That had to be the most spectacularly stupid argument I had ever heard. An accident is what happens when someone is cleaning a loaded gun and it goes off; it is what happens when people drink too much when they are hunting and shoot their hunting partner by mistake. By definition an accident means that you are doing a normally non-fatal activity and something goes seriously wrong (either predictably or unpredictably). Walking into a liquor store with a weapon does not come under that definition. Had Navtej Singh had a loaded gun under his counter and blown Chan-Kee away with it, would the police have arrested Singh because Chan-Kee thought that the weapon wasn’t loaded and therefore attempted to assault Mr. Singh? (Note: the answer to this rhetorical question should be “no”. But, with New Zealand’s politically correct police, who knows?)

The defense was attempting to delve into Mr. Chan-Kee motives for shooting Navtej Singh. It was attempting to suggest the the shooting was unintentional. Unfortunately, the law does not insist on intention before convicting of murder. For a good illustration of this, look no further than the shooting of little Jhia Te Tua. If ever there was a death that was unintentional and accidental, it was Jhia’s. None of the three convicted of her murder intended her death. Yet they now rot in prison for her murder. Because their every action before and after the shooting spoke of their original murderous intention. The same can easily be said of Chan-Kee.

While it is vaguely conceivable that he may have been stupid enough not to check his weapon before pulling the trigger, it is certain that he did not attempt to help Singh in any way after the initial gunshot. Indeed, he hung around the shop waiting for his mates to return from the car almost as if nothing had happened, so any attempt to paint his lack of care for Mr. Singh as a panic reaction is dubious in the extreme. Certainly the Jury thought so.

I confess, I am surprised that Chan-Kee has been found guilty of murder, but his mates have not been found guilty of being accessories to murder. I would have thought there was little doubt that they were accessories considering not one of them attempted to aid Singh, nor did they call an ambulance, nor did they report to the police. I have always thought the maxim of the law is qui tacet consentire – he who is silent gives consent. They did nothing and said nothing about a killing they most assuredly knew about – they were, therefore, aiding and abetting a murderer. Bailey Kurariki went to jail at a very tender age for not a lot more than that.

But for real excuses and hypocrisy, look no further than Manukau City councillor Daniel Newman who pontificates about Singh’s liqour store thus:

“Mr Singh’s death is a tragedy for which the entire community grieves. There is no excuse that can possibly justify the behaviour Anitelea Chan-Kee or his associates.

“But the store where Mr Singh was murdered is also an establishment that is strongly opposed by a large number of Randwick Park residents. That opposition has remained steadfast for as long as the store has been selling alcohol, because residents fear the wider social cost associated with small suburban liquor outlets trading in residential communities.”

Mr Newman said alcohol purchased at the Riverton Drive outlet was consumed by young people who ended up drunk in local parks, who brawled in the streets and in people’s front yards, and who ended up committing violent acts against innocent residents.”

Ah, yes, silly of me not to see it. Navtej Singh was partly responsible for his own death because his liquor store is destroying the morals of the youth of Randwick Park.

What a load of moralising, politically correct garbage.

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2. Persecuting Victims
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The Royal College of Pathologists of Australasia had come in to assess areas of concern, the health board itself had instigated intensive monitoring and there had been a “radical reduction” in complaints about the service, both from the public and the clinical community.

“We’ve seen a very high reduction in error rates in the delivery of the service, we’ve seen positions that were temporarily filled being filled on a permanent basis at levels of competence we are satisfied with.”

While the article cited rumbles on about confidence and trust taking a long time to be restored, the truth is that most GPs are already growing accustomed to Labtests’ different way of doing things and the more egregious errors have all but disappeared. Unless Labtests stuff up in some major way, in a year the muttering of doctors will have died to nothing. By the time of the next contract negotiation, the medical fraternity will be calling for the DHBs not to change everything again, saying that they are “happy with Labtests excellent service etc”.

Frankly, the whole laboratory debacle was inherently predictable. It was always highly unlikely that Labtests was going to be able to manage a “cold start” from scratch without major teething problems. The best that could be hoped for would be that they did not seriously harm or kill anyone. Thankfully they managed this. No doctors were harmed in the making of this new laboratory and only a few patients were significantly inconvenienced.

For a major change of laboratories, that’s pretty good. For a major change of labs where the old lab is not going gracefully, your major clients are already disgruntled before you start, you don’t actually have all the people you wanted AND the contractor has reduced the service offered in the contract – it is nothing short of a miracle. It is my understanding that nothing like this has been attempted before anywhere in the world.

This will probably be the one and only time.

It was also very predictable that the new lab would eventually get itself together and produce a halfway decent service. With things now running smoothly, it is amusing how the vociferous CEO of DML is now silent.

Long may that last.

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My colleagues working in the area I was in in 2007 say that it has become more difficult for them as well, but I suspect much of the problem lies with the hopelessly understaffed (with doctors, not bureaucrats) Waitemata DHB (they of closed Waitakere Hospital ED fame). So far they have refused to see patients with mostly surgical problems which are not life-threatening (but are very debilitating). None of these were frivolous referrals and all need to see someone other than yours truly.

The aspect of this that really worries me is that these refusals are apparently done on the basis of obscure point-scoring systems that are assessed by lay people (or, possibly, junior doctors) without anyone beside myself ever seeing the patient in person. This means that they are completely reliant on my referral letter to contain all the information that they need. Unfortunately, at no point have they bothered to tell anyone what information they are looking for and their default position is to give the lowest score if the information is not there. This means that many referrals are very under scored and falsely rejected.

It is clear to me that this system is utterly hopeless. What needs to happen is that the scoring needs to be put into the hands of GPs – after all, it is the GP who the only doctor who has seen the patient. The score sheet and the referral should then be faxed to the hospital and the appointment booked the next working day for an appointment within the acceptable time frame for that score. The only reason why appointments are not made this way is because DHBs do not trust GPs to be honest in their assessments. The dysfunctional relationships between GPs and DHBs is longstanding and has not been improved by the DHB model, or the PHO one.

Under no circumstances should first specialist appointments be rationed. This appointment is the gateway into the rest of the hospital. If a first appointment is not made, I have no alternative but to tell my patients to try the emergency department (as this is the only other gateway available). Unfortunately, to get past the ED nurses (who often send chronic problems straight back to the GP), my patients have to wait until they experience a deterioration in their condition, which is about as far from ideal management as you can get. Suddenly a simple elective procedure becomes a major problem. People should not have to be dying to get into the hospital system.

This is a direct consequence of socialised medicine and it is why I get ratty when someone makes the silly comment “but at least even the poorest of us can get treatment” as a justification for it. No they can’t. Unless they have an acute illness or a potentially life or limb threatening problem, the uninsured amongst us are often denied treatment in the name of “triage” or “resources” or “points”. What is usually not explicitly stated is that this is simply rationing and that the poor, as usual, bear the brunt of it.

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The actual amount spent by candidates on an election is not relevant. Despite Labour’s longtime gripe over election spending limits (and Len is the Labour candidate), no-one has ever demonstrated that the amount spent on an election has any real bearing on the number of votes received. The Green’s billboard campaign in 2008, and National’s campaign in 2005, were well designed – that is why they were effective. It had precious little to do with the amount of money involved.

Having said that, if Len Brown is proposing to spend only $150,000 on a campaign that is supposed to influence 1.4 million people, it tends to suggest that perhaps he is not very serious about standing for mayor.

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Why is it that, every time  Tony Ryall says anything about health funding, the effect of the change is either minimised, if positive, or greatly exaggerated, if negative?

Health cuts loom as Govt refocuses spending

District health board chiefs are bracing themselves to make deep cuts to their services next year after receiving Government indications their funding will slip.

Papers for an Auckland District Health Board committee meeting yesterday suggested it might have to cut as much as 5 to 10 per cent from its spending.

As usual, the DHBs are starting to position themselves for the next round of funding from government. As usual, they make dire pronouncements about the drastic cuts to services they are going to have to make if their funding is reduced. As usual, the media swallows this ploy hook, line and sinker.  Now the real story:

Health Minister Tony Ryall has widely signalled in speeches that because of the recession, the sector – although in line for an increase in next year’s Budget – will receive much less than the $750 million boost it got this year. Health is receiving more than $12 billion this year. [emphasis mine]

Ryall has said that the boost in funding will not be as big as the $750 million given this year. There is no cut – just less of a boost. It is possible that this boost will be less than inflation meaning a drop in real terms. But as inflation is currently 1.7% this would mean an increase of less than $204 million to be under the rate of inflation. This is possible, but not very likely. And Auckland DHB are planning for $75-150 million less (5-10%). Somewhere there is a very, very large disconnect.

Now the MacDoctor worked out that Auckland DHB were just scaremongering and proved it in less than 5 minutes. Yet the “journalist” in question just repeated the nonsense without thought, preferring to spam. Which is better than many of the left wing blogs who are commenting extensively on this garbage as if it were a solid fact.

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