AQ: Australian Quarterly July - Sept 2016 by AQ: Australian Quarterly

VOL 87 ISSUE 3 JULâ&#x20AC;&#x201C;SEP 2016

The Difficult Problem: Chronic Pain & the Politics of Care

SMART CITIES:

Socio-Technical Innovation for Empowering Citizens

STATE OF THE NATION: Queensland

FROM THE ARCHIVE: Pauline and the Magic Pudding

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CONTENTS

AQ VOL 87 ISSUE 3 JUL–SEP 2016

The Surprise State:

Smart Cities:

From the Archive:

More than Rocks, Crops and Beaches

Socio-Technical Innovation for Empowering Citizens

Pauline and the Magic Pudding

DR GEOFF GARRETT AO

IMAGE CREDITS: Please see article placements

DR CHRIS EIPPER

PROF ALI BABAR

The Difficult Problem:

Electoral Reflux

References

Chronic Pain and the Politics of Care

DR CHRIS EIPPER

SEAMUS BARKER AND PROF G. LORIMER MOSELEY

COVER IMAGE: © Sergey Nivens - Fotolia.com

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A WORD

Australian Quarterly

y the time you read this, we will have had ourselves an election. Yet one thing is increasingly obvious – something that bears out in this edition: How the country votes is, in many ways, irrelevant. If the fabric of politics and the tapestry of Australian culture doesn’t perceivably change, then elections and their oxygensucking campaigns are simply an act of theatre.

Though it seems like the legs of politics are pumping ever faster, occasionally a spectre of the past will raise its head, reminding us that we can’t so easily outrun ourselves. This election, that spectre is Pauline Hanson, once thought locked back in the depths of our collective subconscious. 18 years is an epoch in political circles. 18 years ago John Howard still had almost a decade left in him; he had just taken the GST to an election and was being forced to compromise on his full sale of Telstra; parliament was debating the wording of the 1999 referendum to become a republic. In this edition we reprint Dr Christopher Eipper’s 1998 article Pauline and the Magic Pudding. The echoes are uncanny – there’s the Double Dissolution, the shadow of the ‘recession we had to have’, the war between business economy (Jobs and Growth!) vs social economy, and the fear of the foreign. All we’ve done in the last two decades is switch enemies. Whether or not Turnbull’s Double Dissolution holds open the door to parliament for Pauline’s One Nation is immaterial; that Australia remains fertile soil for populist fear-mongering is what matters. Looking forward though, and AQ contemplates the drive towards ‘Smart Cities’. What will the metropolises of the future be like? Autonomous cars commuting on solar-powered roads, city-wide information networks augmenting every aspect of our lives? Our cities are already changing; Australia can be a world-leader if it embraces the possibilities. Also, we take a look at the politics of pain. From Descartes to the modern day, our out-dated understanding of chronic pain only adds to the social and economic burden of this debilitating issue. And lastly, Dr Geoff Garret AO, Queensland’s Chief Scientist takes us through the state’s diverse and exciting scientific opportunities, proving that the Sunshine State is more than just rocks, crops and beaches. Much food for thought,

Grant Mills

Editor

NOTES FOR CONTRIBUTORS AQ welcomes submissions of articles and manuscripts on contemporary economic, political, social and philosophical issues, especially where scientific insights have a bearing and where the issues impact on Australian and global public life. All contributions are unpaid. Manuscripts should be original and have not been submitted or published elsewhere, although in negotiation with the Editor, revised prior publications or presentations may be included. Submissions may be subject to peer review. Word length is between 1000 and 3000 words. Longer and shorter lengths may be considered. Articles should be written and argued clearly so they can be easily read by an informed, but non-specialist, readership. A short biographical note of up to 50 words should accompany the work. The Editor welcomes accompanying images. Authors of published articles are required to assign copyright to the Australian Institute of Policy and Science, including signing of a License to Publish which includes acceptance of online archiving and access through JSTOR (from 2010) or other online publication as negotiated by the Australian Institute of Policy and Science. In return, authors have a non exclusive license to publish the paper elsewhere at a future date. The inclusion of references and endnotes is the option of the author. Our preference is for these to be available from the author on request. Otherwise, references, endnotes and abbreviations should be used sparingly and kept to a minimum. Articles appearing in AQ are indexed ABC POL SCI: A Bibliography of Contents: Political Science and Government. The International Political Science Abstracts publishes abstracts of political science articles appearing in AQ. Copyright is owned by the Australian Institute of Policy and Science. Persons wishing to reproduce an article, or part thereof, must obtain the Institute’s permission. Contributions should be emailed to: The Editor at info@aips.net.au

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EDITOR: Grant Mills ASSISTANT EDITOR: Camille Thomson DESIGN AND PRODUCTION: Art Graphic Design, Canberra PRINTING: Newstyle Printing, Adelaide SUBSCRIPTIONS: www.aips.net.au/aq-magazine/ subscribe ENQUIRIES TO: Camille Thomson, General Manager, AIPS, PO Box M145, Missenden Road NSW 2050 Australia Phone: +61 (02) 9036 9995 Fax: +61 (02) 9036 9960 Email: info@aips.net.au Website: www.aips.net.au/ aq-magazine/ Facebook: www.facebook.com/ AQAustralianQuarterly ISSN 1443-3605 AQ (Australian Quarterly) is published by the Australian Institute of Policy and Science. This project is supported by the Commonwealth Government through a grant-in-aid administered by the Department of Finance and Deregulation. ACN 000 025 507 The AIPS is an independent body which promotes discussion and understanding of political, social and scientific issues in Australia. It is not connected with any political party or sectional group. Opinions expressed in AQ are those of the authors. DIRECTORS OF THE AUSTRALIAN INSTITUTE OF POLICY AND SCIENCE: Leon R Beswick (co-Chair) Andrew Goodsall Maria Kavallaris (co-Chair) Janelle Kyd Suresh Mahalingam Ross McKinnon Peter M McMahon Peter D Rathjen

STATE OF THE NATION: QUEENSLAND

The Surprise State

More than Rocks, Crops and Beaches So what does a Chief Scientist do?

~ My question,

back in the middle of 2010, when Queensland’s first and excellent Chief Scientist, Peter Andrews called me. Seven years into the job and looking to ‘retire', he emphasised "it's the best job I've ever had!"

ARTICLE BY: DR GEOFF GARRETT AO

ersonally, I've always been a fan of Queensland, and Queensland science – beginning with my first visits as a brand new Australian, to head up CSIRO, in January 2001. We rapidly caught The Smart State vision of the then-Premier, Peter Beattie and his team, who were seeking to lay the foundations for a more diversified economy that went beyond the ‘rocks, crops, and beaches’ label. And they were ‘putting their money

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his approach is presumably intended to reduce the Government’s fiscal risk, and the associated ‘moral hazard’ assumed to arise if governments were to accept subjective reports of pain as a legitimate basis for a claim to relief. However, could such an essential scepticism of the reality and legitimacy of a person’s pain contribute to the difficult

IMAGE: © Neuro Orthopaedic Institute

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THE DIFFICULT PROBLEM: CHRONIC PAIN AND THE POLITICS OF CARE

One in five Australians, about the same population as Sydney, suffers from chronic pain that reduces their quality of life. Chronic pain cost Australia AUD 34 billion in 2007.

problem, by encouraging stigmatisation of chronic pain sufferers, damaging doctor-patient relationships, compelling unnecessary scans and tests, and incentivising ongoing disability and old-school treatment approaches? Chronic pain is, by definition, chronically unpleasant and chronically protective. We contend that the politics of chronic pain bear some semblance to chronic pain itself. That is, powerful and complex protective mechanisms for avoiding fiscal risk and maintaining the equilibrium of the body politic have become maladaptive and self-defeating. We discuss biological and sociological reasons why the politics of chronic pain may be contributing to the problem itself.

The burden of pain and Australia’s National Pain Strategy Everyone knows what pain is but not everyone knows what it is like to have pain day in, day out, week after week, month after month. A surprising number of Australians do however, and it is their pain that stops them from going to work, school, university. It is their pain that wreaks havoc on their mood, their relationships, their engagement in meaningful or

productive activity. The realisation of the unmet needs of people in chronic pain led to the development in 2010 of Pain Australia – a coming together of some leading pain experts, consumer groups and key stakeholders. Their purpose was to develop a National Pain Strategy – a way out of what was seen by some at the coalface, to be a complete mess and a national disgrace. Fifteen months and a posh gathering in Parliament House’s Great Hall later, the National Pain Strategy was completed and presented to representatives of both Federal and State Governments. By way of introduction, the Strategy document described the huge personal and economic burden of pain in Australia, the problematic current state of pain management, the barriers to improved outcomes, and a strategy aimed at solving the problem. What exactly is the burden of chronic pain? Access Economics’ pivotal cost analysis is ageing but remains compelling: one in five Australians, about the same population as Sydney, suffers from chronic pain that reduces their quality of life. Chronic pain

cost Australia AUD 34 billion in 2007 – AUD 7 billion in direct healthcare costs; AUD 11.7 billion in lost productivity; AUD 11.5 billion in burden of disease; AUD 2.6 billion in ‘deadweight losses’ – welfare payments and lost taxation revenue. Individual pain sufferers bear 55%; the Federal Government 22%; State Governments 5%; the remainder covered by charities, employers, friends and families. More recent figures indicate that costs are rising in line with the costs of care and lost productivity and early retirement, such that our own figures reflect those of the USA and Europe, where chronic pain is more costly to society than cancer and diabetes combined. It is no understatement to suggest that, when it comes to societal impact of health problems, chronic pain can be seen as ‘the difficult problem’. The personal burden of chronic pain is largely a private affair. By definition, pain is unpleasant, and chronic pain, therefore, is chronically unpleasant. The impact of chronic pain often infiltrates every aspect of the sufferer’s life: it threatens their ability to participate in meaningful life activities, such as socialising with friends, family, children, maintaining relationships, having sex, being active, caring for dependents, working. It brings with it depression, fear of injury and activity, anxiety. It can bring with it a suite of bodily disturbances – disturbances of internal temperature regulation, movement, thought, digestion, sleep, sensory processing. Attempts to gain even temporary relief are associated with side effects and risk of addiction and accidental (or

IMAGE: © Harald - Flickr

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IMAGE: © Dept of the Prime Minister and Cabinet

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ike everywhere else, Australian governments, councils, and private sectors are realising that it is becoming imperative to find solutions to effectively and efficiently manage city resources while providing social and environmental standards relevant to the norms and values of their citizens. Recently, the Turnbull government released their ‘Smart Cities Plan’ 1 – a document that advocates the concept of ’30 minutes cities’ – to guide urban planning

SMART CITIES: SOCIO-TECHNICAL INNOVATION FOR EMPOWERING CITIZENS

A ‘Smart City’ helps capitalise on opportunities while easing the challenges of urbanisation.

so that a city’s residents can have access to employment, shopping, services, recreational facilities and schools all within 30 minutes of their homes. Its aim is to act as a framework for policy and decision making, at the city and federal levels, to improve Australian cities and regions, along with the expectation that appropriate infrastructure planning and investment will support the plan. The federal government’s ‘Smart Cities’related initiatives are coincident with many debates and initiatives supporting sociotechnical innovation and entrepreneurship, which have the potential of delivering benefits to all Australians. Advances in Information and Communication Technology (ICT) are at the centre of the socio-technical innovation that underpins ‘Smart City’ programs

all around the world. And at the very core of the innovation driving the ‘Smart Cities’ agenda, needs to be extensive and robust engagements and collaborations between different stakeholders, including governments, councils, citizens, industry, and universities. Any discussion about ‘Smart Cities’ needs to look into the needs, different forms, and mechanisms for conceiving and materialising ‘Smart Cities’ initiatives in their respective contexts. With ‘Smart City’ becoming a catchphrase, initiatives and platforms are mushrooming. Whilst rapid urbanisation introduces challenges to city services and infrastructure, an increased population also creates economic opportunities and social advantages for citizens. A ‘Smart City’ helps capitalise on opportunities while easing the challenges of urbanisation.2 This means that improving

cities’ infrastructures towards ‘smartness’, as well as educating the next generation with IT skills, is crucial for future economic growth and competitiveness. So what is a ‘Smart City’ and what types of challenges can be involved in conceiving, creating, and evolving a ‘Smart City’?

Human Before Machine There exists a large variety of definitions to describe a ‘Smart City’, which has also been referred as: digital cities, intelligent cities, ubiquitous cities, information cities and also creative cities, knowledge cities, learning cities, and smart communities. Based on our own perspective and work, we define a ‘Smart City’ in this way:

A Smart City embodies innovative solutions enabled by digital technologies for effectively and efficiently creating and sustaining liveable and vibrant infrastructures and ecosystems for socioeconomic benefits of involved stakeholders including communities, enterprises, and governments in the 21st century.

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Electoral Reflux Dr Chris Eipper looks back at his 1998 article, Pauline and The Magic Pudding, and wonders whether history – as a dish served cold – is a cultural choking hazard.

ARTICLE BY: DR CHRIS EIPPER

istory’s nothing if not a “cut-and-come-again” pudding. Our enjoyment can’t compare with Bunyip Bluegum’s, Bill Barnacle’s and Sam Sawnoff’s delight in theirs though. History’s too difficult to digest; it repeats on us, and never more so than at election time. We should be thankful we’re so seldom treated to a Double Dissolution. When forced to endure regurgitation, I’d advise becoming a connoisseur of it. Hence these ruminations. None come infected with the full fly-blown salmonella, but the risk remains. Boiled down, the government’s election slogans have mostly had the

pig-shooter capable of bringing home the reek of yesteryear: bacon. No mention was made of Ricky • “Just because you can’t stomach us supplying either the rifle or the ute. A bloke doesn’t mean you won’t choke on who knows a bloke tells me they called the that lot.” pig Clive. I don’t believe it. If anyone can • “We’re offering all you can eat, but watch dodge a bullet, it’d be him. Not everyone out when they say it, they didn’t include does. Joh didn’t, even if Little Johnny did the tax.” linger on. • “Buy our budget meal, theirs is way Yet who’d have predicted Lazarus with worse — don’t be sucked in, it’s a black a triple bypass and his budgie-smuggling hole designed to empty your pockets buddy would give birth to a love child and fill your house with foreigners.” called Scott? Or that Not that the other randy Tony and blousy parties were ever Bronnie would call theirs serving up anything A bloke who knows a Policeman Pete? Who’d spectacular. As for bloke tells me they called have imagined the best the ferals, the best way to save asylum showed some convicthe pig Clive. I don’t seekers from themselves tion, but the worst believe it. If anyone can would be to stick them in were full of passiondodge a bullet, it’d be concentration camps? ate stupidity. Who’d him. Not everyone does. The Wonderland of have thought that Oz has always been a bit Pauline would turn Joh didn’t, even if Little rabbity. Now it’s got to into one of the great Johnny did linger on. where Alice shacks up try-hards of Australian with Dorothy and out politics and still skips little Annabelle appeal to something Crab-apple. Who else could lure politicians like a quota of Queenslanders? into pretending their place was in the Who’d have guessed she’d spawn a kitchen, while still feeling entitled to those surrogate baby sister? No sacrificial lamb, sugar-coated puddings of hers? our Jacqui, just a true-blue Tassie Devil! Seconds anyone? AQ The Betoota Advocate featured her as a

IMAGE: David Jackmanson - Flickr

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18 YEARS AGO:1998

FROM THE ARCHIVE

FROM THE ARCHIVE:

Pauline and the Magic Pudding This article is an edited version of a piece that ran in the July-August 1998 edition of AQ. To read the original article see: www.aips.net.au/aq-magazine/ current-edition-July-Sept-2016/

Increasing numbers of Australians are chasing a new political dish. But having had their fill will they soon lose their taste for it? ARTICLE BY: DR CHRIS EIPPER

ustralia's in strife, the word has passed around: the magic in the pudding's been whisked away. Why, who's responsible, and what we have to do to get it back, is not something about which we can agree as Australians. The phenomenal electoral success of Pauline Hanson's One Nation Party in the Queensland election would seem to indicate that around a quarter of that State's electorate has been prepared to identify itself with a populist, protectionist, racialised view of the world.

The media's response to the election has provided both a confirmation of Hanson's achievement and a publicity platform upon which her party can now build. Her success has meant her critics have been obliged to show her a degree of begrudging respect that it has hitherto been all too easy to deny her. Similarly her support base: it's been shown to be rather more "mainstream" than most commentators hoped it might be or made it out to be. The difficulties now confronting the Coalition Government have been stressed – among these: the threat to the National

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The Difficult Problem: Chronic Pain and the Politics of Care Chronic pain is arguably ‘the difficult problem’ in health care, not just because of its massive burden on the bottom line. Even though pain is essentially private and invisible, the Australian Government defines pain in terms of ‘proof’ – either of an organic lesion understood to cause the pain, or of a level of disability arising from the pain. However, could such an essential scepticism of the reality and legitimacy of a person’s pain contribute to the difficult problem, by encouraging stigmatisation of chronic pain sufferers, damaging doctor-patient relationships, compelling unnecessary scans and tests, and incentivising ongoing disability and old-school treatment approaches? SEAMUS BARKER AND G. LORIMER MOSELEY

Smart Cities: Socio-Technical Innovation for Empowering Citizens By 2020, 80% of the world’s population is expected to be living in cities. Some estimates are predicting that the cost of urban congestion will reach $37.7 billion by 2030. Under the pressure of such drivers governments, councils and leaders in all spheres of life are rethinking urbanisation and are looking to futuristic solutions to improve the liveability, sustainability and economy of our urban spaces. It won’t be long until we are all living in ‘Smart Cities’, fully networked cities that provide increased efficiencies to their citizens. But how to minimise the risk of developing these complex projects, and how to capitalise on the global ‘Smart City’ trend? Within Australian Universities might lie the answer… ALI BABAR

The Surprise State – More than Rocks, Crops and Beaches Queensland has a global reputation for its sun, surf and natural wonders. Yet the Sunshine State is also readily becoming known for its world-class research, modern trans-disciplinary institutes, and its budding entrepreneurial sector. Supported by some innovative government initiatives, the Queensland science landscape is looking increasingly diverse, proving that there is more to the state than just rocks, crops and beaches. Queensland’s Chief Scientist, Dr Geoff Garrett gives us the bird’s eye view of his state’s science opportunities in the next of our State of the Nation series.

IMAGE CREDITS: Please see article placements

GEOFF GARRETT AO

From the Archive: Pauline and the Magic Pudding Just when you thought Pauline Hanson and One Nation had been shoved deep into the recesses of Australia’s collective subconscious, the spectre of Fortress Australia once again raises its head. AQ looks back to 1998 when One Nation came of age – and the parallels to modern Australia are eerie. The Double Dissolution, the shadow of the ‘recession we had to have’, the war between business economy (Jobs and Growth!) vs social economy, and the fear of the foreign. It seems like all we’ve done in the last two decades is switch enemies… CHRIS EIPPER

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