Interview - AMA President, Dr Bill Glasson, with Louise Maher, Radio 2CN ABC666 'Morning': Medicare under 16 legislation

Now, Tony Abbott thinks that 15, 16 year olds, that the parents of those teenagers should have access to their medical records.  Some disagree, including Dr Mal Washer who is a Liberal member from Western Australia.  He's actually threatening to cross the floor over this, he says young people's lives are at stake.

Dr Bill Glasson is Federal President of the Australian Medical Association.  He too is opposed to the legislation.  Good morning to you Dr Glasson.

GLASSON:    Good morning Louise.

MAHER:         Can you explain exactly what Tony Abbott wants to do?

GLASSON:    Yes, under the current legislation parents are able to access the medical records of children up to 14.  Now Tony wants to extend it up to 16 and, for the reason that he feels it's the right of the parent. 

He's absolutely right, I mean as a parent myself with a child of 12, and one of 14 and 18, I feel that if my child goes to the doctor without me knowing I'd probably feel as though that I had failed my child because I felt that my communication wasn't good enough.  And in a normal family unit, your child won't go off to the doctor without you knowing about it or without you being with your teenager.

But the reality is there's lots of families out there where the ideal family unit doesn't exist and it's a dysfunctional family.  and for reasons of child abuse, reasons of sexual abuse, physical violence, domestic violence, depression, suicide - a whole range of issues that teenagers for whatever reason feel that they can't talk to their parents about and they'd like to go and talk to somebody else.  Now you can talk to your priest, you can talk to your teacher, or you can talk to your doctor. 

And I suppose what we're saying here is that we should make sure that the route by which young teenagers can access their doctor in a confidential way should be preserved, but with the full knowledge that your GP, the first question that he or she will ask of the teenager is have you discussed this with your parents, if so why not? 

And if there's a good, or not a good reason why it hasn't been discussed then obviously you sit down with the child, counsel the teenager and say listen, I think you should talk to mum and dad about this.  and try and get the communication re-opened, re-established.

So doctors don't try and divide parents, they try and bring them back together, but what we're suggesting with Tony Abbott's legislation will just put another barrier between the doctor and the teenager.

MAHER:         I'd like to hear what our listeners have to say about this this morning.  Our number is 6275 4666, if you've got something to say, an opinion this morning on the Government's attempt to make medical records for 15 and 16 year olds available to parents.

Dr Glasson, how would parents access these medical records?  How would they find out?

GLASSON:    Louise, through the HIC...

MAHER:         ...the Health Insurance Commission?

GLASSON:    The Health Insurance Commission, basically you'll contact them, they will indicate what services have been carried out, what has been prescribed and yeah, that's the way you'll access it.

Now I mean I suppose for everyone sitting out there as I say, if you're a normal family unit you think well this seems like a lot of nonsense to me, I need to know what my children are doing, and I totally support that.  But on the other hand, please understand that there are many families out there where kids don't get brought up, they get dragged up.  They get pushed from pillar to post and they've got no one to turn to. 

As I said it used to be the priest, and in some cases they still turn to the priest.  But they often turn to their doctor because they've known their doctor since they were a small child, they've developed that trust with the doctor and know they can go down and talk to the doctor.  And please understand the doctor will try and preserve that communication I suppose, or re-establish the communication if it has broken down to make sure the family unit is preserved.

MAHER:         If it's a particularly sensitive issue, isn't the young person more likely to go to an anonymous doctor if you like, not the family GP, but someone at a medical centre?

GLASSON:    Yeah that's true, but see, really under the HIC you can look up the data, you can give the Medicare number on your child...

MAHER:         So you don't have to know the doctor's name?

GLASSON:    No you don't, exactly.  You can actually access the or the HIC and the HIC will say, listen, yes, your child visited Dr Bloggs on this day, and this is what was prescribed.

Now can you access the records directly - no, they can't.  They can't actually go down and say, listen, I demand to see the records per se, but it's really getting, I suppose, MBS and PBS information from the HIC to say, yes, your child was put on an anti-depressant or your child was referred off to another institution, or, you know, in other words if the child is being threatened by say child abuse or physical abuse or sexual abuse and often will involve other agencies that can help support that child through that event.

So it's trying to preserve, I mean, some degree of confidentiality and trying to make sure that we don't actually put these children in a position where (a) they won't access the doctor in the first place, and if it's around depression or suicide, and I say to the people out there, we have an unacceptable rate of suicide amongst our young teenagers, we don't talk about it, we bury it, and I just think it's very unfortunate, so anything that prohibits open communication either within the family unit or within the doctor patient relationship is, you know, needs to be addressed.

MAHER:         What reason has the Government, or at least the Health Minister, Tony Abbott, given for wanting to change the legislation?

GLASSON:    Louise, I'm not sure.  Now he claims there's been a number of parents inquiring or expressing concerns about the fact that they can't access medical records on their children, and they feel that they should.  

I suppose the question I would ask those parents is why, you know, why has your child gone off and seen the doctor without you knowing.   In other words, don't blame the child for that.  I think we should actually look at ourselves as parents.

Now children, through the teenage years, it's difficult.   You don't know who you are, what you are.  You've got a self esteem problem, self awareness body image problems, so it's a difficult time of your life, and sometimes you just think, well, look, I might go and talk to my doctor about this and see, you know, if what mum's telling me is good and common sense.

And as doctors we say, listen to mum - I know mum really well - she loves you and she's trying to support you.   You're sort of striking out because you're suddenly becoming a young woman, or a young man, and so the doctor tries to re-establish the communication as I say. 

They're not there to divide families, they're there to bring them together, and I just think all this legislation will do will put up another barrier between our teenagers and our doctors and nowhere for them to turn to, and as I said, it really worries me about the issue of depression amongst the young kids and the incidence of suicide which, as I said, is unacceptable.

MAHER:         I suppose parents would argue though, Dr Glasson, that if they're supporting their children, if their children are living at home, if they're expected to abide by the rules of the family then that child shouldn't have any secrets, shouldn't be going off to see the doctor?

GLASSON:    Well I accept that, the fact that you, you know, you're putting the money up and you're paying for the upbringing of your child - I think that's probably the wrong philosophy, you should be wanting to know what's happening to your child because you love them, because you're really interested in them and you want to know what's happening to them and I think that's what all parents would be saying.

But, having said that, there are a lots of families where the relationships break down and where there's a real issue around domestic violence, and when you look at the figures around sexual, physical and emotional abuse of children in this country it's not falling, in fact it's increasing, and so, you know, for us to sort of bury our head in the sand and say, well listen, we don't want to know about that, we want to talk about the normal family here and the well communicating family.

Well fair enough, if you're a well communicating family this legislation will have no impact on you, you can get on with your life and forget about it, but don't forget about those children out there who don't have a normal family relationship, who are under a huge amount of pressure within the issues of domestic violence and as I said, often around issues of various forms of child abuse, so we've got to make sure to look after these kids and don't actually put up further hurdles to access their medical practitioner.

MAHER:         It would be interesting to know and I don't know whether you have any idea of the figures, but how many visits to a doctor each day by say 15 to 16 year olds who are there without their parents knowledge.   Do we have any figures at all?

GLASSON:    I don't know, Louise.  I don't think there's a huge number.  I suggest that probably 95% of, you know  14 and 15 year olds that go to doctors have their mum and dad, or one of them, sitting with them.

MAHER:         Yes, to pay the bill.

GLASSON:    Well that's right.  That's right.  And also obviously because they're the normal sort of family unit, but for the 2% or whatever it is that go there without a parent you've got to ask yourself what would actually derive a 14 or 15 year old to wake up in the morning and say I can't talk to mum or dad, I can't talk to my family, friends, priest or the teacher I've got to go and see my doctor. 

Look, it's a decision made in desperation, it's not something just made on the spur of the moment, they would think about it for weeks or months and say well who can I turn to, and so they go and turn to their doctor, you know, as I say in desperation to try and get someone to sort of listen and try and address the issues that concern them.

MAHER:         Dr Glasson, we're just getting news through now from Parliament House - as I said at the start, the Joint Party Room, that is Coalition MPs and Senators were discussing the details of this bill this morning prior to the legislation being introduced into Parliament, but the word we're getting from Parliament now is that following the Liberal back bencher, Mal Washer's announcement that he would consider crossing the floor if the bill wasn't withdrawn, or if there wasn't a conscience vote on the bill, which I know is what the AMA has been asking for, that following that the Health Minister, Tony Abbott, has now decided to defer the bill.  He's saying it won't be introduced this week.  Your reaction?

GLASSON:    I think that's - I mean I commend Tony Abbott for making that decision.  I commend Mal Washer because I know  Mal Washer very well and he's a very principled man.  He's a great doctor and he's a great family man, and so he in standing up and making obviously a passionate plea to the joint Party's meeting, I think a lot of politicians will listen to him and listen to the sensible sort of argument he put forward because, as I said, if this was going to somehow bring a whole lot of families back together that were currently not communicating, or this was somehow going to address all the issues of domestic violence and child abuse and suicide, then I'd say great, bring it in and let's implement it, but the reality is it's bad health policy, it's bad social policy, and we have been, you know, I suppose expounding that over the last week or so.

MAHER:         Do you expect this is the end of the bill now?

GLASSON:    Well I think there'll obviously be a lot more discussion out there, and I think that Tony Abbott has listened, and I congratulate him for listening if they have deferred the legislation because I think this is what democracy's all about, to hear the views of parents and to hear the views of families around this country and obviously the politicians reflect those views in the parliament of the day, and so I commend the Parliament for being responsible and really allowing the debate to occur, and this is not criticism of Tony Abbott, by the way, who's probably one of the best Health Ministers we've had, you know, for actually allowing this debate to occur and actually listening to people ...

MAHER:         We also know that there's an election looming.

GLASSON:    Well, I mean if it has been pulled because of an election, well, I mean, I think they wouldn't have put it up in the first place if it is because of an election, so I think the reality is that I in fact asked them why were you putting this up in a an election year because it was going to cause a huge a mount of controversy, but I think that, you know, that Tony Abbott felt that it was important, and felt it would be discussed and I commend him on actually allowing the debate to occur.

MAHER:         Dr Glasson, thank you very much for joining us this morning.

GLASSON:    Louise, thanks very much indeed.

MAHER:         Dr Bill Glasson, Federal President of the Australian Medical Association.

Funny isn't it how a story can change in just a few minutes while you're actually talking to someone about it on air.

At the start of that interview with Dr Glasson the Government was still determined to put that legislation into the Parliament but there has been a meeting of Coalition MPs and Senators this morning and they've obviously heard from Dr Mal Washer who's threatened to cross the floor over this, the Liberal back bencher from Western Australia, and Tony Abbott now deciding to defer the bill.

There will be more details on that in ABC News at midday.

Ends