Queensland is in desperate need of a bold plan for the future, the state’s biggest ever sentiment survey, The Courier-Mail’s Your Say 2020, has revealed.
While the survey’s 8000-plus respondents listed “beautiful”, “sunny”, “safe” and “friendly” as the top words to describe Queensland, next up was “broke”.
Creating jobs and driving down crime were overwhelmingly the top priorities across Queensland and the biggest issues the State Government needs to address.
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More than 86 per cent of respondents agreed “Queensland needs a bold plan for the future”, even the majority of those who backed the incumbent Labor Government.
Creating jobs for Queenslanders was the top priority across the state (40.4 per cent), followed by cutting state debt (20.5 per cent) then tackling youth crime (15.1 per cent).
Less significant were driving down energy prices (8.2 per cent) and reducing surgery time waiting list (5.2 per cent).
The Gold Coast is pleading for jobs while north Queensland is desperate for an end to the scourge of youth crime.
In North Queensland, an incredible 45.9 per cent put tackling youth crime as their number one government priority, double the number calling for more jobs (22.7 per cent).
Older northerners were even more concerned, with crime topping the list for more than half (51.5 per cent) of seniors aged 65-74 years.
In the far north, 30.6 per cent wanted an end to the juvenile crime wave, compared to 26.4 per cent chasing jobs.
On the COVID-smashed Gold Coast, it is all about jobs (38.6 per cent) and cutting state debt (19.6 per cent).
Look at the mortgage and school fees age brackets, and the cry for jobs gets even more desperate: 46 per cent for anyone aged between 35 and 54 years.
Statewide, Queenslanders are almost evenly split on the question of whether borders should remain shut to states with community COVID transmission – 49.9 per cent open, 50.1 per cent shut.
But go to the Gold Coast, and the push for borders to open gathers far more followers, with close to 60 per cent pushing for the gates to Queensland to reopen.
Four-fifths believed the State Government should invest more in regional Queensland, with support higher in regional areas like the north (93.8 per cent) and southwest (92.4 per cent), and lowest on the Gold Coast (72.7 per cent).
Business groups echoed the call for a bold plan to lift Queensland out of COVID and beyond.
The “Unite and Recover” plan – that state ministers have been holding almost as a totem in public – lacked detail and much that addressed the COVID need.
Property Council Queensland boss Chris Mountford said business wanted to see more detail.
“One of the frustrations across our membership at the moment is a sense there isn’t a bold vision, with that strong economic focus coming from the State Government at the moment,” Mr Mountford said.
“The economic recovery strategy that they’ve released is really just a statement of things that are already occurring and some broader statements, nothing really concrete that gives that sense of a of a bold vision going forward.
In the context of an election next month now’s the time to start putting those ideas forward.”
SCROLL DOWN TO READ THE FULL SURVEY RESULTS
Chamber of Commerce of Industry Queensland general manager of policy and advocacy Amanda Rohan said Queensland needed a clear plan for where it was going and what it was spending public money on in the face of looming tight budgets.
“Even pre-COVID our thoughts were that we really need a vision for the future for Queensland,” Ms Rohan said.
“Let’s transform Queensland’s economy, building on where we are now, building on our resource sector, building on agriculture.
“But let’s look for future opportunities.
“We’re not seeing a cohesive vision for the state.
“We’ve gone through a few iterations in the past, We’ve been the Sunshine State, the smart state, we really consider that we need to be a future looking, future facing state.
“We need to know where the light on the hill is, where are we going.
“It helps us really focus decision making and budget spending.
“We’re going to be in times of tight budgets for the future.
“Let’s make sure that every bit of spending is really going to where it should be to build our economy and transform it.
“We’ve been very vocal on the current government economic recovery plan and the lack of detail around the cohesive approach to their plan.
“We know lots of announcements have been made over the past three weeks or four weeks since the plan was released. But we can’t see how it all fits together.”
Priscilla Radice, Infrastructure Association of Queensland chief executive officer, said government spending alone would not get Queensland what it wants.
“We need to collectively design a new playbook.
“Investment in people and productive infrastructure is vital. The private sector needs to be
allowed a greater role.
“Government spend alone will not deliver jobs and prosperity.”
A State Government spokesperson said it was spending more than New South Wales per head and had put in place measures that would keep 334,000 Queenslanders in jobs.
“This has been recognised by the Australian Bureau of Statistics National Accounts, detailing that Queensland’seconomic recovery expenditure has been the most significant in the nation in cushioning the impacts of the recession.
“The ABS said that falls in household spending was partly offset by ‘a 4.6 per cent rise in government consumption expenditure driven by increased state and local spending in response to the COVID-19 pandemic’.
“This data also shows that the recession was less severe in Queensland (-5.9%), South Australia (-5.8%) and Western Australia (-6%), where borders were closed to other states with community transmission.
“This is being confirmed by data all over the world – that economies are faring better where the virus is more contained.”
“Our economic recovery plan now includes $8 billion of announced commitments with the $500 million Renewable Energy Fund and the $500 million Backing Queensland Business Investment Fund.
“And we have made it clear at page 3 of the COVID-19 Fiscal and Economic Review that a $4 billion provision has been identified for borrowings to support the economic recovery.
“That will take our total additional economic support to $11 billion.
“We have been clear about how our economic support is being provided.”
They said the State Government had made $196m in grants to 20,000 small businesses, just extended more than $1b in payroll tax relief and given $1b in loans to 7,000 businesses.
Back on the cheyne gang again
Though he is normally filled with optimism and looking towards the brighter side of a situation, former world surf tour legend and Gold Coast local Cheyne Horan has admitted things have been tough on Queensland’s glitter strip.
Having operated his surf school at Surfers Paradise, Burleigh, Kirra and The Spit, Cheyne has experienced the highs and lows of the region’s tourism industry, with his primary market being tourists from interstate and overseas.
“With COVID, things have died for us, and you have that feeling all along the coast,” he told The Courier-Mail.
“It’s really killed things, and it’ll take a long time for the coast to recover and bounce back.”
Like many others, Cheyne has had to take up a secondary job to support his family, now working on driveways for Concrete Doctor.
“Like everyone else, I’ve got a family to support, and at the moment I can’t do that with just the surf school,” he said.
Originally published as Desperate plea for plan to save Queensland
Boris Johnson has warned pubs across Britain may be forced to close early in a bid to save Christmas, as he admitted actions to stop a second surge must be “tough now”.
His words came as stricter new measures are expected to be announced for the North East of England, where cases are on the rise – including a reported curfew on pubs.
He admitted more people could die from the virus if his new ‘rule of six’ law is ignored and a second wave strikes Britain.
The PM said: “I remember when the pubs used to close at 11 anyway in the old days. That sort of thing, we will be looking at it.”
However, referring to similar draconian measures taken in other countries, including curfews, he added: “I don’t think we are yet in that position.”
The PM said people have to be “both confident and cautious” and that it is “crucial” the country does not re-enter “some great lockdown again that stops business from functioning”.
He told The Sun : “Christmas we want to protect, and we want everyone to have a fantastic Christmas.
“But the only way to make sure the country is able to enjoy Christmas is to be tough now.
“So if we can grip it now, stop the surge, arrest the spike, stop the second hump of the dromedary, flatten the second hump.”
He spoke as people in the North East await an announcement on Thursday on new measures which are expected to come into effect from midnight.
In south Wales, a local lockdown will come into force from 6pm on Thursday, meaning people must not enter or leave the Rhondda Cynon Taf area without a reasonable excuse.
Under new rules, licensed pubs, bars and restaurants in the area will have to close at 11pm – and meetings with other people indoors will not be allowed, including for extended households.
The area has the highest testing positivity rate in Wales, with the seven-day new case rate at 82.1 per 100,000 people in the area.
Newcastle upon Tyne has also seen a sharp rise in its rate, up from 51.2 to 64.1, with 194 new cases in the seven days to September 13.
There were 141 new cases in South Tyneside, up from 92 the previous week, and 198 in county Durham, a rise from 172.
Communities Secretary Robert Jenrick said the new measures are being introduced after a rapid rise in cases.
He told ITV’s Peston show: “The number of cases has been rising rapidly in many parts of the country, but in particular in the North East, and so a decision has been made to impose further restrictions there.”
He added: “Over the course of the day a full briefing will be made available to everybody including the councils and business community.”
Newcastle City Council leader Nick Forbes said the “additional, temporary restrictions” were being planned to “prevent another full lockdown”.
The spikes in infection rates came as Mr Johnson admitted there is not enough capacity in the system after demand “massively accelerated” in recent weeks.
He told MPs at the Liaison Committee on Wednesday: “We don’t have enough testing capacity now because, in an ideal world, I would like to test absolutely everybody that wants a test immediately”.
He said the virus was spreading from the young to the more vulnerable elderly, with the rate of cases among the over-80s doubling in just days – and warned that would “lead to mortality”.
On Thursday afternoon, Baroness Dido Harding, who is interim executive chair of the National Institute for Health Protection – and oversees the NHS Test and Trace system, is due to give evidence to the Commons Science and Technology Committee.
Following the publication of the latest test and trace figures last week, the Tory peer insisted the system was “working” despite key targets being missed and the number of close contacts being reached falling to a record low.
It was revealed earlier this week that tests will have to be rationed while the Government struggles to get to grips with soaring demand.
A prioritisation list for testing, setting out who will be at the front of the queue, has not yet been published but the Sun reported nurses, care home workers and teachers would be among those at the top.
Meanwhile, the Daily Telegraph reported a Government source as saying while they are “not yet at the stage of restricting access to tests for those who have symptoms” they are “considering the options for what to do further down the road”.
Millions of Australians have been working from home during the pandemic, which means for many their bills have skyrocketed.
The pair have been using extra electricity and gas to keep the lights on, plug in their computers and heat up their meals at home.
“Compared to this time last year, July time, we’re up about 150 per cent on average,” Miles told 9News.
Their gas bill increased from $23 to $100; while electricity jumped from $127 up to $317.
Electricity and gas usage have increased 24 per cent across the country compared to the pre-pandemic period.
The largest cost of working from home has been heating.
“It all adds up, if you’ve got three, four, five people in your home, all those small numbers together add up to a lot more usage,” Fred van der Tang from Make it Cheaper told 9News.
Mr van der Tang encouraged people to shop around and look at changing energy providers.
“We’re seeing on average, customers who shop around, and compare and switch can save up to $400 a year.”
If people are yet to do their tax return, getting an accountant to look at it rather than using the government’s simplified method could also help households save money.
“About 95 per cent of our clients are actually worse off if they claim the 80 cents rate,” Mark Chapman from H&R Block told 9News.
According to ATO guidelines: “You can claim a deduction of 80 cents for each hour you worked from home in the 2019–20 income year during the period 1 March to 30 June 2020” on two conditions.
You “were working from home to fulfil your employment duties and not just carrying out minimal tasks such as occasionally checking emails or taking calls”, and you “incurred additional running expenses as a result of working from home.”
Facing rooftop solar panels east and west instead of north may save homeowners money and help with electricity grid stability, new research suggests.
- Kirrilie Rowe is not the first person to think of pointing panels more east and west, but she has quantified the benefit
- The University of South Australia scientist says the orientation change would help capture morning and afternoon sun
- AEMO is seeking solutions to better integrate rooftop solar with the electricity network
Kirrilie Rowe, a scientist at the University of South Australia, said the electricity use of most households peaked in the morning, dipped in the the middle of the day, and peaked again in the late afternoon.
“So if we were to face our panels to catch more of the morning sun, we can better match electricity load in the morning,” she said.
“And similarly, if we face our panels to catch the late afternoon sun, we can better match our electricity use in the late afternoon.”
Ms Rowe said she was not the first person to think of pointing panels more east and west, but what she had done was quantify the benefit.
“We’ve calculated for an average-sized system you could reduce the amount of power you need to purchase by between 4 to 5 per cent,” she said.
“But I think one of the critical things to note is that you’re reducing it in the peak demand periods.”
Facing panels east or west could also help stabilise the grid by generating less power during the middle of the day, she said.
The deceptively simple idea received the thumbs up from Audrey Zibelman, CEO of the Australian Energy Market Operator (AEMO).
“I think that would be fantastic,” she said.
“And that’s exactly why we alert people to these problems, because then you have very clever people say, ‘Well, here’s an easy solution’. And that’s what we’re looking to encourage.”
The rise and rise of rooftop solar causing new challenges
Around Australia, the massive uptake of rooftop solar has led to a surplus of power in middle of the day and less need for traditional power generators such as coal and gas.
“We have a whole lot of people with photovoltaics on the roof that are generating power. But they’re not using power,” said Peter Pudney, an associate professor at the University of South Australia.
“And one of the things about the grid is that you have to keep it in balance all the time. The amount of power being generated has to match the amount of power that’s being used,” he added.
Currently, traditional generators like coal and hydro are needed to keep the supply of electricity stable in a grid that was never designed to handle large amounts of rooftop solar.
Without new solutions, traditional generators won’t be able to be switched off completely without risking power outages.
The biggest generator of electricity
There are now more than 2.3 million rooftop solar systems in Australia, according to the Clean Energy Regulator, with almost 20,000 new installations every month.
In South Australia, rooftop solar is now the state’s largest generator of electricity and records for minimum demand for grid power are regularly being set.
The AEMO has warned that within three years South Australia could become the first large electricity region in the world to effectively eliminate the need for traditional generators in the middle of some days, due to the increase in rooftop solar.
“Rooftop solar has grown so fast. And now it’s a very significant portion of the power system,” Ms Zibelman said.
“And one of the things we worry about, of course, is that when the sun is shining and there’s too much solar, and there’s excess, how do we manage that so it doesn’t create a problem for the system?”
New solutions urged
Changing the direction panels are facing is only one of a series of solutions homeowners can take to help solve the midday solar surplus problem.
“What people need to do is use as much of their high-draw power appliances like spas, pool pumps and dishwashers, and have them running during the middle of the day,” solar installer Tracey Barnett said.
She said changes to the solar tariff in Western Australia made installing home batteries more attractive.
“The new system is now going to be paying 3 cents during the day. And then from 3 o’clock to 9 o’clock they’ll pay you 10 cents for whatever you export out,” said Ms Barnett.
“If you’ve got batteries and your batteries are full, then that will still get exported out to the grid even when the sun has set, and you’ll still be able to make some money out of the network.”
AEMO wants more control of rooftop solar
But even with changes in the way homeowners use and generate power, Audrey Zibelman says the AEMO will increasingly need more control and visibility of rooftop solar to avoid blackouts in extreme circumstances.
“Now that it’s a significant portion of the system, we want to make sure that we’re making the best use of it and have all the right kind of arrangements so that people are protected,” she said.
In South Australia, the AEMO recently mandated new solar installations be connected to the internet in an attempt to better manage the export of electricity to prevent blackouts.
Peter Pudney said the way the AEMO controlled rooftop solar would need to be designed very carefully to not impact all rooftop solar owners.
“It’s important to control the amount people are exporting to the grid without reducing their ability to generate and use their own power without exporting,” he said.
The blood-sucking, ancient lamprey might look spooky, but its evolutionary and culinary history is setting fishermen, conservationists, and chefs across the globe on a mission to preserve the living fossils in decline.
- Lamprey have been an important food source in many cultures for thousands of years
- To preserve old traditions annual lamprey festivals are held in Europe
- Record numbers of the native pouched and short-headed lamprey have been counted in South Australia
As one of the most primitive vertebrates alive today, scientists have recorded about 40 different species of the jawless, eel-like fish.
“They have an oral disc with several quite savage looking teeth inside and they use this to attach to larger fish out in the ocean, raft a hole then feed on blood and fluids and even chunks of flesh,” SARDI research scientist Chris Bice said.
“They only feed in the marine environment and as soon as they move into freshwater [from saltwater] and start their upstream migration, they stop feeding.
“So, whilst they may look a bit savage, they are of no risk or danger to humans.”
Lamprey are found all over the world, but numbers of the most common species in Australia, the parasitic pouched lamprey and short-headed lamprey, had been in decline and are only now slowly recovering in the mighty Murray River.
“There’s a lot of action that has been undertaken now to support their migration a bit more, and we are seeing some pretty positive signs of their abundance in certain locations.”
Rich flavours from the deep
The frightening-looking creatures have been coveted throughout history, as a prized food source for ancient Romans, kings and First Nations people.
Today, it is still considered a culinary delicacy by many different cultures, including Dutch, French and Latvian.
Henri Roquas is a food archaeologist, artist and chef from the Netherlands who has founded the Zeeprik Genootschap, a sea lamprey society dedicated to bringing attention to the unique marine dweller.
His fascination for lamprey dates back to his childhood when a near drowning experience in a local river left him fixated on what lay below the body of water.
“[Almost a year later] we caught a fish sucked on another fish, that was said to be a lamprey. It was in that same water I almost drowned in, so that struck me.”
Many decades later, Mr Roquas is fostering ancient traditions around consuming the unique creature.
While he has been preserving old traditional French recipes, the lamprey lover has also been experimenting with new methods, each with a different taste.
“Or you can roast it, resulting in a totally different taste.”
Even celebrity chefs like Heston Blumenthal have tried their hand at cooking up middle age recipes with the hideous creature.
Festivals, fees and feasts by the Baltic Sea
Meanwhile in Latvia, lamprey is more humbly cultivated.
Safonovs Gundars has been fishing since his childhood and remembers catching lamprey by hand.
“I would catch and smoke them in the woods right by the river,” he said.
But today, there are restrictions in place and catching lamprey in Latvia requires a licence, or people face a 40-euro penalty for each one caught during the off season.
It has lead to local fishermen being highly sought after in the small Baltic nation, for their precious bounty that is caught with special traps.
“The price of lamprey is quite high, but buying them from small-scale fishermen is up to three times cheaper than buying it in the store.
Connection to ancient culture and the creatures that have snaked through time are celebrated across Europe each year with annual lamprey festivals, such as the Negu Svetki in Latvia’s riverside town of Carnikava each year.
Lamprey lives on Down Under
Whilst in Europe they rally to preserve the culinary and cultural connections, in Australia, it is all hands on deck to boost the numbers of a native species that was almost wiped out.
This year, South Australian monitoring has found record numbers of lamprey migrating in the Murray River, with 93 pouched and three short-headed lamprey detected.
“During the Millennium drought, we didn’t have any freshwater flows to the Coorong for almost three years,” the Environment and Water Department’s Adrienne Rumbelow said.
“The barrages were all shut, water levels below Lock 1 dropped and for fish like lamprey that need to migrate between freshwater and saltwater, there was no opportunity to breed during that period.
GWS young gun Brent Daniels has booted one of the goals of the season after slotting a dribble kick from 40 metres out.
Tight on the boundary line at the Gabba, Daniels had no other choice but to dribble the ball through the goal, pleasing the #savethedribble fans.
The dribble kick has long been targeted by Hawthorn great Jason Dunstall on Fox Footy’s Bounce, with his regular frustrations over poor attempts going viral.
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However, Daniels’ effort was sure to impress Dunstall, given the degree of difficult and lack of options the youngster had.
Not only was the kick impressive, but the flick up from Daniels to get the ball in his hands.
“I don’t think I’ve ever seen one from that far out,” Richmond legend Matthew Richardson said on Channel 7.
While James Brayshaw labelled it as “totally nuts”.
Daniels has great memories from the same spot, given he booted the matchwinning goal for GWS against Brisbane in last year’s finals series, from a similar position.
Gary Davies and his partner were paying $950 in rent per week for their run-down flat – but they’ve slashed $300 off that hefty bill by taking part in the nation’s COVID exodus.
The couple realised rents had been falling across the city as a result of the coronavirus crisis, and decided to move out of their ground floor Potts Point apartment and into a brand new one in Zetland.
Their new home is on the 15th floor with “amazing views”, lifestyle amenities and a modern kitchen – and not only is it $300 a week cheaper at $650, they also managed to score two weeks of free rent as landlords scramble to entice apartment tenants in particular.
“Where we were living before was quite expensive and it wasn’t bad, but it was old and needed a bit of a renovation with mould on the roof and that kind of stuff – there was no light at all,” Mr Davies told news.com.au.
“Some mates were moving to Zetland so we looked around and found a brand new apartment on the 15th floor with a pool and sauna that’s so much cheaper, so it has been a good decision.
“It’s got a marble kitchen and it is basically a big upgrade – for $300 less a week than before.”
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The 28-year-old said he had decided to look into moving house as it was now a renter’s market.
“I heard through the grapevine that because of COVID-19 people can’t rent out apartments – I actually heard of one place offering four weeks of free rent (to lure renters),” he said.
“Our new place was on the market for $800 before we got it for $650 after they dropped the price.
“Thank you COVID – it’s one of the only good things to come out of it.”
The rope access technician said at least three other friends had moved to take advantage of cheaper rent recently and said the market had changed dramatically in a short period of time.
“There are so many more places out there now and fewer people to take them, especially as there’s less people in the country now,” he said.
Mr Davies, who is originally from Scotland but who has been living in Sydney for three years, said his advice for other renters was simple – “go for it”.
“It’s definitely worth the effort to find a new place,” he said.
“For example, I’m planning to go home to Scotland next year to visit my parents, and now having an extra $300 a week that used to go towards the flat will help go towards that.”
But Mr Davies and his friends aren’t alone in embracing the COVID exodus, with new research from comparison site finder.com.au revealing one in five Aussies have moved house or are considering moving in 2020.
That’s the equivalent of 3.8 million of us who are pulling up stumps on our pre-COVID abode – and it’s well worth the effort, with Finder analysis of SQM Research data showing renters now stand to save $3640 a year on average by moving to a cheaper rental property.
Finder personal finance expert Kate Browne said the pandemic had accelerated many people’s moving plans.
“Millions of Australians are questioning what’s important to them and whether their current accommodation still meets their needs,” she said.
“Living close to the office might be less important – while open space and local amenities might rank more highly.
“Thanks to the cloud over the rental market, it’s a good time to find a bargain.”
And there’s plenty more evidence to prove renters are now in a position of power, with the most recent CoreLogic data revealing capital city dwelling rents are down 1.4 per cent overall since the end of March.
In that period house rents have fallen 0.3 per cent while unit rents have dropped by a far more substantial 3.5 per cent – and a whopping 5.1 per cent in Hobart.
CoreLogic’s head of research, Tim Lawless, said weaker rental conditions across the unit sector were the result of a combination of high supply and low demand.
“Supply levels for rental grade units have surged over recent years, especially in Sydney and Melbourne, where high-rise unit supply across key inner city markets has remained substantially above average,” he said.
“At the end of March there remained around 51,000 units under construction across NSW … and about 45,000 units were under construction across Victoria.
“On the demand side, rental demand for inner city apartments has been significantly impacted by stalled overseas migration, including foreign students, as well as less demand from domestic students who are generally studying from home.
“Rental demand has also been impacted by weak labour market conditions across industry sectors common with renters, including the food, accommodation, arts and recreational services sectors.”
CoreLogic rental listings data shows advertised rentals in certain inner city areas had more than doubled between mid-March and early August – a trend that was “likely to persist, at least until international borders reopen”.
Realestate.com.au chief economist Nerida Conisbee told news.com.au she had never seen such disruption in the rental market – and that there had never been “so much power in renters’ hands”.
“Generally we’ve seen much more power with landlords, but that has really switched around since COVID hit,” she said.
“In areas where there are a lot of vacancies some landlords are having to throw in incentives like weeks of free rent which has been interesting to see.”
Ms Conisbee said the trend was “definitely happening” but that renters were able to get better deals in certain locations.
They include inner city areas where there has been the biggest uptick in apartment rental listings such as the Sydney CBD, Erskineville, Macquarie Park, Schofield and Rhodes, and the Melbourne CBD, Southland and Docklands.
“Early on in the pandemic it was a really good time to get a bargain, but everyone was scrambling and very nervous about the future,” Ms Conisbee explained.
“But there are still good deals to be had across Australia, primarily because foreign students have not returned and have left a lot of vacant apartments.”
Ms Conisbee said with tertiary education going online during the pandemic, many local students had also moved back home to save cash if their families lived nearby – a trend exacerbated by job losses in the retail and hospitality industries which tend to employ more young people, who were also more likely to rent.
“There’s a bit of an intergenerational issue at the moment and the rental market has been really disturbed,” she said.
If you’re a renter, Ms Conisbee said the first step was to do your research on average rents in your area and then contact your landlord to try and negotiate a rent reduction.
Failing that, she urged people to consider moving to areas that had seen the biggest increase in listing volumes where landlords might be “more prepared to strike a deal”.
New York City’s lockdown and violent crime spike have driven away many office workers, and on Thursday business honchos finally told Mayor Bill de Blasio that they’ll be reluctant to return unless he cleans up the streets. What took them so long?
“We need to send a strong, consistent message that our employees, customers, clients and visitors will be coming back to a safe and healthy work environment,” some 160 business leaders in the Partnership for New York City implored Mr. de Blasio in a letter. “People will be slow to…
Nearly 3.5 million cases of heart disease and stroke could be prevented, and £68 billion saved in health and social care costs over a period of 25 years, if every adult in England at high risk of cardiovascular disease were diagnosed and treated, suggests an economic analysis, published in the online journal BMJ Open.
Picking up all undiagnosed cases of diabetes would accrue the largest overall health and financial benefits, calculate the researchers.
There are more than 1.8 million people in England on the coronary heart disease register and more than one million on the stroke or mini-stroke (TIA) register. Cardiovascular disease is estimated to have cost the UK economy around £23.3bn (€26 bn), overall, in 2015.
As part of its strategy to improve cardiovascular disease prevention, NHS England has highlighted six high risk conditions that are currently under-diagnosed and insufficiently well managed despite a range of available treatments and lifestyle modifications. The six high risk conditions are: high blood pressure, high cholesterol, atrial fibrillation (irregular heart beat), diabetes (types 1 and 2), high blood glucose, and chronic kidney disease.
Increasing diagnosis and treatment of these six conditions could improve health outcomes and potentially save substantial sums, but to date, the potential benefits haven’t been quantified, say the researchers.
To rectify this, the researchers estimated the total cost savings and health improvements that might be achieved if all adults with one or more of these high risk conditions in England were diagnosed and treated to current standards of care, or in accordance with National Institute for Health and Care Excellence (NICE) guidelines.
Their analysis also explored which high risk groups would benefit the most from optimal detection in terms of cost savings and health benefits.
They used a disease prevention model (School for Public Health Research (SPHR) CVD Prevention Model), focused on English NHS and social services, and the demographic and clinical features of participants in the nationally representative 2014 Health Survey for England to inform their estimates.
They calculated incremental and cumulative costs, savings, and quality-adjusted life years (QALYs)—a measure of years lived in good health, as well as the net monetary benefit to the NHS and social services in the UK, over 5, 10, and 25 years.
The interventions included in their modelling were taken from NICE guidance for each of the high risk conditions. These included: diagnostics (NHS Health Check, annual review for people with a pre-existing high risk condition); drugs (for lowering cholesterol and high blood pressure, blood thinners and treating diabetes); lifestyle modifications (weight management, smoking cessation, diabetes education, and nutritional advice for chronic kidney disease); as well as supplementary assistance (blood pressure self-monitoring, medicines use review).
The results showed that if every adult with one or more high risk conditions were diagnosed and then managed appropriately at current levels, £68bn could be saved, 4.9 million QALYs gained, and 3.4 million cases of cardiovascular disease prevented over a period of 25 years.
And if all these people were managed according to NICE guidelines, £61bn would be saved, 8.1 million QALYs would be gained, and 5.2 million cases of cardiovascular disease prevented. The greatest benefits would come from picking up undiagnosed high cholesterol in the short term and undiagnosed diabetes in the long term.
The researchers acknowledge that their results depended on accurate modelling of current care in England, which, in turn, drew on a range of data sources that were sometimes based on relatively small numbers. And the figures might be an underestimate, because the model didn’t include some vascular conditions such as peripheral vascular disease, they point out.
Nevertheless, they conclude: “Substantial cost savings and health benefits would accrue if all individuals with conditions that increase [cardiovascular disease] risk could be diagnosed, with detection of undiagnosed diabetes producing greatest benefits.”
Sticking to NICE guidance would further increase the health benefits, they suggest, adding that the “projected cost-savings could be invested in developing acceptable and cost-effective solutions for improving detection and management.”
What are the cost-savings and health benefits of improving detection and management for six high cardiovascular risk conditions in England? An economic evaluation, BMJ Open (2020). DOI: 10.1136/bmjopen-2020-037486
British Medical Journal
Optimal detection and treatment of cardiac risk could save millions of lives and billions of pounds (2020, September 10)
retrieved 10 September 2020
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