One of the best lessons you can learn in life can be summed up in a few words, thanks to a saying that’s been around for centuries; “Fool me once, shame on you. Fool me twice, shame on me”
Everyone Almost everyone knows the line well. The idea is if someone fools you once, shame on them for tricking you. But if they fool you a second time, shame on you for letting them. The saying doesn’t go on to mention third, fourth, fifth times and so on, but you get the idea. Given deception and trickery is so prevalent in this day and age, perhaps it’s time the old saying was given an update to reflect the times.
It’s concerning how often we see organisations, public figures, the media and others being flexible with the truth to push their own agendas. Whether it’s misquoting people, exaggerating or bending the truth, misrepresenting statistics or having the audacity to shamelessly manipulate data, we see it often and at various levels of seriousness. It’s that common we’ve come to be expect it from our politicians, lobbying groups, journalists and co. Fortunately, most people are intelligent enough to know that most claims need to be taken with a grain of salt, and due diligence is always recommended.
However when it comes to those in the medical profession, it’s a different story. Those who take the Hippocratic Oath have always been seen as pure bastions of truth who only have our best interests at heart. We often confide in our doctors and nurses more willingly than we do our loved ones. We don’t think to question this trust, rightfully so in most cases. Doctors and nurses devote themselves to saving lives, healing the injured and curing the sick. There is no reason to suspect an ulterior motive here and 99.9% of the time this trust is not abused. But as we have learned from scrutinising reports and data trumpeted by Dr Gordian Fulde, even the most noble amongst us is capable of telling a few white lies….
Dr Fulde was responsible for a study published in The Medical Journal of Australia in August last year titled “Presentations with alcohol-related serious injury to a major Sydney trauma hospital after 2014 changes to liquor laws”. The objectives of the report were as follows –
The full study can be found here. Many of the findings came of no real surprise for those with knowledge of recent crime trends or those with common sense. Predictably, on the surface the results of the study seemed to strengthen the position of Dr Fulde and justify his hard line stance. However under closer scrutiny, the data used curiously appears to have been misconstrued somewhat and crucial key factors have been left out completely. The report comprises data which the author was personally responsible for creating and the end result appears to be a biased study full of misrepresented and/or inflated statistics with the purpose of pushing an agenda via deception. Basically what government funded (100% independent!) temperance society FARE do on a regular basis.
Before looking at anything else, it needs to be noted there are two major flaws with the report. Firstly, St Vincent’s obviously does not just cater for Kings Cross and the CBD entertainment precinct. St Vincent’s caters for a large percentage of the Eastern Suburbs and accepts patients from areas outside the zone such as Double Bay, Bondi Junction, Bondi, Moore Park, Paddington, etc. A perfect example is this incident – a man who had earlier attended an A-League match at Moore Park was attacked outside McDonalds in Bondi and taken to St Vincent’s – which would have been included in the report.
Therefore if we don’t even know where the patients are coming from, how can this data be of any relevance to the objectives of the report? This point has been disregarded and those patients been included with no explanation or clarification. The only legitimate reason I can think of that’s remotely plausible is to take into account displacement, something that has long been denied. But if that was the case, the study is meaningless without data from Royal Prince Alfred and Prince of Wales.
The second reason is the integrity of the data. Whilst the report does acknowledge “To avoid any bias, the researchers were blinded to which year was being analysed” it then goes on to admit “One of the authors (G F) was assigned as the sole assessor who identified cases of alcohol-related serious injury”. Dr Gordian Fulde was assigned as the sole assessor, meaning he and he alone would be able to pick and choose what data would be included in the study. Findings cannot be blindly trusted when the author was also the one who classified the data to be analysed at the best of times, let alone when there is a very public history of bias and a clear conflict of interest. Yet in this case it appeared as though the author who had intimate knowledge of the cases presented had the total power to include or exclude as he pleased.
Whilst the report credited three authors, it is clear that one has far more authority than the others. The practice of including multiple authors was once regarded as a way of displaying transparency and peer-review, but has recently been questioned by the academic community. Not to mention the Emergency Department Information System (EDIS) where ER data is captured is far from reliable and its implementation has been responsible for deterioration in patient care and hospital performance.
“In order to identify patients injured by serious assault, but also those suffering other serious injuries and major traumas associated with alcohol (such as vehicular and pedestrian injuries, or falls from a height), the presenting symptoms, triage assessment and diagnosis of all patients who presented as a result of serious trauma during the periods of analysis were examined for any reference to alcohol. All patients identified in this manner were included in this study”
Given these two factors we have established, it is appears clear that the report is essentially just meaningless rhetoric. To quote its findings without proper scrutiny or clarification would be negligent and misleading. The extract above shows us the scope of incidents Dr Fulde was able to include at his discretion. Like the Bondi incident mentioned earlier, a pedestrian hit by a drunk driver in Woollahra or a rider coming off their bike in Vaucluse having consumed alcohol earlier in the day would be included in this study. An intoxicated man falling from a balcony in Rose Bay or a young lady who needed their stomach pumped after consuming too much alcohol throughout their day before somehow ending up in Kings Cross would also be included in the report.
It’s interesting to observe the information published by Dr Fulde related to presentations at various times of the day. Firstly, if this was a true study into the impact of the new liquor laws, the majority of the day would be immaterial. Surely the only times that mattered would be those times the laws were in effect. Despite this, the results still made interesting reading. The difference between “before” and “after” is most noticeable between 1am and 2am. This is understandable, as at this stage people are under the supervision of venue staff and security who take their RSA obligations very seriously. This has always been the case, especially on the night Daniel Christie was attacked. Shaun McNeil was denied entry from multiple venues who were all doing the right thing. If only local area police were holding up their end of the bargain, perhaps we would not even be having this discussion. But more importantly, perhaps a life would have been saved.
Looking at weekend stats, or High Alcohol Time (Hat), what is intriguing is between 11pm and 1am incidents have actually increased. The report was quick to label this fact as a “small increase” and only gave us this weak suggestion as to the cause – “The small increase in alcohol-related injuries between 9 pm and midnight after the changes were introduced may have been related to increased alcohol intake earlier in the evening (“preloading”), before the times when the various bans take effect; the 1 pm spike may reflect lunchtime alcohol consumption.” Strangely. the increase was totally dismissed. Perhaps because it did not support the author’s agenda.
Come to think of it, why on earth are we even including anything that happens during the day? If we look at the graph above we can see reductions at 1pm (2 to 0), 2pm (1 to 0), 3pm (2 to 1), 4pm (4 to 0) and 5pm (3 to 1). Aside from the post 1am decrease when everyone is inside, the next biggest drop is seen at 8pm (8 to 2) then 10pm (11 to 7). That’s 10 less during the day and late afternoon and 10 less in the early evening making it 20 less before midnight. In fairness, this is balanced out slightly by increases at 7pm (2 to 3), 9pm (3 to 6) and 11pm (12 to 14). I’ll be generous and not question reductions up until 6am, as that’s no doubt attributed to the fact nobody is around to get themselves into an incident. Between 7am and 1pm there is barely a change, going from 2 to 1.
In total, this brings the total reduction of incidents that has occurred during hours not remotely relevant to the lockout laws to 16 presentations.
2am – 4am sees a slight decrease as does 4am – 6am. In the case of the latter, the numbers show barely any change of statistical relevance. Over the entire night the numbers are so small compared with decreased patronage of up to 84% in this City of Sydney report, that per person you are statistically far more likely to be assaulted if you’re out in the precinct.
The fact is the data, when analysed correctly, tells a very distinct story. Just not the story Dr Fulde and other lockout “supporters” want to hear. Hence why Dr Fulde seemingly preferred to base his report on a blanket period from 6pm Friday to 6am Sunday, rather than individual times. Hence why he ostensibly preferred to use information he personally categorized – regardless of whether or not it related to the topic or whether or not it even occurred in the precinct. There are a number of reasons why this may of occurred, but given the overall situation there only appears to be one that I would be confident betting on, and that is to misconstrue. With real statistical analysis the entire argument falls flat on its face (incidentally if a person were to have done this and ended up at St Vincent’s, they would also be included in the report).
Even if you were to take Dr Fulde’s findings exactly as presented (as above), the report is still not impressive in the slightest. They do not even remotely provide any hard hitting evidence to back up lockout supporters Even if you disregard everything you have read so far, and take the report purely on merit, the findings of his result speak for themselves. The reduction in serious trauma cases during “High Alcohol Time (HAT)”,turns out to be a grand total of 34 incidents. 34! Although it sounds better when presented as 24.8% But as we found earlier, presentations had dropped by 16 between midday and midnight. Lockout begins at 1.30am, so that reduction has no relevance. All of a sudden we’re looking at a reduction of 18.
This is without looking at what we’ve discussed today. This is even without taking into account the Nigerian scam email of policy, the Alcohol Linking Program With a proper breakdown of incidents included in the study that figure is far, far less. Possibly even single figures. The whole “even if it only saves one life” argument should never be used in intelligent discussion, but it is especially illogical here given people are statistically more at risk. Yet people still want to claim that the laws have worked???
Just to further muddy the water, as per the study presentations in the year preceding lockout legislation came in at 6,467. The following year they saw 6,643. An increase in 176. Dr Fulde opted to completely ignore these numbers in what can only be described as a grown ups version of “if I can’t see you, you can’t see me”. Not a single, solitary acknowledgement was given. I’m not going to speculate on possible reasons for the increase, but it is food for thought. Especially given the process for categorising incidents….
Dr Fulde often talks about the “warzone” and the “carnage” down at St Vincent’s ER, but his hysteria has had a bucket of cold water thrown over it by his own research. Failing a trip to Syria to observe a real warzone, I suggest Dr Fulde spends a few days a week lending his expertise to one of our hospitals out west. That’s where the real “carnage” is. In the last couple of weeks alone we’ve seen a defenceless individual savagely bashed by a gang of grubs in Mount Druitt. We’ve seen a mass brawl involving dozens of thugs beating the living shit out of each other at a petrol station in Macquarie Fields. We’ve seen a wild brawl outside Westfield in broad daylight that sent bystanders running for cover in Parramatta. Would these scenes not be far more fitting of all the hysterical hyperbole? I dare say a week in Blacktown or Liverpool ER would be somewhat of a reality check
Whilst obviously any level of violence is unacceptable, the good doctor fails or refuses to realise that there is a far bigger problem outside of the Kings Cross bubble. I covered the issue of “fuckwit related violence” at length in this article, and it is truly the real issue at hand. It’s an uphill battle, especially when kids have no respect for the law or other human beings, parents have no interest in taking responsibility and magistrates that; well, who knows what the hell they’re doing. Taking steps to address the real problem requires time, thought and actual effort to address, not just a Baird-Aid solution slapped over a three word slogan.
The figures above are taken from a report by the NSW Bureau of Crime Statistics and Research (BOCSAR) also published in August 2015. The report, titled “That’s Entertainment: Trends in late-night assaults and acute alcohol illness in Sydney’s Entertainment Precinct” examined police reported grievous bodily harm & assault and acute alcohol illness emergency department presentations that occurred between 10pm and 6am from 2004 to 2013. This study only included incidents that had occurred within the entertainment precinct. A far more accurate and relevant sample, not to mention independent. The report showed that violence had been on a steady decline since 2008 and illness was at a steady level. It concluded, quite rightfully, that continued alcohol harm remained to be addressed. It also showed nothing to suggest lockouts were a remotely viable solution to a complex issue. In fact, it shows that the laws that were eventually implemented were ill-conceived and of little relevance to the issue they were supposed to be addressing.
The 4 graphs in the slideshow above are also taken from BOCSAR and show assault data from the period of Dr Fulde’s study, as well as from 2008 when violence began decreasing noticeably. Late last year the herald presented statistics supporting the displacement theory. Statistics such as these are of far more use and relevance than the questionable data presented by Dr Fulde. BOCSAR simply provides the facts. Enormous potential variables such as location and equivocal incidents are just not a factor. Nor is emotion applied. This is the only data worth looking at, not the ambiguous, hand-picked findings of a man with an fairly strong agenda. We all have a common goal here, and that is to put a stop to violence. We should be working together, not trying to con each other. How are we supposed to develop effective ideas and strategies if one side continuously tries to undermine the other, especially in this manner? It’s a shame the holier than thou side of the discussion will not acknowledge the bullets they’ve put into their own feet. We cannot achieve tangible results without cooperation.
Dr Fulde has been one of the biggest lobbyists for this legislation, alongside good pal and fellow Thomas Kelly Youth Foundation director, Ralph Kelly. This association is of great significance. Thanks to our initial report into casino interests potentially funding The Thomas Kelly Youth Foundation as well as the subsequent revelation of Ralph Kelly’s exorbitant salary, questions are being asked in the mainstream media regarding the activities of those involved. Dr Fulde is one of only two current directors who have been involved since the start, the other being Macquarie Bank heavy, Guy Reynolds. Dr Fulde and Mr Reynolds were two of just three who voted to approve Ralph Kelly’s salary in 2013.
I’m curious to know what went down late 2013 which made 3 directors, including long term family associate Dr Tim Hawkes, abruptly cut ties with the foundation. Whatever it was, it wasn’t enough to rattle Dr Fulde or Mr Reynolds. The Star and Macquarie Bank have a deep association (that will be discussed in greater detail in an upcoming article) which goes some way to potentially explaining Mr Reynolds involvement and obvious conflict of interest. But what of Dr Fulde? Where does he fit in to all this? He must have some idea who he is in bed with, and everything that is going on around him. Just look at the Safe Space funding program, there is a conflict at every corner. Is it possible he is just turning a blind eye to any potential wrongdoings?
Casinos have a long history of digging deep and donating to worthwhile causes as a way of offsetting the damage they cause in the community. In general, that is something I have no issue at all with. Hospitals need and deserve all the additional funding they can get. In fact, I’m going have a google and find something good to donate a few bucks to today. St Vincent’s has been the grateful recipient of many generous donations over the years both from Echo / Star Entertainment obviously the Packer family / Crown. The Packers have a 50 year association with the hospital and Roslyn Packer sits on the board of trustees. Recently The Packer Foundation pledged millions to St Vincent’s to assist a truly worthwhile cause, with the money going towards funding long distance organ retrievals. This is undoubtedly fantastic for both the hospital and the community and is part of the reason why casinos get a pass in this area. The damage they cause can be seen as a means to an end. But is it possible that financial support for the hospital is conditional? Could it be Dr Fulde believes furthering casino interests at the expense of small business, local economy, culture and freedom is just a means to an end as well?
Dr Fulde is obviously a highly intelligent man. He has enjoyed a brilliant career in the medical profession, with many achievements to his name and many countless accolades earned. Deservedly so. Which is why I cannot accept any suggestion that he would publish and promote these findings by error. Anyone can see that the statistics do not justify the laws that he feverously campaigns for and defends. So why? Could he be such a staunch supporter of unjust legislation simply because he is tired, jaded and cynical? Is it confirmation bias? A combination? Perhaps, but if this was the case it would be even more reason to ignore testimony that is clearly fuelled emotion. It’s understandable considering he no doubt would have seen and dealt with a lot over the years. But if this is the case, his word has no weight and he should not preach it. By the same token, it is foolish of people to take it as gospel.
It seems obvious from his recent outburst on Q and A that there is something here we do not know. For those who missed it, Dr Fulde goes on a bizarre, barely coherent rant where he discredits the lockout laws, appears to endorse binge drinking & “preloading”, talks about drinking a bottle of wine at 4am and recommends people “go to the casino”. This is despite the fact the casino and surrounding area is arguably more violent than the CBD entertainment precinct and Kings Cross. This is also despite acknowledging or considering the vast array of health, social and economic issues that can arise through problem gambling.
What is the motivation for this and everything else? For all we know the good doctor and recently appointed Senior Australian of the Year may be strategically positioning himself for a lucrative, post-medicine career on the speakers circuit.
Either way, Sydney has always been a bit crook, but the last couple of years have felt like Baz has re-introduced the plague and I don’t like all these symptoms.
What’s the diagnosis, Doc?
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