Football Archives - The Best Mouse Tap

Modest Expectations – Southern Sudan

In 2006, my younger son and I went to Munich to see Australia play Brazil at football. It was World Cup time. I still have the scarf. As I remarked to the chap sitting next to me in the stadium, it would probably be the first and only time that I would be watching Australia play Brazil in anything. Australia was in a navy blue strip; the Brazilians the traditional yellow and blue. The similarity of our colours threw a golden ring around the field. Brazil was too good for us (2-0), but it was a competitive match just in the same way the recent encounter with Argentina was. Soccer or football (as it’s more universally called) was to us Australians very much a fringe sport, basically imported after the war to Australia, initially clubs being formed around particular migrant groups.

Australia had imported rugby and cricket from England and was playing test matches against them in the nineteenth and early twentieth century. But not football. Football was a working class sport; a winter niche filled in Australia by Australian Rules football and Rugby League. The latter was also a sport of the coal mining areas in Northern England. Then there was Rugby Union, the sport of the public schools in England and predominantly NSW and Queensland. Not much room for football in schools.

In 1956, at the Melbourne Olympic Games, Australia fielded a team when there were only eleven teams. Australia reached the quarter finals after beating Japan, only to be comprehensively beaten by India in the quarter final. The Soviet Union won the gold medal. On either side of the Olympic Games in 1954 and 1958 saw West Germany and Brazil win the World Cup; neither bothered to send teams to Australia. In 2000, as host nation for the Olympics, Australia received a free pass, but this was a genuine test among modified national sides. The Cameroons won; Australia came 15^th.

I was in a taxi in New York when I learnt that Australia had qualified for the round of 16 for the 2006 Cup, when Australia later lost unluckily to Italy which then went on to win the title. However, this was a “golden” team with plenty of players in the top flight European leagues and their coach was one of the acclaimed Dutch coaches, Guus Hiddink – a very talented gun for hire but not in any way close to being an Australian by adoption, despite the media hype.

Graham Arnold, the current Australian coach is a knock-about Australian, who fits within the description of a typical “Aussie bloke”. His zone? An abusive father; mother who dies of cancer when he’s 20; lives in straitened circumstances as a teenager, soccer journeyman who has pushed his innate abilities to its limits; underestimated; a chip on his shoulder compounded by his rumpled appearance. Moreover, he drinks at the Sackville Hotel in Rozelle (renamed for the Cup Sacky-roos), which I know well also. Rozelle – now gentrified – a long way from his childhood yet with identifiable parts to which he could relate, like his Sackville patron mates.

He has been around a long time, spent a lot of time playing second violin. Where does the Australian Football team go from here, after this run of magic – does Arnold know when the trail of gossamer ends? Next year, when the Woman’s World Cup will be played out in the Antipodes it may go a long way towards answering that question.

Pity about Argentina.

Chenozem, indeed

I sent an e-mail to a friend in Sweden after Australia beat Denmark, commenting this win was like Sweden beating Australia at cricket.

In response, after congratulating the Australian achievement, he mused over the state of Northern Europe – “Weather impacts will be great, we suffer high energy bills and Ukranians freeze and buy simple wood ovens to compensate. Last week a full foot of heavy snow fell here, resulting in fallen trees and much shovelling. The area is littered with fallen fir branches.”

I sent him a poem entitled Black Soil, which I have written about the Russian Invasion of Ukraine and which will be published as part of an anthology in the New Year.

BLACK SOIL


Saffron the sun emergent

Caerulean a sky beginning to dawn

Trees wintry tracery on the light

A flag limp in a flowerpot

Blood dripping in the terracotta


Black soil 


A footprint; a lonely shoe

A carved track; a burnt out tank

A sunflower once tall; now bent 

Sap dripping from its torn stem

But still life lives in this sap
 

Black soil
 

Once a feathery highway

Of fun and laughter

Where children ran 

Where parents chided 

Where bicycles slowed and 

Everyone as sunflowers were waving in the gentle breeze.


Black soil


Now mud 

Where chilled men and women lie

Twisted and burnt

In tatters and shreds

In graves 

In plastic body bags

Alone with company
 

Black soil

 
A way beside a church

Where once Putin prayed 

Where Oligarchs prayed

Where a Muscovite Prayed

A Patriarch with heavy braid

Prayed

To God


Black soiled.

My friend’s response was brief:

“Chenozem” indeed.

Well, here was an unfamiliar word, which I found out is derived from the Russian word for “black soil”. Nearly a quarter of the world’s most fertile soil, known as chernozem, is located in Ukraine.Chernozem is black soil -rich in organic matter made up of decomposed plants – “humus” in fact. I live and try to learn.

Who suggested this?

Under the Higher Education Loans Program, commonly known as HECS, the government covers the cost of students’ contributions until such a time as they earn a minimum salary of $48,361 and repayments of one per cent a year kick in. Repayments are staggered to $141,848, at which point graduates repay at a rate of ten per cent through the Australian Tax Office.

While the loans are indexed to CPI, no interest is paid on them. Legislation passed in the Federal Parliament this month will wipe more than $70,000 from university debt accrued by doctors and nurse practitioners who spend three years working and living in a rural or remote area after they graduate. The policy will apply to students enrolled from January 1 this year and is designed to attract an estimated 850 additional doctors and nurse practitioners to hard-to-staff areas. In the AFR, the education editor stated this initiative to encourage graduate medicos to go bush is unlikely to achieve its aims. She went on to say experts believe is unlikely to succeed. Dozens of attempts over the past 40 years to influence student course choice by lowering tuition fees have largely failed.

I would agree.

I was involved directly in the national establishment of university departments of rural health, rural clinical schools, regional university medical schools (James Cook University and later Deakin) and in Victoria the Murray to Mountains Program directed at training interns totally in rural areas of Victoria. All were successful, at the time I retired to join the ranks of the aged and infirm. So, what the hell is going on.

Money is one incentive, but not in isolation.

The problem with attracting doctors to rural practice is that it is not about money, it is about providing the right non-monetary incentives and from the latest initiatives, it looks as though the Government has learnt nothing.

I have seen what does not work. It is somewhat depressing when you devise policies that have been shown to work and you see in your retirement 20 years later the policy jesters and theory purveyors without field experience write their formulaic repetition of what does not work, and which I discarded long ago.

One of the initiatives that did not work was providing funding to retain doctors in the country, just as bursary systems don’t work if there are no linked career prospects. The idea that you dragoon recent graduates to work in the country for two years is not only bad policy it is damaging to medical practice across Australia.

My view, which was vindicated, was that if you present an opportunity for medical students to train in rural areas, not just a brief “holiday” visit, but a full-time living and learning experience with committed staff co-ordinated by a director of clinical training, good outcomes are achieved. The student is in effect being socialised into rural practice. It has been said that if one grows up in the country, one is liable to go back there for a career – as long as your memories are positive. When the rural clinical schools were first funded, there was considerable resistance until those who went through the program found they both enjoyed themselves and learnt the important skills to enable a doctor to resuscitate a patient and look after that patient until they are transferred, get better under your watch or die – all up significant clinical experience.

The problem with training in the rural areas is that it is completely foreign to most of the deans of medicine and their ilk who have grown up on a diet of research with an elitist view of teaching hospital training as the only legitimate pathway. To them, training in the country is second class. These people unfortunately have the ear of government because research laboratories are embroidered with toys to suck in the politicians who have no idea of what they are seeing but are glitzy. Medical education should be primarily about developing the majority of students to work as medical practitioners from the day they graduate, not research scientists. Rural clinical schools were funded independently from the Department of Health not Education to protect the funding from being “skimmed” by the universities for administrative costs.

As I have written extensively, certain matters must be satisfied for rural practice to succeed, and the overall assumption is that time as a rural general practitioner should be around five years. Social dislocation, professional isolation, community tolerance and over all succession planning. In explanation, social dislocation recognises that one’s partner needs to be accommodated and, in the longer term, factor in the education of the offspring. Professional isolation recognises that single person practice without a backup program is undesirable. Community tolerance means that in a rural community one sacrifices the anonymity of the big city and the level of social acceptance not only by the community at large but also by fellow professionals is essential for a good experience.

The simple fact is there is need for a system that can provide long term solution; succession planning is an integral part of the policy.

The Murray to the Mountains Intern Training Program showed clearly that by the end of the intern year, the doctors were capable of independent practice, able to handle emergencies and having had the benefit of an ongoing comprehensive professional development program – organised for maximum attendance of the interns and where feedback was actively encouraged. The appointment of a Director of Clinical Training able to co-ordinate the professional education component and provide a degree of pastoral care is important. For a successful program, dumping young doctors in rural areas of which they know little is doomed to failure. Then there will be the cohort who seek exemption or release from the program, often by way of legal action, and the program will be quietly dumped without fanfare.

This is a precis. As I have said, mine is the perspective of somebody who spent 30 years involved in rural health policy development, not flying a desk in Canberra but working in the field, and seeing what worked. Needless to say, I had my fair share of unproductive policy cul-de-sacs.

From an economist’s point of view, Richard Holden has been reported as saying “Writing off student debt for doctors who practice in the bush is an unfair and inefficient use of taxpayer dollars that amounts to bus drivers subsidising wealthy kids to get medical degrees.” Professor Holden went on to say that the decision to wipe out student debt for doctors and highly trained nurses was inefficient, unfair and would shift the cost of educating rich kids who become doctors onto the working poor.

Students from rich families tend to be over-represented in medical programs because of the established link between wealth and academic performance, particularly on the Australian Tertiary Academic Rank. They also can pay off HECS and thus exchange of compulsory rural placement is not much of an incentive.

As further reported in the AFR, Andrew Norton, a higher education policy expert from Australian National University, said the repayment of debt would turn into a bureaucratic nightmare as the Australian Taxation Office and education departments try to sort out the debts of about 850 graduates if the target is reached. The US-based think tank, The Brookings Institute, recently described student loan forgiveness as “regressive whether measured by income, education or wealth. Student debt is concentrated among high-wealth households and loan forgiveness is regressive whether measured by income, educational attainment or wealth.” That position was backed up by a recent Productivity Commission report. The October report was disdainful of free places in TAFEs and universities, saying such policies come at a huge cost to taxpayers, which is largely borne by people who don’t directly benefit from them.

Overall, dreadful policy, which will go nowhere – but who will ever say so?

Who do you think you are?

Halima Begum, director of Runnymede, a race equality think tank, said: “The courtier in question was born in the 1930s and is the product of a time and place defined by British imperialism. However, this does not excuse racism, whether or not it occurs inside the king’s London home.”

As background, Begum has been the boss of this Trust since 2020, itself set up in 1968. She represents “the organisation across national and international forums and has led major research, development and policy programmes spanning education, equality, human rights, public health, the environment and post-conflict reconstruction”. It is best for it to wallow in its self-defined worthiness. Great Britain is the home to so many of these worthy organisations.

There is something vaguely offensive in her italicised statement heading the article. I suppose because I am nearly 83, I find some woman who runs one of those worthy organisations dismissing us as the product of own time, as though that has any particular meaning, patronising. I was born into a Commonwealth Dominion that may have been defined by British imperialism, even though we followed Great Britain into a destructive WW11. In fact, looking at her background enmeshed in Bengali heritage with a tough early life to understand, I suppose I should cut her some slack, but reading it slowly suggests some degree of the very thing she has committed herself to eliminate – racism.

Yet, the object of this contumely is an easy target. Lady Susan Hussey, the aggressive confidant of the late Queen, served as her enforcer. I just imagine the late Queen asking her to deal with “those difficult hussies” and then her unappreciated way of dealing with Princess Diana and more recently the Duchess of Sussex. Once her patron was gone, then it was only a matter of time before Lady Hussey with all her hoar frost would follow. The exchange with an equally aggressive black woman with an African themed persona who took umbrage at being asked where she was from, certainly made the most of the exchange

Unfortunately, one could deduce from this report that all people born in 1930s should shut up and drink their cocoa. One of the ways I have always learnt is to ask people about themselves. After all, that is what makes you interesting. The taxi driver from Bangladesh is amazed that I even know where Bangladesh is and then tells me he comes from a hilly area there and dispels in my mind that the country is totally deltaic and floats around in the Bay of Bengal. He tells me about his family, but before he can produce the family photos, we have reached home – and I have learnt about a middle-aged man who I’ll probably never see again – but I was enriched by the conversation.

Perhaps Lady Hussey looking at the Ms Fulani expressed herself insensitively, but then if I pranced into a garden party dressed as a harlequin in a fur coat and Roman galea and an 83 year old woman asked where I was really from, then perhaps I might understand if she repeated the question, confused by my heterogeneous garb. But as reported, seven times! I think not.

In any event, the nobility knows when the execution block beckons, and this fifth daughter of the 12^th Earl Waldegrave descended from the union of James 11 and his mistress, Arabella Churchill has played the game and stepped down. I’m sure the crocodile tears have been mopped up.

Ngozi Fulani, born Marlene Headley, has a scalp in Lady Hussey and publicity for her charity – for the moment. “Ngozi” is “skin” in Swahili, the lingua franca of the East Africans, but Fulani are a West African people. As I wrote above, a heterogeneous lady. I just hope that these publicity hounds don’t use the elderly, less able to cope, as targets for confected outrage. One problem is having written the above I’m likely to find Nigel Farage on the same side as myself.

Mouse Whisper

Since it is round ball and hands off time, some majestic trivia:

King Charles is a Burnley supporter. Camilla undisclosed, possibly Plumpton Athletic.

His mother, clue is the only team she ever hosted at Buck House was Arsenal. His father – rumour hath it he supported Leeds.

Prince William very Aston Villa, whereas wife Kate supports Chelsea. Prince Harry is Arsenal. Duchess of Sussex? Not stated.

And Princess Diana? Philadelphia Eagles.

Modest Expectations – Aryamann Tandon

This maybe my last reference to the woman who has been background activity throughout my life. I have not watched any episodes of The Crown. To me, it is difficult to have lived a life without her intruding upon it, and I don’t need another’s interpretation. Hence the views contained in this blog.

I am an information omnivore with a photographic memory for trivial facts; I was at lunch yesterday and at it there was a bloke with whom I had been friendly at school. He recalled that I could recite every book of the Old Testament. Today, we agreed we would be hard pressed to go beyond the Book of Ruth.

Yet here was a person, under the cover of the “Royalty Tag”, who had structured her movements by the use of her handbag and her political opinion by the brooches she wore. These non-verbal communications may be the tip of huge tumulus of royal communications known to very few but enabling the Queen, even in death, to move seamlessly without having to give voice to any political opinions. Her brooches and other adornments could identify likes and dislikes. This was a life so scripted that even “times of spontaneity” were inked into the daily routine. The detailed code has not been published – as yet.

Nevertheless, if the leaking pen is any indication, non-verbal communication may not survive under King Charles III.

As a corollary of our mutual recollections on the pavement outside the lunching venue, I reminded him of the time he was driving home with his wife. I was in the back seat with my then wife. She had warned me that my friend was drunk, but with myself having a haze of alcohol casting a generous interpretation on his condition, we all got into the car.

Less than a kilometre on, we had just topped the hill, and there was a tram coming up the other side, its lights blazing, and the driver urgently ringing his bell. It did not seem to affect my erstwhile friend until the last second when he tried to avoid the tram, but to no avail. The tram struck us.

We were fortunate. We were struck almost at the terminus and as a result the tram was slowing down. Otherwise, who knows. Miraculously we were all uninjured; the driver’s wife gave him a dressing down – and up as well.

We did not stick around. There was a taxi passing which fortunately was empty. I remember looking up the newspaper the next day. There was nothing reported, and as we did not see them again, the question of accepting another lift never occurred.

Her Last Hurrah

The British do funerals extraordinarily well, and probably her funeral was the last and most telling of Queen Elizabeth’s non-verbal communication. The reasonable assumption is that she involved herself in the overall planning of this – even that, given the length of her reign, funeral arrangements would have to be updated regularly, especially with such a huge group of actors. The turnover of naval ratings drawing the gun carriage must have been just one example.

The fact that it was so meticulous, a “professionalism” showed when compared to that of her father’s and grandfather’s, confirms that this woman had a keen eye for detail.

Her father’s and grandfather’s coffins were taken to Windsor from Paddington by train, and the railway station is about a four-minute walk from Windsor Castle. Elizabeth preferred the motor hearse. Following the hearse along the Long Walk is a five kilometre forty minutes walk. Added to the three kilometres they had to walk behind the catafalque in London, she ensured that her children and grandchildren had a pleasant Monday walk of about eight kilometres; stiff armed with small steps which, in spite of the solemnity of the occasion, it was very reminiscent of a group of toy soldiers. Both Andrew and Harry had to walk the walk in mufti.

Her funeral had a distinctly Scottish flavour, with her Scottish bodyguard – the Royal Company of Archers – being very prominent. Scanning the two previous funerals, I could not detect them, at least not in a prominent place.

And the funeral procession itself dispensed with the gaggle of European royals and heads of State, who were ensconced in the Abbey without the obligation to walk.

At the funeral for George V and VI, there was only one service and that was at St George Chapel at Windsor Castle. In fact, the last time prior to Elizabeth II that Westminster Abbey was used for a Royal funeral was George II in 1760. This recent production thus provided a prime television venue at the Abbey, and then the smaller service at Windsor. In part this enabled the Heads of State to go straight to the Abbey and not provide a distraction, which would have occurred if they had marched. It was a two-part tableau.

At her father’s funeral, Elizabeth travelled in a carriage while the Dukes of Edinburgh, Gloucester, Windsor and Kent walked behind the gun carriage. The Queen had travelled with her mother and sister and the Princess Royal, cloaked in black with black veils covering their faces and heads. Looking at these shapeless figures, it is no wonder the Queen determined that when she died, the female royals would be clearly visible and not subjected to wearing “widders weeds”.

Yes, four billion people participated in this last great complex example of the late Queen’s non-verbal communication.

St Paul

I named my first son Paul. I am not a Biblical scholar, but St Paul always appealed to me because of his forthright personality. The King James version of the Bible demonstrates his eloquence in exhorting the early Christian Church to stay strong and true to a religion founded on the death and ascension of Jesus Christ about 25 years before. In fact I have read the letters he wrote to all and sundry.

Paul recognised that he had a limited time on this planet too. After all, his eloquent farewell in his second letter to Timothy attested to this: “I have fought the good fight, I have finished the race, I have kept the faith.” The rest of the letter is telling his followers what they had to do in regard to his unfinished business.

At the Queen’s funeral was Paul’s defiance in writing to the Corinthians – “O death where is thy sting? O grave where is thy victory?” (I unapologetically use the King James’ version.)

Yet his most famous exhortation was also in his writing to the Corinthians:

When I was a child I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things.

For now we see through a glass darkly; but then face to face: now I know in part; but then shall I know even as also I am known.

And now abideth faith, hope, charity, these three; but the greatest of these is charity.

It was not on the Queen’s list of favourite Pauline aphorisms, perhaps by his use of “man” rather than “adult”. St Paul was undoubtedly authoritarian in the way he ordered all and sundry to do the right thing. St Paul was big on obedience, and hence the accusation of misogyny is understandable; given his view of women, St Paul seemed at times to be a “pain in the arse”, and yet he was a brave, resolute person, just what the early Church needed.

After all, as its text the anthem at the funeral took an excerpt of Paul’s letter to the Romans which advocates an indissoluble bond between the believer and “the love of Christ.”

Prime Minister Truss, in the second reading, also quoted from Paul’s letter to the Romans:

“None of us lives for himself, and no one dies for himself: for if we live, we live for the Lord, and if we die, we die for the Lord. And so in life and in death we belong to the Lord. For this is why Christ died and came back to life, that he might reign over the dead and the living.

Like everything this meticulous woman did, the Queen inserted St Paul’s views strategically throughout her funeral service. To have the Prime Minister read these words shows how far the Pauline instruction has drifted from the actual way Prime Ministers conduct their lives. The Queen could have anticipated Boris uttering and choking on these words.

Further, perhaps the Queen felt that St Paul very much reflected her husband’s forceful independent streak. Perhaps not; but we shall never know. She would not have left any note. That was not her way.

Komedy Korner?

I repeat this report in the Washington Post, without comment except to say I hope America can identify madness early enough as Germany did not. More prosaically, if it does not work don’t do it again. Ergo, consign Trump to the political dustbin of history.

Former president Donald Trump has set up his office on the second floor of his Mar-a-Lago estate in Florida as part replica of the Oval Office and part homage to his time in the real White House.

On the wall during a visit last year were six favourite photographs, including ones with Queen Elizabeth II and Kim Jong Un. On display were Challenge coins, a plaque commemorating his border wall, and a portrait of the former president fashioned out of bullet casings, a present from Jair Bolsonaro, the so-called Trump of Brazil.

This has become Trump’s fortress in exile and his war room, the headquarters for the wide-ranging and rapidly escalating conflict with investigators that has come to consume his post presidency. It is a multifront war, with battlefields in New York, Georgia, and the nation’s capital, featuring a shifting roster of lawyers and a blizzard of allegations of wrongdoing that are hard to keep straight.

Look! Well? Feel! Well?

It is time to examine the evidence behind the medicines flogged on television by the entrepots, which specialise in the modern equivalent of snake oil.

Perhaps I do snake oil a disservice. Made from the oil of the Chinese water snake, which is rich in the omega-3 acids that help reduce inflammation, snake oil in its original form is alleged to have been effective, especially when used to treat arthritis and bursitis. The workers would rub the oil on their joints after a long hard day at work. The story goes that the Chinese workers began sharing the oil with some American counterparts, who marvelled at its effects.

From then the descent into chicanery commenced and one American, Clark Stanley, for no scientific reason substituted rattlesnake (the water snake being unavailable). Rattlesnake oil anecdotally was far less effective, and then in a further descent, Stanley’s Snake Oil was shown not to contain any snake oil at all. It was found that it primarily contained mineral oil, a fatty oil believed to be beef fat, red pepper and turpentine.

At least the American investigators as far back as the turn of the 20^th century had charted a pathway, and the judgement printed below is salutary reading.

Not that for one moment am I suggesting that the tonic and tinctures being flogged by these modern drug entrepots are all derived from heirs of the Oil of Water snake.

What is remarkable about these advertisements however is that first everybody pictured in these advertisements seems so very healthy. Yet we have the spectacle of basically young people with occasionally the obligatory child waltzing along a line of drugs with a shopping basket for God’s sake. How many pills, tablets or capsules are those depicted taking daily? In other areas of public policy, governments rail against the overuse and misuse of drugs. And yet here is its flagrant advocacy.

It is the very essence of the polypharmacy drug culture uplifted out of the gutter into some ambrosia-filled suburb of tree-lined streets. The people in these advertisement images are the last people who need any dietary supplements.

Now what are these spruikers, who seem to be bright, healthy and blonde women telling us to buy. There are the vitamins. In our society, there are more than enough vitamins in a normal diet not to need any supplementation. Having said that, I have developed a habit of taking vitamin D daily. This was due to a controversial measurement which tended to underestimate the level of vitamin D in the body. It has become a habit. As the Lancet opined “For those who ‘believe’, the lack of benefit found in most trials completed thus far can be attributed to issues including inadequate supplementation, testing of a population not sufficiently vitamin D deficient at baseline, incorrect formulation, underpowering, or insufficient follow-up.

However, the spruikers do not say what vitamins actually do, apart from inane slogans; or for that matter, what the next lines of placebos – the magnesiums, the zincs, the seleniums and other inorganic compounds. Obviously iron supplements are part of the treatment for anaemia, but not to be consumed as a spruiked lolly known as a “chew”.

Then there are the organic compounds – as they say, herbs, and spruikers are active here too. I must admit when a well-regarded doctor told me to take krill oil some time in mid 2013, when I had been progressively feeling something was wrong, I did; nothing changed. I just got worse.

In the end, I was diagnosed and placed on prescription drugs, which worked. I do not object to people taking anything which has been classified as herbal, as long it is not toxic. Herbs included in food are different from those sold as medicine. For instance, I do use two remedies – ginger tea for an ageing genito-urinary system and honey for a persistent cough. Each has some evidence of efficacy. Yet I like honey on my toast, and pickled ginger is a necessary condiment for sashimi.

Pharmacy has always built walls to protect its monopoly, which has also demonstrated the power of the pharmacy profession. I well remember when pharmacies were the only place one could purchase toothpaste – Ipana. However, it did not stop pharmacies from retailing not only the range of medicines which quacked but other goods. For instance, body hygiene and the “hypo-allergenic remedies” was equivalent to perfumes and cosmetics. It was only about 20 years ago, that some pharmacies still stocked tobacco products.

The drug warehouse is just an extension of using the screen of the pharmacist monopoly provisions to peddle all sorts of claims for their remedies, often with no or little evidence of their collective efficacy.

The Review into Pharmacy Regulation and Remuneration in 2018 stated the following, which was broadly supported by the Federal Government.

Community pharmacists are encouraged to: a) display complementary medicines for sale in a separate area where customers can easily access a pharmacist for appropriate advice on their selection and use; and b) provide appropriate information to consumers on the extent of, or limitations to, the evidence of efficacy of complementary medicines. This could be achieved through the provision of appropriate signage within the pharmacy (in the area in which these products are sold), directing consumers to ‘ask the pharmacist for advice’ if required.

Judging by the way these products are being marketed, the above recommendation arising from the school of personal responsibility or lack of same, broadly falls within the rubric of “laissez-faire”.

The problem with the Therapeutic Drug Administration (TGA) is to know what does it do; and more to the point why is whatever it does done so slowly. How can such a government authority watch such blatantly dubious advertising as is occurring on media outlets and allow it to go unchecked. Since the above recommendation by the Review ignores any suggestion of it being a TGA responsibility to ensure its implementation being policed, why not just yawn, roll over and go back to sleep.

Arryn Siposs

Now hands up if you have heard of Arryn Siposs. Well, he played 28 games with St Kilda, being delisted in 2015. However, as he was a prodigious kick, he decided to go off to America and try his hand (or rather his foot) at American football. He went through the College football grind at Auburn University in Alabama. He then had a difficulty, not unsurprisingly, in getting a place in the AFL or NFL, being on the fringe for a number of years before nesting with the Philadelphia Eagles. Even then he is the guy who holds the ball for the kicker.

Then, the other day, his time came, playing against the Minnesota Vikings. He was holding the ball when the kicker kicked the ball into the opposing team, and it rebounded. Immediately one of the Vikings corner backs raced away and picked up the ball for an apparently certain touchdown against the play.

Siposs, who had to give the corner back more than a few metres, ran him down and saved that touchdown embarrassment. His speed in picking up the player and tackling him, when one of his fellow Eagles failed and given he grabbed the ball carrier in less than 20 yards drew the attention of all the networks.

Siposs is very much one of the lesser lights, being on a contract of about $US850.000 for this year.

His remuneration very much fades when compared with two of his compatriot kickers, Mitch Wisnowsky (San Francisco 49ers) and Michael Dickson (Seattle Seahawks). Wishnowsky is reported to have signed a four-year extension recently worth $US13 million ($A19.3m) while Dickson is in the second year of a four-year extension of his own, worth about $US14.7m ($A22m).

Dickson is reportedly the highest paid punter in the league, while Wishnowsky’s new deal sees him move to seventh or eighth ranked and inside the top five highest paid Aussie players of all-time. Wishnowsky from Perth and Dickson from Sydney both played Australian Rules but at a far lower level than Siposs achieved. They went through the Melbourne-based Prokick program before being affiliated with colleges in Utah and Texas. Their careers, which commenced about the same time as that of Siposs, have been of a totally different trajectory.

Yet Siposs still has his Australian accent.

Mouse Whisper

So much written recently about the Cats – that Geelong Australian Rules football team which won the 2022 Australian Football League Premiership. On and on… I am just sick of all this adulation for a group of muscular leather chasers dressed up in blue and white. One former Cat once even changed his name to “Whiskas” for a week.

I tried to find out if any sporting team called themselves The Mice. A good robust name implying speed and resilience. But unfortunately not; not even the Rats. Elsewhere the Shrews are the nickname for Shrewsbury Town, a third tier League Club in England; but Shrews are insectivores; different tribe.

Modest Expectations – Marcus Aurelius

How depressing to see the Prime Minster spending “quality time” with Lachlan Murdoch, at a time when Murdoch is trying to bully the newsletter publisher, Crikey into submission. The description of Crikey as a minnow is to underestimate its clout and the intention of Eric Beecher to confront what he perceives as the malign influence of the Murdochs.

It is important to place Beecher in context, and while his own bio is scant, this quote from the Public Interest Journalism Initiative provides a summary of his early achievements. Beecher started in newspapers as a journalist on The Age in Melbourne and later worked at The Sunday Times and The Observer in London and The Washington Post in the US. In 1984, at age 33, he became the youngest-ever editor of the Sydney Morning Herald and in 1987 was appointed Editor-in-Chief of the Herald and Weekly Times newspaper group.

He has spent a large part of his later life as the pamphleteer, railing against the privileged plutocracy, which has grown under cover of globalisation and the so-called information revolution. He has explored alliances with other writers with a like attitude.

Lachlan Murdoch is targeting him in the defamation jurisdiction on Earth most sympathetic to the complainant – namely NSW. Nevertheless, Beecher has taken the decision after initially retracting the offending comment to challenge the Murdoch Empire of “alternative facts”. As Beecher has commented, any morality in journalism has been sacrificed in the pursuit of financial profit, and Murdoch, once the supporter of Whitlam and the Republic, has given over to a son without any connection to Australia, apart from a father who has long deserted his citizenship, again in the pursuit of profit.

Thus, it is tedious to see the Prime Minister giving the Murdochs the normal vassal symbolism of going cap in hand to them. When will they learn? Remember, Rudd was entrapped by a Murdoch operative in a New York strip club. Prime Minister, have you forgotten the disgusting behaviour of Murdoch in Great Britain, where yon Rupert almost apologised by closing down the “News of the World”? But then it was the other son James in the firing line, rather than Lachlan.

I’m not surprised that Marles joined in the pilgrimage to Compostela de St Rupert, given his common Geelong Grammar School heritage with Rupert. Marles, as with Murdoch, had an elderly father, and both his parents were high achievers. So, both “slumming” in a working class electorate and rubbing shoulder with the establishment is a recurrent behavioural pattern among some of the Victorian Labor party private school elite.

But really, Penny Wong! Or were you just practising dealing with some of the unsavoury types lurking around the world in some of the foreign affairs portfolios?

Presumably to demonstrate neutrality in the ongoing stoush, the Prime Minister should visit Crikey and break bread with Eric Beecher and his crew in a less plush setting but in keeping with his electorate’s wish.

Finally, yes, we have contributed to Crikey’s defence.

St Kilda

I have been reading about St Kilda.

Not the beach suburb of Melbourne, although I must admit that I was surprised of an association; I’ll come back to this later.

St Kilda was a few rocks stranded in the Northern Atlantic Ocean about 60 km from the Outer Hebrides and where, for centuries, a small group of hardy settlers subsisted. Until the nineteenth century, they lived a very isolated existence with the occasional ship calling carrying salt, iron and timber for which they traded cows, sheep, feathers and grain.

It was a hard life, living in such a state without money, where the whole population gathered as their local council, with strict observance of the Sabbath with Christianity interwoven with pagan practices, where the infant death rate was greater than 50 per cent because of neonatal tetanus, which is terrifyingly described.

The islanders raised sheep and cattle and grew some crops, barley and potatoes. They did not fish, but rather raided the bird nests which were clustered in the steep cliffs which ringed the islands.

The largest and inhabited island was Hirta and thus the inhabitants were more commonly called Hirtans rather than Kildans. The link with Melbourne is that some of the islanders apparently found their way to Melbourne. St Kilda beach in Melbourne may have sea birds on its sands, but that was the only similarity. The immigrants would have missed their roasted puffin, but surely cooking a puffin reminds one of the old recipes about cooking a galah with a stone.

Collecting eggs and birds from the cliff face was a Hirtan skill, which even to today’s rock climbers would have presented a challenge, as the ropes they used were very rudimentary, with much jollification while this hazardous operation was happening.

In the nineteenth century, St Kilda became a tourist spot, even though landing on the island presented problems, especially when the weather was bad. There was a post office where postcards could be stamped. Photographs of the islanders became popular. Paradoxically, the standard of living rose, as shown in contemporary photographs of the improvement in the housing, but the attrition of a population, now exposed to the mainland “delights” increasingly losing their previous self-sufficiency, accelerated.

The final paragraph of the description of the Hirtans in Shadowlands is evocative. By 1930, the population was reduced to 36.

“…in the dying days of August 1930, the final postcard was sent. Its message, from a tourist called Freda, said, just “Last Greetings from St Kilda.” Then the post office was shut forever. The final service was held in the church and bowed by sorrow, the islanders rounded up their dogs, those indomitable hunters and guardians, tied weights around their necks, placed them in sacks, and dropped them from the pier, looking sorrowfully on as the yelping bundles sank beneath the waves. They returned to their houses and waited for HMS Harebell.

And up on the stacks of Boreray, from their nests in the cliffs, the birds rejoiced.”

It is an example of the problem of civilisation intruding on a community which has achieved a fragile ecological balance and then, over time, from being endangered they are rendered extinct. Our forefathers characterised the Australian Aboriginal people as remnants of the Stone Age whereas they had developed a very complex hunter/gatherer society, but unlike the Hirtans they had a far bigger canvas upon which to work. Nevertheless, what have we learnt from the Hirtans, especially as with the Australian Aboriginals, there was no written language – not even an ogham?

Same Old Rubbish?

I have been a supporter of the Essendon Football Club for most of my life. It was because of the Doust family, who lived on the corner; and then after WWII they went back to Britain, leaving me with a black and red scarf. We lived nowhere near Essendon, and so it was quite a trip across the city to watch them play. The Victorian Football League (VFL) then was essentially composed of inner suburbs extending west and north. The only team in the eastern suburbs was Hawthorn, and when I was small, its team was a “basket case”.

Essendon did not conform to the original teams when in 1897 the VFL was formed. Essendon was not an inner working class suburb. Yet Australian Rules was essentially a working person’s game, despite having a posh beginning as a game between an Anglican and a Presbyterian private school.

Many of the clubs were both Irish and Roman Catholic, none more so than Collingwood in the era when John Wren virtually owned the club. Essendon was not Roman Catholic – far from it. But the nuances of this history were lost on one small boy, even the fact that Essendon once played their games in East Melbourne where the railway yards now stand and they were nicknamed “the Same Old”.

By the time I became a supporter, the team was located at Windy Hill, high on the hill in Essendon where the gales blew. In winter it was a place for the frozen spectator, even rugged up and with the obligatory Thermos in hand; and because the suburb Essendon had become the location of Melbourne’s airport, the football club adopted the nickname of the “Bombers” in 1940.

It was a different time with the VFL progenitor, Victorian Football Association (VFA), having many of its teams in the eastern, south-eastern and southern Clubs still active. Oakleigh, nicknamed the Devils even though they wore gold and purple colours, just down the road was my club, but I was never as addicted to Oakleigh in the same way as I was to Essendon.

This long introduction is to say that most of my life has been consumed in my support of Essendon, even at one time being a paid-up Essendonian. However, that changed when the game became an exercise in keepings-off and Essendon relinquished its Windy Hill home.

Sport at the top level is now a moneyed game driven by TV rights. There is also a stadium fetish, to ensure that the pampered few are spared the rigours of winter with access to glass boxes awash with alcohol. The players from teenage years are moved around as well-paid commodities without, in most cases, any deep-seated loyalties. After all, being doled out in a draft means that these players are separated from their hearth and home. And that gnaws away at the special nature of the Game loyalties.

Curiously, the game is reverting to the original game where there seemed to be limitless players, running on and off in a blur, to maintain the momentum of the game, keepings off, scragging; little men in yellow running around making arbitrary decisions so they can keep up with a game, which is driven by the manic desire of those who run the game to make it faster and faster. The only difference between the original game in 1958, which perhaps should be introduced, is running among the gum trees in Yarra Park and the length of the playing arena when rules as today were arbitrary or non-existent – and of course the little yellow officials.

However, there is a veneer of corporate civilisation. As somebody wrote about the Essendon worship of bright and shiny baubles “Walking up the concrete steps, Essendon’s headquarters feels like a corporation. The generic nature of the massive building continues inside where it becomes immediately clear the home of this historically great football club – which has not been anywhere near great since it moved to Tullamarine – has no heart.

That is my problem – once a fanatical supporter who imparted the same spirit to my sons and then they to most of the grandchildren. But then only one of these six was alive – just – when Essendon won its last premiership in 2000. My heart has gone – I no longer care.

Maybe a flicker of nostalgia when I read about Michael Hurley’s complete loyalty to the club. (pictured)

The AFL has a heritage round, but what is meant by heritage? True heritage would be playing twenty a side – eighteen on the field with two emergencies, which came on as replacements and were not interchangeable. Yet that rule only operated from 1946 until 1978 when the interchange rule was introduced. The longest time the rules of the game have not been changed was nine years between 1877 and 1886. Now, there is more year-to-year fiddling with the rules than in a Bullamakanka bush band.

Then see how the spectators would enjoy it. The grounds are more uniform than in the past. When playing at Hawthorn, you were on a compressed ground wedged against the railway lines – and with the right conditions the full back kicking out, if accurate enough, could kick a goal at the other. I repeat “if the conditions were right”. Oh, for the suburban grounds that had character.

Now, what an exercise in sterility, but the AFL is now politically correct. Gillon McLachlan, scion of the South Australian Establishment, you have left your legacy – you have pasteurised the game behind pay walls. Well done.

What the Butler saw

The Strengthening Medicare Taskforce is bringing together Australia’s health policy leaders. The diverse membership has been drawn from across the health professions, and includes consumer, rural and regional and Aboriginal and Torres Strait Islander representatives.

The Taskforce will work to deliver concrete results through its recommendations, including:

Improved patient access to general practice, including after-hours.
Improved patient access to GP-led multidisciplinary team care, including nursing and allied health.
Greater patient affordability.
Better management of ongoing health conditions including chronic conditions.
Decreased pressure on hospitals.

Here we go again. The Same Old!

Mark Butler, a lawyer and union official prior to being elected to Parliament, under Rudd had an exposure to matters relating to Health, in various parliamentary secretary and ministerial positions between 2009 and 2013. He had been Shadow Minister for Health since January 2021

Unlike another South Australian, Neil Blewett, who maintained continuity in the portfolio whether in Opposition or Government to became one of the best Ministers of Health, when the Labor Party went into Opposition, Butler was handed the shadow environmental portfolio by the then Opposition Leader, Bill Shorten. The Health shadow portfolio was passed to Catherine King. After the 2019 election, the shadow Health Ministry was held by Chris Bowen, until it was passed back to Mark Butler. The Health portfolio seems to have been in the “pass the parcel” category among the Labor gentry.

One of the prerequisites for the Health portfolio incumbent is that unless one learns the language of Health, it condemns you to being at the whim of translators. Blewett as a linguist was fluent in Health, and he also had a bunch of public servants who had served in health matters for a considerable period, and while they were not necessarily health professionals, they were more or less fluent in Health. Guys like Alan Bansemer and Bernie MacKay.

A 17 member committee is doomed to failure as anything but a megaphone, given that allows every member an average of 3.5 minutes an hour to speak. Also the bigger the Committee the more unwieldly, although technology allows for everybody not to be in same room for a meeting; however, that introduces the trickiness of the membership being in isolated cells, without any meaningful interaction. But maybe that is a deliberate ploy. I have faced public service running interference and have dealt with it mostly – without winning any popularity polls.

Scanning the list of Butler’s Committee, the only one with any decent corporate memory is Stephen Duckett; like all of us who have been in the health sector for as long or, in my case, longer than him we have our own set of biases. Duckett sure has his, and his bias against private practice is well-known. He is sure to raise salaried practice and capitation as alternatives; but Medicare has served Australia well, even under conservative governments where it is always allowed to decay. Added to this the central agencies hate uncapped programs as Medicare has been.

My problem with the medical representation is that each is there because they have been elected as distinguished members of one of the many tribes of medical graduates, not as experts in health economics and policy. To them, reforming the health system is not a full time pursuit, but a task force gives them all the opportunity to whinge, and in a couple of years these office holders are gone.

The only medical graduate on the committee, a former President of the AMA with some experience of the vicissitudes of Medicare, is Hambleton. He does not fill me with any confidence because once when I asked why the AMA had ceased being deeply involved in establishing doctor’s incomes, he seemed confused about the value of the bilateral Medicare Enquiries between the AMA and the Federal Government last held in 1984.

Looking down the list it seems that the aim is to include every player in the provision of primary care and a wish list of aims without any means of achieving it. Thus presumably, the Department will prepare a series of working papers – a variation on the Jenny Macklin National Health Strategy Initiative where she was asked to review Australia’s existing system, which produced a series of discussion papers of varying quality. That task force was disbanded in 1993, without any discernible effect on the health system. My involvement goes back to listening to Gough Whitlam expounding on health reform in 1969 at the time of the Nimmo inquiry, when the genius of John Deeble and, to a lesser extent, Dick Scotton provided the intellectual capital for both Medibank and Medicare.

The crux of the primary care problem is that despite all the talk about professions working together, it just does not happen spontaneously. I am a patient in a very good general practice, with very competent medical and nursing staff. They have their tasks and they don’t spend their time in formal training in how to get along. As a patient, I want to be able to converse with my general practitioner and yet realise I have a limited time to do so. Yet despite its caring profile, this long term traditional suburban general practice has been absorbed into the corporate world, and if it were not profitable, you could bet your bottom dollar that this world would not be there. This presents a bit of a paradox. Substantial investment on the one hand; crying poor on the other.

The other variable is general practices now closing off appointments for new patients, which effectively caps throughput. Given that Medicare is uncapped – and the rule of thumb is to maximum daily limits for doctor – namely seeing 80 patients a day for 20 days a year or 30 telehealth consultations for the same period a year, otherwise any more will attract a reference to the Professional Services Review Committee. That is the only comment on optimal throughput – two extreme positions. The Committee should address optimal throughput.

Given that the public has been used to bulk billing in general practice, I can now ask a question: “What is general practice?” and then ask, “what is the most cost-effective way to deliver general practice?”

My premise is that general practice is heterogeneous. Yet it conforms to certain rules. For instance, at least three doctors are required if the practice provides a 24-hour service. Yet how many practices exist as standalone services providing such a service? In rural areas in the small towns such a service is problematic, but general practitioners there do have a local hospital to back them up. I have no idea what the “urgent centre” proposed by NSW and Victoria is; and where does the staff come from – Mongolia?

In any question of general practice, one must ask the question of what level of coverage by general practice yields the most effective return. The fact that the so-called 24 hours clinic or general practice attached to urban hospitals has not become standard suggests this is a work pattern unacceptable to the majority of the general practice workforce, notwithstanding that its income is underwritten by government.

From a question of what is general practice, and the most cost effective organisation of same, then it becomes a cost accounting exercise. The best cost accounting depends on ensuring that all the assumptions underpinning the process are clear. There are times when approximations will be made; and it is the test of any good cost accountant to know when to approximate. After all, if one waits for a complete census of any population when 90 per cent will provide a useful approximation and if the information can be obtained in a reasonable time, then delays are avoided that otherwise can render the data of limited use.

The problem is that the advice provided by cost accounting is ignored by government, because it is often inconvenient. We once showed that the most effective radiation oncology practice was one based on three linear accelerators at any one site. What happened was the States bent to political pressure and scattered one machine facilities across its jurisdiction; as well as being uneconomic, these facilities had difficulty maintaining staff.

In the end, once the true costs are known, then it can be discussed what should be the professional cost of the practice, the expected income of the general practitioner, which is subsidised through fee for Medicare benefit and what can be gained by additional charges that the patient has to find. This figure is complicated by the corporatisation of general practice. After all, general practitioners can charge what they believe is fair and reasonable. What does their corporate boss want to charge?

The Federal government provides a patient benefit not a doctor’s fee. The patient benefit is constitutionally valid; but setting fees is not. The Australian voters in the 1973 referendum rejected Federal control on prices and income.

And there you are. Answers are gained, and the 17 member committee can deal in facts adorned by assumption rather than opinion warped by bias and, I hesitate to say, “enlightened self interest”.

Where fantasy meets reality

In the Boston Globe, Stephanie Ebert runs a regular opinion piece chronicling what is happening due to the Supreme Court ruling, overturning Roe v Wade. This is her latest update I’ve edited hopefully without affecting the original content.

The consequences of withholding reproductive choice were expressed in stark and varied terms, by a Republican state legislator in South Carolina, by voters in New York, by political pundits balling up their midterm predictions, and by HBO viewers shocked by the premiere of the “Game of Thrones” prequel “House of the Dragon.”

But before we get to Westeros, let’s stop in the Palmetto State (South Carolina), where a Republican state lawmaker’s abortion regret clearly struck a chord.

Rep. Neal Collins told an emotional story about the real-life fallout of the “Foetal Heartbeat Bill” he had supported, which prevented a 19-year-old whose water broke at 15 weeks from terminating a pregnancy that was not viable. She was sent home from the hospital with a greater than 50 percent chance of losing her uterus, he said, and a 10 percent chance of developing sepsis and dying.

“That weighs on me. I voted for that bill,” Collins said in a video clip that circulated on social media. “These are affecting people.”

The clip was picked up by CNN Politics, where commentator and former Trump aide Alyssa Farah Griffin said that in some states, the GOP was going too far with abortion restrictions.

“This very extreme position will backfire on Republicans — not having exceptions for rape, incest and life of the mother — and I absolutely think we need to course-correct,” she said.

That’s the view of many political observers who are rewriting their predicted narratives for the midterm elections since voters began having their say at actual ballot boxes. A special election victory by Congressional candidate Pat Ryan — a New York Democrat who campaigned on abortion rights after the Supreme Court struck down Roe v. Wade — is a sign that Democrats are now more competitive in the midterms than anticipated.

Anger over the abortion ruling is translating into new voter registration and could fuel a pushback at the ballot box, several new analyses suggested.

Tom Bonier, CEO of the political data firm TargetSmart, dug deep into Ohio voter registration and reported that women out-registered men by an 11 percentage-point margin since the Supreme Court’s Dobbs decision on June 24 — a huge change from the 2018 midterms.

Bonier documented the surge of women who registered to vote in Kansas after the leak of the Supreme Court’s draft ruling in early May before Kansans voted overwhelmingly to preserve abortion rights in the state’s first-in-the-nation referendum on the issue.

Not to be outdone, the New York Times’ The Upshot examined new voter registration in 10 states and found the number of women registering to vote rose by about 35 percent after the decision was leaked, while men had an uptick of 9 percent.

Meanwhile, abortion bans have taken effect in 12 states. But in one of those, Idaho, the Justice Department prevailed in a legal challenge that partially blocked criminal prosecution of doctors who perform abortions. A federal judge agreed with the Justice Department that Idaho’s abortion ban conflicts with the federal Emergency Medical Treatment and Labor Act, which requires hospitals that receive federal funding to provide treatment in medical emergencies.

In Texas, the decision was the exact opposite. A federal judge agreed with Attorney General Ken Paxton that the state can’t be compelled by the federal government to save a pregnant woman’s life with an abortion.

In other news

Once vulnerable, N.H. Senator Maggie Hassan is suddenly benefiting from abortion ruling, other Democratic breaks – The Boston Globe.

Google, criticized for steering those search for abortion to anti-abortion crisis pregnancy centres, takes steps toward clarity – Bloomberg

The aforementioned HBO series “House of the Dragon,” which requires both trigger and spoiler alerts for a brutal childbirth scene that was upsetting to many women.

Still, one of the showrunners told the L.A. Times that the women consulted during production offered positive feedback. “Some felt it wasn’t violent enough,” he said.

Was it gratuitous – as was often said about its patriarchal forebear “Game of Thrones?” Was it transparent in its intentions, like a latter-season “Handmaid’s Tale”? I was surprised to discover it was written and filmed well before the Supreme Court ruling.

Mouse whisper

Appalling taste. According to The Economist, there are those Brits who are promoting Larry the Cat as the next British Prime Minister. Extraordinary how the Brits have embraced this serial murine killer. But then Larry has had to deal with Boris Knotgudonov, who has tried to portray himself as a cool cat, but turned out to be an appalling mouser.