Kieran Gilbert hosted Kelly O'Dwyer and me on the Sky AM Agenda program this morning. We discussed the Gillard Government's ongoing committment to deregulation and meetings with business leaders today. Other items up for debate were monetary and fiscal policy and the carbon price and its reduction of complicated requirements for business.
Support for R18+ rating for games, The Chronicle, 3 April 2012
One of the fastest-growing pastimes in Australia is computer gaming. According to one recent survey, 95 per cent of Australian homes with children under the age of 18 had a device for playing games.
Over the past generation, we’ve moved from clunky arcade games like Pacman and Space Invaders to games like EverQuest and World of Warcraft, with slick graphics and millions of players interacting with one another. No longer are gamers just teenage boys. Today, nearly half of all gamers are women, and the typical Australian gamer is aged 32.
But while many Australians love computer games, parents also want to know that their children are playing games that are appropriate for their age. That’s where the proposed R18+ rating comes in. At present, most other nations have a video game rating of R18+, but at present the highest rating for Australian games is MA15+.
Not having an R18+ rating for games causes two problems. First, some games are refused classification, so cannot be sold in Australia. Second, some games that are only available to older people overseas can be purchased by younger people in Australia. For example, Call of Duty (a game that warns of intense violence and strong language), has an M17+ rating in the United States, but an MA15+ rating in Australia. When the Attorney-General’s Department held an inquiry into the proposal, it received over 58,000 submissions, with 98 per cent supporting an R18+ rating.
Parents understand how quickly children pick things up from their environment. A friend of mine told me about her 11-year-old boy who was watching a TV show and he said one of the characters was snorting coke. His mum asked, ‘How do you know that?’ He replied, ‘I know it from Grand Theft Auto.’
The Gillard Government is introducing an R18+ classification because it helps prevent children and teens from accessing unsuitable material. But it also lets adults make their own decisions about the computer games they play.
While some might yearn for an era when children played more backyard soccer and fewer computer games, mass usage of computer games is here to stay. Perhaps the most optimistic vision of how gaming might shape our society is a book by game designer Jane McGonigal, titled Reality Is Broken: Why Games Make Us Better and How They Can Change the World.
McGonigal proposes a variety of ways in which games can help us be happier in everyday life, stay better connected with those we care about, feel more rewarded for making our best effort and discover new ways of making a difference in the real world. For example, a game called The Extraordinaries challenges its players to take two minutes to write a short text message of encouragement to students in Mexico, Venezuela or India, who are about to take an important exam. At their best, computer games aren’t just fun – they can help build a better world.
Andrew Leigh is the federal member for Fraser, and his website is www.andrewleigh.com.
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Driving a clean, green future, Canberra Times, 3 April 2012
Last month another charge spot was added to Canberra’s growing charge network. In addition to their charge locations at the Belconnen Markets, National Convention Centre, and Crowne Plaza, Better Place opened a new spot at the Novotel Hotel on Northbourne Avenue. Across the ACT there are now 14 charge spot locations.
Electric cars have the potential to benefit Australia’s economy, health and environment. With global oil prices steadily creeping upwards (due to growing demand in China and other emerging economies), average Australians are now paying over $1.40 per litre for unleaded petrol.
Petrol-consuming passenger vehicles account for nearly half of Australia’s liquid fuel consumption. Hybrid and electric cars offer the chance to reduce our dependence on the global oil market.
Using current national electricity generation methods, producing electricity for travel in hybrid and electric cars releases less greenhouse gas emissions than combustion in petrol cars. This is true even if the electricity is produced using ‘dirty’ technology. For example, an electric car powered by electricity from a coal fired power station emits less greenhouse gas than a petrol car.
If the electricity comes from renewables, we can do even better. In 2010, Australia generated 15,000 gigawatt hours of renewable energy, sufficient to supply a fleet of five million electric cars without any ‘well to wheel’ greenhouse gas emissions. The Australian government is committed to generating 20 per cent of Australia’s electricity from renewable sources by 2020, which equates to 45,000 gigawatt hours of renewable energy annually. That’s enough to supply an entire national electric car fleet with zero greenhouse gas emissions.
The health benefits of electric cars are also significant. Unlike petrol vehicles, electric cars have no tailpipe emissions, only pre-combustion emissions. Unlike those from petrol vehicles, these include virtually no carbon monoxide, hydrocarbons or particulate matter emissions and only a quarter of the nitrogen oxides released by petrol vehicles. The total reduction of air pollutants in electric vehicles’ emissions compared to petrol vehicles’ emissions ranges between 10 and 20 grams per kilometre.
Electric vehicles also require less maintenance, as they have 70 per cent fewer moving and consumable parts. This is estimated to halve maintenance costs over a ten year period.
Research from RMIT finds that electric cars require 20 per cent less lifecycle energy and associated greenhouse gas emissions than petrol vehicles. Indeed, because they’re so cheap to run and maintain, the only risk that I can see being posed by electric cars is that they could encourage more people to commute by car, thereby increasing traffic congestion.
One of the great advantages of electric cars comes because the wholesale cost of electricity varies dramatically over the course of a day. Electric cars can take advantage of this by charging when electricity is cheapest (and putting power back into the grid when it is most expensive). This minimises the impact of electric cars on the energy infrastructure and allows them to collect and store up to seven kilowatts of energy, generated in times of low electricity demand, which would otherwise be wasted. A car can then later return any surplus energy to the grid in periods of high demand to power the community or other cars that require immediate charging, greatly reducing the demand for additional energy generation.
By capturing, saving and returning excess energy to the grid, electric cars are a neat complement to energy production sources like wind generation. On one estimate, each electric car could enable the retention of 43 megawatt hours of renewable wind energy annually. Because each electric vehicle would require only 2.7 megawatt hours of electricity to recharge over a year, this means that each car is effectively saving 40 megawatt hours of energy that would otherwise be lost. This means that a fleet of one million electric vehicles would allow us to achieve the 45,000 gigawatt hours of renewable energy required by the national Renewable Energy Target.
With the charging network now in operation, having more electric cars in Canberra offers us an opportunity to save money, increase the health of our community, and decrease car maintenance costs. By reducing Australia’s greenhouse gas emissions, we have the opportunity to charge towards a new cleaner, healthier and more sustainable future. Now that’s the kind of change we’re driving towards.
Andrew Leigh is the Federal Member for Fraser, and his website is www.andrewleigh.com.
‘Teamwork and Healthcare: The Role of Allied Health Professions’
Speech to Allied Health Professions Australia (AHPA) Conference
Federal Member for Fraser
Realm Hotel, Canberra
2 April 2012
Let me start with a story.
In 1999, a three-year old girl was out walking with her parents in a small Austrian town of Klagenfurt. They lost sight of her for a moment, and she fell into an icy fishpond. Her parents jumped in after her, but it was 30 minutes before they found her on the bottom of the pond.
Following instructions from an emergency team they called on their mobile phone, they performed CPR and called rescue personnel, who flew her by helicopter to the nearest hospital, performing CPR all the way. On arrival, she had no blood pressure, no pulse and no breathing. Her body temperature was 19 degrees.
As quickly as they could, the team connected the girl to a heart-lung bypass machine. By the time it started to pump oxygenated blood to her body, she had been lifeless for 90 minutes. After 6 hours, her body temperature was normal, but there was too much water in her lungs to use a mechanical ventilator. So they switched her to an artificial lung system called ECMO – extracorporeal membrane oxygenation. This involved opening her chest with a power saw, and sewing the lines directly into her heart. With her chest still open, the intensive care team worked on removing pond water and debris from her lungs with a fibreoptic broncoscope.
Over the next two days, the girl’s major organs recovered. But they were worried about her brain. There was global swelling, but no dead zones. So they drilled a hole into the girl’s skull, inserted a probe to monitor the pressure, and slowly adjusted her fluids and medications until it returned to normal.
After a week, the girl began to breathe on her own. Soon after, she woke up. Two weeks after being admitted to hospital, she went home. She still had some paralysis in her arm and leg, and her speech was slurred. But with extensive therapy, she had made a full recovery by age 5.
In his book The Checklist Manifesto, medical writer Atul Gawande points out how extraordinarily complicated the girl’s rescue was. To save one child, scores of people have to keep lines sterile, replace batteries, keep air bubbles out of the heart, and engage in painstaking occupational therapy. Yet a small Austrian hospital was able to save a girl who had lain at the bottom of a pond for half an hour. They did it not because of one great surgeon (as you might on TV), but because they recognised the need for all the parts of the medical system to work together.
In the years before this girl had come in, the hospital in Klagenfurt had tried to treat 3-5 patients a year who were suffering from cardiac arrest. But no matter how hard they tried, something seemed to fail. They often found a key person or action missing. It was only when the hospital instituted a checklist, which set out all the key actions and people required, that they began to save lives.
As allied health professionals, you know in your bones the value of teamwork. I believe we – the Australian Government and the allied health professions – share the same objectives for Australia’s health system.
The theme of your conference, ‘Strengthening Health Outcomes’ speaks to the challenges facing Australia’s health system, and the opportunities to work together to help Australians live longer and healthier lives.
- We want the best-quality health care delivered to Australians when and where they need it.
- We want to build the capacity of the health workforce and system.
- And we want health reforms to be sustainable.
Current pressures on the health system
As the Australian population ages, we are looking at an alarming and growing list of complex and chronic illnesses.
With advances in systems and technology, Australians also expect more of our health system.
We need to help and encourage Australians to manage their own health to a greater extent than ever before.
We want to keep them healthy as long as possible and out of hospital care by boosting their long-term health outlook and general wellbeing.
These pressures were key factors in the most far-reaching and systematic review of our health system – through the National Health and Hospitals Reform Commission, the Preventive Health Taskforce and development of the National Primary Health Care Strategy.
Current Medicare support and other support for allied health
The Australian Government is committed to building a stronger primary health care system which values the role of allied health care providers.
Medicare rebates for allied health services are available to: patients who have a chronic or terminal medical condition and complex care needs requiring multidisciplinary care, and who are managed under the relevant Chronic Disease Management (CDM) care planning items; and to Indigenous patients who have had a health assessment.
These items enable GPs to plan and coordinate the health care of patients with chronic or terminal medical conditions, and where necessary, refer patients for allied health services under Medicare. That’s the system working collaboratively.
Last year, more than 7 million services were provided through the CDM and associated allied health items. That’s one service every
These Medicare services were introduced to complement services provided by state and territory governments, and to increase access to private allied health services.
The Australian Government also supports access to allied health services by subsidising private health insurance premiums and through targeted programs such as the Rural Primary Health Services Program.
The Government will continue to provide ongoing support to train, educate and retain our allied health workforce.
The new health environment & allied health
But we also want to make important changes.
We want to see more effective care - outside of hospital where appropriate - focussing on preventing disease and modifying lifestyle.
We have committed to a range of initiatives under the National Partnership Agreement on Preventive Health – the largest investment an Australian government has ever made in health prevention.
The aims of the National Health Reform Agreement are consistent with tackling differences in health services and outcomes:
- improving the efficiency of public hospitals – using activity-based funding based on a national efficient price;
- standards of clinical care through the Australian Commission on Safety and Quality in Health Care;
- local accountability and responsiveness to communities’ needs by establishing Local Hospital Networks and Medicare Locals; and
- providing GP and primary health care services by developing an integrated primary health care system.
Primary health care reform
Our reforms within primary health care aim to shift the centre of gravity from hospitals.
This includes fast-tracking reforms to GP after-hours primary health care services, and bringing forward more Medicare Locals.
Medicare Locals are particularly significant for allied health professionals, focusing as they do on local communities’ health care needs.
Patients will benefit from a smoother transition, in and out of hospital, and by receiving the right care, in the right place, at the right time. That’s medicine working as a team.
The AHPA will have an important role – working with the Government, Local Hospital Networks and Medicare Locals to establish effective collaborations and to support allied health professionals developing local networks.
Allied health professionals continue to be involved in e-health – an important element of national health reform. Working with AHPA, we have invested significantly in research to better understand the position and readiness of allied health professionals for e-health.
We have published a landmark study on the readiness for e-health of more than one thousand allied health professionals.
GP Super Clinics
Allied health professionals, as part of primary health care teams including GPs and nurses, will have opportunities through GP Super Clinics to provide integrated, multidisciplinary primary health care services to local communities in one location.
Incentives are available for allied health services to relocate to newly-opened GP Super Clinics – discounts on rent, centralised administration services and IT support.
At the end of January, nurses and allied health professionals were providing services for about one-third of the presentations at operational GP Super Clinics.
A number of clinics offer preventative health services – lifestyle modification programs, women’s health services, diabetes clinics and smoking cessation programs. Good health requires collaboration across the sectors.
The future contribution of allied health professionals to the health system is also being taken into account in planning of the health workforce.
Health Workforce Australia (HWA) is doing this through four main areas: workforce planning, policy and research; clinical education; innovation and reform of the health workforce; and the recruitment and retention of international health professionals.
In 2012, HWA will begin National Training Plan Mark 2. This will analyse, in selected groups of allied health professionals, how future workforce demand for these professions up to 2025 will be affected by improved workforce retention, increased productivity and innovative health reform measures.
HWA will also start work shortly on projects which seek to look at the role of allied health professionals in a variety of settings.
Let me finish with another story.
In 2009, US Airways flight 1549 took off from La Guardia airport in New York. It was an Airbus 320, with 2 engines. About 90 seconds after takeoff, it struck a flight of Canadian geese. At least 3 geese (weighing around 5kg apiece) went into each engine. Both stopped.
Now all of you know what happened next. The plane, piloted by 57 year-old Captain Sullenberger, glided for 3½ minutes before landing safely in the Hudson river. All 155 people on board survived. It is the most successful ditching in aviation history.
In the press write-up afterwards, the focus was on the pilot. He had flown gliders for the air force, and the media saw him as the hero of the moment. Captain Sullenberger was phoned by President Obama. Every TV talkshow wanted to feature him.
Yet the story is actually one of teamwork. When crash investigators look at aircraft disasters, a common theme is a failure to work together. In the case of Flight 1549, cockpit voice recorders show that success occurred because the pilot, co-pilot and 3 flight attendants worked together. For those crucial 3½ minutes as the pilot turned the plane past Manhattan skyscrapers, the co-pilot made preparations for landing, and worked to restart both engines. The flight attendants got the passengers into brace position, and made sure they were ready to don their life jackets. 155 lives were saved that day not because of a great pilot, but because of a great team.
As allied health professionals, you are committed to primary health care and to improving the health of patients.
I leave you with this key challenge: engage with the health reforms; take up the opportunities offered by eHealth; and finally, establish links with the key organisations in your local area, particularly Medicare Locals, but also more broadly with other primary health care organisations like GP Super Clinics and individual health care providers. Success in healthcare, as in so many other areas of life, is about making great teams even better.
 Markus Thalmann, Ernst Trampitsch, Norbert Haberfellner, Elisabeth Eisendle, Raimund Kraschl, Georg Kobinia, 'Resuscitaton in near drowning with extracorporeal membrane oxygenation', Annals of Thoracic Surgery 2001 72: 607-608. Cited in Atul Gawande, The Checklist Manifesto, Macmillan, New York, 2009.
 As told in Atul Gawande, The Checklist Manifesto, Macmillan, New York, 2009.