1970 to 1996 I
would like to support Greg Lenthen (”Let’s rethink this
renovation”, February 7).
David Littlemore was one of the architects who completed the
Opera House interior. While acknowledging the genius of Joern
Utzon, this much maligned group (Hall, Todd and Littlemore) did the
best they could with a difficult vacuum. The major hall had the
same design defects (lack of wing space etc) as today’s Opera
Theatre.
When the first interior alteration was carried out, Littlemore
said to me, “I hope they’re very careful with this building - it’s
a fragile structure.” I’d hate to think what he would say about the
plans for the Opera Theatre. Sydney is devoid of great modern
buildings. Just think what could be created with $700 million - a
real opera house. This time let’s start with the inside.
David Brown Bondi Junction
Lenthen’s answer to the problems of the Opera House is painfully
obvious. Rebuilding the Opera Theatre to bring it up to
second-class standards is ridiculous - it will always be inadequate
because the shell containing it was originally designed to hold a
drama theatre. The hall should be returned to that function.
Another option would be to rebuild the concert hall and return
it to its original intended use as the opera theatre. Building
another hall for the orchestra in a convenient location would allow
the Bennelong Point building to truthfully be called the Opera
House.
The Opera House was one of our luckiest gambles. Why can’t we
now do something brave, but this time with confident intent instead
of being frightened by our own shadow? Oh, of course - the Iemma
Government.
Richard Lynch Waterloo
Lenthen is right on the money. And let’s build a parking station
next to the new Opera House which you can leave in shorter time
than the length of the performance attended.
Peter Wilkenfeld Dover Heights
Lenthen makes a compelling case for an obvious proposition:
leave the Opera House alone, accept it as it is, don’t deny three
years’ worth of visitors the joy of experiencing this great icon.
Note to the powers that be: the striving for perfection is the
mother of much anxiety and many a headache - not to mention
horrendous cost.
Carsten Burmeister Cremorne
Lenthen is spot on. This ill-considered idea will produce an
extremely expensive compromise, far removed from the quality and
technical capabilities of recently completed houses, such as
Copenhagen’s, built for a similar amount of money.
As an architecture student in the 1960s, I had the pleasure of
being taken on a tour of the podium by Joern Utzon. He explained
the idea of the plateau of lobbies and auditoriums, extending like
contour lines across the base, with the shells billowing overhead.
This was fundamental to his concept. Putting the theatre deeply
into the podium will permanently defile the concept of this unique
building.
The existing auditorium can be made into an excellent house by
moving the pit forward by two rows, free of the overhang for much
of the smaller scale repertoire.
A new large-scale opera theatre on the old Tivoli site facing
Belmore Park could provide real opportunities for the most
challenging of art forms to flourish.
Andrew Andersons Paddington
Hang on to your assets and borrow to invest
Here’s a radical idea for the State Government. Instead of selling
the silver to fund $15 billion of infrastructure investment
(”Costa’s power play on sell-off”, February 7), how about borrowing
the money from the capital markets and making use of your AAA
credit rating?
On the Government’s annual income and asset base, borrowing $15
billion is chickenfeed. This puerile aversion to government debt
has to stop.
Brendan Jones Annandale
Michael Costa says he will ignore conference resolutions and
proceed to sell state electricity assets, because he is “governing
on behalf of the people”.
If that’s the case, Mr Costa, why don’t you seek a mandate from
the people for your policy?
Colin Drane Narwee
Explosive argument
Is Duncan Dawson (Letters, February 7) trying to say the bombs the
terrorists exploded in Bali were not aimed at people, but some
inanimate object, such as morality?
Or that the best way to prevent moral turpitude is to blow
people up, even if they are not guilty of any moral
transgression?
Richard Gray Northbridge
Practise what you preach
Simon Ioannou (Letters, February 7) calls for some kind of
department of religious review to ensure imams’ sermons are in line
with the values of a secular democracy. Why stop there?
The Exclusive Brethren bar followers from voting. This is not
just illegal, it is against our secular democracy’s values. Was
Peter Jensen’s article on his beliefs around homosexuality proper
in a pluralistic society?
You cannot silence the haters by permit. You defeat them by
countering their arguments with words and actions of good
faith.
Chris Howe Woy Woy
Peter Jensen and the Anglican Diocese of Sydney have not changed
their position on the ordination of women (Letters, February 7). Dr
Jensen has always ordained women as deacons.
However, in keeping with the Bible’s teaching that women and men
are equal but have different roles in the church, women are not
ordained as priests in this diocese.
Phillip Colgan Bexley
Time to repay debt
The blockade of the Kokoda Trail is militant, but understandable
(”Villagers declare Kokoda Trail closed”, February 7). The money
these people are being offered is substantial for their
circumstances.
Surely the Australian Government could devote foreign aid of $10
million a year as a gesture of goodwill towards those who aided us.
If Australians want to leave the area untouched, we should pay for
the privilege.
Ben Ellis Riverview
It was no problem for us to mine in Jabiluka, even though it was
considered sacred to Aborigines, but now that a proposed mine
affects “white” Australian history, we have the audacity to talk
about respect and sacrilege. It’s their land, their future and
their choice.
Rehan Panditaratne Erskineville
Pilots not above the law
Professor John Faulkner seems to think the Indonesian pilot should
not face criminal prosecution for wilfully flying in a dangerous
manner, resulting in death and injury (Letters, February 7).
Should pilots be exempt from the law, while other professions
are not? I take his point on cockpit voice recorders, but I
question his sense of perspective when the requirements of accident
investigation take precedence over due process of law. If pilots
turn off the recorders, maybe that, too, should be viewed as an
offence. As a former air traffic controller, I never had the option
of turning them off, nor wanted it.
Wayne Talbot Kelso
Opera is everyone’s domain
Correct me if I am wrong, Liz Nield (Letters, February 7), but the
taxpayers fund a large portion of Opera Australia. Many cannot
afford tickets for the opera and therefore look forward to the
“free” performances. I would urge you to survey your Domain
audience and see how many, other than the subsidised sponsors, had
paid to attend a performance at the Opera House.
Perhaps a free concert once a year is not such a big ask. The
provision of a reserved area for commercial sponsors cannot be
justified as all attendees have contributed financially.
Lee-Ann Groblicka Turramurra
So, Liz Nield, what was the nature of the sponsorship provided
by Malcolm and Lucy Turnbull to Opera Australia?
John Lees Castlecrag
My husband camps overnight in the Domain to get a good position,
and every year we sit next to dozens, sometimes hundreds, of empty
VIP seats. They don’t seem to give a Tosca.
Maggie Ramsay Woolloomooloo
Distorted view from the Hill
It’s a bit rich for Rodney Crute of Hunters Hill to lecture people
from Blacktown about home insurance and responsible lending
(Letters, February 7). These are not flash houses: most are riddled
with asbestos and many are ex-housing commission. These people are
doing the best they can with what they have.
Yes, Rodney, they may have made careless decisions. The
difference between them and you is that you have a buffer; they
don’t.
When the eastern suburbs was damaged by hail we all felt very
sorry for people as they waited nine months for roofing slate to be
imported from Wales. But these are only westies. I mean, who do
they think they are, wanting their kids to sleep in a dry bed?
Danielle Wheeler Wilberforce
Could do better
Helen Pellegrino (Letters, February 7) joins a long line of
ministers, bureaucrats and principals seeking more power to tell
rural and isolated schools they don’t count. A teacher in an
inner-city school in England can live in a nearby leafy suburb or
village. Teachers in rural NSW usually don’t have that option.
Her comment that teachers who worry about earning points to pick
their next school do not have the best interests of pupils at heart
will be offensive to many. She should prove her commitment to
students in NSW by taking a position in an isolated,
difficult-to-staff school west of the sandstone barrier and
guarantee she will stay for at least 30 years - the period teachers
without transfer rights could be locked into if ministers,
bureaucrats and principal associations get their way.
Kevin Farrell Beelbangera
Bring on those headphones and let the rest of us talk
What a splendid idea (”Party’s on: it’s BYO headset”, February 7).
Now if we can only get the Australian Hotels Association interested
we can return to the days when people went to their local pub for a
quiet drink and a chat, and those who wish to listen to full volume
television can do so through their headphones.
Bryan Hayes Mount Pleasant
I thought the idea of parties was to have fun and socialise. Why
not just go to a party online and avoid meeting people in real life
altogether?
David Ashton Orange
Had a sporting chance
Section 115 of the Broadcasting Act prevents pay-TV operators
siphoning off coverage of nationally important events before
free-to-air broadcasters have had an opportunity to get the
broadcasting rights. Can someone from one of the free-to-air
channels (I’m looking at you, SBS) explain why the rights to the
Socceroos’ World Cup qualifying campaign were not purchased?
Todd Kelly Brighton (Qld)
Freudian fallacy
Maurice Whelan’s testimonial to the far-reaching effects of
Freudian ideology reflects poorly on current critical analysis
(”Could be a wiser world with the doctor’s analysis”, February 7).
Freud is dead - spiritually, emotionally and intellectually - yet
the carcass clings to life. Would it surprise anyone that there
isn’t a scintilla of experimental or objective evidence for any of
Freud’s theories? I will not be visiting the exhibition at the
Nicholson Museum to pay homage to the Freudian bric-a-brac. Trust
me, a cigar is just a cigar.
Anthony Inatey Bathurst
A chance to stand out
Steve Barrett, Tasmania wants to be noticed from space for Earth
Hour (Letters, February 7). It isn’t noticed from mainland
Australia at any time.
Alan Lloyd Katoomba
Just them crusty codgers
The only two politicians letter writers could come up with who had
“beautiful” English both had upper-class British accents. Looks
like the cultural cringe and snobbery are alive and well.
Debby O’Brien Armidale
Still handing out the bacon
I know it’s the year of the rat, but I bet I’m still writing the
year of the pig on my cheques for at least another month.
John Tuckfield Abbotsford
Plenty of drama elsewhere
Like many people with poor co-ordination, I suffered teasing and
humiliation in physical education classes. Years later, my son’s
self-esteem was eroded by a bullying, win-at-all-cost soccer coach.
So, John Christie (Letters, February 7), when I wish to be
thrilled, amazed and inspired, or to observe skill, will and
beauty, I look to ballet, art, music and literature. For
infuriation and bastardy, there is always politics.
Sally James Melrose Park
I experience all those emotions every day when I ride a bike to
work on Sydney roads.
Daniel Lowinger Bondi
The perfect pitch
I’d love to hear Richie Benaud say “Super Tuesday”.
Michael Deeth Como West
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