TOP STORIES

Gaps blame refuted

A new AMA poll has disproved Federal Government claims that the profession's processes of informed financial consent are flawed, with results showing that a majority of inpatient services are provided with up-front advice on fees or no gap.

A Government paper released in May - at the same time as its $15 million gap cover campaign - considered professional self-regulation of informed financial consent processes as inadequate (AM, 2 July).

Pressure on premiums

United Medical Protection has warned of continuing pressure on medical indemnity premiums over the next five years following last year's controversial 'call' on members. Fending off criticism of its performance, UMP says there is no guarantee of a plateau in court awards for medical negligence claims.

Pap smear cost savings rejected

Proposed government cost savings on cervical cancer screening could put women at risk, the AMA has warned.

A draft consultation paper developed by the Federal Health Department includes a recommendation to improve efficiency in the national cervical cancer screening program by increasing the screening interval from two to three years.

AMA turns up pre-election heat

The AMA has stepped up its plan to make health the main policy focus in the looming Federal election campaign with the release of a document outlining key health issues.

The 21-page document has been sent to Coalition, Opposition, Australian Democrats and Independent MPs as part of the AMA's comprehensive pre-election strategy.

Turf wars will fragment power

Moves by a group of surgeons to apply for registration as a union will fragment professional industrial representation, the AMA has warned.

Australian Association of Surgeons President Dr Graeme Brazenor addressed AMA Federal Council last month, seeking support for the proposed surgeons' union.

INSIDE

A dose of reality

At present, Australia is well entrenched in the medical simulation industry. But there is a long way to go. Difficulty in attracting financial backers and an untested crossover between virtual skills and human surgical competence is testing an industry with a valid place in medical training.

Mapping the mind

Complex psychiatric illnesses remain a genetic mystery - but scientists are closer to an understanding. In this edition of AM Garvan Institute researcher Renee Badenhop says that 'positional cloning' now makes it possible pinpoint the chromosomal location of disease genes.

Summit calls for action on youth health crisis

Strong support emerged at the Commonwealth Bank and AMA National Youth Health Summit for a new model for a national non-government youth peak body.

The AMA also renewed its call for Medicare cards to be issued to all Australians as soon as they turn 15, and a new information kit was launched to help young people cope with and learn about some of the major health concerns they will encounter.

From the President - The tribulations of heroin trials

Dr Kerryn Phelps

There's nothing like the sniff of an election to give a contentious social issue a bit of air. That's what's been happening in Canberra…again. This time it's drugs.

Buried on page 23 of an otherwise capable but non-newsworthy 52-page National Crime Authority (NCA) Report this month were the following sentences:

'We must respond to the ongoing progression of this problem. Among the many measures worthy of consideration is to control the market for addicts by treating the supply of addictive drugs to them as a medical and treatment matter subject to supervision of a treating doctor and supplied from a repository that is government controlled.'

Translated this means that one of the nation's peak law enforcement agencies is backing a prescribed heroin trial - a medical solution to an element of the drug problem in this country. A proposal which first became official AMA policy back in 1999.

The media were soon crawling all over this story and the politicians didn't have to go far to find a microphone to capture their wisdom and their attitude to this proposal.

As usual, the debate split into the Prime Minister's table-thumping total rejection of the idea of a heroin trial, the Opposition Leader's cautious support for the idea, and the experts who totally support the idea.

Everyone else fell into place along party lines, even some notables who were on the record as supporting a heroin trial in the past.

The NCA has made a powerful statement that, despite all of the efforts governments and law enforcers have put into controlling supply, the outcome has been monumentally unsuccessful and it is time to change focus.

The AMA fully supports the assertions of the NCA that heroin dependence should be treated as a health issue. When thinking about whether or not you support heroin trials, consider this: the key word is 'trial', not 'heroin'.

We are talking about a scientific trial, and where would science and medicine be if we didn't ask questions and seek answers? Sometimes we don't expect the answers that we get, but when we do we quite often find a cure - we quite often find a solution. At the very worst, we find something that doesn't work and then we know not to pursue that line of investigation further.

When it comes to finding solutions to the problems of drugs in the community, we need courage, creativity and vision. And we must listen to the experts working in the field. As a community, we know we need to do whatever we can to save lives and reduce the collateral damage caused by the methods people are forced to use to get the money for the drug.

So great is the problem, we should not close the door to any possible solution. It doesn't matter how many methadone, buprenorphine, or other programs are out there, there are still people who cannot get off heroin.

From health and social perspectives, we need to look seriously at a prescribed heroin trial, but to be effective it would need an integrated program of medical and counselling support.

Resourcing is a chronic problem. It should be at least as easy to get into a quality rehabilitation program as it is to score heroin on the street. But it isn't.

The problem of heroin addiction is there in the community and it needs to be dealt with. These addicts are mothers, fathers, kids, loved ones, providers, and dependants, people you see in the street every day. If they suffer, the people close to them suffer, and the community suffers.

Nobody is immune from the problems related to heroin dependency. Family breakdown is a community problem. Stealing is a community problem. Violence is a community problem.

Australian families want solutions to the drug problem, not political dogfights over ideology.

A prescribed heroin trial offers the possibility of solutions. Why not give it a go?

We can't afford a scaredy-cat approach to illicit drugs from our community and political leaders. The time has come for practical decisions about approaches that just might work.

As medical practitioners, we know that heroin is almost identical to legal prescribed drugs like morphine and methadone. The treatment of heroin as an illicit drug makes the world of difference. I believe the public is ready to hear the truth.

The time has come for political courage. Unfortunately that is a rare commodity in the shadow of an election campaign.

Dr Kerryn Phelps is President of the Federal AMA