Dr Kerryn Phelps, AMA President, Radio 3AK, with Derryn Hinch

He says I'm rather dismayed at the petulant and dismissive response of the Prime Minister, which shows he's not prepared to apply his mind in a rational way. And you've had the boss of the NCA saying that nothing should be ruled in, nothing should be ruled out as they look for something in the war that we are losing.

I notice that Rob Moody, the … Victorian Health's Chief Executive, he says he thinks the AFP, the Federal Police, are delusional if they think the battle to halt the illicit drug trade is being won. And the President of the AMA, Kerryn Phelps, says the war on drugs has reached crisis point.

I have her on the line now, Dr Phelps good morning.

PHELPS: Good morning Derryn.

HINCH: On this issue, the Prime Minister reacted very knee-jerk I thought, in Parliament this week. And virtually said never ever, never ever and yet there is a whole range of people now, ranging from you with the AMA, police, prosecutors, Mr Cowdrey, even the leader of the Opposition, Kim Beazley. All virtually saying something different has to be tried.

PHELPS: It absolutely does. We're seeing lives being ruined, families being destroyed, the community is suffering with the collateral damage from drugs because … not necessarily from the drug itself but from the methods that people have to use to get the drugs.

And we … what we're saying is that we shouldn't actually throw out any options. We shouldn't reduce the amount of law enforcement, which … particularly the types of law enforcement that are being successful.

And we certainly shouldn't close the door on an option like prescribed heroin for people who have tried other options and failed, and want to get off the problem of heroin.

HINCH: Well I made a point in a column in the Sunday Herald Sun here last weekend, the fact that up until 1953 you could legally get heroin linctus on prescription. And I think that should be, I think, my belief now, is that should be tried again.

PHELPS: Well the thing is that heroin is very closely related as a chemical compound to morphine, codeine, methadone, a number of other narcotic analgesics. And the fact is that heroin alone out of that group of drugs is illegal.

And so it has become a nasty, with all the implications of organised crime and what people have to do to get hold of it, when they are addicted. Now, if we look at this as a medical problem, and if people are appropriately assessed as being a correct case or reasonable case for prescribed heroin as a solution to their problems in their lives created by the drug.

Then it … if you take a medical approach to this, it really isn't that much different to any of these other narcotic, strong narcotic analgesics, properly prescribed, supervised and with appropriate counselling.

HINCH: Yeah well I go along with that. I mean it's … it was … to some people though it's a knee-jerk thing to say, oh look what you're doing, you know, you're encouraging heroin use. Which is not the case at all, is it?

PHELPS: No well you're not sort of saying to people, hey you should try this stuff. What you're saying is, if a person has a major problem with drugs … if you have a look at the side issues to do with, not just the drug itself, but the way it's cut with chemicals that are very unsafe.

The way it is prepared, which is not in a sterile environment or in a sterile way. The way it is injected, where needles might be shared. The way that people have to get the drug because it's illegal, in other words to commit crimes to get the drug, which is committing a crime in itself.

And it's all of those problems which … the experts are saying we might be able to get some containment of that collateral type of problem if we have prescribed heroin for particular types of people. And they would be people who have tried other things and simply can't get off the drug.

HINCH: Yeah. Were you surprised, or encouraged I should say, by the reaction of … I mentioned other people, names like Mr Cowdrey in New South Wales, the Director … you've got the NCA, you've got other people from law reform groups. They are actually now looking at it saying well, the so-called war against drugs has not worked.

I mean, it is … we are only grabbing … something like 12 per cent of all heroin smuggled into Australia is found.

PHELPS: Well I've been talking extensively with people who work in the field, who work directly with people with drug problems and who are looking for solutions all the time. And it became official AMA policy in 1999 to support heroin trials.

We passed, just at our last Federal Council meeting, support for supervised injecting room trials. And we are very much as a medical profession of a mind that we have to use science to find solutions, and that part of science is having an open mind.

And, you know, where would medical science be if we didn't have trials and didn't have a scientific basis for our investigations? And this … when we're talking about heroin trial, I think we should take the emphasis off heroin, put the emphasis on the word trial and say let's give it a go because it just might work.

And if it doesn't, we don't need to revisit that particular way.

HINCH: Well I made the point the other day, we were talking about the war against heroin, the war against drugs. I said, the addicts aren't fighting this war, who's fighting it?

I mean, the educational situation obviously is not working. Because if there's a kid in this country at the moment who doesn't know that drugs are bad for you, that putting something in your arm is bad for you, no matter how many TV commercials they run, it's not going to change.

PHELPS: Well it doesn't matter how much people know that drinking too much is bad for you, they still get drunk too. And people still get in their cars and drive. And so whenever you're talking about an addictive drug, then there will be a subgroup of people who will run into problems with it.

I mean obviously the ideal is that people never pick up cigarette, that they never get drunk and that they never even try illicit drugs, but the reality is that people do and some people run into serious problems with them.

And then they become, in the case of illicit drugs, they become a criminal justice issue. And when they run into health problems with their drug taking - and part of that is because it's illicit - then they become a major health problem to themselves, the community and obviously the medical profession is looking for ways to help these people.

Throwing them in jail is not the answer.

HINCH: Yeah, in any trial like this, with anything or any medication, a corollary presumably would have to be that the person tries to alter their way of life. That, it's like if I'm taking pills for cholesterol I've also got to try and get my weight down and lower my cholesterol levels and eat the right food.

Presumably somebody who was getting heroin linctus from a prescription from a doctor would also be trying to do detox or trying to do rehab or trying to be educated in that way?

PHELPS: We need to see far more resources into rehab. I mean I've often heard the statement that it's easier to get a … score heroin on the streets than it is to get a place in rehab. And that's absolutely true if you've ever tried to get anybody into a rehab program who is motivated to do so, it's really difficult because the places just aren't there, the funding is not there for it.

So I'd like to see, you know, much more funding and resourcing and as much emphasis on rehab as there is in law enforcement. But similarly I think that we need to look at … when you're talking about changes in lifestyle it's a really important point.

Because it's the method of people having to get the drug because it's illegal that creates a lot of the lifestyle problems. So that if somebody is getting the drug that they need while they're getting rehabilitation and counselling, then they're not going to be out on the street prostituting themselves through the night.

Breaking into people's houses, stealing cars, committing violent crime, and of course that takes them out of that milieu and out of that environment where they're likely to run into problems associated with the illicit nature of the drugs.

HINCH: One final question, it's not quite on your bailiwick I suppose, but you're probably aware now that there's industrial action going on here from nurses, voting to close one in three hospital beds, and the industrial action here in Victoria. Does the AMA have a stand on issues like this?

PHELPS: Yes we absolutely do, in fact by coincidence I had a meeting yesterday with Jill Iliffe, the Secretary of the Australian Nurses' Federation, and we discussed a range of issues of great importance to both the nursing and medical professions.

And we will be looking at what we can do to try and raise awareness of the problems facing nursing. In particular, there is a crisis in nursing workforce, and it is impacting on patients, and it's impacting on doctors and the way that we are able to provide care to patients.

Particularly in the public hospitals, but it's also in the private sector. The Nursing Federation tells me that we have enough trained nurses in Australia to have an adequate workforce, but it's issues like working conditions, hours, staff numbers, the workload, that is making the work so difficult for the nurses that they just don't want to do the work.

Even though they're committed and dedicated to the profession.

HINCH: Yes.

PHELPS: This is a major problem and unless we fix it now, unless we listen to the nurses and address their concerns it's going to be a problem that's with us for generations.

HINCH: One final question, what's the AMA's reaction or attitude to nurse/patient ratios?

PHELPS: We have to have sufficient nurses to be able to do their work appropriately. And if that means being able to sit and spend time with patients, to have appropriate amounts of time to care for patients, and this is where I think that the nurses are … have a very, I think, appropriate cause for grievance.

And that is that the nurse to patient ratios have altered over recent years so that there are fewer nurses per patient. And that means less time to spend with people, less time to be able to care, and I think an increased risk to quality and safety within our hospitals.

There's a lot more to quality than training and education, and making sure that there are enough people to do the job well is one of the core parts of providing quality and safety in our hospitals. And we have to listen to what the nurses are saying because otherwise we're just going to see an exodus increasing, of nurses away from our hospitals.

And that would be a tragedy.

HINCH: Yes. Dr Phelps, thanks for your time.

PHELPS: Thank you very much, Derryn.

HINCH: Bye bye. The President of the AMA, Dr Kerryn Phelps.

ENDS