Pharmaceutical Companies & Doctors

This week, the Australian Competition Tribunal, at the request of the ACCC, has determined the validity of new reporting rules for drug companies. They will have to declare their gifts to doctors every 6 months, and post them on the Internet. The information to be made publicly available includes: venues, the number and types of professionals invited, and the total cost of food, travel, accommodation and entertainment provided.

They are not required to identify individual doctors (or other health professionals), nor where they come from or work. Some see these as shortcomings in the new rules. Such information would certainly allow others to determine where and who the drug companies are targeting; and possibly examine any change in prescriptions following the "education" of doctors.

Let no-one be fooled. These are marketing projects, designed not to educate doctors, but to market the companies' products to doctors, and to increase pressure on the Federal Government to include 'new' drugs on the PBS scheme. Such inclusion would effectively guarantee widespread prescriptions, and increase drug company profit$.

There are other issues to be aware of:

• if we were to limit the marketing/'education seminars' by drug companies, how do doctors gain information about new drugs? There are not many scientifically reputable, peer-reviewed publications (they are independent of drug company interference in what they publish, and how articles are written). The Australian Medical Journal, the British Medical Journal are two, but how many doctors subscribe, and have the time to read thoroughly? Perhaps summaries could be provided through the AMA at reduced subscription, or through the PBS itself to doctors.
• the ethics of doctors accepting the drug company offers. It is almost unthinkable that doctors do not know they are being manipulated and (ab)used by drug companies. Yet they still accept the "gifts".
• there are suggestions in the SMH 30-June-07 about fraudulent or "doctored" research (pun intended!)
  (http://www.smh.com.au/news/national/take-two-see-your-drug-company/
  2007/06/29/1182624165418.html)
  
• The primary goal of drug companies "sponsored & doctored" research is to gain PBS approval and sell, sell, sell, at almost any cost. It was only last year they had to be almost forced to remove Celebrex and Vioxx from the market, after denying and obfuscating about the deaths they caused. This year, the same levels of delay and obfuscation were used when side-effects of the sleeping tablet Stilnox became known.
  

The bottom line in all this is that drug companies are out to increase their bottom line! We shouldn't have to tolerate them being snake-oil salesmen, though.

The Analyst

Lack of Consultaion on Indigenous Intervention

Since Mr Howard announced Federal intervention in Indigenous communities in the NT, there have been a a number of developments. You will remember from my previous post on 23 June that I said that therre were a number of things that Mr Howard needed, and were not announced; and that he would be leaning heavily on logistics experts to cover the gaps.
( http://truepolitik.blogspot.com/2007/06/howard-intervenes-in-indigenous.html )

This week there have been a number of meetings involving stakeholders: indigenous people, health & welfare experts, lawyers and church groups among them. Together they have raised serious questions about Mr Howard's methods, in particular about his lack of consultation wit the very people he says he wants to help. That is his style: he did it when announcing the national water initiative, with the conflict on the wharves (although he probably consulted with Patrick Corporation), and with the WorkChoices initiative. So it should be no real surprise that he did not consult those most affected.

There have also been suggestions that the policy was driven by his own electoral concerns. The suggestions have come from Aboriginal activists, and some others. My opinionis that Minister for Indigenous Affairs, Mal Brough, who has previously toured communities in the NT, was a driving force. However it is likely that Mr Howard was smart enough to see some political advantage for him in an election year, additinal to his personal concern.

The lack of consultation could turn out to be a strategic error by Mr Howard. Not only did he not involve the communities, their representatives or those working "on the ground", he did not recognise the strength of desire by indigenous communities to have a say in what happens to them, their families and their communities.

The Analyst

Ethics, Whistle-blowing and Governments

On Friday last week (22 June 2007), a former Customs officer, Allan Kessing, was handed a 9-month suspended prison sentence. His crime? Releasing aspects of a report about Sydney airport security that alerted the public to serious flaws and inaction leading to high risk of death or injury. He was a "whistle-blower".

There a number of reasons that might lead a person to ethically release information that, under normal circumstances, they would not release. They include:

• a poor, or nil, response from an organization when the whistle-blower has tried to work through normal internal channels to effect change
• there is a real risk to public safety
• reckless actions or inaction by an organization constitute serious wrongdoing
• releasing the information would pass a "public interest" test

In this instance the report highlighted serious security problems, and Customs, Sydney Airport and the Federal Government made no attempt to initiate improvements to security. That inaction put the public at risk. Less than 1 week after the story became public there were significant and wide-ranging changes made by the Australian Federal Government and Sydney Airport Corporation.

A reasonable person would link the publication of the story and the resultant flurry of action, and think that the whistle-blower had done a "good job".

The Federal Government's response: call in the Police, because the Federal Government does not recognise public safety or public interest as cause for whistle-blowing; and it makes no secret of the fact that it will not tolerate, or protect, whistle-blowers or journalists, who act in the public interest. The US and many European countries do. John Howard does not. His government, and his hand-picked heads of departments, refer to whistle-blowing as "democratic sabotage". (Peter Shergold, Head of the Dept of Prime Minister and Cabinet) What nerve! The sabotage that is occurring in our democracy is that whistle-blowers are not protected if they act within strict guidelines, and that senior Public Servants no longer serve the public, but the politicians. This occurs at both State (Labor Gov'ts) and Federal (Lib/National) levels. They are are high-priced lackeys who answer "Yes, Minister" or ask "What advice do you want me to give?" Theirs, and their political masters, is the shame, and the democratic sabotage.

The Analyst

Howard Intervenes in Indigenous Communities

The Prime Minister's announcement that the Federal Government will intervene in NT indigenous communities to stop child sex abuse has drawn mixed reactions. The intervention occurred following the release of a report into child sex abuse in indigenous communities in the Northern Territory. He has asked the State Premiers to do likewise, and that he will fund it.

Parts of the plan include:

• a ban the sale, import and distribution of alcohol
• a ban on pornographic material
• quarantining 50% of welfare payments to spent for the benefit of children
• compulsory health checks and treatment for every child up to 16 years old

The plan has drawn criticism from some: ACT Chief Minister called it racist; Professor Judy Atkinson from Southern Cross University (author of 3 reports into child sex abuse in Aboriginal communities) predicts an increase in violence, suicides, suicide attempts and despair; the NT Anti-discrimination Commissioner called is "discriminatory". I don't believe it's motivated by racism,, or by discriminatory attitudes.

It is certainly true that alcohol and other substance abuse; petrol sniffing; violence and sexual abuse have been known about for decades. It is also true that little has changed. Many people would think that alcohol, petrol sniffing and pornographic material are underlying contributors to acts sexual abuse. They might, or might not, be correct. Some would even question Mr Howard's underlying motives - there is an election due and there is public belief that he has a poor track record on social justice policies. Whether that is true, or not, action is certainly needed.

The shortcomings in Mr Howard's announcement are the social interventions required to help stop the problems recurring. Enforced rule of law, bans and medical checks & treatment are not enough. Mr Howard needs the following:

• Cooperation and close working with indigenous elders on the health care
• Social programs to engage the different gender, and aged-based and family groups in meaningful activities. Such activities could include using & developing traditional knowledge and skills, taught by those who have the community's respect.
• Recreational activities that suit the different ages and genders, and that fit with indigenous interests
• Inclusion of aboriginal language and culture in formal and indigenous educational settings.
  
• Repeat, and on-going health and welfare cooperation, including appropriate diet and counselling services
  
• Developing community leadership, including a return to appropriate traditional values of care

None of this was announced. Mr Howard might well be leaning on his logistics experts to develop and implement appropriate strategies and programs. I'm not sure he has the social policy awareness to recognise the extra needs, unless advised.

The Analyst

Postscript: see also my post on 28-June-2007 at
http://truepolitik.blogspot.com/2007/06/lack-of-consultaion-on-indigenous.html

Politicians - "We're all right"

Yesterday's (19 June 2007) announcement that politicians will get a 6.7% pay rise from next month has rankled many people in Australia. What annoys people is not that they get a pay rise, or even the amount, per se. After all, it is reasonable to pay our politicians.

What has rankled the Australian people are the following:

1. that members of the major parties (Liberal, Labor, and even the National Party) stood before the press and boasted that they had an "independent body/umpire/tribunal" to set their pay.
   Many Australians, those under WorkChoices contracts do not: the body that sets their wages is part of the Ministry, and therefore under effective political control.
2. that one coalition (Liberal MP David Jull) replied that "we have a judge to set our pay". This is a member of Parliament that voted to remove the power of judges in the Australian Industrial Commission to set wages independently of government. The hypocrisy of his statement is mind-boggling!
3. that one coalition Senator (Sue Boyce, from Queensland) said the following about the less fortunate in our society:
   
   "I'll probably buy some extra pearls to cast before the deserving poor or something"
   
   Perhaps that is a modern equivalent of "let them eat cake"? Such a comment is indefensible, reprehensible and is one that would not be made by any decent person, under ANY circumstances. Poverty and disadvantage is something about which honourable people do NOT jest. (I suspect that is her preferred "defence".)
   

It really is the hypocrisy and and the detrimental social impacts of their policies that annoy people. If only our leading politicians would recognise that and act in the interests of ordinary Australians.

The Analyst

Cardinal Pell & The Separation of State

Sydney's Catholic George, Cardinal Pell's most recent foray into politics has been his most damaging and ill-conceived.

Cardinal Pell attempted to pressure Catholic MP's into voting against a bill to reverse the ban on therapeutic cloning. Indeed, some have construed his comments as a threat (to ban from communion) to politicians. A threat, of course, would be illegal.

The issue, here, is really about the separation of Church and State. For centuries the Catholic Church, and other Churches when their members became political leaders, exerted considerable influence and political power. Pope Pius XI, in 1933, wrote in his Papal Encyclical Dilectissima Nobis of his "great sorrow" that the new Spanish Constitution had affirmed the "separation of Church from State."

However, biographical notes, released by The Holy See, on Japanese Archbishop (now Cardinal) Peter Seiichi Shirayanagi note that:

In 1989 on the occasion of the death of Emperor Hirohito, Archbishop Shirayanagi spoke on behalf of the Japanese Catholic Bishops, asking the Government to observe strictly the separation of State and religion in Japan.

( http://www.vatican.va/news_services/press/documentazione/documents/
cardinali_biografie/cardinali_bio_shirayanagi_ps_en.html )

While Cardinal Pell has the same rights to lobby politicians as all of us, the inclusion of religious interference in the secular, "separated-from-Church" running of our democracy, and his application of religious pressure and judgemental consequences is unreasonable. Some have likened it to the intrusive and intolerant outbursts of (Islamic) Sheik al-Hilaly.

Our democracy does not need such behaviours ... from any religious leader. We do need our politicians to take all issues seriously, and vote well, to satisfy, as well as possible, the sometimes conflicting secular desires and religious conscience.

The Analyst

NSW U-Turn on Lane Cove Tunnell Fines

Yesterday (31 May 07) NSW Roads Minister, Eric Roozendaal, did an about face on fines for motorists caught speeding in the Lane Cove Tunnel.

Mr Roozendaal himself is reported to have said "Clearly there is a problem. Around 13,500 infringements have been issued through the Lane Cove Tunnel". The tunnel was opened in March.

The problem appears to be speeding drivers!

There are a number of problems that ought to concern anyone who values democracy:

1. The change in mind, after saying, effectively "tough" cam about because there were lots of calls to (commercial) talk-back radio. Such shows are usually run by "shock-jocks", some of whom have had their own brush with speeding fines. Governments depend on the "goodwill" of such shock-jocks, so if they complained to the Premier, the Premier jumped. Should the Premier, or any of his Ministers, intervene in matters of law, just because talk-back radio gets calls?
   
   
2. Should Ministers, or any politician, intervene in any legal matter that might come before the courts?? Not in this democracy, they shouldn't!
   
   
3. Drivers have primary responsibility to read road signs, be aware of changed speed limits, drive at an appropriate speed (even less that the speed limit). Further, they know that there are speed cameras: not only are there signs, but they are highly visible.. If drivers have been irresponsible, or reckless, they ought to be caught on camera and fined.

The State Labor Government's actions were driven merely by political expediency. Mr Iemma and Mr Roozendaal have shamed not only themselves, but our democracy as well.

The Analyst