Both these local health districts were the worst performing in a recentsurvey of clinician/management engagement conducted by the Australian Medical Association and the Australian Salaried Medical Officers Federation.

The Minister for Health, Jillian Skinner, should take notice. If both clinicians and the ministry have identified problems with St Vincents, what about western NSW?

Out here in Orange, we have had votes of no confidence in administrators, calls for a caretaker administration, petitions, public rallies and yet the minister has not answered the calls for help. Perhaps she is listening to the wrong people?

Her usual response – "that is a matter for the local health districts" – is hardly reassuring to the public if the problem is the local health district's management style itself.

Could the minister avoid a few scandals and tough question times in Parliament by listening to clinicians and the public, and by performance managing the poorly performing local health districts?

The AMA survey identified Sydney as a high performing local health district, which is a testament to the quality of the management there.

Can we have some quality health management too, please?

THE government's "revolutionary change" aimed at cutting the cost of welfare dependency would be more convincing if it tackled the cause: the shrinking availability of adequately paid, non-casual, full-time and part-time work.

The government carries much of the blame for this.

It has been leaching jobs out of the economy through its loose allocation of 457 visas.

These visas have exploited untrained foreign workers at low pay rates while also undercutting trained Australian workers who are competing for similar jobs.

The China-Australia Free Trade Agreement allows Chinese companies to bring in their own workforce without the requirement that jobs be offered to local workers.

Also, the Coalition government has underspent on new national infrastructure.

Large engineering infrastructure projects are outstanding job-making investments, as they generate many additional jobs through the economic multiplier effect.

The government needs to correct the employment abuses allowed under 457 visas and the China-Australia Free Trade Agreement, and invest more money into long-term infrastructure projects using Australian contractors.

Otherwise, Social Services Minister Christian Porter's new "investment approach" will be little more than an attempt to change the behaviour of our desperate underclass, particularly single parents, while doing nothing to tackle the graver reasons for their under-employment.

IF DONALD Trump becomes president, I suspect there will be a migration crisis from the United States on a scale greater than that from the war-torn Middle East. Will our government send these people to Nauru or Manus Island?