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81
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by LP -
You have one disadvantaged group whose health outcomes are improved because of this policy, and other advantaged groups whose health outcomes are the same as a result of this policy.
I don't think anyone is genuinely disadvantaged, but I also fear the reason for the change is not really a reason at all!

If we first subset the health study by alcoholics, then subset the alcoholics by ethnicity, we will see biases appear but they aren't or may not be genuine biases as they are created by the selection of categories. If you remove the alcoholism from the figures and present the remaining data you have manufactured a bias that appears social or racist.

However, it could be argued if you swiftly promote someone to admission who you cannot yet begin treating, you will potentially be consuming a bed waiting for the opportunity to treat. In this case maybe someone is disadvantaged, but at the bare minimum you have created waste and inefficiency.

I would think in a resource stretched system the case for the "good of the many" suggests greater throughput.

I could be even more cynical, and suggest administrators see this as a way of getting increased funding, they need more resources to maintain or improvement treatment levels in the face of a "systematic bias"! ;) The Admins certainly know politicians won't make decisions that negatively impact their constituency.
83
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by LP -
LP, you know that I worked in Indigenous affairs for over 30 years and that's not how the system works.  For a start, what "Federal benefits" would they be claiming?  With some exceptions, like Abstudy, Indigenous Australians access the same Centrelink payments as everyone else.  Skimming Centrelink payments wouldn't be a very lucrative form of blackmail.

In my experience, the mob is very quick to expose anyone who falsely claims to be Indigenous.  For example, see Michael Mansell's rejection of Bruce Pascoe's claim of Tasmanian Aboriginal ancestry: https://tasmaniantimes.com/2020/01/bruce-pascoe-is-not-aboriginal/
Yes, I understand all this, and I do not want to hijack this debate. My point is more about the elimination of subjectivity in the assessment, not whether or not it is actually needed.

If St Vincent's were making indigenous wait 3 times longer because they're indigenous then they should be shut down.
On the specific issue, like the St Vincent's study, there are stats and then there are damn stats and lies, which feeds back into my doubts. You can take the numbers and make them say whatever you want through flexible categorisation or cherry-picking categories that paint a picture towards your desired conclusion.

For example, I was made aware was one of the key reasons for waiting for treatment in general is alcohol abuse preventing immediate treatment. So if you have a small subset that is categorised differently because of the choice of category they will show up strongly despite there being no embedded systematic discrimination. The root of the problem is then not really the system, but the social driver that causes alcoholism. So if the group you analyse has a higher percentage representation in terms of presenting under the influence of alcohol they will show up strongly.

Alcohol is a great example because some ethic groups present with a greater percentage allergic to alcohol, if you analyse treatments that delayed or denied due to alcohol allergy, without listing the alcohol allergy as a cause, the numbers will show up as Asians being discriminated against.

Like most stats, the problems are not the numbers, but how the numbers get interpreted, the conclusions drawn and the politics. The sad thing is that the politicians and media know this, they just choose not to communicate it because clear explanations do not rate.
85
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by Thryleon -
st Vincent's is not solely in the NT.

So are we saying they dont want to wait like the rest of us are forced to?

Did you miss “First Nations patients were also waiting, on average, three times longer compared to non-Indigenous patients.”?
I didnt miss this claim.  In fact there is no way to substantiate that and its precisely what someone defending this move would say irrespective of whether or not its fair.

Thing is, why is that the case?  Why are they waiting longer?  Is it because the data is skewed by hospitals in areas where there is more indigenous people being treated than not? 

More questions than answers out of the claim.  So by doing this in metro hospitals they treat the minority as priority to paper over not enough health care institutions in remote communities where the majority of indigenous patients presents skewing the data?

Is that the right outcome? Or more manipulation of the books to satisfy criteria?

Ultimately i dont know how anyone can defend a policy where an ethnic group is treated differently to others for right or wrong reasons. Sounds like they cant be bothered fixing the real reasons the issue exists and are papering over the cracks to me.
86
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by DJC -


Mate, they die younger, they live sicker lives.
Come up and visit me and you’ll see that 40-70% of the NT mob are wrapped in filthy bandages despite the medical professions best efforts.
We are not discussing intelligent well educated and articulate people like say Ernie Dingo here, we are discussing the downtrodden.
If you and he presented simultaneously you would both recieve the same treatment as (relatively) young fit healthy men, of this I have no doubt.
Certainly so here in the Territory.

st Vincent's is not solely in the NT.

So are we saying they dont want to wait like the rest of us are forced to?

Did you miss “First Nations patients were also waiting, on average, three times longer compared to non-Indigenous patients.”?
87
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by Thryleon -
this is not affirmative action.

If i walk in to this ED and an indigenous bloke walkS in, both with category 4 classification, EXACT SAME ISSUE, he goes first because he's indigenous even though I was triaged before him.  He gets upgraded to category 3.

Effectively they're fast tracked based on race.  Seems fair....

Mate, they die younger, they live sicker lives.
Come up and visit me and you’ll see that 40-70% of the NT mob are wrapped in filthy bandages despite the medical professions best efforts.
We are not discussing intelligent well educated and articulate people like say Ernie Dingo here, we are discussing the downtrodden.
If you and he presented simultaneously you would both recieve the same treatment as (relatively) young fit healthy men, of this I have no doubt.
Certainly so here in the Territory.

st Vincent's is not solely in the NT.

So are we saying they dont want to wait like the rest of us are forced to?

89
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by northernblue -
Let's hear from St Vincents:

"Hi everyone, Many of you will be aware of media coverage over the last few days related to our Emergency Department (ED) and our efforts to deliver fairer health outcomes for First Nations patients. I wanted to share a brief message with you to explain what we’re doing and why. Across almost every indicator, First Nations Australians experience worse health outcomes than non-Indigenous Australians. Research conducted in St Vincent’s Melbourne’s ED showed First Nations patients were three times more likely to leave without being seen than non-Indigenous patients. First Nations patients were also waiting, on average, three times longer compared to non-Indigenous patients. But our research also showed that First Nations patients were more likely to remain engaged with their care if seen within their first hour in the ED. We’ve been working to address this issue for many years, but in April 2024, we took a new approach and implemented what’s known as a Minimum Category Three Triage policy. The idea is straightforward: in an ED, patients assigned as being ‘Category Three’ receive medical assessment and start their treatment within 30 minutes of arrival. Under our policy, we now assign a minimum Category 3 to all First Nations patients so that they begin their treatment promptly and to minimise the risk of disengagement and poorer health outcomes.

The results have been outstanding. Since introduction, we have successfully closed the gap in ED wait times between First Nations and non-Indigenous patients. While there is still much work to do, that is something to celebrate. Let me be very clear about what this approach does not do… It has not affected overall wait times in the ED. Analysis of our approach – which concerns only a small number of First Nations patients in the ED each day – shows it has had no impact on overall ED flow. Patients presenting with a serious or life-threatening emergency – regardless of their background – will always be seen first. That's what ED triage is designed to do. We can do both. We’ve arranged our resources and processes so that the small number of First Nations patients in our ED don’t have their care delayed for longer than 30 minutes, while also making sure that the most urgent cases are still seen as a priority. We've closed the gap between two groups without negatively affecting either. This is what good healthcare looks like. The St Vincent’s mission has always been about helping people who face barriers to accessing quality healthcare. That’s who we are. It’s what defines us. And it’s core to this approach. I’m proud of what we’ve been able to achieve. I’m proud of our Aboriginal Health Liaison Team, our Emergency Department team, and all our staff who continue to show leadership through initiatives like this. While there has been much said over the past few days, please know that we will continue to advocate for what is right and for evidence-based healthcare. And if you’ve found the last few days upsetting, please approach your manager, colleagues, or our EAP service should you need assistance.

Kind regards, Nicole"

Evidence-based healthcare that has closed the gap between two groups without negatively affecting either?  That's got to be grounds for racist outrage!



I’m triggered… 🙄
90
Blah-Blah Bar / Re: Shawny’s concerns about Victorian and Australian Governments
Last post by DJC -
Let's hear from St Vincents:

"Hi everyone, Many of you will be aware of media coverage over the last few days related to our Emergency Department (ED) and our efforts to deliver fairer health outcomes for First Nations patients. I wanted to share a brief message with you to explain what we’re doing and why. Across almost every indicator, First Nations Australians experience worse health outcomes than non-Indigenous Australians. Research conducted in St Vincent’s Melbourne’s ED showed First Nations patients were three times more likely to leave without being seen than non-Indigenous patients. First Nations patients were also waiting, on average, three times longer compared to non-Indigenous patients. But our research also showed that First Nations patients were more likely to remain engaged with their care if seen within their first hour in the ED. We’ve been working to address this issue for many years, but in April 2024, we took a new approach and implemented what’s known as a Minimum Category Three Triage policy. The idea is straightforward: in an ED, patients assigned as being ‘Category Three’ receive medical assessment and start their treatment within 30 minutes of arrival. Under our policy, we now assign a minimum Category 3 to all First Nations patients so that they begin their treatment promptly and to minimise the risk of disengagement and poorer health outcomes.

The results have been outstanding. Since introduction, we have successfully closed the gap in ED wait times between First Nations and non-Indigenous patients. While there is still much work to do, that is something to celebrate. Let me be very clear about what this approach does not do… It has not affected overall wait times in the ED. Analysis of our approach – which concerns only a small number of First Nations patients in the ED each day – shows it has had no impact on overall ED flow. Patients presenting with a serious or life-threatening emergency – regardless of their background – will always be seen first. That's what ED triage is designed to do. We can do both. We’ve arranged our resources and processes so that the small number of First Nations patients in our ED don’t have their care delayed for longer than 30 minutes, while also making sure that the most urgent cases are still seen as a priority. We've closed the gap between two groups without negatively affecting either. This is what good healthcare looks like. The St Vincent’s mission has always been about helping people who face barriers to accessing quality healthcare. That’s who we are. It’s what defines us. And it’s core to this approach. I’m proud of what we’ve been able to achieve. I’m proud of our Aboriginal Health Liaison Team, our Emergency Department team, and all our staff who continue to show leadership through initiatives like this. While there has been much said over the past few days, please know that we will continue to advocate for what is right and for evidence-based healthcare. And if you’ve found the last few days upsetting, please approach your manager, colleagues, or our EAP service should you need assistance.

Kind regards, Nicole"

Evidence-based healthcare that has closed the gap between two groups without negatively affecting either?  That's got to be grounds for racist outrage!