Tony came to social work later in life. It gave him a sense of purpose that had previously been missing. After volunteering at Lifeline, he began studying social work and developed a passion for  therapeutic work. Studying social work changed his values profoundly. He got a job counselling gamblers and began to understand the the interplay of social forces that created the preconditions for addiction, depression, anxiety, child abuse and domestic violence.

As he developed his knowledge and skills he began to work more creatively and wholistically with a range of NGO’s, including confronting men around violence and abusive behaviour.

In the course of his practice he became very concerned about punitive practices in child protection which he felt did not uphold human dignity, or work for the best interests of children. This led him to systemic advocacy work in an effort to correct these abuses.

Our conversation explores the causes of child abuse and the effectiveness of prevention policies. We tease out some important questions. How much power or influence does the state have in preventing child abuse? When things go wrong, what is the balance between blaming individual workers versus cultures and systems? How much responsibility do we have to call out unethical practices in institutions? Given the truckloads of investigations, reports, and commissions that point to remedies to improve child protection, why do we see so little change?

For more information on the Child Protection Party- check out their website.

I have joined many of my fellow citizens in paying less and less attention to the daily news. Political chat shows are also off my agenda. There is simply no substantial discussion of any of the things that I care about. The casual visitor from another planet might conclude from our media that things are going ok – and so its business as usual. Shark attacks, drug busts, murders, robberies and weddings.

We hear little or nothing about climate change, the Murray Darling basin, the Great Barrier Reef, the health, dignity and prosperity for our first peoples, the gross inadequacy of the dole and other welfare payments, the lack of investment in primary health care or mental health, the epidemics of obesity, anxiety, depression, and loneliness, the root causes of domestic violence and child abuse, racism and sexism, unfettered gambling and pay day lending, social media monopolies, the explosion of personal debt, the stagnation or decline in real wages, the lack equal pay for all, and the precarious hand to mouth existence for the younger generation- with no security in jobs or housing.

Both major parties are largely in agreement on their policies on all of the above. They confect and inflate minor differences, marketing themselves  like two brands of soap powder colored slightly differently.

Enter the Greens who actually are talking about a better world -and are in genuine opposition to the two major parties.

And so in this episode I would like to introduce you to Hall Greenland , an Australian political activist. He studied history at the University of Sydney in the 1960s and was a president of the Labor Club.

As editor of the student newspaper Honi Soit he was highly critical of the war in Vietnam, and at a time when Australian politicians were fawning over LBJ, Honi Soit accused the US of war crimes.

Hall was one of the participants of the Australian Freedom Rides in 1965. The Freedom Riders were a group of University students, who took a bus around country NSW exposing racism towards the indigenous community.

During the 1970s he wrote for  Rolling Stone and The Digger. He served on Leichhardt Council and is the recipient of a Walkley Award. In 2013 he was the Australian Greens candidate for the Federal seat of Grayndler, losing narrowly to Anthony Albanese.

He was instrumental in saving Callan Park in the inner suburbs of Sydney from rapacious development and he is the author of a biography of Nick Origlass.

He was a founding member of NSW Greens when it was launched in Sydney in 1984 at a public meeting in Glebe Town  Hall. Up until recently Hall was the co convenor of the NSW Greens.

Our conversation covers the early history of the Greens, and the ongoing policy debates in the party. I revisit the theme of episode 2- is democracy dead? And can politicians be held accountable to party members.

We dream a little about utopia, joy and a deliberative grassroots democracy.

If you have an apple device you can subscribe via itunes.

Kudos to the overwhelming number of African Americans, both in front of and behind the cameras, who made this movie so entertaining.

But many of the audience will not know or care who made the movie. They will simply enjoy it because it is a bit funnier, a bit smarter, and a bit easier on the eye than the average super hero film. (And a warning – there a plot spoilers ahead.)

So why bother to review this film? Black Panther also offers a delightful thought experiment on the choices that a nation has when it finds itself with the means to become an imperial conqueror.

Imagine a country with superior weapons, and a belief that its technology, culture, language, religion, medicine and forms of rule are the best on the planet. It could, like the ancient Romans, set about building an empire. Or in a similar vein a thousand years later, behave like the Europeans, fanning across the globe, with lawyers, guns, money, alcohol, flour and missionaries to spread its beneficence.  A beneficence that includes setting nations against each other and enslaving people with no means of defence. Or in an example closer to home it might mean (Like the Russians or Americans), arming minorities just enough to irritate you enemies and maintain an uneasy balance of power.

Alternatively, a potential global superpower might choose a more ethical course. Although we currently lack a worked historical example!

In the world of Black Panther, Wakanda is such a country. Hidden from view in central Africa, it is fabulously wealthy, high tech, and populated with a happy, stylishly dressed and enlightened citizenry. They have great music too!

Although my utopian dreams of government tend more towards decentralised anarcho-syndicalist collectives, I cannot fault the Wakandan King’s decision.

After some elegant CGI battles, the King emerges victorious from an internal civil war in which his opponent was intent on using Wakandan resources to forcibly establish an empire. (A very cool villain, with a heart- tugging back story)

We next see the King at the United Nations, offering his country’s wealth, science and technology to promote peace and prosperity for all.

And why not?

There is a corrupt hypocrisy that operates between governments and their citizens. All nations claim that whatever they do in the foreign policy space is guided by the noblest of motives. But everyone privately acknowledges that any congruence between good ethics and the “national interest” is a happy coincidence.

By and large the drivers of “national interest” are racism, sectarianism, fear of refugees and short term economic gain.

Lets hope we grow before we blow up.

He kindly agreed to an interview with me to discuss his work and some of the implications for the human services sector.

Q: You started off as a social worker; tell me how you got to working in climate change and sustainable post-carbon futures?

A: Yes, sure. Like a lot of people I was interested in social work from the beginning, due most of all to a passion about social justice but always with an awareness that there was a link between social justice, environmental issues and ecological sustainability. That has always been in the background of the work I’ve done along with a strong interest in linking critique and action. That perhaps helps explain why I’ve spent a fair bit of my life working across university, public sector and NGO’s.

That link between social justice and environmental issues I’ve always felt was important and clear, but really it has been in the last five or six years that the climate change issues have become quite sharp; particularly for me when I was working as director of a research centre called the McCaughey Centre in the School of Population & Health at Melbourne University. That was a Centre that focused on high level drivers of population health – issues of poverty, racism and violence and so on. But increasingly over that period the evidence that just kept coming into my inbox, that the accelerating risks of climate change were going to be one of, if not the most important health risks, particularly for vulnerable people; to such an extent that the Lancet now quite clearly argues that climate change is really the biggest health risk of the 21^st Century.

I’m sure I wasn’t alone in reading a lot of the material that has come through on climate change over the last 6 to 7 years and its link to social justice and health within and beyond Australia. From that I made a call about two or three years ago to leave the position as Director of the McCaughey Centre and move to the Sustainable Society Institute at Melbourne University to convene the climate research cluster. We continue to work on climate health and social impacts but I’ve also switched increasingly to the solutions side, and on how might we drive a fast shift to a low emissions, low carbon economy. So that’s a way of summarising the journey I’ve been on.

Q:   So what’s the worst case climate scenario for Australia?

A: The place I’d always start on that is Australia being part of the world, the worst case for the world is global warming beyond 4 degrees, and that’s exactly the track we’re on. There are many ways in which these statistics can sound a bit dry but I’ve always been struck by the comments of one of the world’s most eminent climate scientists, Professor Joachim Schellnhuber who advises the German government. He makes the sobering comment that a world in which there is 4 degrees of warming or more is probably not fundamentally compatible with human civilisation along the lines that we currently understand it. To put it another way, it’s probably going to lead to a global population of something around a billion people and if you just stop and think what that might mean, it is very chilling.

Now if we turn to the worst case scenario for Australia – Australia’s climate and its environment on the one hand makes this country particularly vulnerable to climate change, and on the other hand we remain relatively wealthy as a country, so maybe we’ve got better capacity to adapt than less affluent societies in Africa or South-East Asia or the Pacific Islands. Those countries are where the consequences are going to be harshest and fastest. But having said that, there are plenty of people in Australia, low-income people and people in rural and Aboriginal Australia, who are already feeling the sharp end of what climate change means in terms of fires and floods and droughts. So like most things it is the most vulnerable people who are worst affected. The worst case climate scenario for Australia, as in the rest of the world, is extremely serious. Even five years ago when I first started thinking about these issues, like a lot of people I thought, “Oh yes, this is some way away, this is something we might have to think about in the future”. But now we’re all increasingly aware that the impacts and the implications are upon us and so these matters are for urgent decision and action now, as well as in the future.

Q: So how much time do we have left to complete a transition to zero carbon emission?

A: Some people have talked about this as the critical decade between roughly 2010 and 2020 and I believe that’s a good way to think about it. It gives some sense of the urgency. If you see 2 degrees of global warming as the minimum guardrail, then you would want to see a global transition to a zero carbon economy by about 2040, and you would need to keep drawing down carbon after that. But given that countries like India and China are still in a different league in relation to issues of poverty, developed economies like Australia and the US would need to move much sooner to a zero carbon economy and really, ideally, within the next 5-10 years, but certainly as quickly as possible. So yes, the answer is “extremely fast”.

Q:   Yes, that sounds incredibly urgent.

A: Some people would use the word “emergency”. The real issue is that the longer you leave the turnaround the harder it gets. So the sooner we start the less difficult the task is, and if you leave it too long it really becomes enormously difficult to get emissions down at a reasonable rate. So the sooner the better.

Q: Your group has done some work on what the ingredients are, the essential components of a rapid transition. What does that look like?

A: A number of colleagues at Melbourne University – we’re involved in a two part project called “Post Carbon Pathways”. We had a close look at the best large-scale low carbon transition plans around the world and then we spoke to their lead authors and the people putting them into practice. The first thing it tells you is that a zero carbon economy is possible. There are things that need doing very fast, but from a technological point of view this is doable. The big barriers are political. The key ingredients are remarkably agreed and there are three or four that are fundamental; firstly replacing fossil fuels with renewable energy, in other words, phasing out coal and replacing it with solar, wind, other forms of renewables. Secondly, improving energy efficiency – there are huge gains to be made in more efficient houses, more efficient uses of energy and more efficient transport, and of course many of those gains are of particular value to low income people, to vulnerable communities. And thirdly, reducing emissions from forestry and agriculture. Low carbon land use has important implications for farming and for the rural sector, and we need to think too about how forestry and agricultural land use can help us drawn down carbon. The last point I would always add to that list, a central ingredient is making sure that the most vulnerable people are supported in that transition process.

Q: And the cost to the economy of putting all these measures in place quickly?

A: Well, in general, in every study that has been done around the world comes to remarkably similar sorts of figures of 2 to 3 per cent of GDP perhaps. So that’s a really significant amount of money – but not impossible. I think there are a couple of important points when we talk about costs though. Firstly there are very real economic as well as social costs in not reducing emissions rapidly. There will be economic costs and you can see that if you talk to the insurance companies around Australia. They are very acutely aware of the rising impact of extreme weather events on their bottom line; so there are many ways in which there are economic costs in not acting. Secondly, there are really big potential employment and economic opportunities in acting; there are big opportunities in renewable energy and energy efficiency and in different sorts of land use. That’s why many people would say Australia – the current government at least – are lagging behind not just in acting on climate change but we’re also in danger of missing out on a whole lot of economic opportunities.

Q:   The general public however could be forgiven for thinking that the message out there is (a) it’s too expensive and (b) it’s actually unrealistic to replace fossil fuel use very quickly with alternatives that people talk about, you know, base load power as being something that can’t quickly be transitioned.

A: It’s striking that many Australian households – not necessarily just inner city greenies; they’re making their own conclusions about this. Look at the speed with which lots of Australian households are deciding to put solar PV on their roofs. I think there are a lot of people who are taking a view that says in addition to it being a good environmental decision, there might actually be smart financial reasons for making that switch as well. Yes, as with any large scale change there are some costs but there are also important opportunities and there are countries like Germany or other European countries who don’t seem to be doing too badly and are making a much faster switch to a new low carbon economy than we are.

Q: Given what has happened over the past few weeks with petrol prices dropping, I actually wondered whether the fossil fuel industry will start dumping product on the basis that it will be worthless soon, and actually that would be a very perverse outcome.

A: Yes. I think there must be a lot of people in fossil fuel industries looking nervously at their bottom line just at the moment in terms of what their profitability is going to be like, so the finances, the costs and benefits of, say, renewables compared to fossil fuels are changing incredibly fast, much faster than many people, either consumers or more people in the industry would’ve thought. But the lowest hanging fruit and the quickest way for a lot of people to save money is just reducing energy consumption. Energy efficiency is a great way for everybody to reduce costs, so that just makes good sense all around.

Q: Well, given that we have such little time left to avoid a greater than 2 degree rise in temperature, the actual price of carbon ought to be very, very expensive right now.

A: Yes, I heard an interesting talk late last year by a guy called Peter Bakker who is head of the World Business Council on Sustainable Development. He used to run the biggest transport company in Holland and he made it very clear he was no extreme environmentalist, and that he was arguing from a strong business position. He represents lots of big companies like Siemens and Apple and he said, “Look, in my view we certainly have a strong, robust, lasting carbon price and” – in his view – “it is time to stop mucking about, it needs to be about $100 a tonne”. Now in the Australian context where we used to have a carbon price of a bit over $23, that sounds like a lot, but I think when you start hearing people in those sorts of positions saying that’s what is needed, certainly a strong, clear message about a carbon price is a pretty good way of getting people to make a very rapid change.

Q: It seems to me that in any great upheaval, whether technological or climatic, the way that politics is organised, it is usually the poor and vulnerable that get shafted. How will it be different this time?

A: Well, unless we do something about it, unless we take action, it certainly won’t be different. The poor and vulnerable globally are already on the receiving end. If we think of recent events over the past few years in the Philippines or in Bangladesh or Pakistan and we think of the floods and events, we can see it happening. And we can see in Australia too that the people who are worst affected by extreme weather events are the poorest. The people who are worst affected by heatwaves are the oldest and the most unwell. So it highlights the importance of making sure that the most vulnerable are most protected; for ethical reasons and also for strategic reasons. Internationally if you look at the most recent negotiations in Lima and in the run-up to Paris later this year, the biggest debates will be about, fairness, about who pays, who carries the burden for this change. With countries like India or South Africa saying, “Well, you guys in America or Australia have been having something of a party for quite a while and have been doing rather better than us and have been emitting more carbon”. There is a discussion about fairness and I think it’s true in Australia as well. If you’re going to convince the Australian people that a solid carbon price is necessary, that large scale change is necessary, then you also have to convince them that it’s going to be done fairly, the changes will be fair and that workers who lose jobs in the coal industry are supported. People who are affected by rising heating or energy bills, need proper procedures in place to make sure they aren’t unfairly affected.

Q: Well, given it is in our own interest to make this transition as soon as possible, why isn’t it happening?

A: Well, it’s true that it’s in most people’s interest. I think some people continue to do quite well out of the current system in the short-term, and in a way that’s true of all of us at least in the developed world. Even for those of us who say, yes, we recognise there is a real issue here, it is tempting to think short-term and focus on our current lifestyle. There is a range of ways in which all of us tend to focus on the short-term and so as a general comment I think the human capacity to think short-term rather than long-term is a major problem.

But in the Post Carbon Pathways Report I mentioned, we also asked key climate policymakers and activists around the world exactly this question. What are the biggest roadblocks, the biggest barriers? There are about half a dozen points that people continually make. One is denial; either denial that climate change is happening or perhaps more commonly and more worryingly, denial that we should do anything about it, that it’s too difficult or too expensive or somebody else should do it. There are all sorts of rationales that people come up with.

I think the second point that many people would make would be vested interests, in other words people who stand to benefit at least in the short-term from current fossil fuel investments and production. Just as the tobacco industry was pretty good at protecting itself against criticism about health outcomes, the fossil fuel industry is also pretty good at protecting its interests and its investments.

The third roadblock is what some people call path dependencies or lock-ins, meaning that if you’re on a certain track it’s often hard to move off that track. A good example of that will be cars. Even if you know that it would be a good idea to shift from petrol‑based cars to electric cars, when we stop to think about how we replace all our petrol stations with charging stations and so on, it’s a path that is hard to change. So that needs leadership and a visionary kind of action.

The next roadblock is unfairness, and inequality – that gets well and truly in the way of concerted action. Then there is unconstrained consumption; there’s the power of our culture and of the advertising industry to keep us buying stuff, lots and lots of stuff. And then lastly there is practical decision‑making governance coupled with financial constraints. We have to find different ways of channelling finance into renewables rather than fossil fuels, we have to find different ways of managing energy so there are a number of roadblocks and we have to learn to be smart about dismantling those quickly.

Q: Normally you would expect the more progressive political party, the Labor Party, to be taking a bit more of a lead in undoing some of these roadblocks, but that doesn’t seem to be happening.

A: I think that’s probably true around the world. Labor, social democratic and progressive parties around the world have been caught in this tension between doing the right thing on environmental issues and also trying to meet the shorter term political demands of constituencies to keep taxes down and keep prices down. Those are the sorts of drivers that are affecting them. It seems to me that the onus is on all political parties to provide a leadership in showing that this is a change that is coming, it’s a change that is necessary, a change to a low carbon, a low emissions future. It is a change in which it is crucial to act quickly but it is also smart to act quickly if you want to be on the right side of history.

Q:   Doing it fairly seems to me to involve a lot of redistribution from richer people to poorer people and there’s a lot of resistance to that idea at the moment. One of the attractions of a price on carbon is it’s a market mechanism and there is a conviction these days that markets are the best way to get things happening but there are lots of things that you’ve flagged that simply involve a redistribution from the well off to the less well off.

A: Yes, I think even in the last few days we’ve seen figures that show that we’re close to having 1% of the world’s population owning over 50% of the wealth, so we’re heading into a world that is increasingly unequal.

Q:   Referring to the Oxfam report?

A: Yes, exactly. I mean, there’s simply no way of driving a transition to a fair zero carbon economy while those sorts of inequalities keep accelerating. That is not going to work.

Q: There seems to be inbuilt driver or inbuilt accelerator with capital accumulation if you believe Thomas Piketty’s critique. He’s saying basically that capital accumulation is on a fast track now.

A: Sure. I think Piketty has provided a bit of a wake-up call to lots of people around how that works, and so I agree with you that simply setting a price on carbon, while I do believe that’s really important, is by no means the only thing that needs to happen. There will need to be strong action on progressive taxation and then the channelling of taxation resources partly into investment in a low carbon economy and partly in the actions needed to make sure that that change happens fairly.

Q: It seems to me that there’s going to be a real problem for those changes to happen fairly if we leave things in the realm of the market and when I look at the way economists and politicians discuss these things, there seems to be an underlying assumption when you look at all the political conversation in Australia and the rest of the western world that market fundamentalism is just good and it will get things right and we should just let it rip. But whenever we see it rip, it really smashes the vulnerable and the poor and creates a greater gap between rich and poor -so the rhetoric doesn’t match the reality. Market fundamentalism seems to be the new religion in some ways.

A: And has been for some time. Yes, just as I can’t see how you can have the transition to a fair zero carbon economy with current inequalities of wealth, I can’t see how you can do that with current inequalities of power. An unfettered and unregulated free market as you said is one in which inequalities not only of money but of power will tend to accelerate. So yes, there will need to be a shift in power. In particular I suppose one good example of that will be the power of some of the biggest vested interests -the giant coal and oil companies – and we need to find ways of challenging that power.

Now, some of that has to come from the grassroots and from social movements; the large demonstrations that we saw late last year in places like New York at the United Nations and elsewhere around the world, Lock the Gate and other processes against coal seam gas and all of those things are important examples of grassroots movements challenging that kind of power. But I think we’ll also need to see some role for government and perhaps also some role for different approaches to how businesses are run. I think there are promising signs in some of the alternative thinking about not for profit businesses and social enterprises and so on. So all of those are about questioning the dominance of an unregulated free market system.

Q: Market fundamentalism does seem a very radical religion, for want of a better word, because it does tear things down very quickly and create a lot of disruption. I wonder what has happened to a conservative view of the world, -let’s just take it slowly and see what these changes might mean before we hop into them.

Q: Yes, words like “conservative” and “radical” have become perhaps confusing. There’s nothing conservative about an extreme set of free market policies that mean increasing inequality for the vast majority of people.

Q: A lot of resistance around the world to coal seam gas exploitation is really those communities being very conservative about their lifestyle, their local economy and their opportunities for enjoying what they’ve got.

A: Conserving what they’ve got.

Q:   Exactly, conserving what they’ve got. But few people name this radical force of market fundamentalism for what it is – Naomi Klein talks about it sweeping across the planet and tearing it up.

A: Naomi Klein, as you said, does say it very well and her book brings a lot of these arguments together very effectively. There are others perhaps less well known in this country. Rebecca Solnit is another American environmentalist author who makes some similar points very well. There are clearly parts of the environment movement – 350.org comes to mind – who have clearly identified the need to challenge the power of the fossil fuel industry through strategies like divestment. While that might not use quite the same language as the critique of market fundamentalism it is certainly identifying inequalities in power and control over resources as really important to those debates. If you look at some of the ideas being discussed around the demonstrations in the US and elsewhere on climate change last year, issues of climate justice are starting to become more visible and that’s a good thing -but there’s a way to go.

Q: There seem to be twin arguments around divestment and one is the ethics; we shouldn’t invest because it’s bad, you know, like tobacco. And an argument which says actually all the stuff in the ground – the coal, gas, petroleum – we can’t actually use it because if we do we kill the planet so therefore it’s actually not worth anything near what it’s valuation currently is; they are essentially dead assets -so any smart capitalist is going to get out of a dead asset.

A: Yes, if we had said even two or three or four years ago that divestment would have moved so fast as an important part of the strategic discussion on climate change, I think many people would have been surprised by that. I do think it’s important and it’s important for a couple of reasons; not just because of the amount of money being moved out of fossil fuels and into other purposes like renewables although that is important, but certainly in Australia that is still a relatively modest amount of money. I think what it has done more importantly is to start a public debate about investment priorities, and more fundamentally about what some people call the social licence of large fossil fuel companies. Just as the debates about divestment from big tobacco fuelled a public discussion about was it ethically right to make money out of tobacco, so too the divestment issue tends to fuel a discussion around people’s kitchen tables about whether or not it is right to make money out of fossil fuels particularly when we know that to have any real chance of avoiding extreme climate change, most of the current known reserves of coal and oil and so on will need to stay in the ground. So yes, there are good economic reasons for being aware of that but there are also good ethical and political reasons.

Q: Yes, I think if you’re coming from an ethical point of view there is a stronger argument for reinvestment in a sensible means of—

A: Oh, completely, yes, and so at the same time as we need a divestment movement we also do need a reinvestment movement. It remains quite hard in Australia really to identify ways if people want to put their personal investments or their superannuation into more environmentally sustainable purposes it is still quite hard to find ways to do that.

Q: One of the biggest class of investors is actually people in super funds. We’re talking about millions of Australians. Has any economist done any work on how much the super funds actually have in fossil fuels and what might be the impact of getting out of that and getting into something more sensible?

A: Yes is the answer and there are a number of organisations – in Australia again 350.org would be a good place to start, but there are others who have began to do those figures. I think it is a really important set of questions for people to ask, to write to their superannuation companies or indeed their banks and say, “Hey, I’d like to know how you’re investing my money” and indeed, more strongly, that they would like to look at options for switching.

Q:   I noticed the other day that the Australian Quakers are actually getting out of the Big Four banks for that reason.

A: That’s right and quite a lot of other churches either have or are looking at that. There is discussion of the Catholic Church more broadly posing questions about where its funds are invested, and yes, it cuts both ways. It opens up issues on the negative side of divestment but it also opens up positive questions about how people would like to invest their money.

Q:   But we aren’t just talking about big organisations, there are also an many employees in our sector, and NGOs, trade unions, professional associations who are running super schemes for instance, so I guess I’m a little surprised that more work hasn’t been done amongst those organisations. I’m surprised there hasn’t been some kind of rainbow coalition formed to share information about that, to spread ideas about what ethical investments might look like in terms of contributing to a rapid transition.

A: I think that there is huge potential for the community sector, the health sector, for workers individually, co-actively, to raise these questions, to talk with either the organisations they work with or superannuation funds directly. Clearly a major part of the health and community sector works on issues of ageing, of disability, and of social insurance more broadly. So people in the community sector, are well positioned to raise lots of those issues either as employees or as consumers or as members of superannuation funds. All of those are important ways of acting and I think sometimes when people talk about climate change there is that sense of “Yeah, but what can I can do?” or “What can I do other than switch off my lights and those sorts of personal things?”, and there is nothing wrong with that but it is important I believe to think about ways of acting more collectively as well.

Q: Yes, well, talking to your bank and your super fund and so on I guess are potentially very powerful and quite obvious -but doing it collectively you have even greater power.

A: Yes, quite. I agree.

Q: John, I really appreciate your time. I think my readers will be very interested. Are there any further comments that you want to make about this whole area?

A: Well, only to go back to what you asked me to begin with, “how does somebody who starts off as a social worker end up talking about climate change?” As I said at the beginning, it seems to me there is a key link between social justice, health and wellbeing and the environment – it’s not new but the link is becoming closer and closer and more and more important. I believe that most people are increasingly aware of that, particularly young people, and so yes, it makes lots of sense to me that these issues are seen as very closely connected. It strikes me as interesting how strongly many health workers have become involved in climate change issues. I know lots of friends who are doctors, nurses, health workers and people in the health sector and there is a very good website, The Climate & Health Alliance, which brings together a lot of that work. Perhaps there is an opportunity for a greater involvement by community sector workers collectively or working with the health sector to go the next step in this discussion.

Q: Yes, the issue is more coordination and leadership because there are a lot of good ideas out there. It certainly struck me when you said that the Lancet had rated this as the number one health risk for the future. Thanks again.

This interview with Professor Wiseman has prompted me to fire off letters to my bank (ANZ) , my trade union (HSU) and my professional association (AASW) to find out what their investment policies are in relation to fossil fuels, as well as their approach to the super funds of their employees. Will keep you posted.

It is heartening to note that the AASW is a member of the Climate and Health Alliance.

The compromises they made that day ensured that the inherent dysfunctions of our illness industry would keep on accumulating. Consequently, instead of an integrated unified health system, the states have kept on running hospitals, as well as many primary care functions, whilst the Commonwealth kept funding GPs. The compromises continued in setting up Medicare Locals. Their boundaries did not match the state health districts and their cooperation with the states around primary health care lacked essential governance.

For all the faults of Medicare Locals, progressive forces hoped that they would continue, but the AMA, in a churlish submission to the Horvath Review, put paid to any slim hopes of that occurring. The doctor’s peak professional body claimed that there had been a deliberate effort to down play the role of GPs, failing to take advantage of their leadership and expert understanding of primary care.

The reality is very different. The history of GPs in Australia is one of successive governments heavily subsiding the income, infrastructure and continuing professional education of primary care medicine. This has been done largely within a fee for service funding model, which might suit some GPs but has been a failure for many patients. Last year only four in 10 NSW adults who have a regular place of care reported that their GP always helps coordinate their care- a decrease of 17% from 2010. The doctors response? They just need more funding. This fails to recognise the systemic flaws in driving primary health care through a fee for service model. The red tape piles up- along with a bunch of perverse incentives and system gaming. In 2011 the World Bank reported that there was not enough evidence to justify the $2.7 billion dollars spent in the previous twelve years on a range of incentives designed to complement fee for service.

This sets the scene for Professor John Horvath’s review of Medicare Locals delivered in March this year. Professor Horvath’s credentials for conducting this review? He is certainly no expert in primary health care. Formerly a specialist renal physician, appointed by the Howard Government in 2003 as Chief Medical Officer, he is now better known as a board member of the casino gambling group – Crown. He is also Chair of the Crown Responsible Gaming Committee. (Many would think responsible gaming is a tautology)

But Professor Horvath’s most valuable credential for this review is his unabashed market fundamentalism. In his report he bluntly stated,

“I found it particularly concerning that a number of stakeholders described to me instances where Medicare Locals established services in direct competition to existing services. I consider this to be outside the Medicare Local mandate. The role of PHOs should be restricted to facilitators and purchasers and not to directly deliver service, except where there is demonstrable market failure, significant economies of scale or absence of services and patient care would be compromised.”

 Professor Horvath did not trouble us with any examples. Ironically, GPs were instrumental in setting up these services. Every single Medicare Local board has a least one GP on it; and in most cases two or three doctors. This connects to the heart of the prevailing fiction that GPs are experts in primary health care. They are actually experts in their own field, namely, medicine.

A significant proportion of GPs simply want the Medicare Locals to do what the Divisions of GPs used to do; i.e., help them with credentialing, infrastructure and continuing professional education. Credit to those GPs who step forward for leadership roles. But keep in mind that they see the world through the lens of their own small business/clinical practice. To step outside this frame is like asking an independent truckie to advocate for better rail infrastructure.

Come next July, 61 Medicare Locals will morph into 30 Primary Health Networks. The current Medical Locals are busy scrambling amongst themselves to form new consortia to tender to become PHNs. There may be some surprises. Governments are probably a little weary of throwing money at models that do not deliver for patients. We might see big charities and big health insurers stepping into the ring.

Increasingly the care coordination of complex patients will be put in the hands of real experts with specific training for the role. Inevitably this will often fall to nurses and allied health professionals. Knowing the political persuasion of our government we can expect the routine high volume care coordination to be privatised/(outsourced), and the complex stuff done directly by government; a model that the poor and socially isolated should fear when we consider how this is working for the unemployed and the disabled.

Social workers, (and indeed all allied health professionals) who looked to Medicare Locals to integrate them into primary health care, have been largely disappointed. As a consequence patient care has suffered. Many Medicare Locals opted for a token allied health presence on their Boards, without a robust mechanism for consultation with fellow professionals. We have an opportunity to get it right this time around.

A good example of what is possible can be found at the Inner Western Sydney Medicare Local, which is jointly owned by three organisations; the Central Sydney Allied Health Network (CSAHN), the Central Sydney GP Network, and the Central Sydney Health Community Network. There are over 2,000 allied health professionals within the boundary of this Medicare Local, and 215 of them are members of CSAHN. This includes 85 psychologists, 33 pharmacists, 23 physiotherapists, but sadly only 8 social workers. Consider the following from the CSAHN annual report,

One of the key projects this year has been the establishment of HealthPathways Sydney to improve the patient journey and increase coordination of services. With CSAHN support, HealthPathways has been consulting with local allied health professionals to receive their input into these important pathways of care. Discipline specific HealthPathways for allied health are also being established to increase the understanding and integration of local services and appropriate referral pathways.. which will provide long lasting benefit to the local community. ..

Another significant project that we have undertaken is that of improving public/private allied health partnerships and lines of communication. All the allied health directors at the SLHD met with the CSAHN Board to discuss ways in which we could work together to create a better coordination of services and ultimately improve the patient journey. Many initiatives were agreed including joint service directories, shared CPD events, appropriate referral pathways between public and private, improved discharge reports from SLHD and shared student placements. This has been an incredibly rewarding experience working with the SLHD and something which we hope to develop further in the years to come..

 Of course like the GPs, there will be many social workers and other allied health professionals who simply want to focus on their discipline specific contribution, but without local professional leadership and a strong voice they will be sidelined again.

It is now a matter of urgency to get together and get organised. Within the boundaries of each of the 30 PHNs there should be a general meeting of all allied health professionals to form an organisation committed to making real the vision of truly multidisciplinary primary health care. This kind of thinking is encompassed within the position papers of many of the health related professional associations including the AASW. The time for motherhood statements and position papers is over.

This task cannot be done from above, but all the relevant professional organisations must help by providing the connectivity, organizational tools and resources to local leaders to make this happen. Allied Health Professions Australia must set up a clearing house/coordination hub to provide local leaders with practical support for effective community action.

Coincidentally, the AASW is finally getting around to forming a national private practice committee. Involvement in this piece of work ought to be its first priority.

Civil society seems to be in rapid decline. The opportunity to drink alcohol, gamble, borrow money, eat junk food has now expanded to 24/7. Welcome to the freedom to buy whatever you want, whenever you want. No money? No problem. You can borrow beyond your means with your friendly pay day lender. It’s a free country. Caveat emptor baby! Here we are now…entertain us!….bread and circuses….sport and war, shock and awe.

Meanwhile social mobility declines. The rich get richer. Our jail population expands. Our climate is changing -and not for the better.

No matter who we vote for- the social/economic trajectory is the same.

The political class, both Labor and Coalition share the same narrow view of what is possible. Sorry folks… we have to up the retirement age.. and by the way we can no longer “afford” a welfare safety net that allows for human dignity. Good bye Gonski….farewell to a properly funded NDIS.

On many fronts, our politicians are seriously out of step with us. Most Australians actually don’t want war, and we wouldn’t mind a tax increase if it improved public transport, health services and education. We are comfortable with the idea of voluntary euthanasia and same sex marriage, and we don’t like privatization or deregulation.

This must be a source of great frustration to media barons who constantly push a pro war, free market, low tax, pro-gambling and anti-euthanasia mind set.

Richard Cooke’s essay, A Class of Their Own, in the June 2014 Monthly is illuminating reading on the topic of the disconnect between politicians and the rest of us.

http://www.themonthly.com.au/issue/2014/june/1401544800/richard-cooke/people-versus-political-class

His observations are worth quoting at length.

“In the United States, what you might call the “bore in the bar” theory of democracy – that it’s all bullshit – is starting to look more persuasive. In academia, it’s called the “Economic Elite Domination” model: the unhappy idea that democracies are oligarchies in drag. This theory was once unpopular but is now resurging, partly on the back of disquieting research by two American political scientists, Martin Gilens and Benjamin Page. After an analysis of 1779 legislative outcomes over a 20-year period, the researchers determined that “economic elites and organised groups representing business interests have substantial independent impacts on US government policy, while mass-based interest groups and average citizens have little or no independent influence”.

 Little or no independent influence. Stew on that for a moment.

 Gilens and Page found that once you account for the preferences of “affluent” citizens, “the apparent connection between public policy and the preferences of the average citizen may indeed be largely or entirely spurious”. Seen this way, the shrivelling public involvement in politics isn’t a retreat from modernity and community, but a rational appraisal of how things are. After all, why give legitimacy to a system that just ignores you?

…..How did it get to this? In her Quarterly Essay Great Expectations, Laura Tingle outlines some of the difficulties facing contemporary politicians. They’re weak in the face of a modern, globalised economy, but suffer intense media scrutiny at just this moment of impotence. Both the public and their representatives now have no clear, shared idea of what government is supposed to do in a deregulated market, and instead expect it to do everything. Everyone ends up disappointed. Shrinking revenues and an ageing population will “require us to forge a much more explicit new settlement, a much clearer social contract than the one we have had to date”. That this contract will end with Australia as a low-tax, small-government nation open to the world is taken as a technocratic inevitability.

 The trouble for the political class is that this version of Australia is the opposite of how most of us want to live. Australians are suspicious of immigration. The public is extremely hostile to privatisation and foreign investment. We want the government to take measures, up to and including nationalisation, that will protect local jobs and manufacturing. We want more spending on health care and are willing to pay higher taxes to fund it. We support regulation, and we think big business has far too much power.

 These positions are shared to a surprising extent across the political spectrum. Our leaders are frustrated by this dogged counter-vision, and the way the public clings to it. “The head members of both major parties,” as Guy Rundle puts it in an article for Crikey, “share a mutual sympathy at the stupidity of their own supporters in rejecting neoliberalism.” On the other hand, on social issues of gay marriage, voluntary euthanasia and abortion, these same leaders are decades behind “ordinary” Australians.

 This dissonance helps explain why the last two election campaigns were so shambolic. They were failed sales jobs, repetitive, mendacious and joyless attempts to win over slivers of the population. The most recent, in 2013, managed to limbo even under the abysmal standard of the 2010 campaign. Several political veterans described it as the worst they had ever seen. The Labor stalwart and commentator Barry Jones, not a man for hyperbole, called it a “policy vacuum” and “the worst in our modern history for the debased quality of political discourse”. For an event supposedly tailored to what the people wanted, it left them completely dissatisfied.”

It gets worse. Not only are our politicians out of step with the rest of us. Far from being a noble profession of selfless public service- they are as venal, hypocritical and self-serving as any group that has access to power and money.

Enter the Greens.

By and large the Greens policies are the best reflection of what most of us actually want. (including me) If you don’t  believe me look at their policy platform.

There is off course one notable exception- immigration and refugees. Back in the day, Labor were the anti-immigration party. This was driven by fear of the hordes from the north swamping us and taking our jobs. Conversely, when labour was in short supply, the conservatives championed greater immigration. Gina Rinehardt is still holding out for this.

But for Labor and the Coalition are now united in a race to the bottom. If Australia were not already a signatory to the UN refugee convention, we would not be signing it now. Scott Morrison has declared that the convention is a tool for people smugglers to “run death voyages”.

By contrast the Greens want to honor our commitments, end off shore processing and raise our humanitarian quota.

It remains to be seen over the next few decades which view prevails; policies driven by fear of people in need, and what we might lose by being generous – or love of our fellows- and what we might gain by being generous.

My decision to join the Greens is not however just about policy. Greens politicians and leaders have yet to display the venal, snouts in troughs behavior of the more established political leaders, who happily serve in the neo-liberal oligarchy.

Of course there is always the risk. But to date the Greens have gone to enormous lengths to work in a way that is inclusive, democratic, transparent and ethical.

Consequently, when a Greens politician speaks they have considerable moral authority. I hope it lasts as more power comes to them.