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Committee on the Health Care Complaints Commission REPORT OF PROCEEDINGS BEFORE COMMITTEE ON THE HEALTH CARE COMPLAINTS COMMISSION INQUIRY INTO THE PROMOTION OF FALSE AND MISLEADING HEALTH-RELATED INFORMATION AND PRACTICES ——— At Sydney on Wednesday 3 September 2014 ——— The Committee met at 10.15 a.m. ——— PRESENT Mr D. Page (Chair) Legislative Council Legislative Assembly The Hon. P. Green Mrs R. Sage (Deputy Chair) The Hon. H. Westwood Dr A. McDonald HEALTH CARE COMPLAINTS 0 WEDNESDAY 3 SEPTEMBER 2014 CHAIR: Good morning everyone. Thank you for attending this public hearing of the Committee on the Health Care Complaints Commission. The Committee is holding hearings this morning in relation to its inquiry into the promotion of false and misleading health-related information and practices. Today we will be hearing from Friends of Science in Medicine, Complementary Medicine Australia and the Health Care Complaints Commission itself. For the benefit of the gallery, I note that the Committee has resolved to authorise the media to broadcast sound and video excerpts of its public proceedings. Copies of the guidelines governing the coverage of proceedings are available at the table at the entrance to this room. I now declare the hearing open. I welcome Professor John Dwyer, President of Friends of Science in Medicine. JOHN MICHAEL DWYER, Professor, Friends of Science in Medicine, sworn and examined: CHAIR: I thank you for appearing before the Committee on the Health Care Complaints Commission today to give evidence. Can you please confirm that you have been issued with the Committee's terms of reference and information about the standing orders that relate to the examination of witnesses? Professor DWYER: I have, yes. CHAIR: Do you have any questions about the information? Professor DWYER: No, thank you. CHAIR: Before we start questions would you like to make an opening statement? Professor DWYER: I would. I would appreciate the opportunity to set the scene, so to speak. First of all, thank you for holding the inquiry; I think it is very timely. The problem that we are dealing with is a pervasive one. It is somewhat frustrating in that in this most scientific of all ages so many consumers, so many people in the public have little or poor knowledge of the health literacy standard; they do not really understand, for example, the importance of taking a personal interest in the evidence for any treatment that is given to them by a doctor or anybody. The penetration of pseudoscience and misleading information into the community is very pervasive and the regulatory environment for protecting consumers is, I feel, very weak. I thought I would just mention that in an organisation like mine we have been campaigning to strengthen the role of the Therapeutic Goods Administration [TGA] in terms of protecting consumers. There have been numerous recommendations made to give the TGA more power to do this because we have been able to document numerous occasions where it has failed consumers. You only have to look at all of the failure to control the false weight-loss claims that have been put out. We know that the recommendations that have been made are lying on the Minister's desk in Canberra and the information we have is that the Government is extremely unlikely to make any changes. Mr Dutton has said in Parliament that he thinks the TGA is fine and does not need to have any more powers. We think nothing could be further from the truth. So consumers are not getting the protection they need from therapeutic goods and practices from the TGA. I also wanted to emphasise, because it will have a big effect, I think, on the future role of the Health Care Complaints Commission [HCCC], that following numerous interactions now with the Australian Health Practitioner Regulation Agency [AHPRA] in the first few years of its new life with more registered practitioners, chiropractors, osteopaths and traditional Chinese medicine and problems that have been associated with registered health practitioners going way beyond the acceptable scope of practice for their profession, when we have approached AHPRA with documented problems—registered chiropractors claiming that you should bring your child with autism to them for treatment and the like—it has been made perfectly clear to us that, under the current legal structure, AHPRA has no power to influence the scope of practice of a registered medical practitioner. The standard codes of practice about being good people and being ethical, et cetera, there is no nitty-gritty detail about what services these practitioners can offer or what they cannot offer. When we even went to the AHPRA and then the Physiotherapy Board because we had documented at Friends of Science in Medicine, much to our distress, some 80 or so physiotherapists who were not offering standard physiotherapy but were offering sarco-cranial therapies and pseudoscientific practices, we were told to take them to the HCCC, "They are the only agency that can handle this." We are very conscious of the fact that we have swamped the HCCC with complaints about these sorts of things. In the submission that we have put HEALTH CARE COMPLAINTS 1 WEDNESDAY 3 SEPTEMBER 2014 before you we have documented numerous examples of registered chiropractors, osteopaths, doctors and nurses who have strayed, in our opinion, and are offering misleading information and misleading practices to the public, as well as, of course, a lot of information about unregistered medical practitioners who are offering a whole range of pseudoscientific services that we think require addressing. If you look at the HCCC itself, and we all welcome the fact that the legislation that you passed gave the HCCC some more powers in terms of being proactive, but if I could tell you a very quick story that you have probably heard before, but put it in the context of today's hearing. If you have not heard this story, I want you to imagine that a handful of doctors and even some dentists refer patients to a New Age healing clinic—patients with quite serious medical conditions—and when they get to the clinic they meet the leader of this clinic who tells them that he used to be, in his original life, a tennis coach, but he had a vision and knew then that he had to set up an esoteric healing clinic to help patients. He tells his patients that he is the reincarnation of Leonardo da Vinci and patients are subjected to a whole series of nonsense therapeutic approaches—esoteric breast massage; they claim they can massage your back and actually massage your lungs if you have lung conditions; the practitioners say they have the power to talk to a woman's ovaries and learn about that; and they explain that all illnesses are due to past misdeeds in previous incarnations of your life. On the website the leader of this group says that he knows more about medicine and healing than anyone in the history of the world has known about it and that, indeed, he knows about a technique called chakra-puncture, which is a form of acupuncture that predates any of the Chinese involvement in acupuncture, and he can use it to treat people who have had chemotherapy and their body needs to be purified of these things. Patients go to this unit and they are shocked at what they hear so they go to the Health Care Complaints Commission and they say this is what happened. To add to it, they say, "One of the reasons we accepted that there might be something in this is that we were referred by our doctors, including some specialists." The complainant says, "Surely, the doctors should be questioned as to why they would refer us to such a service?" So the HCCC gets the complaints, it says, "We will have to consult the medical board about the doctors and we will look at your complaints" and it comes back to the complainant saying, "The medical board says the doctors were just expressing an opinion when they sent you to these people. They were not really endorsing this service", despite the fact that the code of practice for doctors makes it perfectly clear that you can only refer someone in good conscience if you know the clinical competence of the people you are referring to and that that clinical competence would be accepted by the vast majority of your peers. But the HCCC's report back said, "This is just doctors expressing an opinion", and since no actual physical harm was documented to these patients, despite the fact that there was psychological harm and despite the fact that one patient claimed that she had spent $30,000 with them—as if robbery is not harm—and the HCCC, since January 2013 at least when these complaints have come in, have not done anything about this organisation. To me, it is a classic example of the fact that the HCCC is crippled by a lack of capacity to act. You would have thought that a prohibition order would have gone out immediately saying, "Cease and desist. You cannot continue to do this to the public. If you continue to do that we will prosecute you". But no. We are going to suggest today from Friends of Science in Medicine that the HCCC may not have the resources that it needs and it does not have the adequate powers, and we have made recommendations to you for five or six changes that we think would be crucial. We are recommending that there needs to be much more proactive action to stop the spread of misinformation and to stop practices that cause harm, but the definition should be broadened to make it perfectly clear that people who can almost be indoctrinated into a cult or can have psychological damage, be robbed or have a condition not properly diagnosed and treated in a timely manner because they have been mislead, should be addressed.
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