Parents, needy hit as fees increase

Parents, needy hit as fees increase BULK-BILLING CRISIS

Catherine Robinson went to a 24-hour clinic with severe pain. She was a student and needed bulk-billing, but it was a Sunday morning and the clinic told her it no longer bulk-billed on Sundays. Unable to pay $32 up-front, she was turned away.

“Even if I’d had the money at home, I didn’t have the strength to go and get it and come back,” she says. “And I was in so much pain that I didn’t care. I just went home to bed.” Later she spoke to her mother, who was so concerned that she paid to have her own GP visit her daughter, then 21, at her home in Caulfield. He admitted Ms Robinson to hospital and she had emergency surgery that afternoon.

The link between money and medical care has strengthened since that incident, 18 months ago. The rate of bulk-billing has been falling since 1997 and is now at a 10-year low of 74.5 per cent of GP consultations. The number of visits to GPs that were bulk-billed fell by 1.6 million in the March quarter.

AMA Victorian president Mukesh Haikerwal predicts the rate of fall will accelerate because of the cost to doctors of the indemnity insurance disaster. “By September, I’d estimate the figures would show another 20 per cent drop,” he says.

Where does that leave patients who cannot easily afford to pay? They can try alternative services, scrabble for the money – or avoid going to the doctor, making a mockery of the idea of a universal health care system.

For city people, there are alternatives. The State Government says the number of patients presenting to hospital emergency departments with GP-style problems has jumped 6.6 per cent in the past 12 months. Dr Chris O’Neill, of the North Yarra Community Health Centre in Hoddle Street, says its custom has risen 10-15 per cent in the past year after two “stalwart” bulk-billing doctors moved out of the area.

But the crisis is most acute in rural and outer metropolitan areas. Program manager for the Eastern Ranges GP Association in Lilydale, Kristin Michaels, says a recent consumer consultation found lack of bulk-billing was the second greatest medical concern of local residents.

Sandra Daly, 56, recently moved to the outer suburb of Cranbourne. She says she has been unable to find a medical practice that will bulk-bill her, even though her only income is a widow’s allowance.

Ms Daly says she could not afford to get her usual flu vaccination this year, and now she cannot afford to see a doctor with the flu she has caught as a result. “I happened to go into a clinic off the street last week, because I was not very well at all, and they refused me,” she says.

For families whose children have special needs, putting off doctors’ visits is not an option. Darrell Harding, from Lara, near Geelong, has a son, Rhys, 10, with an autistic disorder. Mr Harding says: “I work full-time, but on pretty low wages. Our family doctor used to bulk-bill but doesn’t any more. The difference we have to pay is about $12 per visit.

“When it comes to the weekend and you want go for a drive to the beach or into town, that’s about $12 worth of petrol. Some weeks, if Rhys has had a bad run and needed several visits, we’re forced to stay at home.”

Chief executive of the Association for Children with a Disability, Michael Gourlay, says the problem is widespread.

“All the good doctors – the ones who are prepared to take the extra time to understand children’s special needs – are saying they can’t survive on bulk-billing,” he says. “If families look elsewhere, they face an inferior service from the few doctors still prepared to bulk-bill on the basis that their consultations are kept very short.

“Bulk-billing’s demise is hitting hardest among parents who are in the paid workforce but on low wages. They’ll still go to see the GP but it will mean they get behind with their electricity bills, or they’ll have to make a heartbreaking decision not to let their child go on a school camp or excursion.”

City people are only just discovering what country people have long endured. The rate of bulk-billing has always been much lower in regional areas.

A sole parent who lives in Sale, Nadine Hatfield, says she found the lack of bulk-billing humiliating.

“When I wasn’t working, it was either pay up-front or buy food for the week, but you don’t want to have to explain that to a doctors’ receptionist because the waiting room is full of people and it’s a small town, so everyone knows everyone,” she says.

Kaylene Lay, who lives in Stratford, about 12 kilometres from Sale, says there is no medical practice near her that bulk-bills all patients.

“If I or my husband or my children visit the doctor, it costs $45 up-front, so we’re $21 out of pocket for every visit,” she says. She says this means “you watch their temperature and hope they’ll get better. You try and barter with your doctor to get prescriptions you may never need to fill. A couple of times I’ve been to the doctor with my son, who gets tonsillitis, and if he hasn’t needed penicillin that day I’ve said, `Can you give me a script and if his tonsils get worse I’ll fill it?’ rather than having to pay another $45 the next day.”

For Christina Jones, of Benalla, the issue is the way in which cancer tests and treatments are not bulk-billed. Her breast cancer has now spread.

“I just had radiotherapy, and the gap was just on $650 for two weeks,” she says. “Some of the scans – MRIs are up to $700 and you only get something like $400 back . . . I only earn $18,000 a year.”

She says she would rather pay an extra 3 per cent Medicare levy and just “walk in and have everything for nothing and know I’d be all right”.

First published in The Age.

How people power moved a minister SEX ZONES

It was always ambitious, but in the end consensus over red-light areas proved just too hard, writes Karen Kissane.

The poster is edged by condoms and syringes. The picture in the centre has two smiling girls, aged three and five, holding more condoms and syringes. The headline reads, “We play in a sex-tolerant zone in St Kilda”.

Deputy Premier John Thwaites seemed not to blanch when St Kilda traders showed him the poster last week. They told him it would be part of their campaign if Mr Thwaites, also their local member, did not halt the push for red-light zones in their neighbourhood.

“He’s been around for a long time,” cafe owner George Takis says of the way Mr Thwaites’ expression seemed not to change. But Mr Takis says that the minister’s adviser’s did.

It is hard to know to what degree the traders’ threats influenced the decision to pull the plug, at least for now, on the proposal to regulate street prostitution into “tolerance zones”. The government says Attorney-General Rob Hulls was concerned by community protests. The St Kilda council says it too is listening to the people.

But it is also possible that this controversial experiment in participatory democracy, which tried to include residents and sex workers, has been vanquished by a coming ritual of participatory democracy: the looming state election.

“It’s probably related to the state election and that’s probably not unreasonable,” says George Tickell, president of the Fitzroy and Acland Streets Residents Association. “I don’t think the issue itself should be tackled during an election because it’s just going to become a political football.”

The anti-tolerance campaign posters, devised by the Fitzroy Street Traders Association, alienated even protesting residents who would otherwise have been the group’s natural allies. Mr Takis says that as well as the children’s picture, there were posters of a house disappearing down a toilet (attacking possible damage to property values).

“I found (the pictures) extremely offensive and didn’t want to be associated with them,” says Jeanette Davison of the Port Phillip Action Group.

But Steve Paraskevas, president of the Fitzroy Street Traders Association and a leader of the delegation to Mr Thwaites, thought they were justifiable.

“Mr Thwaites has . . . obviously listened to us and at this stage we are just going to see if we get a better outcome.”
The push for sex zones was always going to be hard to win, Mr Tickell says. It suffered multiple blows: “Council probably mishandled it. Some of their consultation wasn’t as good as it might have been. There were pretty heavy attacks from talkback hosts. And the issue has been heavily politicised in that the position of some of the groups campaigning against tolerance zones has been closely aligned with the opposition.”
And then there was the not-in-my-backyard factor; even those who sympathised with the idea of tolerance, like resident Leslie Cannold, erupted when told that their own area was a proposed site for it.

Ms Cannold, a spokeswoman for the St Kilda Circuit Action Group, says she was pleased with the report that first recommended tolerance as a strategy because she thought her area would be protected as it contained homes and a church.

“Anyone who had been following the process was dumbfounded (by the proposed sites),” she says.

Ms Cannold says the council talked about “Best fit, least harm”, as if they were going to move it to places where 2000 residents weren’t going to be bothered but 1500 were.

She says residents were so concerned that groups from different areas banded together to object, even though it would have been easy for each to lobby that the other take the problem.

Ms Davison first joined the advisory group that recommended tolerance zones because she lives in a street affected by the sex trade. But she too was disappointed by the proposed sites.

Port Phillip Mayor Darren Ray insists that the council still supports the recommendations of the State Prostitution Advisory Group. He says the council’s decision had nothing to do with state political agendas, and that its processes were not fundamentally flawed. However, he says the council realised the process needed to slow down if it was to win support.

But has the idea been so utterly defeated by geography that notions of consensus are wishful thinking? Does St Kilda have any areas that fulfil the sex workers’ requirements – lighting, toilets and a circuit for customers – and are separated from houses, shops and places where children congregate?

Ms Cannold thinks not: “The only way to implement (tolerance) is to go outside St Kilda. The logic is incontrovertible. None of the sites made sense.”



· The State Government proposes tolerance zones in St Kilda and at least one street-worker centre. The Attorney-General’s Street Prostitution Advisory Group recommends a two-year trial.


· Opposition Leader Denis Napthine says the Liberals won’t support the plans , claiming the area could become “seedy”.


· About 200 residents attend a meeting of Port Phillip Council as it considers the zones.


· About 130 rally outside St Kilda Town Hall to protest against the proposed zones.


· Residents and traders threaten to sue the council.


· Luna Park operators say the plan for Cavell Street, between the park and the Palais Theatre, to be a zone for male prostitutes will jeopardise the park’s “ability to maintain the perception of a clean, safe environment”.


· The government shelves the proposed legislation.


LESLIE CANNOLD, St Kilda Road resident

We welcome that the council has allowed us to have meaningful input into the process and that they’ve heard our concerns.

STEVE PARASKEVAS, Fitzroy Street Traders president, Monroe’s restaurant managing director

I don’t agree with having tolerance centres in one of the best boulevards in Melbourne. The residents and traders are all united on this, and I think we are going to fight this one off.

DARREN RAY, Port Phillip Mayor

This is not about stopping. What we need to do is take slower steps to ensure all of our community understand the process so that we can move forward with confidence.

JOHN THWAITES, Acting Premier

If you’re going to move forward in this area, which is extremely difficult, you have to move forward gradually with community support.

First published in The Age.

Meet Virginia, the woman some love to loathe

A newsreader’s mid-life craving for motherhood has struck a raw nerve. Karen Kissane reports.

When Virginia Haussegger wrote about her grief at having missed out on motherhood in her race to a career, she did not expect a flood of responses.

Strangers in the street have said they felt sad for her (“Tears welled up in my eyes and I had to walk away”). She has had more than 70 letters and e-mails, a mixture of the savage and the sympathetic (“Even a few saying I’m praying for you”).

Many confirmed that she was not alone. “I had one woman who I’d worked with over 10 years ago almost in tears over the phone, saying I had no idea how much her story mirrored mine.”

Haussegger has also heard from parents with daughters her age who worry that they might never be grandparents because their daughters see motherhood as a second-rate option.

Haussegger, an ABC news presenter in Canberra, has been a TV journalist for 15 years. Two weeks ago she ignited a furore with an article in the opinion pages of The Age that blamed her “feminist foremothers” for the fact that she was childless as she was pushing 40.

Haussegger wrote that the women who had inspired her to believe that a career would be her greatest fulfilment in life had not warned her about her biological clock – the way her fertility would fade after 35 – because “they were all knocked up” by
their 20s.

The result, wrote Haussegger, is that women like herself who finally realise they do want children find that their chances of conceiving are slim.

Haussegger says she and her partner are reluctant to try IVF because the success rate is low. “As my brother said, `If you were a horse, Virginia, would you put money on you? Nah’.”

The response in articles and letters to The Age has been mixed. “They say the first sign of maturity is when you stop blaming everything on your parents. Grow up,” advised one reader tartly. “As for the biological clock – that didn’t suddenly drop out of the sky in 2002.”

Others pointed out that feminists have always written and talked about motherhood, which was devalued long before the women’s revolution. Still others have written Haussegger off as another gen-X whinger given the world on a platter but still bleating about the menu.

Haussegger herself has been fending off overtures from family-values conservatives who assumed she was a voice in their camp. “One radio commentator said I was a victim of Nazi feminism,” she said.

“I said no, I don’t feel I’m a victim. Certainly I’ve been a beneficiary of feminism. The point I was making about women in my generation is that somewhere along the line we have picked up a message that was devaluing of motherhood.”

She says she is now finding baby “hunger” intensely painful, “to the point where I find it very hard to look at babies. I find it very hard to look at happy family situations. I find I often have to turn away”.

Haussegger is shocked by how primal the longing is, so fundamental that it is beyond rationality. “It goes against everything I intellectually believed. I thought (deciding on motherhood) was about choice, but what I have found is that it chooses you.”

Her ache has not been eased by the sometimes bitter responses to her article about how motherhood corrals women. One woman wrote to The Age that motherhood had left her, at close to 50, with no job, no degree and no superannuation.

Another wrote that there were days she wished she had never had her children: “Can children redeem life’s pointlessness? If I can just get a leg up on this pile of laundry, nappies and paracetamol bottles to contemplate that metaphysical horizon, I’ll get back to you.”

Haussegger says she knows how hard it is to raise small children because she has watched sisters and friends do it. But she believes the fact that women still talk this way about motherhood says something about how society treats mothers. “Women have to make choices that are dramatically life-altering,” she says.

“By and large (parenthood) only causes ripples in men’s lives. It causes tidal waves in women’s careers . . . The sheer truth of gender is that women are forced into `either-or’ choices in a way men are not.”
Haussegger says that in her youth she did not absorb information about the biological clock because she was convinced she would never want children. Some of this resistance, she acknowledges, was because she was determined her life would be different to that of her mother. Her grandfather would not let her mother have a career, and she went on to raise six children.

Later, Haussegger learnt that television current affairs had little room for mothers. At one job interview, the prospective boss told her, “You employ all these women and before you know it they want to go off and have babies.” She says that as a result of her article, one family of five sisters, aged 22 to 32, is discussing how they must plan to fit children into their lives.


Some of the e-mails sent to Virginia Haussegger after her article in The Age.

I just wanted to say how much I appreciated the piece and how I heard what you were saying – I heard some of the pain and I thought it would be dreadful to write such a thing and not at least have that acknowledged. These are painful discoveries.

My heart went out to you because you are exactly where I was a little over 11 years ago. Now 11 years later, my daughter playing in the background as I type this, the nameless emptiness has disappeared.

You are in my prayers for a little one.

What a perverse perspective, and how very petulant of you. I would expect as much from my 15-year-old.

Virginia, though the past cannot be undone I believe the future is full of possibility and hope.

Stop acting like a spoiled, immature brat and start aiming your darts where they belong. Show a bit of backbone.

First published in The Age.

Gaming: almost the end of a life

When Bill Connellan’s sister Elizabeth visited him in jail in January he seemed “a bit like Toad of Toad Hall”.

Like Toad, Connellan had gone on a wild escapade. Only it wasn’t his friends he took for a ride, but the country’s largest bank.

Connellan, a loans officer with the National Australia Bank, cooked the books on his day job to feed his after-hours habit, a pokies addiction. Using breathtakingly simple scams, he extracted more than $1 million from his employer in less than two years.

Visiting her brother in jail just after his arrest, Elizabeth Fitzgerald found him “still very much in the performance and completely away with the fairies . . . He was very anxious to share the drama of being in jail”.

People such as Connellan, who was sentenced last week to five years’ jail, and Deidre Frederickson, a law clerk who stole $450,000 to feed her pokies habit, have highlighted the human cost of gambling.

Yesterday Frederickson was sentenced to five years in prison, with a minimum sentence of 30 months. At the same time, an extraordinary panel of people, including State Government ministers, the Reverend Tim Costello and industry figures such as Ross Wilson, the outgoing head of Tabcorp, met to discuss problem gambling.

Connellan, 44, is the youngest of six children, and his five elder brothers and sisters are all achievers. He had always tried to chase after their success, said his lawyer, Jack Rush. He used to big-note to his wife, Maddie, about his long absences from home, claiming he was doing important deals with clients.

He acted like an unfaithful husband, Mr Rush said, making up stories to cover his secret activities. He would claim he had been held up at rehearsals of the Gilbert and Sullivan opera society he loved, or that his car had broken down. With a flourish of life imitating farce, he once got out of trouble by telling his wife he had run over a pedestrian.

Mr Rush said: “It got to a stage where (he was gambling) six, seven days a week, on average four hours minimum a day, ranging up to 12 to 14 hours a day. It wasn’t infrequent that he would be going home at 7 o’clock in the morning, showering and then going to work, with the explanation that he had been with clients doing deals all night.”

Many of his “clients” were creatures of his own imagination. Connellan pleaded guilty to one charge of false accounting and five counts of obtaining a financial advantage by deception. Behind these counts lay two credit cards in a false name, 54 false bank loans and 40 false bank accounts. Connellan averaged a new loan every fortnight.

He was systematic. In April, 1999, he set up the first false bank account in the name of Robert John Quick. He had seen the name in a newspaper and chose it because they shared the same date of birth. He used the bank documents and cards from that account as identification to get a birth certificate in the same name. Then he used the birth certificate to rent a post office box that he used as the address for many of his fictitious clients.

He entered false loan applications into the bank’s “Autolock” system, knowing what assets and liabilities would be required to get an automatic approval from the computer. He was also meant to create a file for each loan and send it for checking to the lending services division. He did not.

As he drew on each loan, he sent some of the money to the Quick account for his own use. He would divert the rest to a false bank account in the same name as the false loan account and set up direct debits to make payments on the loan. He ultimately obtained $1,199,800, of which $244,563 went into repayments.

Withdrawals went straight from one machine to another. Connellan took money from automatic teller machines at gaming hotels and fed it instantly into the venues’ poker machines.

He bought himself nothing. His suits were his older brothers’ hand-me-downs. “This man was living in a rented house in Camberwell Road, the car that he owned was a 1984 Sigma, and he did not own any other type of real estate,” Mr Rush said. “The persons who have gained from Mr Connellan’s criminality have been the (gambling) establishments and, ultimately, the government.”

Connellan was caught only because a woman whose name he had taken from the phone book persistently complained to the bank when it sent her statements about a loan she had not taken out.

“Cases such as these before the courts, sadly, are becoming not uncommon,” Mr Rush said. “Twenty years ago, without the access of computers and without the access of, I suppose, carte blanche responsibility, with far more checks and balances, if one saw a bank employee stealing $30,000 that was considered to be a monumental amount of money. But . . . this matter went on for a protracted period of time.”

Putting Connellan in a bank was like putting a kid in a candy store. His gambling problems went back to his late teens, when he got caught up with illegal pokies in the Carlton area. He had two convictions for stealing from employers and one for having taken social security benefits while he was working. In 1996 he went into voluntary bankruptcy with debts of $40,000.

As with Toad, those who loved him had tried to save him from himself. Over the years there had been family meetings and family loans, his sister told the court.

This time they acknowledged defeat. Mr Rush said Connellan had not applied for bail because his family knew he would be jailed.

“How does a person get over such an addiction?” Judge James Duggan asked Ian Joblin, a forensic psychologist reporting on Connellan.

“Probably being where he is, unfortunately, your honour,” Mr Joblin replied. “He was deceiving his wife, he was deceiving his employer . . . there was no possible way leading up to the time of his arrest that this man was going to stop of his own resources. It could not happen. He had no conscience.”

But incarceration would not solve his emotional problems, he said. “The whole issue of why one needs to gamble in order to find stimulation and excitation in life, those are the issues that need to be addressed.”

He said Connellan would need coercive conditions placed on his release and should be supervised by the Parole Board for an unusually long time.

Connellan had come down from the artificial high that followed his arrest, his sister said. “I think it was a sort of defence mechanism . . . In the time he has been at the Port Phillip Prison he is a much more sober, more focused man who is, I think, seeing the fact that at 44, `What have you got to show for it? And if you don’t change, your life is virtually over.’ ”


The former Geelong mayor gambled away $8 million belonging to clients of his accounting firm. Mr De Stefano, 53, gambled mainly at Crown Casino. He will face charges in the Supreme Court in September over the missing money.

The 32-year-old was employed as the AFL’s membership manager when she began siphoning money from the league in a scam that netted her $374,000. Over nine months Henderson wrote 20 suspect cheques that were used for gambling or to pay back “loan sharks” at Crown Casino. Sentenced to 18 months’ jail.

Described in the County Court as a “pathological gambler”, Roden stole $1.3 million from his employer. Roden was employed as a financial controller by a family import business in 1996 but after seven months he began forging his boss’s signature on cheques made payable to himself. He was sentenced to 27 months’ jail.

An addicted gambler who threatened to set off a bomb outside Crown Casino on May 13, 1998. He sold his wife’s car and his new utility and gambled the money away at Crown. He pleaded guilty to the bomb incident and received an 18-month community-based order. He was ordered to do 200 hours of community work.

Played the pokies at the Ferntree Gully Hotel while her 19-month-old son Brian was dying in a scorching locked car on a hot day in a case that shocked the nation. Yu, 41, was sentenced in 2001 to four years’ jail for the manslaughter of her son but in an unusual move she was paroled almost immediately for a psychiatric assessment.

First published in The Age.