Good Democracy needs Strong Media: What impact the Fairfax sackings?

Yesterday, Fairfax Media, the publishers of some of the oldest, most respected newspapers in Australia announced it would radically downsize and move its prime business on-line. More video, Lateline and a detailed timeline.

"The Fourth Estate" is a fundamental to strong Democracy - in Economics terms, it (notionally) provides "full/perfect information" for the Market. It's how the Public become informed of Things That Matter.

I posit that the "Golden Age" of Democracy of the 20th Century co-incided with a strong newspaper, newsreel and later "electronic media" culture:

• there is strong public demand for "information" coupled with a willingness to pay.
• "Fresh" news and stories are a competitive advantage: News 'Scoops' made money.
• Strong competition amongst providers for "fresh news" funded a lot of technology, a lot of research and stimulus to "look under every rock".
• Under this pressure, the News Cycle shrank from weeks, to days, to hours and minutes. Twitter with its 'news cycle of seconds' may be the end-game.

Media companies had a sound Business Model for around 100 years because they filled a fundamental human need: curiosity and concern.
They had worked out a great way to place a tax on that, far better than just paying for 'a' paper: advertising.

But is this Value Proposition of "Fresh News" dissolving in the New Media?

Newspapers used to be "News", i.e. the facts of {Who, What, Where, When, How and if known, Why}, not "Opinion" - the stuff that I'm writing.

After the Vietnam War, TV took over the immediate delivery of "News", as in "What's New(s)?".

Newspaper couldn't 'break' fresh stories because TV would always beat them with the 6PM or 10Pm bulletins, unless stories were non-obvious and required unusual research.

Newspapers found new niches with Opinion, Analysis and Entertainment and Informing (vs 'News' of delivering new facts).

Woodward and Bernstein's "Watergate" investigation happened precisely because:

• Post Vietnam, TV had taken over as "where Fresh Stories break" forcing the paper to "dig deeper" for stories,
• the Washington Post had the resources and editorial judgement and nerve to fund the research and publish the results "without fear or favour",
• "sources" respected the paper and its journalists enough to speak, with an implied contract that they'd be treated fairly and respectfully and their identity would be protected if needed, and
• the public trusted the facts were real, correct and checked, and trusted that any fraud, confabulation or misrepresentation would be outed and all those responsible would "suffer consequences".

The Washington Post had an owner that was interested and engaged, and would back their Editors and Journalists. The people on the coal-face trusted they would be defended if they told the truth and acted in Good Faith.

What evolved with News reporting was a delivery pipeline with well-known "rendezvous points", Trust, Respect, and "Reputation" that took decades to build and a moment to destroy, and diversity with competition.

Who kept the Media Honest? Their competitors!

Who prevented complacency, sloppiness and indolence? Their competitors!

And the Media, "the Fourth Estate", with its insatiable appetite for News and Fact, kept those in positions of power and trust, Politicians and Business leaders, accountable.

For a hundred years, the public could (mostly) trust what the papers said and trust them to hold those in power accountable on their behalf.

Without a vibrant, competitive and highly professional News Reporting disciple, this half of the democratic system dissolves...

In a Democracy, the citizenry has a duty to care, to actively maintain their Rights and hold those in positions of power to account. We're not going to see riots in the streets over this, it seems like an inevitable, and minor, business failure or restructure.

But what can and will replace a strong, free Press?

The Internet does Change Everything, but where's the business model that will fund good News Reporting? None has yet to emerge, and after ~15 years of "The InterWebs", if it was going to appear, it should be apparent.

Censorship in 300 words or less. What's up at Fairfax?

[Post moved to other blog.]

An article in the Fairfax media entitled "Homeopathy | Alternative Medicine | Ian Gawler" drew my attention. I went to the effort of registering and making a comment. It didn't appear, having been "moderated", presumably breaking the Fairfax Rules for Commenting on articles and blogs :-

... any comments that can be reasonably considered offensive, threatening or obscene will not be allowed.

• Do not post material that may incite violence or hatred.
• Gratuitous abuse - be it of the author, subjects of the story or other commentators - will not be accepted.
• Please keep your comments relevant to the discussion at hand.
• Do not use the comments section for commercial purposes or spam.

Herewith my comment and the original article... [See full post]

Friends of Science in Medicine: Hypocritical call to action

[Post moved to other blog.]

Update: 17-Jul-2012: There is now considerable blowback from the Medical Community towards Dwyer and his "little Friends". The MJA [Medical Journal of Australia, behind a paywall] of 16-Jul had multiple articles on this topic.

From a report on the Editorial and associated articles.

Professor Stephen Myers, SCU [Southern Cross University]:

“the real benefit of an appropriately mentored and approved university education is the exposure of students to the biomedical sciences, epidemiology and population health, differential diagnosis, safe
practice and critical appraisal."

Professor Paul Komesaroff, Monash University, on MacLennan's MJA in editorial in March-2012:

“exceed the boundaries of reasoned debate and risk compromising the values that FSM claims to support”.

Professor Komesaroff:

"while there was now an extensive evidence base in relation to complementary therapies, the concept of evidence-based medicine was highly contested and debated within Western medicine itself." 

"It is not appropriate for doctors or scientists with a particular view of medicine to impose those views on the whole community; rather, they should respect the rights of individuals to choose the approach to health care they feel is suitable for them." 

“It is important that those who seek to be friends of science do not inadvertently become its enemies. We call on the members of FSM to revise their tactics and instead support open, respectful dialogue in the great spirit and tradition of science itself”

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In writing an inadvertently long piece on the Irrelevance of Marron and Dwyer's "Friends of Science in Medicine", I had to reflect on what what a convincing "short version" would be. Here's an attempt:

• Dwyer, as a respected and long-serving medico, has to be aware of the estimated 18-35,000 preventable deaths in Australian Hospitals each and every year. [1995 QAHCS report, disputed.]
• He must also be aware of the lack of good data on Adverse Events (AE) and Iatrogenic Injuries.
• Similarly, the extra $2B/year estimated additional cost of treating AE's in hospitals.
• He should also be aware of Dr Brent James reports (2001) from Intermountain Health, Utah, that only "3.5% (of patient injuries) resulted because of a human error" and from the APSF report on Iatrogenic Injuries (2001)  "The causes of iatrogenic injury appear to be systemic".
• There is also a 2004 report on the effects and additional preventable deaths from overcrowding in Accident and Emergency. 

All of which could be used to suggest by Dwyer and friends:

Australian Medicine and Hospitals do very well in the face of insurmountable odds and lack of Political will and funding. [A justification used by AMA President Rosanna Capolingua in 2008, below.]

Only it isn't so...

Compare the complete lack of an Evidence Base for Patient Outcomes for Australians and any coherent, credible, co-ordinated plan to address this with the UK's Civil Aviation Authority's current Safety Plan. 

Secondly, Dr Brent James reported a 20% reduction in costs by reducing Patient Injuries through a "Do it Right, First Time" approach to Quality. This corresponds with the 2002 results from Ehsani, Jackson and Duckett. As Berwick suggests, organisational change is required to address systemic issues. Unless the system is changed, results won't change.

The CAA's Safety Plan [excerpted below] conspicuously shares a feature unknown in Australian Medical literature and seemingly in Hospital improvement plans: The Most Important Problems List.

The CAA has its "Significant Seven" and Dr James his "Bg Six List".
These seem unknown and unreported in Australian Hospitals and Health Department Plans and Operations.

Where this line of reasoning leads to:

After 50 years of large jet aircraft being used in Commercial Aviation, 'we' know exactly what has to be done to economically achieve good, reliable and safe Public Services, so why isn't this approach being advocated and adopted by Medicos and Hospitals?

From Dr. James, we also know that it is cheaper to fix systemic issues through a "Get it Right First Time" Quality approach, so after more than a decade of being known in Australia is this not being done?

How many "Adverse Events" are there in the Australian Hospital system? We don't know.
But the best evidence available is that they are not reducing. [below]
The most conservative estimates, "Sentinel Events", counts around 270 adverse events/year.
The QAHCS report estimated 18,000, the difference being direct, provable causality.
While the Australian Doctors Fund (ADF) would like us to use the American UTCOS report figure of 3.3 times less, of ~5,500 per year.

From Dr. James definitive work, the number of patient injuries is around 30 times the number of Adverse Events reported, reasonably 165,000 per year.

So why isn't Prof. Dwyer advocating and campaigning for the Medical Profession in Australia to adopt known, effective Evidence-Based Systems for itself preventing thousands of deaths, eliminating hundreds of thousands of injuries and reducing needless waste, rather than what appears to be a distracting side-show of "look at all those Bad Guys over there!".

This is the nub of his hypocrisy: Everyone else is doing it wrong, but we are beyond reproach.

Rudd versus Gillard: Everyone loses.

A copy of a letter I sent today to my local ALP senator.

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Dear Senator,

Not sure if you care what one of your constituents thinks about your internal party matters, but here goes.

Julia Gillard is, IMO:

• a competent legislator,
• a good administrator, and
• outstanding at achieving 'meeting of minds'
• negotiating with many competing parties,
• with conflicting aims and differing agendas, and
• hence achieving legislative aims in a hung parliament.

Her record of accomplishment in the actual business of government is, again, very good, doubly so in that it's a hung parliament. Not 'revolutionary' like Whitlam and his many reforms, not 'breakthrough' like Keating floating the dollar (because we aren't in those times), but solid important stuff that matters now and matters for the future - balancing the budget, creating the next century's infrastructure and improving our intellectual competency and competitiveness.

So what's wrong that she doesn't have the 60-70% voter approval rating that she should have??

There is a serious disconnect between what Gillard does and her perceived performance in the electorate. It's worth at least 30-40% in her approval rating, IMO.

I have no idea why this is so. My best guess is that it is somehow related to the advisers around her in the PMO.
 [PMO = Prime Ministers Office, her personal unit staffed by her vs Dept. of Prime Minister and Cabinet, a normal Public Service Agency]

Howard had Arthur Sinodinos and together they made a formidable team, unbeatable for a decade. Proving the point that Great Leaders have Great Teams around them. But that's speculation on my part.

What Gillard is experiencing (approval vs performance gap) seems to me to be the political equivalent of business' "glass ceiling".

Women work incredibly hard, are exceptionally competent and do very good work but regularly get overlooked for promotion by their managers. I've personally worked with a number of mid-level Managers in the Public Service who've been trapped this way, but never were any of them men.

This can't be blamed solely on bias, nor solely on "Men do this to us".
Part of the effect, at least, has to be something in the way that Women approach work and promotion. A side-effect of this is that Women Entrepreneurs coming from this group are hugely successful in the plethora of small businesses they create.

There's such a weight of evidence about this 'overlooked for promotion' effect that I'm surprised it hasn't been studied extensively and that 'remediation' courses/training aren't available for it.

None of which might help Ms Gillard right now :-(

But this is my attempt at explaining why one of our most competent and apparently most broadly knowledgeable and informed political leaders isn't getting due recognition from her 'employers', the electorate.

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Rudd:
Plays well to the public and sprouts lots of great sounding stuff.
Unfortunately, has proven to have very limited ability to 'execute'.

Or to sell difficult decisions.

After 3-4 attempts to get up Carbon pricing legislation, he quite rightly said, "enough time wasted on this now, we'll  defer it until after the next election when we should have better upper house numbers".

If he'd been up against Nelson or Turnbull (whom I'd call 'reasonable men'), that would've been the end of the matter...

But Abbot creamed Rudd, and easily so, quickly bringing him down.

Abbot has beaten two Labor leaders - Rudd lost office and Gillard didn't win the unloseable election.
But Abbot doesn't understand there's a difference between beating an opponent and winning over them.

A Rudd vs Abbot election will be another debacle for the ALP.
As would currently, a Gillard vs Abbot election.

---

I talk to my friends, most of whom like me have been voting since Whitlam or before and cover a spectrum of political persuasions, and we all would like to vote "None of the Above" if the next election is between Abbot and either Rudd or Gillard.

The consensus is: "Not ALP, not Liberal, Not Greens, but WHO?"

And many wish we could vote for Independents as gutsy as Windsor and Oakeshott, or a little less wild-eyed than Wilke. Katter is just plain crazy, but so one-eyed pro-QLD his electorate must love him.

---

If I was in your shoes, I wouldn't know which potential Leader could get the ALP over the line at the next election - at least not against Abbot.

Gillard doesn't sell herself well enough to the electorate and has been kicking far too many 'own goals' recently, and Rudd is like week old fish, flashy but well past its Use By.

Crean was leader for a time, but the "Anyone But Crean" sentiment is still strong.

There are many other fine people serving in Parliament who, in time, might make outstanding leaders - but anyone contesting and deposing  an incumbent ALP Prime Minister for the second time, no matter how good or well respected, will be hated by the electorate, just for the act.

If the ALP was in Opposition, this would all be moot. We, the electors, expect there to be jockeying amongst the contenders for 'a shot at the title' (to use a boxing analogy, appropriate for Abbot).

But the electorate, wrongly, presume "we vote for the Prime Minister", as I saw stated in a voxpop last night.
That's a direct outcome of Australian political parties succumbing to the 'Presidential style' of campaigning and government.
We aren't the USA...

While a single, strong 'all-powerful' leader is an easier sell to the electorate, this situation we find ourselves in is its inevitable conclusion.

Why are all these unpleasant stories and opinions about Rudd and his poor performance/personality only coming out only now? Why not when they were happening?

Because the Parliamentary wing of the ALP collectively and consciously created and maintained the fiction of "one good all-powerful leader", possibly telling itself that "Disunity is Death" (the flip-side of "Workers, United, can never be Defeated").

Being caught out in "the Big Lie" is also "political Death".  The electorate are just finding out about being sold "the Big Lie" and are NOT at all happy about it.

As Richo said, "Politicians Lie" (that's what they are forced to do by our Political and Media System).
We, the electorate know that, but don't expect/condone such monumental constructs, hence the massive rebound effect.

You'd think that the way to cut this Gordian Knot is for Gillard, not Rudd, to revert to Radical Honesty.

There'd be an immediate backlash for sure, but it would completely destabilise and confuse Abbot.
And given time, might win over a bunch of the disenchanted electorate.

It also needs Open, Honest, Transparent comment/opinion from inside the rest of the Cabinet and potentially the Caucus.

There's a time for a rigidly controlled, disciplined "single message", and perhaps a time for close-to-genuine Honesty.

For evidence, I offer Bob Hawke. A hard-drinking womanising larakin if ever there was one, that we still applaud because he can scoff down a beer faster than most.
He was forgiven these indiscretions by the public because he announced them, unlike the damaging backroom succession deal with Keating, or the unfulfilled Howard/Costello agreement, reported to the public by others.

If the Liberal party can get behind a good Leader, someone besides Abbot who thinks constant whining is a strategy, before the next election then the ALP, if it doesn't do something very different, could well be in the wilderness for another generation.

But I don't expect changes like that in Politics, just like I don't expect a fuchsia Airborne porcine division to swing by here. [A squadron of Pink Flying Pigs]

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All the best in whatever happens.

regards
steve jenkin

--
Steve Jenkin, Info Tech, Systems and Design Specialist.
0412 786 915 (+61 412 786 915)
PO Box 48, Kippax ACT 2615, AUSTRALIA

stevej098@gmail.com http://members.tip.net.au/~sjenkin