Of course the Health system is in crisis, not only in N.S.W. but Australia wide, world wide shortages of doctors and nurses, which is why the Howard Government has had a two pronged attack on the situation. They have moved to dramaticly increase university places for doctor's and nurses in Australian universities with the help of their $11 billion surplus, and also increased funding to the States in the 2004 Federal/State Health Agreement for hospitals.....er,sorry. I got lost a little bit there, they actually didn't do No 1.and did the opposite of No 2.however, I am certain it will all work out for the best.....if you are wealthy, if you are a lowly paid employee with a family, just vote for John Howard again, and think yourself lucky to live in this great country we call the United Sta...er Australia.

Whilst preventative care and community based care make logical sense, changing the system inevitably runs into the usual stumbling blocks. There are a lot of vested interests involved. There is a huge amount of money made out of the system by people who will resist changes - try telling specialists that they can no longer charge $1,000 per one hour procedure, and instead have to go and do preventative work on a salaried basis, for less money. Try telling the pharmaceutical companies that they can no longer make mega-millions from producing drugs which are not really required. Try telling industry that it should stop bombarding children with junk food ads. Try telling the car lobby that the massive costs inflicted on the health system by road deaths will no longer be tolerated.

On top of that, whilst people might say that they believe in prevention, the world is littered with well intentioned, but failed attempts to get people to change their damaging diets, habits, addictions.

I'd love to see it happen, but it takes strong, principled leadership, and strong principled leadership is notably absent in Australia these days.

Right on there Shonga

I am almost 100% alongside you there with perhaps the exception of the university trained nurses.

In my limited medical experiences overseas, where the "whoopy-do-everything" drugs were in very short supply, I found that the nurses who had done the traditional course of going through a "Nurses Apprenticeship" were far more reliable, more caring and just that so much better than the uncaring medical staff here in Australia and the three times I was taken after a slight hang gliding accident from a lot higher I would have preferred to have fallen from, an ambush that left me with a fractured cheekbone and of course another slight incident where I was given some extra un-natural opening in my stomach and chest - they were not cured by the wonders of modern surgical techniques, but love, pure grace and care for their fellow man - even though I was not from their tribe. And believe me stitches without anaesthesia do have a tendency to bring a few tears to the eye.

In contrast here in Australia, the nurses here in Australia are avaricious and in the main, uncaring. We have the dregs of the unqualified "Patel's slicing their incompetent way through flesh and bureaucrats and politicians lying like pigs in "you know what" to cover their own foetid hands in the matter - and let us not forget that Keating not only did not have any medical coverage, but probably did not even pay his Medicare coverage either

Just remember - Lawyers sue their mistakes - doctors and politicians bury theirs.

I see your randomly selected juries were "educated" before making their choices.
Sounds like brain washing, in order to get the desired result to me.

Just what we want are two academics in theory who do not practice with scalpal, knife, blood, broom or pan.
I pan you on what you spill here.
The doctors and nurses need the heart to bypass such theorists and tell the story as they see it. It is no song while they toil.
They are head down arse up with little budget to stitch the wound, heal the sick, and mend the grieving. It is a cancer this hospital crisis beyond hospital concrete and community. It is politics.
What we need is the whole GDP of Australia to go into the Department of Health and not into the department building war ships and guns. To make ourselves mentally and physically healthy is our best defence.

Cant let kekenikidas assesment of nurses go through to the keeper with out comment

I am a nurse, my wife is a nurse, her sister is a nurse my brother in law is a nurse, my own brother is a nurse his wife is a nurse and my father was a nurse - I even have some friends who are nurses - the best man at my wedding was a nurse - As a class of people I can not accept the allegation that they - we - are avaricious or uncaring.

So he come across a few who might be - Ive known plumbers, doctors, solicitors who are avaricious and un caring - we dont need that kind of generalisation - it leads to all sorts of silly conclusions -

As for Boxall and Leeder - they are right. As for a crisis they're wrong - we have a major problem with priotities and coordination: there's plenty of money in the system its just going to the wrong places; the biggest hurdle we face is that there is no money in health prevention or promotion -

Thank you Anne Marie and Stephen for your thought provoking comments. In local government community-based planning is becoming the norm and councillors and the administration understand well the importance of working with communities to determine priorities for spending. We do not have the strength of leadership at the Federal level for this to occur.

Another issue to ponder is that when we talk about ways to improve the health of populations and PREVENT physical and mental illhealth we need to be looking outside the health sector - to the social and economic determinants of health.

We know that factors such as poverty, education, employment, transport, isolation, child care, housing directly affect our health and that all levels of government must be willing to address these issues as well as reorientating health services to provide access to good community-based health promoting programs.

What we need is a Minister for Health Promotion - Canada has done why can't Australia?