Doctors are feeling forced out by the system’s unfortunate flaws

What a tragic loss for an outstanding mid-career GP to feel forced to retire (“I’m just one more female GP quitting”, August 29). All that knowledge, experience and empathy lost due to a system failure. In addition to poor remuneration for complex consultations, many GPs expressed to me, as a hospital-based specialist, the stress from not having access to specialist consultation. One survey showed that 50 per cent of the time they were unable to access it because their patient couldn’t afford the fee gap. Commonly, GPs are seeking just a single consultation for a definitive diagnosis and management plan which they will implement. The obvious solution is to markedly expand out-patient clinic services within the public hospital system. It may not increase GP income but it will ease the strain of a very hard job and perhaps slow the loss of first-class clinicians like Dr Goodsall. Graeme Stewart, Avalon Beach

Dr Elly Goodsall points to the fatal flaw in the government’s promotion of bulk-billing as the panacea for our health system. Bulk-billing may be good politics, but it does not necessarily encourage good medicine. The economics of bulk-billing encourage practices to increase patient throughput and shorten consultations. For patients with complex chronic conditions, this can be a false economy. I have three which are, in some respects, interrelated. A meaningful GP consultation can easily require 20 to 30 minutes. Instead, complex matters mostly have to be spread across separate appointments. Chris Rivers, Port Macquarie

As a resident of Newcastle for more than 50 years, I have watched the closure of hospitals dealing with mental health and the shortages in psychology and psychiatry. It’s not surprising, then, to read Elly Goodsall’s article. Recognition must be given to GPs, many of them women, as they attempt to make up for the deficiencies in the system by giving extra time to patients in great need. Zeny Giles, New Lambton

I agree with Dr Elly Goodsall’s point that many female general practitioners bring a high level of empathy and genuine concern to their patients. That said, not every patient requires a long consultation. For several years, my own GP visits have been under five minutes (after 30-40 minutes of waiting at the clinic to see a GP). This is simply because many patients do not require extended time for medical treatments. Some people leave their chosen professions for various reasons, including not coping with the professions and its demands, but there is no government support. In this context, the medical profession has lifetime job security guaranteed. Dr Goodsall could come back anytime to work again as a GP if she wishes. Mukul Desai, Hunters Hill

False economy

One Nation candidate Mike Newman might like to look at what cuts to the public service in the US achieved (“New One Nation candidate labels Sloane ’weak‴⁣⁣ , August 29). The FDA, food drug and safety: 11,000 cases of cyclospora with 500 hospital admissions, major outbreaks of salmonella and E coli infections. National parks: closed or reduced operating times, lack of maintenance, loss of wildlife protection and conservation work. Outbreaks of H5N1 bird flu in cattle. Infections in cattle of the flesh-eating screwworm parasite, which had been eliminated from continental US. The CDC, Centre for Disease Control: loss of disease surveillance, high rise in cases of measles, loss of expertise in the ability to track and monitor ebola, mpox and cyclospora. These are a few of the foreseeable outcomes when you slash the public service and do not include areas such as education, building standards or land management. You don’t notice all the good work done by people in the background until they are gone. Shona Kirchen, Kiama

Boost from Coalition

Following on from One Nation’s weekend success in WA (“One Nation claims victory in Secret Harbour as last-minute votes seal Labor’s fate”, smh.com.au, August 30), Angus Taylor and the Coalition may well reflect on their previous decision to preference One Nation in the Farrer by-election. This decision appears the catalyst for the momentum One Nation is now enjoying, predominantly at the Coalition’s expense, and shows that decisions based on ideology over commonsense rarely work. Bob Cameron, Coffs Harbour

Another One Nation male with firm opinions wins a seat in federal government. I think Pauline Hanson had better watch her back, or perhaps bring in quotas? Ken Pares, Forster

Still at the trough

I find it baffling that Anthony Whealy, chair of the Centre for Public Integrity (“Lobbyists’ revolving door is spinning out of control”, August 29), should think retiring parliamentarians need “transition support” in the form of “temporary financial support, retraining assistance, financial and psychological support etc”. When I retired from a full-time academic position at the University of Sydney, there was none of this. All I got was a short-term affiliation and no support. The university authorities would have fallen about laughing if I had asked for anything more. Similarly, after my 25 years of academically productive retirement, they offer no support or interest today. Parliamentarians need to get real and realise they have no automatic right to keep drawing on the public purse after they leave their job. John Lee, Bowral

Grove ghost haunting

The Parramatta Powerhouse is turning into the farce it was always destined to be (“Inside story of the day that rocked the Powerhouse”, August 29). From the moment of former Premier Mike Baird’s original brain-fart, it was always and only about freeing up the real estate in Ultimo. The Ultimo site is now devastated and demeaned while the alleged museum at Parramatta is becoming a very expensive entertainment and convention space. Instead of preserving Parramatta’s heritage and giving us a more appropriate museum on a more suitable site, they gave Parramatta second best. The ghost of Willow Grove will haunt this institution forever. Bob Edgar, Moss Vale

Doesn’t hold water

So Donald Trump wants Lake Ontario to be renamed Lake America (“Trump orders renaming of Lake Ontario amid his trade war with Canada”, August 29), regardless of how the name originated. The Canadian government has just as much right to say Lake Erie should no longer carry the name of an American town that no-one has ever heard of. It should carry the name of some obscure Canadian place instead. Grant Agnew, Coopers Plains (Qld)

The spat over Lake Ontario is yet another example of Trump’s pathological need to dominate and frame pretty much everything as win-lose. Lake America? This level of pettiness could be seen as a wild invention if it had been included in a movie plot. Norman Broomhall, Port Macquarie

Last year on a trip to Kuwait City, being driven down one of the main streets, I couldn’t quite help but feel that the street’s name on signposts, “Arabian Gulf St”, didn’t sound quite right. Then I realised that most of the world refers to the body of water that forms the Kuwaiti coastline as the “Persian Gulf”. Seems it is not only the US president who unilaterally renames large bodies of water. Dale Bailey, St Leonards

Perhaps it’s time for the world to rename Donald Trump. Any suggestions? Kristina Vingis, Church Point

Glacier tragedy puts heat on us all

The loss of life and devastation resulting from the ice-rock avalanche in Nepal is heart-wrenching (“Support surges to Nepal”, August 29). I grieve for the victims, and am angry at the same time. I am angry because this tragedy may not have happened, had the world taken seriously Al Gore’s warning about global warming 20 years ago. Climate change was clearly a factor in this disaster. The reticence to accept and deal with global warming is unforgivable. I am at a loss to know what it will take for climate change deniers to accept the bleeding obvious, or to shake some non-deniers out of their complacency and apathy. Our own government still refuses to do enough to combat global warming. It’s disturbing that the populist One Nation party has gained supporters, when it doesn’t even believe in human-induced climate change. Graham Lum, North Rocks

The sight of that huge boulder hurtling downstream in Nepal after the massive glacier melt must be a warning to even the most intransigent of climate change deniers. Of course, Australia will offer to contribute to the rebuilding of the area with money and expertise but how long will it be before something similar occurs? And where else in the world will there be similar disasters and fatalities? The planet is warming; it is up to us to face facts and deal with our dependence on fossil fuel. Nola Tucker, Kiama

Fires in Canada and the UK. Floods in France. Disaster in Nepal and Tibet. Apparently, climate change deniers say, there’s no such thing as climate change. Yeah, right. Rose Lysnar Windsor (Qld)

We will see more disasters than the Nepal horror unless worldwide governments of all persuasions pull their heads out of the sand and take drastic action against climate change. It has not escaped the world’s notice that this disaster was caused by a glacier melting. What caused that if not for global warming? Meanwhile, Pauline Hanson, a climate change denier, continues to garner voter support. What are Australians thinking? Stephanie Edwards, Leichhardt

Not a word of sympathy and concern from Pauline Hanson for the people affected by the flood disaster in Nepal. Peng Ee, Castle Cove

In the latest chapter in our environment’s breakdown, a glacier collapses and unleashes devastation downstream. Politicians offer sympathy and money for the countries affected, yet they bear real responsibility. Every coal mine approved, every gas field signed off, fed the forces behind this collapse. They claim it doesn’t matter because the coal is exported, not burned here, and dress it up as vital to “the economy”. Make no mistake: there is blood on their hands, and future generations will curse their names. Marie Belcredi, Epping

Digital deck chair

According to a cabinet source, Anthony Albanese is shifting his key legacy item to blocking teens from social media, investing in AI and the digital duty of care (“PM pushes big-spending agenda for third term”, August 29). All this while apparently continuing to do as little as possible about climate change. A digitally secure, AI-enhanced deck chair on the Titanic, anyone? John Croker, Woonona

Ill-advised

The aftermath of scandals at KPMG, PWC, Catholic Schools NSW and NSW Liberals should include banishing two words from future corporate-speak: consulting and advisory (“Perrottets a double act as ICAC closes in”, August 29). Political lobbyists be advised. And while on the subject of nomenclature, does Anita Perrottet remain “not a person of interest” to the ICAC (“ICAC hears claim over $254,000 advice fee”, August 27)? She certainly caught my attention. Peter Campbell, Potts Point

Anita Perrottet may have some memory lapses about events over the past couple of years, but I doubt she will forget her past couple of days in the witness stand. Andrew McCarthy, Toormina

Gee, it must be a risky proposition paying $600,000 for verbal advice to someone with such a poor memory. Malcolm McCallum, Dulwich Hill

Cheeky turn

Rose from Potts Point may have been right when she said that the ICAC hearings are “the best show in town” (“At the best show in town, witness suffers ICAC- induced amnesia”, August 29). They certainly make for good reading and a cheery morning of belly laughs. But I continue to be amazed that some of these people continue to check in as “conservative Christians”. It makes you want to read the small print on the labelled contents. Tom Mangan, Woy Woy Bay

Anita Perrottet’s performances to date, surely, are worthy of an Academy Award. Operation Rosny gives ICAC’s Operation Jasper in 2012-13, starring Eddie Obeid and Ian Macdonald, a run for its money. Edward Loong, Milsons Point

Compliments to chefs

Just when you might be convinced the humanity “sucks”, the story on Shaun Christie-David and Mitch Orr running their Second Chance Kitchen program (“Serving Time”, August 29) involving young male offenders in detention, gives an opportunity to reconsider. Bravo chefs – and all those connected with making it happen. Marie Del Monte, Ashfield

Thank you, Cathy

We will miss you, Cathy Wilcox (Letters, August 29), the most serious opinion writer of our age. You made us laugh out loud, at ourselves, and everybody else. My own opinions are full of numbers, so nobody understands them, but yours convey meaning without anything but reference to our literary heritage. Thank you. Noel Thompson, Riverview

Chalk it up

Recently, I received an unasked-for invitation to join a Defence Force Health Fund. It made me wonder if half a century as a teacher made me eligible Marjie Williamson, Blaxland

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