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22 Nov 2017

Transcript:  AMA President, Dr Michael Gannon, with Ashleigh Gillon, SKY News,Wednesday, 22 November 2017

Topics:  Health of asylum seekers; FASD; kids’ screen time.



ASHLEIGH GILLON:   Well, the situation on Manus Island may have dropped out of the top stories, but the standoff there is continuing. We know that there are still several hundred men who are refusing to go to the new facilities the Australian Government is urging them to go to. Joining me here in the Perth studio this morning is the AMA President, Dr Michael Gannon.

Dr Gannon, good to see you. Thank you for your time. Are we seeing a health crisis unfolding on Manus Island?

MICHAEL GANNON:   Well, it looks a lot like it, and there's the potential for it to get a great deal worse. Very simply, if you have situations where there's not access to clean running water, not access to adequate hydration, nutrition, people not getting access to regular medications, things will inevitably get worse, and we fear that there might be tragic consequences.

ASHLEIGH GILLON:   So what specifically are you worried about? Is cholera, for example, a serious risk?

MICHAEL GANNON:   Well, there's been talk of cholera, and if you don't have access to fresh running water, that's the kind of bacterial infection that can take hold, and if you're talking about a group of people who might already be vulnerable, in terms of their health, that would be one of the infections we'd be concerned about.

We're concerned about both physical and mental health aspects of this situation. What we've called for is transparency so that we can find out exactly what is going on. The reports we hear are particularly harrowing. We cannot take the Government at their word. We want independent verification of the standards in place on Manus Island.

ASHLEIGH GILLON:   That's quite a statement to make, that you can't take the Government at its word. What do you mean by that? I know that you've been making representations to the Immigration Minister, Peter Dutton, to send an independent team of doctors to assess this situation for themselves. What response have you got from them, and why don't you believe you can trust the Government on this issue?

MICHAEL GANNON:   Well, the truth is we simply don't know. So if we have reports from refugee advocates; we have credible reports from senior clinicians who, one way or another, have found their way to look at the video that's emerging exactly from the centre; reports on social media; letters that have leaked out of the centre. Both can't be right, so what we've called for is an independent review, and the AMA is uniquely placed to know which doctors can go up there in a credible way to make an assessment of the conditions.

We've got those people within our membership: public health experts, infectious diseases experts, psychiatrists, GPs; people who can go there, look at these conditions, and often, perhaps, fall down in line with the Government's statements and say: you know what, the situation's not that bad, or to say this is unacceptable, like the UNHCR has said, and to make recommendations of how to improve these conditions.

ASHLEIGH GILLON:   So just to clarify: the Government hasn't rejected your offer, you're just waiting to hear back from them still?

MICHAEL GANNON:   I'm hoping that I'll be able to meet with Minister Dutton in Canberra next week. We think that this is in everyone's interest. What's happening to these men is happening in the name of the Australian Government, it's happening in the name of the Australian people, and Australia's doctors are saying that we have an ethical requirement to call for an appropriate standard of health care and accommodation for these men, who enjoy the legal protection of international law and protection under Australian law.

ASHLEIGH GILLON:   Mental health concerns on Manus Island - and Nauru, for that matter - are not a new problem. It's not a new issue. Should the AMA have been a lot more vocal on this issue much earlier?

MICHAEL GANNON:   We've been vocal the whole time on this issue. Obviously, what we've seen in recent weeks is with the closure of the RPC, this has made the issues far more acute. We do not claim expertise in immigration or citizenship matters. When people talk about the legal ramifications of this and who has authority to do this or that, that is not our expertise. But what we do have are very clear policies from the World Medical Association, and very clear principles of medical ethics, that we will always call for appropriate levels of treatment.

We worry about the known mental health consequences of long-term detention. We worry about the mental health consequences of the uncertainty that these men and the people on Nauru have in their lives, but we are not interested in stunts. We have been working behind the scenes over the past two or three years to make sure that individual patients are well looked after. But there are sovereignty issues here. We can't just barge into New Guinea and take over. But what we can do is try and advise the Government on a way out of this mess.

ASHLEIGH GILLON:   Just on another story a bit closer to home. The Northern Territory Royal Commission is recommending that children in juvenile detention there are screened for fetal alcohol syndrome to try and give them some treatment and make sure that they know what they're dealing with with these children, often who are locked up. Would the AMA support that move?

MICHAEL GANNON:   Yes we would strongly support that. I have little doubt that underlying some of the recidivist offending in Aboriginal and Torres Strait Islander kids and adults in the Territory - and for that matter elsewhere and for that matter in non-Indigenous people - underlying that is the chronic brain impairment that is fetal alcohol spectrum disorder. So using clinical screening tools for that might enable people to get the appropriate treatment. This condition's not an excuse, but it might underlie so much of the offending we see. That makes prevention of this condition so important and when we come to talk about alcohol policy, whether that's licensing, pricing, other ways it's handled, we need to remember that FASD underlies so much of the problems we see in the criminal justice system.

ASHLEIGH GILLON:   Finally, yesterday we saw the Government releasing some new guidelines for parents involving how we should really encourage an active lifestyle for young children and babies. Now part of that - the most controversial part I guess that a lot of people are talking about today - is how much screen time that children should be getting. The recommendation is that children under two shouldn't have any access to this technology, they should have zero screen time. Is the medical evidence actually there that watching television or playing a game on a computer is actually going to lead to negative health consequences for those young children?

MICHAEL GANNON:   This was an interesting report and I'm sure it will be an emerging area of evidence. We know that, increasingly, smart phones and tablets have taken the form of a form of babysitting for so many parents. The lights and the colours and the sounds are very stimulating. There may be benefits for young children. But with this report is it's an attempt to look at what science does exist. There's been cooperation with Canadian authorities. I think this is worthwhile that we look for the evidence so that we can give credible advice to parents on this topic.

ASHLEIGH GILLON:   Right, but it's not there yet is what you're saying, there's a lot more work to be done. Is it a bit premature to be telling parents, well, this is a no-go zone?

MICHAEL GANNON:   From first principles I would have concerns about protracted periods of screen time and what we know from limited evidence we have in adults is that the sheer stimulation of some of the games and some of the videos is not conducive to falling to sleep in the period after that. So I think you're right, I think we need a lot more evidence but from first principles it might not be the best environment to be in just before you're attempting to settle or sleep.

ASHLEIGH GILLON:   Yeah, most parents would be pretty keen to avoid anything that would stop their children falling asleep. Michael Gannon, the AMA President, appreciate you joining us here in the Perth studio. Thank you.

MICHAEL GANNON:   Pleasure, Ashleigh.



22 November 2017

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Published: 22 Nov 2017