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US right up in arms over treaty

More than 65 countries have signed an arms trade treaty that has been championed by Australia at the United Nations since work began on it in 2006.
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Speaking after signing the treaty on Monday at the UN’s New York headquarters, Australia’s Minister for Defence Materiel, Mike Kelly, said it was moving to be present at the culmination of such a long effort to bring about a treaty designed to reduce the suffering caused by the unregulated international flow of conventional weapons, especially small arms.

He paid tribute to Peter Woolcott, Australia’s Permanent Representative to the UN in Geneva, who was president of the drafting conference for the treaty.

The treaty requires signatories to monitor the sale of conventional weapons by manufacturers and prevent their flow to the black market or to groups that may use them to commit genocide, crimes against humanity or war crimes.

With 154 nations voting for the treaty and only three opposing it – Syria, North Korea and Iran – it is expected to soon win ratification in 50 nations to take effect some time in the next two years.

But despite this overwhelming support it is not clear whether some of the world’s largest arms makers, including Russia and China, will sign it.

And though the treaty has the support of the Obama administration it is not clear if it would survive a ratification vote in the US Senate, where many conservatives are hostile to any measure that could be interpreted as an infringement on gun owners’ rights.

So eager were some members of the Senate to vote against it that they did not even wait for its signing, but voted on a motion against it earlier this year. One of those was Republican senator Jerry Moran, who has criticised the treaty for failing to explicitly recognise the right of individuals to bear arms.

”The United States should ratify treaties only when they are in our national interest, clear in their goals and language, respect our sovereignty, and do not create any openings to infringe upon our constitutional freedoms,” he said.

Secretary of State John Kerry dismissed those concerns, saying, the treaty ”will not undermine the legitimate international trade in conventional weapons, interfere with national sovereignty, or infringe on the rights of American citizens, including our Second Amendment rights”.

Nonetheless, America’s most feared lobby group, the National Rifle Association, which has close ties to manufacturers of rifles and ammunition that could be affected by it, has spoken out against it, effectively putting politicians on notice that they could be criticised for voting for ratification.

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City targets energy drinks

The New York City Health Department, locked in a court fight with an industry group that includes Coca-Cola and PepsiCo over a ban on large serves of sugary soft drinks, is now going after sports drinks, teas and energy drinks that it says can be just as deadly.
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New television ads and subway placards flash pictures of fruit-flavoured drinks containing added sugar, saying the healthier-sounding choices can cause obesity and diabetes.

One of the TV ads depicts a patient with amputated toes from diabetes, an overweight man slugging a neon-blue sports drink and a surgeon picking at a diseased heart with tweezers.

”Non-soda sugary drinks have been marketed as being healthier, with references to fruit and antioxidants, vitamins and energy,” said New York City Health Commissioner Thomas Farley, a medical doctor.

”We’re trying to warn them that these drinks can have as much or more sugar and calories as soda because we still have a major epidemic of obesity,” he said.

”Once again, the New York City Health Department is oversimplifying the complex set of factors behind obesity,” said Chris Gindlesperger, a spokesman for the American Beverage Association. ”Selectively picking out common grocery items like sugar-sweetened beverages as a cause of obesity is misleading.”

Dr Farley noted that while a 20-ounce (590-millilitre) Coca-Cola has 240 calories, a Red Bull energy drink of the same size contains 275 calories.

The expanded campaign comes before a showdown between beverage makers and the city in a New York state appellate court.

The city has appealed a permanent injunction issued on March 11 to stop a Health Department law pushed by mayor Michael Bloomberg that would cap the size of sugary soft drinks sold in restaurants, movie theatres, stadiums and arenas at 16 ounces (about 470 millilitres) a cup. Oral arguments will be heard on June 11.

Dr Farley said the new ads are not timed to coincide with the appeal, adding that the city is ”optimistic” the ban will be upheld.

The percentage of adults who said they drink one or more sugar-sweetened beverages a day declined from almost 36 per cent in 2007 to almost 30 per cent in 2011, according to a city tracking poll. Of youths surveyed in a similar poll, the percentage declined to almost 21 per cent in 2011 from about 28 per cent in 2005.

Last month, Coca-Cola said it would expand calorie labelling to the front of all packages and reiterated its pledge not to advertise to children under 12.

Beverage makers have used sports drinks, teas and energy drinks to help offset soft-drink sales declines in the roughly $US70 billion US industry.

PepsiCo, Coca-Cola and the beverage association spent as much as $US70 million on lobbying and issue ads between 2009 and early 2012, according to the Centre for Science in the Public Interest. In that time, at least 30 states proposed aggressive excise taxes on soft drinks, all of which failed amid industry push-back.

Whatever the cause, obesity in the US comes at a ”staggering” financial cost, the US Centres for Disease Control and Prevention has said. Everything from treatments for diabetes to lost work by obese employees cost Americans an estimated $US147 billion in 2008.

Bloomberg

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Just breathe

Remember to breathe. Simple, yes? Yet in stressful situations it is possible to either forget to breathe – not good – or to over-breathe, leading to hyperventilation, which affects blood chemistry.
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Breathing is the first and last thing we do, but how many of us do it right and what are the implications of getting it wrong?

Rule 101 is that nose breathing is king. It cleans and warms the air and filters particles such as dust and pollen. It also regulates the amount of air entering the lungs. When you breathe through your nose the sinuses work to filter the air. They also create pressure in the lungs on the ”out” breath, giving them time to extract adequate oxygen. A proper oxygen-carbon dioxide (C02) exchange is necessary for your blood to maintain a balanced pH level, which is key to good health.

Chronic mouth breathing is considered less healthy and can exacerbate allergies and lead to other health issues such as insomnia, sleep apnoea, dental problems, dry mouth and fatigue.

The average healthy adult at rest breathes in and out about 10-15 times a minute (one breath being an inhalation and an exhalation), which works out to be five litres to eight litres of air ingested. If you are running or doing physical exercise, you will obviously take in more.

Associate Professor David McKenzie is head of respiratory and sleep medicine at Sydney’s Prince of Wales Hospital. He says one way you can tell you are breathing well is by not noticing. To breathe well, he says, is to not think about it and to let the body’s automatic control systems work for you.

However, sometimes even the most natural systems need a hand. Breath training can be useful for athletes, or for those suffering with asthma, stress and anxiety issues – which can all be brought on by improper breathing.

Anxiety sufferers can feel breathless. Sometimes this is triggered by overthinking or misinterpreting normal breathing patterns, such as sighing.

McKenzie says sighs are normal and helpful. They ”reinflate the alveoli and redistribute the surfactant material on the inside of the alveoli, which reduces surface tension and so reduces the work of breathing”.

But he says people who are anxious tend to sigh more often and sometimes they’ll attach catastrophic significance to it and think there is something wrong with them.

”Then they get more anxious, suddenly they start hyperventilating and that’s when other symptoms occur, which are often a result of bad breath technique,” he says.

Hyperventilation causes carbon dioxide levels in the blood to drop, reducing blood flow to the brain. Symptoms include dizziness, tingling in the hands, numbness around the lips, confusion and a crawling sensation on the back of the neck.

“These symptoms can then be misinterpreted catastrophically and so the cycle continues,” McKenzie says. ”Psychologists are good at working with these problems through cognitive behavioural therapy.”

He says the Russian Buteyko breathing method, which trains people to slow their breathing, can help those with breathing problems, such as asthma. But he warns against practitioners who suggest asthma sufferers discard their medication.

Naturopath and author Mim Beim became a Buteyko practitioner after she found the practice helped her asthma.

Beim says that when you feel anxious, the body does, too. “The adrenal glands pump out adrenalin and cortisol, the nervous system is frantically sending electrochemical messages, muscles become loaded with tension, breathing rates increase and the immune system just tries to cope. Poor breathing affects your immune system and so many other things.”

The autonomic nervous system (ANS) is beyond our conscious control. The ANS is divided into two parts, the sympathetic (flight and fight) and the parasympathetic (relax and digest). The sympathetic nervous system is switched on by adrenalin, the stress hormone produced by the adrenal glands that is the predominant driver of anxiety. The parasympathetic nervous system helps the body to relax.

Beim says the Buteyko breathing technique teaches people how to access the parasympathetic nervous system.

“The method reduces airway inflamm- ation, constriction and spasm, allowing the patient to breathe freely,” she says.

Lao Tzu was a Chinese philosopher about 500BC. He said ”the perfect man breathes as if he does not breathe”. Beim agrees. “In some cases we are retraining people to breathe the way they did as children, before stress, habits and often poor lifestyle choices got in the way.”

Physiotherapist, molecular biologist and yoga teacher Simon Borg-Olivier travels the world teaching breathing techniques.

He believes learning how to master your breathing can boost athletic performance and alleviate many ailments.

Borg-Olivier cites Australian Olympic snowboarding gold medallist Torah Bright as an example. He says he taught her how to use her breathing to maximum effect.

”We taught her how to take the air from the abdomen in a conscious way until it became a reflex,” he says. ”This triggered a neuromuscular release of muscles that tend to over-tighten the spine, disallowing people to reach peak performance; when spinal muscles are released you get better power transfer.”

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Almaliki puts a new spin on engagement

If Fawad Ahmed and Gurinder Sandhu are the public faces of Australian cricket’s drive towards multiculturalism – into which it plans to pour millions of broadcasting revenue dollars – then Sam Almaliki is its beating heart.
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The 24-year-old is not, like Pakistani-born leg-spinner Ahmed, set to soon be added to Australia’s Ashes squad but he is central to the game’s ambition to produce the next production line of elite players from non-traditional cricket backgrounds.

Cricket Australia’s new senior manager for community engagement is Exhibit A in terms of attracting players and fans and disposing of the ”pale, male and stale” image for which the sport has been castigated.

Almaliki saw his first cricket ball bowled during eight months spent as a boy inside Villawood Detention Centre after his parents and two brothers fled their home in Basra in southern Iraq in 1997. His father, Khalaf, was a political science lecturer at an Iraqi university, only adding to concern for their safety under Saddam Hussein.

”When we came to Australia I saw cricket being played by Tamil detainees at Villawood and then was encouraged to pursue an interest in cricket by my year five teacher Rowan Hall at Punchbowl Primary,” he said. ”He encouraged me to play the game, and I watched Steve Waugh and Australia’s tour of the West Indies in 1999 and fell in love with the game.”

CA announced on Tuesday it would use part of its $590 million from new deals with channels Nine and Ten to accelerate its mission to attract more Australians of non-English-speaking backgrounds to the game, as well as more women and girls, indigenous Australians and people with a disability.

National marketing contracts handed to Ahmed and teenage NSW bowler Sandhu, who is of Indian heritage, have been announced and Almaliki’s job is to build on their emerging status.

His tender age should not be a distraction. At 15 he founded the Sydney Junior Winter Cricket Association, which is now one of Sydney’s largest with 900 players and Test captain Michael Clarke as patron. He has also been chair of the NSW Multicultural Youth Network, a commissioner on the NSW Community Relations Commission and, during his previous posting at Cricket NSW, devised Australian cricket’s first multicultural engagement strategy.

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Watmough keen to axe tag as Blues’ last winner

Anthony Watmough is the only member left of the last NSW team to triumph in a State of Origin series but it is a biographical footnote he wishes had no relevance for Wednesday night.
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”I don’t really class that as a win, that series, for myself,” the Manly and Blues back-rower said. ”I only played the one game. It’s in the record books – they can’t really take it away from me. But there is still that burning desire to get this one.”

Watmough is proud to have been associated with Ricky Stuart’s side of 2005, but he is desperate for the fading memory not to be his last taste of interstate success.

Then 21, he played in game one after starting on the bench in Brisbane – when NSW were beaten 24-20 in golden-point extra time. Although he did not appear in the second and third matches as the Blues fought back, he was officially a member of the series win.

He remembers a very different Origin experience in Stuart’s first reign compared with how new coach Laurie Daley conducts affairs.

”It was intense. It was the 25th year of Origin and the build-up to that with Ricky Stuart was ridiculous compared to how cruisy and player-driven it is now with Loz,” Watmough said. ”They’re totally different. This year it’s good.

”The players have really taken ownership. The senior players have really stepped up and they’re driving it. Loz just has to sit back and when he needs to put his two bob in, he can put his two bob in. But I think with the way it’s running now, he doesn’t need to do that. He just sits back and lets us go and lets us run our thing.”

Watmough is one of the form players in the NRL and looms as a key asset from the bench for the Blues. A player once on the outer at representative level, is now – as a 29-year-old – central to Daley’s ambitions of toppling Queensland again.

”It wasn’t pleasant getting your name tossed around a lot but I hope I’ve changed a few people’s opinions,” he said. ”You’re only one bad game away from missing out on any squad but that’s a good thing to have; that hunger and drive. The time has come with this team where we can stop their momentum.”

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Soward must step up after riding wave of demotion

Dropped: Jamie Soward will start from the bench for the Dragons against the Knights on Saturday night. Photo: John VeageJamie Soward is expected to front at St George Illawarra training on Wednesday morning, ending his short-lived exile from the club. But he does not return as a first-grade player after being dumped to NSW Cup on Tuesday.
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Just two years ago Soward was preparing to make his NSW debut. Now he will take the field for the Illawarra Cutters after coach Steve Price named Chase Stanley to partner Nathan Fien in the halves when the Dragons play Newcastle on Saturday night.

The axing came just a day after Soward was granted a leave of absence from the club. He had arrived at the joint-venture club’s Wollongong base to take part in the team’s usual video session on Monday morning but was given time off after Price consulted Soward and senior players in the aftermath of St George Illawarra’s dramatic 16-14 loss to the Bulldogs last Friday night. Price excused Soward from training for a couple of days ”to clear his head”. The squad had Tuesday off.

St George Illawarra skipper Ben Creagh insisted Soward had the full support of the squad’s senior players despite the premiership-winning five-eighth being dumped to reserve grade for the second time in the space of 12 months.

Speaking only hours before the Dragons confirmed Soward was again NSW Cup-bound, Creagh said: ”He does – 100 per cent. Pricey has given him a couple of days off to clear his head. I’m sure he’ll be at training [on Wednesday] and we’ll get on with it.”

Soward, who will turn out for the Cutters in an NRL curtain raiser against Newcastle on Saturday, has already inked a four-year deal with Penrith from 2014.

His manager Sam Ayoub said Soward had not asked for a mid-season release and would play out the year in Wollongong. Price resisted naming young halfback Josh Drinkwater in first grade or shifting Josh Dugan from fullback. Drinkwater and Soward will pair up in the halves for the Cutters.

Stanley will play five-eighth for the first time in the top grade, with Nathan Green promoted to the centres. Price stressed the entire squad needed to take responsibility for the Dragons’ run of outs.

”We’re all accountable – myself included, and every player that takes the football field,” Price said. ”We’ve got roles to play and it’s important that each individual plays those roles.”

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Meninga to fire up the Maroons machine

It has been suggested Mal Meninga is to rugby league coaching what John Buchanan was to Australian cricket, although with much more substantial thighs.
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In Meninga’s possession is that rarest commodity in sport; not only a group of outright champions but a champion side. Honestly, how hard can it be?

Buchanan was famous for delving into the philosophical and encouraging his players to read extracts from The Art of War. But on the field, the get-out play didn’t require a PhD in psychology: ”Warnie, you bowl at that end, McGrath, you bowl from the other.”

Similarly for Meninga, the virtuosity of his squad has meant his contribution has steadily diminished, or even been criticised by some NSW observers as token. Surely coaching isn’t that difficult when you can just throw it to Greg Inglis, or Billy Slater, or Darren Lockyer, or Johnathan Thurston.

Ask Queensland’s players and the truth couldn’t be further from the perception. Far from a rent-a-legend who bellows a rousing pre-game call to arms, Meninga has become a master motivator and manipulator capable of extracting the last molecule of competitive edge from his playing staff.

With Origin now played by increasingly elite athletes and almost nothing between the sides, it matters. His players say it has been a huge part of their domination of the interstate series, which could stretch to eight in a row should they triumph on Wednesday night and beyond.

”He was a player,” Queensland lock Ash Harrison said. ”He knows what made him tick and what makes us tick. He’s very good at doing those things and he thinks it’s very important for us to know the history of this jersey.

”He never ceases to amaze me with what he comes up with. He seems to push the right buttons every time. It’s one of the things he’s very, very good at.” At the Queensland team announcement, now a gala dinner instead of a media-only event in a dingy hotel space, Meninga was at his best. He assembled members of the 1959 Queensland side, the last to win before the Origin concept in 1980.

Players such as Noel Kelly and Frank Drake stood alongside their present-day counterparts as the 2013 side was called onstage. It was a gesture Meninga had been cooking up since last November.

Meninga has been a picture of relaxation and calm this time around. Zen master Buchanan would be impressed. But as in previous years, behind the scenes, Meninga will have rabbits in his hat.

In series past, when he’s said publicly that NSW taunts meant nothing, his players were then shown DVD of the offending quotes to fuel the fires. He’s had articles pasted on walls and footage of some of the best Origin biffo on rotation.

The now annual trip to regional towns such as Emerald, Bundaberg and Roma has also given players an in-your-face reminder of what the game means to people in the regions. With many of his players growing up in bush towns, it’s not just the fans who benefit.

It all adds to the mix, said Sam Thaiday, but the main ingredient is the man himself. Imposing, deeply respected and an unabashed personification of every Queensland cliche NSW detests, Meninga’s influence over his players is profound.

”If you want to know how good he is as a motivator, you just have to listen to him speak,” Thaiday said. ”We’ve got quite a mix in the coaching staff. We’ve got Steve Walters, who’s a bit of a character, Alfie [Langer], who likes to sling a bit on everyone. But as soon as Mal talks, everyone goes quiet in the room. It doesn’t matter if he’s talking about footy or whatever, everyone shuts up and listens.”

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Origin: it’s back baby

1. State of Origin: A big night for Jarryd Hayne
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Origin is definitely a team game, but I will be particularly interested in the performance of Blues fullback Jarryd Hayne. In recent times, the Parramatta Eels star has developed a real passion for his goal-line defence and has saved several tries for his team with brilliant tackles just when it seemed certain the opposition would score. Winning games is as much about saving tries as scoring them, so I certainly hope Hayne brings this attitude to the big game on Wednesday night. I would also like to see him throw himself into the attacking game to the point of exhaustion. I would like to see Hayne have nothing left in the tank come full-time. If he totally immerses himself in the contest, instead of coasting around waiting for opportunities to present themselves, he can swing the result in his team’s favour.2. Origin: a few facts

The importance of winning game one can never be understated. As an Origin coach, I always placed tremendous emphasis on getting the series opener right. The team that’s won the first game has won 23 of 31 series decided. In series openers at ANZ Stadium, NSW have  won five of six matches. Queensland have won the past four series openers. Since their run of seven consecutive Origin series began in 2007, Queensland have  won the first match on five occasions (NSW won the first game in 2008 but lost that series 2-1). The Maroons have led at half-time in the past  nine matches. ANZ Stadium used to be a fortress for NSW. Not so in recent times though. This is the 20th Origin to be played at ANZ Stadium. NSW have won 13 (including a run of 10 wins and a draw before Queensland registered their first win in 2007. The Maroons have won five of the past  eight at ANZ.3. Origin: Some interesting comparisons

James Maloney and Mitchell Pearce become the 15th different halves combination used by the Blues since 2006. Wow! Look at the combinations NSW has used: Anasta-Finch  2  Gasnier- Gower 1Anasta-Mullen 1  Anasta-Kimmorley 1Bird-Kimmorley 1 Bird-Wallace 2Anasta-Pearce 1 Campese-Wallace  1Barrett-Wallace 1 Barrett-Kimmorley 1Lyon-Kimmorley  1Barrett-Pearce 2Soward-Pearce 3 Carney-Pearce 3

By comparison, Johnathan Thurston and Cooper Cronk are Queensland’s fourth halves partnership in that period. Darren Lockyer and Thurston were together for 15 games; Thurston and Scott Prince for two, and Thurston and Karmichael Hunt for one. The most experienced Origin player on the field on Wednesday is Queensland captain Cameron Smith, playing his 28th match; the most experienced New South Welshmen is Jarryd Hayne (it’s his 17th game).

4. Origin: The bench is vital

When selecting State of Origin teams I always paid particular attention to the makeup of the bench. I think games can be won and lost by the contributions of the players numbered 14-17. Naturally you wanted to cover as many positions as possible with your bench players so injuries during the match to key positions did not pose massive disruptions to the functioning of the team. I also liked my bench players to be 80 minute competitors in their own right. If injury meant they were called upon to carve out 79 minutes in the middle, I needed to know they were capable. I also wanted personalities on the bench who believed they could make a difference. If the starting team was struggling, we needed players who could go out there and turn the tide. If the starting 13 had taken the ascendancy, you wanted your bench players to go out there and ram home the advantage. I hope our NSW bench players understand just how important their role is tonight.

5. Wonderful Warriors

When the Warriors are on song is there a more enjoyable side to watch?  The sublime skills of Feleti Mateo, Johnson and Locke; the raw power of Vatuvei and Hurrell; the four prop rotation of Matalino, Rapira, Packer and Lillyman, which is as good as any in the game, and finally the intestinal fortitude of Nathan Friend and Elijah Taylor in the middle of the ruck. On Monday night against the Broncos, they were firing on all cylinders and were so entertaining. Just three weeks ago though, they were beaten 62-6 by Penrith, which was their 16th loss from their previous 18 games. It’s hard to believe it is the same side.

6. The ‘‘cannonball’’ tackle must be stopped.

The media has termed it the ‘‘cannonball’’ tackle. I could write pages on this subject. Two defenders tackle a ball runner around the torso, securing the ball, before a third defender  tackles the legs of the  contained man to immobilise him and make it easy for the men up top to cradle him to the ground and slow down the play.  The first time I saw it used as a deliberate defensive tactic, I implored the then referee boss Bill Harrigan to ban it. I could see where this was headed. The referees said  ‘‘technically’’ it was not illegal. I contended it was dangerous and not in the spirit of the game.  I hate this tactic.

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Charge over CBD bashing

On his bed inside Sydney’s St Vincent’s Hospital Simon Cramp has woken to good news.
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The man who allegedly king hit him in an unprovoked attack on George Street early on Sunday that left him in a coma has been charged with assault.

”Really? Great,” the 26-year-old telecommunications worker said groggily before drifting back to sleep.

For his family, who have been at his bedside for the past three days fearing the worst, the developments in the past 24 hours have been everything they hoped for.

Mr Cramp is out of his coma, has been moved out of the intensive care unit, is talking, joking and showing signs of his old self.

And his alleged attacker has handed himself in to police, been charged and will spend the night in custody before facing court on Wednesday.

”We’ve been on a rollercoaster,” Simon’s mother, Angela Cramp, said. ”We thought we were having the last day with our son on Sunday. Now he’s been released from intensive care. He’s on the road to recovery, not some horrible future that is not predictable.”

Mr Cramp was standing with two friends outside McDonald’s on the corner of George and Bridge streets just after 3am when he was king hit and fell to the ground.

On Tuesday Mr Cramp was moved from intensive care to a general ward where he will continue his recovery.

The breakthrough in the investigation came after detectives made public on Monday night security footage of three men they wanted to talk to about the assault. On Tuesday morning two of the men, aged 20 and 21, went to The Rocks police station for questioning but were later released pending further investigation.

The third man, 24, from Haymarket, turned himself in two hours later and after spending about 90 minutes with detectives was charged with causing grievous bodily harm and affray. He will appear in Central Local Court on Wednesday. The man’s solicitor said his client would fight the charges.

Acting Superintendent Anthony Bell said he expected others to be charged over the incident and that investigations were continuing.

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Patients are being shifted like pawns: doctors

Waste of resources?: This operating room at Royal North Shore Hospital is being used as a storeroom. Photo: SuppliedOperating theatres at one of Sydney’s top hospitals are being used as storage rooms while patients are being shifted around ”like pawns” to meet surgery targets, doctors say.
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Senior doctors from Royal North Shore Hospital say the decision could put patients at risk, and is a waste of time and money that has been imposed by bureaucrats in the Ministry of Health – directly undermining Health Minister Jillian Skinner’s promise to give local control to local doctors.

Fairfax Media has revealed huge waiting lists for hospital clinics, and the cancellation of life-saving cancer surgeries by a Sydney hospital trying to meet its end-of-year budget. The surgeries were reinstated after public outcry.

Professor Tony Joseph, the acting chairman of the medical staff council and director of trauma at Royal North Shore, said a $1.1 billion redevelopment of the hospital had left it with empty operating rooms and not enough beds.

”It’s a bit of a mess,” he said.

The hospital was operating with fewer beds available than before Premier Barry O’Farrell and Mrs Skinner opened the new building in December, with only 14 of 18 operating theatres funded.

This meant when high numbers of emergency patients showed up, surgeries needed to be cancelled.

”They haven’t funded our surgical capacity to its full potential,” Professor Joseph said.

NSW director of the Australian Orthopaedic Association Andrew Ellis said many of the orthopaedic, as well as ear, nose and throat surgery patients who were being moved had other conditions, such as heart or kidney problems, being treated at Royal North Shore. They could have poorer outcomes without continuity of care, and early assessments might have to be repeated by the new doctors, he said.

The head of orthopaedic surgery at the hospital, David Sonnabend, said it was not clear why they were being moved, as the first patient to be approached had only been waiting for surgery for six weeks. ”We feel that patients are being used as pawns in a political game,” he said.

Labor health spokesman Andrew McDonald said the $3 billion in health cuts and efficiency savings announced by the government were affecting patient care.

”What’s happening is, when staff leave they are not being replaced, and that reduces the capacity of the system, so when you need to ramp up the system to meet demand, you can’t do it because the staff is not there,” he said.

But Mrs Skinner said more frontline doctors and nurses were added when the new building opened, and the district had its budget increased by $33.7 million this year.

”The opening has resulted in a higher level of activity than expected and this has impacted on the hospital’s capacity to do surgery on time,” she said. ”The state priority is that patients receive their care within clinically appropriate times and public hospitals form a clinical network to help that happen.”

Royal North Shore general manager Sue Shilbury said the operating theatres had been built to accommodate demand in future, and there was no shortage of staff.

”As the population increases additional theatres will come online,” she said.

She said since June the hospital had changed operating theatre use so it was not affected by unexpected increases in trauma cases.

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