Thursday, October 14, 2010

As Good As It Gets

It has to be the story of the decade, if not the century. Today all 33 of the miners trapped almost 700 metres underground in Chile for almost 70 days have been successfully rescued. Lost after an underground cave-in they were believed to be dead for 17 days before a remote probe was able to reach their location. When it emerged that all 33 were safe and relatively well a feeling of elation and astonishment spread quickly around the world. But with that came the realisation that any rescue would take months, possibly the remainder of the year. Today, the hopes and prayers of the men themselves, their families, their friends, and complete strangers from every part of the world have been answered. It is a wonderful story of endurance, hope, faith, and triumph over disaster.

It has also been a fascinating story of human frailty with miner Yonni Barrios becoming internationally famous when his wife met his girlfriend while keeping vigil at the mine. What must be at the very least a slightly awkward situation became the source of much amusement and constant jokes around the world. When Yonni finally reached the surface today, he was met by his girlfriend. Although he had invited his wife to stay, apparently she declined, saying “I'm not going to go see the rescue. He asked me to, but it turned out he had also asked the other lady and I have decency. One thing is clear: it's her or me”. According to some reports, it turns out that Yonni actually separated from his wife some years ago, so it would seem that the story is not quite as salacious as it first appeared. But hey, why let the facts get in the way of a good story, especially if it’s good for a laugh.

Now that all 33 men are free they will all have their own opportunities to tell their own stories in their own way and in their own time. No doubt there will be no shortage of offers for paid media appearances, book deals, and I would be prepared to wager, a Hollywood movie deal. I hope that every single one of them profits in some way from what has been after all a supremely difficult period in their lives. They deserve every cent they might potentially earn, and they deserve all of the good wishes and recognition that will come their way. And they also deserve to be left alone to quietly go about rebuilding their lives without further intrusions if that is what they choose. Either way, they have managed to turn tragedy into triumph, as have all of the rescue workers who have made this wonderful outcome possible.

It’s not often that the biggest story in the news is actually good news, and today’s news is as good as it gets.

Wednesday, October 13, 2010

They Are Just Not Listening

It’s no wonder our hospitals are struggling so badly to keep up with the demands placed upon them. All the evidence would seem to suggest that hospitals in New South Wales are overcrowded. Occupancy rates at many major hospitals have been reported as consistently exceeding 90%, with Saint Vincent’s registering 99%, the Prince of Wales running at 95%, and the average across the state reaching 87.9% for the 2009-10 financial year. Doctors have been repeatedly calling for a target of 85% occupancy to be set, describing it as an internationally accepted standard necessary for optimum safe and efficient care. Repeated inquiries and studies have determined that the primary cause of overcrowding in emergency rooms is access block, caused by a lack of available beds in the hospital when an emergency patient needs to be admitted to a ward. No beds available, means that patients are stacked up in the emergency department taking up space and soaking up resources so that new arrivals are forced to wait.

However, when confronted with these facts, the New South Wales government, and the Department of Health simply deny that any problem exists. Deputy Premier and Health Minister Carmel Tebbutt claims that “there is no definitive rule that states it is unsafe for hospitals to operate above an 85% bed occupancy,” and insists that achieving such a target would mean that more than 3000 acute care beds would be left “fully staffed but deliberately empty.” Today I spoke with the Deputy Director of New South Wales Health, Dr Tim Smythe, and he went even further. Dr. Smythe said that the 85% figure is a myth and is meaningless in terms of quality of care. He insisted that the claimed occupancy rates, such as the 99% at St Vincent’s for example, are based on “patient-bed-days” and are not an accurate representation of actual occupancy rates. He further claimed that there is no one single “magic figure” to define optimum occupancy rates with different rates being appropriate for different treatments, different procedures, different patients, different locations, and different circumstances.

This is such a typical bureaucrat’s response, and only serves to demonstrate that figures really can be twisted around to mean whatever you want them to mean. The idea that maximum efficiency is achieved by running at maximum capacity is fatally flawed, one that seems to take industrial theory and apply it to healthcare. But patients are not products, and hospitals are not factories, and it is wrong to treat them as if they are. The target of 85% is supposed to reflect an average which will accommodate surges in demand which might at times stretch hospitals to beyond normal circumstances. Failure to structurally incorporate such excess capacity not only means that there is no surge capacity, but also that staff and resources are pushed to the limit all the time, which only increases the prospect of adverse events such as medical mistakes and unnecessary deaths, which ultimately actually cost us all much more than it would to have a reasonable margin for safety built in to the system.

This bloody minded denial of the obvious also makes it painfully clear that the government, and their bureaucrats, are simply not listening to the doctors, not listening to the patients, and most certainly not listening to the taxpayers of New South Wales.

Tuesday, October 12, 2010

Women At The Top

Westpac Bank has just announced a target of having women in at least 40% of management positions in the next four years. Although it is not the first big company to make such an undertaking, it is one of only a very few. In many ways it seems difficult to believe that such matters remain an issue after half a century of feminism, and long standing equal rights legislation. Surely this is a battle which was won long ago. We have a woman as Prime Minister, and a woman as Premier. In fact, by the time Kristina Keneally became the first woman to be Premier of New South Wales, nobody particularly cared one way or another. All other things being equal it would be reasonable to expect men and women to be more or less roughly equally represented in the top jobs. And yet, for some reason the numbers of women in leadership roles remain significantly and disproportionately lower than men.

Working out just why that might be is not entirely simple, but it would seem that community attitudes and perceptions still play a prominent role. Despite the progress which has been made over the decades, old prejudices are slow to completely disappear. It might have been in the 1960s when Star Trek first showed women in positions of responsibility, but it was still another thirty years before they put one in command of a Starship, and even then the television networks were worried whether the audience would accept it. And that’s just a work of fiction. Here in the real world there are still people who believe that women are somehow not equipped to take a leadership role and that it is somehow wrong that they should try. And some of the people who have said such things to me are actually women themselves. While those views are becoming much less prevalent, I have been shocked to discover they have not entirely disappeared.

Of course, it’s one thing for a handful of old fashioned people in the general community to cling to some old fashioned ideas, but it is entirely another thing for those ideas to hold any sway in the board rooms of our biggest companies. It is hard to believe that modern business, which is so obsessed with bottom line thinking, might be making decisions on executive appointments based on anything other than qualifications and competence. Is the propensity of boards to favour the appointment of men based on old prejudices, or is it the result of a lack of suitable candidates? If it is the latter, then why is there a lack of suitable candidates? Has there been a failure by companies to provide adequate training and opportunities to advance for women? Is there still an “old boys” culture within some companies where jobs are awarded to mates, and all the mates just happen to be men? The truth is that all of these things are contributing factors.

But it should also be remembered that while women fought for the right to work in the top jobs, they did not fight for the obligation to do so. Women fought for the right to have a choice of whether to pursue a career, to have a family, to do both, or to do neither. One woman told me that she believed that women have far more choices than men, because society does not condemn them for staying home and letting someone else be the bread winner, while very few men would be allowed to consider that as an option. On that basis, women would seem to be better off than men, not worse. And besides, who said that running a big company is the only measure of success anyway?

I’m sure that plenty of women are capable of doing it… it’s just that some of them quite happily choose not to.

Monday, October 11, 2010


Once again the debate about speed limits and penalties has sprung up, this time in response to a proposal from the NRMA that the penalty system should be reviewed to more adequately, and fairly, reflect the modern driving environment. The NRMA has proposed that drivers should be allowed a total of 13 demerit points rather than 12, that the demerit points should have a life of two years rather than three, and that good drivers who have not accumulated any points should be rewarded with discounts on their licence renewal fees or registration. Whether or not those proposals are adopted, the NRMA says that it is time for a review of the system which is almost 40 years old, and was introduced before the days of speed cameras.

Of course, the truth is that if you don’t want to be penalised all you need to do is don’t break the law. Of course, there is a need for sensible speed limits, and other road rules, to manage the ever increasing traffic and promote road safety. And of course, if there are rules there should be penalties for breaking those rules otherwise they would easily become meaningless. But there is no shortage of motorists who have become so frustrated that they believe that the penalties are designed to collect revenue rather than to protect the safety of motorists. But I’m not really sure that it’s the penalties that are the problem. As I said, there need to be penalties so that we are discouraged from doing the wrong thing. Instead, I believe that it’s the rules which are the problem.

It’s easy to understand the frustration when the whole system increasing seems to be designed to trap the driver into making a mistake rather than help the driver get from point A to point B safely and efficiently. Cameras, both fixed and mobile, lurking at every turn, a vast array of possible speed limits from 40 through to 110 which could appear in any combination over a short distance, variable speed limits, speed limits for road works when there are no road works actually taking place, transit lanes, and bus lanes, all seem to be designed only to catch the unwary. And the moment you make a mistake, the government gleefully cries “gotcha”, grabs your money and takes away your points. The trouble is that if you keep on making more and more laws, sooner or later it becomes impossible not break at least some of them inadvertently.

And what’s worse, if the rules become too difficult to follow, people will inevitably lose all respect for them and won’t bother to even try.