All of us in the health sector have known for a long time that our system is in turmoil. From the inability - or refusal - of the Health Minister, Reba Meagher, to make changes at the state level, to a decade of the federal Liberals and Tony Abbott appearing to just keep the chair warm, we have got only worse.

This week the federal minister, Nicola Roxon, addressed the National Press Club and spoke about the changes she needs to make. She ended with the words of the pioneering American physician Dr Virginia Apgar - "do what is right and do it now" - and added that that was what she intended to do.

As somebody who has worked directly with patients for many years, let me advise Ms Roxon on what is right to do now.

Administration of health services must be drastically cut: in most cases the administration is bigger and more expensive than the patient contact side. Treatment decisions must be left to the treating professional and not to administrators who make decisions based only on cost.

Doctors must give up their outmoded protests and allow other health care providers to be primary care agents.

If qualified nurses can be given prescribing and testing authority, in one well-considered stroke of the minister's pen she will have covered the GP shortage across much of Australia.

The "Better Access To Mental Health" program must be widened to increase session numbers and include all registered mental health professionals, clearing the backlog of people with problems.

All health professions must have one national registration board as this will go a long way to stopping rogue practitioners - and can be done now.

All these things have been considered before and an excellent model for each awaits deployment.

I acknowledge that making change can be difficult but that is Ms Roxon's job. Most of us in the health system are ready to assist you, Ms Roxon. Just ask.

Stephen Carroll Orange

Kirk a grievous loss

I was saddened to learn that the British aid worker Jackie Kirk had been killed in Afghanistan ("Aid workers killed", August 14). I had the privilege to meet Jackie when she co-facilitated a Sydney University workshop on the provision of education to children in emergencies. Jackie was passionate about the need to normalise life for children affected by man-made and natural disasters and provided valuable insights from her work in many of the world's trouble spots, particularly in Africa and Afghanistan. She was one of the world's leading advocates for children affected by conflict and the world will be poorer for her passing.

Bill Hoyles NSW State Emergency Service, Canada Bay.

Perfection obsession

Since mimicry is now accepted practice at grand spectacles, should we assume that all musical presentations are not what they seem (Letters, August 15)? Why not extend this to theatre, or the orchestra? If the star is having an off night, just feed a recording through the theatre's sound system.

Perhaps the problem is our obsession with perfection rather than marvelling at a live performer's skill, whether or not there are a few flaws.

By the way, were the drummers really drumming?

Kay Kan Cheltenham

Psst! Apparently, not only was that cute little Chinese girl not singing, but our Nikki Webster wasn't flying - she had a string attached. Pass it on.

Rod Ansell Tighes Hill

Foreigners protesting in Beijing realise that by refusing police directions they will get media coverage. This is what happened to the American peace activist Scott Parkin in Sydney in 2005, except he copped seven days with solitary confinement before being deported.

Patrick Sayers Woollahra

What is the role of the two lifeguards at the swimming events? You can see them seated in standard lifesaver high-chairs halfway down the pool.

John McCartney Castle Hill

Gold to Duncan Armstrong for his calm, knowledgeable poolside commentary.

Eddie Raggett Mosman

On a pro rata, seasonally adjusted and annualised base, Australia would lead the medal tally.

Garrett Naumann Willoughby

As our athletes strive to gold, or at least podium, the pleasures of verbing, after a lifetime wasted in cantankerous pedanting, have become apparent. I wonder if I will letter?

Andrew Dix Newtown

Party poopers

Julian Canny (Letters, August 15), Kim Beazley snr would have an answer to your question, "Oh, NSW Labor, what have you become?" Beazley once said, famously, that Labor in his time had gone from the cream of the working class to the dregs of the middle class.

Tough words, but they should resonate with a party that has become the plaything of career apparatchiks.

Paul Ellercamp Gymea

Reba Meagher and Belinda Neal's problems are just a repeat of politicians' grandstanding backfiring. The memoirs of J. W. Taylor, a local historian and farmer, record that in the 1930s Harry Bate MP ran into another car near Bega and asked the other driver for his licence, saying, "Do you know who I am? I am H. J. Bate, the Member of Parliament, and I will report you to the Commissioner of Police." Whereupon the other driver produced identification showing that he was, indeed, the Commissioner of Police.

Bill Orme Neutral Bay

Outsourcing: the catch

John Schumann (Letters, August 15) obviously has not read Catch-22 when he complains about the army outsourcing medevac. Lieutenant Milo Minderbinder perfected this long ago and even arranged for each side to bomb themselves, for a price. That saved fuel to fly to the target, and you could ensure your most vital installations were not hit.

Rather than outsourcing, why don't we stop all these wars and have everyone come home?

Peter Nelson Hanoi (Vietnam)

Costa spin is child's play

Michael Costa hasn't learnt that a politician cannot take on a child and expect to win. We all know the reason Mr Costa doesn't want to give a pay rise to firefighters has nothing to do with providing schools. A tight wages policy funds his superannuation, salary and allowances.

Lynn Burdekin Harbord

Michael Costa has just had a bruising encounter with a 10-year-old who knows the difference between spin and truth. His spokesman tells us that the minister explained to Cate Sullivan that the wages cap on firefighters was needed because "he has a three-year-old daughter and the reason for the [wages] policy was because we want to provide schools".

These would be public schools, would they, Mr Costa? Are you implying that your daughter will attend one?

Graham Allport Marrickville

Oh dear. Little Mickey Costa's been playing with matches. Again.

Phil Stanton Corindi Beach

Whatever the spin, it is still a war with absolutely no winners

Robert Gates, the US Defence Secretary, puts a positive spin on the refusal of the United States to get involved in a military confrontation with Russia. It is, according to him, because the US has spent decades trying to avoid military confrontation with the very unreasonable Russians.

The real reason is obvious. Since World War II the US has invaded, intervened, subverted and overthrown governments in more countries than the rest of the world combined.

The outstanding feature of that record is that they were virtually all weakened, poor or apparently defenceless states.

Like the schoolyard bully, it has always picked on the small, weak kid in the playground. Like the schoolyard bully, it has sometimes suffered a bloody nose from its weaker opponents.

Les MacDonald Balmain

When the Russians invaded Georgia I wondered how long it would be before the usual claims of moral equivalence with the US and Iraq.

The US is one of a few countries that has clearly acted for humanitarian purposes with some consistency since the Cold War. Bosnia, Kosovo, Somalia - all Muslim - come immediately to mind.

While Iraq is untidy, at least the US removed Saddam Hussein and Iraqis have some control over their own destiny.

At the United Nations, Russia, with China, supports the genocidal Sudanese regime and also Robert Mugabe in Zimbabwe. Russia supported Milosevic and Karadzic to stop minorities seceding.

If you think there is a moral equivalence I merely point to the dozens of minorities on Russia's periphery that have lived under its occupation.

Martin Gordon Flynn (ACT)

South Ossetia and Abkhazia either Russian or Georgian? Maybe neither. Reading between the lines of Mikhail Gorbachev's incisive article ("Military assault not way to deal with old grievances", August 14) suggests the solution may be in reintroducing semi-autonomous regions or city-states, by process of self-determination. This would be far more productive and long-lasting than armed conflict, followed by armed occupation and then, possibly, enforced segregation.

Pasquale Vartuli Wahroonga

Napoleon got it right when he said stupidity is no handicap in politics. The President of Georgia, Mikheil Saakashvili, is a living testament to the validity of the observation when he barked at the shins of the Russian bear. Tiny Georgia, with 19,000 American-trained soldiers, had high hopes taking on more than a million Russians. Brave perhaps. Stupid for sure.

Rex Condon Albert Park (Vic)

It is fair enough to criticise the US for the whiff of hypocrisy over its complaint on Russian intervention. But the apologists for Russia reside in glass houses.

Russia's cynical attempt to portray itself as the defender of the rights of ethnic minorities to self-determination should be seen for what it is. Just ask the Chechens.

Darryl Kite Killara

Opera keeps its own score

I could not disagree more with Fiona Janes about artistic standards at Opera Australia ("Sharp notes on opera standards", August 15).

I have just returned from a lengthy world trip, courtesy of a Churchill Fellowship, to research the inner workings at the San Francisco, Metropolitan, Liceu, Deutsche Oper and Mariinsky opera houses.

The musical standards of the Opera Australia orchestra, chorus, ensemble and music staff are as good as ever.

I have been lucky enough to work under the artistic direction of Moffat Oxenbould Simone Young and Richard Hickox in my time at Opera Australia. Each has been passionate and skilled in bringing to fruition their particular vision and although there have been changes in emphasis, repertoire, personnel and artists, the company has thrived.

That Opera Australia excels in a culture more obsessed with sports than arts is a testament to its thoughtful artistic leadership.

Michael Black chorus master, Opera Australia, Strawberry Hills

Story must go on

Anthony Albanese has asked that Qantas not be talked down. Would Mr Albanese have the media stop reporting incidents of maintenance failure? I don't think that's appropriate.

John Couani Leichhardt

Love thy neighbour

I see the wheel of fortune has finally landed on the jackpot for Reg Grundy.

First he was made a companion of the Order of Australia, then he and his wife have dinner with the Governor-General, followed by an overnight stay as house guests of the Jefferys (Vice-Regal Notices, August 15).

Just shows that everybody needs good neighbours.

Allan Gibson Cherrybrook

Paranoid parenting

Charlie Brooker ("Egg the youngsters on, so life tastes better", August 15) has taken a truthful but humorous approach on modern child psychology and should be applauded for his observations on "cotton wool kids" and their "helicopter parents". This modern phenomenon reflects the self-important and paranoid society we seem to embrace.

Mark Slocum Dulwich Hill

POSTSCRIPT

THERE's been a slight warming in relations with Beijing 08 but, on the letters page at least (in fact perhaps only on the letters page), the excitement is contained.

While there was a smattering of praise for our efforts in the pool, readers were more likely to comment on the authenticity of the opening ceremony, the definition of "greatest ever Olympian", alleged racism in the TV coverage, Chinese censorship, human rights, team uniforms or commentators murdering the English language. Barry Arnold of Epping "teared up" when someone "finalled" yesterday, while Clarrie Lawler of Balmain East asked whether, now that we've got the dream team, can a fairy tale ending be far behind?

League tables may be fine for comparing medal tallies but according to most Herald letter writers on the subject, they have no place in the education system. This is a familiar debate which provokes thoughtful, if somewhat repetitive, letters.

Readers express concern that league tables will divide schools into haves and have-nots and that schools are not widget factories.

Letters supporting league tables are a statement of frustration at lack of information.

Those with interests outside the classroom and the Water Cube were moved by the Georgian conflict, FuelWatch, Telstra taking on the unions and the carbon cost of flying.

Miranda Harman Letters Co-editor