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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2009-12-02 Daily Xml
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Parliamentary Committees

SOCIAL DEVELOPMENT COMMITTEE: BOGUS, UNREGISTERED AND DEREGISTERED HEALTH PRACTITIONERS

The Hon. P.L. WHITE (Taylor) (11:03): I move:

That the final report of the committee's inquiry entitled Bogus, Unregistered and Deregistered Health Practitioners, be noted.

In June 2007, the Social Development Committee was charged with examining bogus, unregistered and deregistered health practitioners. In South Australia, as in other Australian jurisdictions, health care services are provided by a range of both registered and unregistered health practitioners. The term 'registered health practitioner' refers to someone registered under one of South Australia's 10 health registration acts. Examples include doctors, nurses and dentists. In contrast, the term 'unregistered health practitioner' refers to a health practitioner who is not registered under one of those acts. This includes, among others, naturopaths, massage therapists, psychotherapists, counsellors, speech pathologists and a range of other complementary and allied health practitioners.

The inquiry also examined the conduct of deregistered health practitioners. For the purposes of this inquiry, the term 'deregistered health practitioner' refers to a practitioner whose registration under a South Australian health registration act has been cancelled or suspended as a result of disciplinary proceedings.

The committee commenced hearing public evidence on 17 March 2008 and completed its hearings on 16 February 2009. In total, 90 submissions were received, consisting of 73 written submissions and 17 oral presentations.

Before going any further, I would like to take this opportunity to thank the other members of the committee for their contribution to this inquiry: first, from the other place, the Hons Ian Hunter, Dennis Hood and Stephen Wade, and, from this chamber, Mr Adrian Pederick and Ms Lindsay Simmons. I also want to thank the staff of the Social Development Committee for their contribution. Our staff provide a very high quality of service in terms of the work necessary for our committee to prepare the reports that it does.

Most of all, and most importantly, I extend my appreciation to those individuals who either wrote to us or appeared before the committee and shared their intensely personal stories. A number of the witnesses had lost the person about whom they came to speak through death or had endured the experience themselves. They were very personal stories and some of them were horrific. I thank those people for their courage and their determination to make sure that wrongs were righted. Over recent years there has been a significant increase in the popularity of many unregulated therapies and treatments. Evidence shows that more health consumers are consulting unregistered health practitioners.

From the outset of this inquiry the committee agreed and acknowledged that many unregistered health practitioners perform an important and legitimate health service to consumers. Indeed, most unregistered health practitioners are reputable. However, some evidence presented to the inquiry suggests that some unregistered health practitioners are not of such good reputation.

The inquiry primarily concentrated on those unregistered practitioners who make extravagant claims that they cannot substantiate and who encourage unsuspecting consumers to spend significant amounts of money on so-called therapies which are, at best, ineffective and, at worst, dangerous. Some practitioners are often skilled at exploiting people's fears, while some practitioners may be delusional, convinced that they are able to cure serious medical conditions. The evidence presented to the committee suggested that others are driven by greed and, in some cases, sexual gratification.

Although the committee received evidence of a number of instances of alleged misconduct, it is difficult to know the extent to which bogus, unregistered health practitioners peddle their wares in South Australia. Overall the number of reported cases is low. However, the inquiry heard that shame and embarrassment often prevented individuals from coming forward. Moreover, in cases where an individual has died, it can be difficult for a surviving partner or family member to pursue a complaint.

Notwithstanding those factors, the inquiry did receive evidence on a number of specific allegations of serious misconduct. These included:

An allegation that Mr Lubomir Batelka, an unregistered practitioner, had claimed that his ozone therapy could provide a 50 per cent cure for cancer and that he had insisted the patient sign a confidentiality form. Mr Batelka appeared before our committee. When listening to his evidence and looking at the gruesome and galling photos he produced of his patients, it made me sick.

An allegation that another unregistered practitioner, Ms Elizabeth Goldway, had promised to cure a woman of her breast cancer, dissuaded the same woman from continuing with conventional medical treatment and required in excess of $5,000 in cash payments. The inquiry heard that Ms Goldway had also displayed a prominent sign outside her premises that read, 'You don't have to die from cancer or any other sickness'.

An allegation that an unregistered massage therapist Ms Elvira Brunt had claimed, while purporting to treat a man dying from bowel and liver cancer, that she could feel his tumours shrinking. How ridiculous, how shonky! Members might know that is the same Elvira Brunt on whose premises a tragedy occurred some months ago when a young child was killed.

The inquiry was also told of an unregistered practitioner Ms Monica Milka whose treatments, consisting of injecting small quantities of various substances and saline under the skin, resulted in at least six people suffering from skin abscesses and one person developing a mycobacterial infection—a condition which is difficult to treat.

All members of the committee were dismayed and disturbed by some of the evidence presented to it. This evidence raised serious concerns about some unregistered practitioners whose training and qualifications, if any, are highly questionable and who make unsubstantiated claims about cures for cancer or employ techniques and procedures that are unsupported by any credible evidence.

While most of the submissions received by the committee accepted the need for some type of regulatory reform, how this should be pursued was a point of considerable difference. The committee grappled long and hard with the difficult question of whether tighter regulatory measures should be established to deal with unregistered health practitioners and, if so, what type of regulation would be most appropriate.

The committee considered a number of regulatory models, ranging from self-regulation at one end of the continuum to reservation of title and hold of practice at the other. The committee has recognised that each regulatory model has its strength and weaknesses. After assessing the pros and cons of a broad range of regulatory options, the committee decided as the inquiry's main recommendation to call upon the state government to introduce new legislation to better regulate the broad range of unregistered health practitioners providing services in this state; and subsequent to the tabling of this report, our health minister (Hon. John Hill) has responded to that.

In so doing, the committee has asked the government to closely examine other regulatory models introduced in interstate jurisdictions. In particular, the committee considered there is merit in the implementation of a code of conduct similar to that which exists in New South Wales.

The committee also considers there is merit in establishing a statutory registration scheme for Chinese medicine practitioners, acupuncturists and Chinese herbal dispensers, similar to that which has been introduced in Victoria. It is recommended that the government look closely at these models to determine their suitability for this state.

Equally important, the committee is calling on South Australia's Health and Community Services Complaints Commissioner to take a much tougher approach in publicly naming bogus, unregistered health practitioners. There are powers under our existing laws, and the committee was of the view that the commissioner should be more proactive in using them.

The committee thought long and hard about the issue of public naming and shaming. It does understand that the decision to issue a public health warning in relation to an individual practitioner should not be made lightly, nor should it occur without procedural fairness being afforded to the individual concerned, and I point to the experience of our former auditor-general, Mr Ken MacPherson. He had a very good approach, whereby he would write to an individual saying, 'This is the report I am going to make. What do you think about it,' and he would incorporate any feedback in his report, but it would not stop him from acting and reporting. I think that is a good approach.

To that end the committee resolved to call on the Health and Community Services Complaints Commissioner to report back to our committee on the progress made in dealing with complaints about unregistered practitioners. Indeed, the commissioner will be appearing before our committee next Tuesday to do just that. In addition, the committee has recommended that the commissioner's legislative powers be expanded to allow her to make prohibition orders against those practitioners who pose a substantial risk to public health.

In total, the committee's report contains 21 recommendations. This includes recommendations calling on the state government to educate health consumers better so that they are able to differentiate between credible health claims and those that are exaggerated and recommendations urging the commonwealth government to strengthen the capacity of the Australian Taxation Office to clamp down on potential tax evasion by dubious health practitioners. It was a common theme that so many of these practitioners are 'cash only' and rarely do you see a receipt.

As I mentioned earlier, the committee was also required to examine the practices of deregistered health practitioners, that is, those practitioners whose registration under a South Australian health registration act has been cancelled or suspended as a result of disciplinary proceedings. The committee notes that health practitioners who have been deregistered are not necessarily bogus and in and of themselves do not necessarily pose problems to helping consumers. However, the committee heard evidence of instances in which health practitioners had been deregistered for unethical or unprofessional conduct but who had subsequently rebadged themselves so as to be able to practise in an unregulated area of health care.

For example, the committee heard of a case involving a psychiatrist who, after being deregistered, had established a practice as a counsellor. The committee is of the strong view that any registered health practitioner who has been deregistered on disciplinary grounds should not be able to set up practice in another area of health care without review. To this end, the committee has recommended that the government consider legislative amendments to all relevant health legislation to ensure that, in such instances, deregistered health practitioners are unable to set themselves up under a different title in an unregulated area of health care.

In summing up the work of the committee and our findings, it is true to say that the provision of health care services is a most serious issue to the public of South Australia. Those who choose to work in health care must be sufficiently skilled and must meet appropriate standards of quality and safety. For too long we have had people perhaps passing through the cracks and able to practise in unregulated areas of health care without enough real safeguards. Bogus practitioners who make claims of curing cancer or other terminal illnesses are particularly insidious. The committee spent a considerable amount of time investigating this issue and, in doing so, it heard some shocking stories.

In considering all the evidence, the committee has put forward recommendations that it feels will better protect the public and strengthen community confidence in our health care system. I urge members to support these recommendations.

Mr PEDERICK (Hammond) (11:19): I congratulate the member for Taylor on her excellent summing up of this inquiry into bogus, unregistered and deregistered health practitioners. Some very torrid tales of people's grief were presented to the committee by people not just locally but from interstate as well. It is interesting to note some people's differing views on what they look at as bogus or unregistered professionals (or people who claim to be professionals) and some people who have a bit of a problem with chiropractors.

I have been a client of chiropractors for many years and, with my shearing and farming experience, I would not have been able to keep going without them. However, it is one field where you can get people who are not very competent at their work but you can also get others who are, and it is up to individuals to ascertain whether they want to ascribe to that kind of treatment. I must say that, as an individual, it certainly has been very beneficial to me. In fact, I woke up one morning and my whole back had seized up and I could barely get out of bed. I made an emergency appointment with an excellent chiropractor, Ms Trethewey. She is operating on Kangaroo Island at the moment. She is an excellent chiropractor and she managed to fix my problem later that day.

However, regarding some of the other issues that were presented to the committee, it was so saddening to see the people who had lost their loved ones to practices that are totally unproven. People are making claims that they can cure cancer, including bowel cancer; people are making claims that they can feel tumours subsiding—absolute codswallop! You could see that the surviving partner—obviously, their partner had died—was very traumatised by what had gone on. I concur with the member for Taylor's comments about many of these practitioners asking people to put down a cash payment—many times, in advance. I acknowledge that these practitioners need investigating, not just for how they operate but as far as taxation purposes are concerned at the federal level.

Some of the presentations made to us by some of these practitioners were quite disturbing in the way that they indicated that they could heal people. One practitioner had some quite graphic photos—and I think everyone on the committee was shocked at how he purported to help people out by looking at samples of faecal stools. Some very graphic and disgusting photos were viewed by the committee.

I can understand, to some degree, people who are on their last legs, who have been told, perhaps, in the normal medical fraternity that there is no chance, go out with a glimmer of hope to these unregistered operators and think they can be cured. However, time and again we heard sad stories where, perhaps, if they had kept up medical treatment they may have at least had a better time towards the end of their life than what they had, because some of these people forwent all reasonable medical treatment and used the treatments of these bogus practitioners.

I have lost a couple of friends to cancer this year. It is fair warning to people that they need to get not only a second opinion from medical practitioners, such as doctors and properly registered professionals, but if they do think that they need to use an unregistered practitioner they need to get second, third and fourth hand advice on whether or not to use that practitioner.

Certainly, from everything that I saw in the committee, I would recommend that never should they walk away from proper medical treatment from registered doctors. As I said, we did hear some sad tales of people who had given up on the normal medical route and believed the codswallop that they were told, that they would be cured or that there was a 50 per cent chance that they would be cured, and it just was not going to happen.

I concur with the committee's recommendations that legislation should be changed so that some form of registration can come in. Certainly, a lot of these unregistered practitioners do have a role, but certainly the ones who are just peddling gimmicks and false truths should not be operating. In fact, if possible, under legislation, whether it be now or in the future, they should be prosecuted for peddling false hope.

As I said, it was quite an interesting reference that we ran through the Social Development Committee. We heard some very sad tales. My hat comes off to the people who came in, many speaking on behalf of loved ones whom they had lost. I recommend the report to the parliament.

Ms SIMMONS (Morialta) (11:25): I just want to add my support to the report. The members for Taylor and Hammond have spoken well on this subject. It was, for all of us, I think, a very disturbing inquiry. The fact that there are people out there preying on our most vulnerable members of the community when they are at a desperate state in their lives was truly shocking.

However, I do believe that there is a model in place which should help us to make sure that this does not happen. I believe, as the member for Taylor said, that the health complaints commissioner must use the full scope of her capacity to name and shame people who are referred to her to ensure that members of the community are not taken in by the hoax practitioners who are out there.

What was particularly disturbing was the encouragement by some of these unregistered practitioners for people, particularly with cancer, but with other stomach and bowel complaints as well, to cease taking traditional medicine in order to get the full benefit of the treatment that they were prescribing. It meant that some people really did not have the pain free death that they probably could have had had they maintained having the treatment from their doctors.

This sort of practice has gone on for many years, hundreds of years. There have always been shonky doctors around, but in this day and age we should really be able to do something far more to control these practices. Part of the reason for the previous minister for health, the Hon. Lea Stevens, putting in place the health commissioner was so that we actually had controls over these practitioners. I commend her for the principle of doing this.

However, we do need to make sure that every aspect of the commissioner's act is followed, and we do need to name people who we know are not practising as they should be and who are not registered, whatever the certificate on their wall may say. It is often a certificate that has been self generated or has come off the computer in some way and it is misleading to those people who go into their offices. I think it is really important that those people are named, they are shamed, and that it is publicised that their practices are not appropriate. I very much support this report and hope that the chamber will too.

The Hon. L. STEVENS (Little Para) (11:29): I would like to thank the members of the Social Development Committee for the work that they did on this particular matter and for the resulting highlighting of a range of issues that need to be attended to in making sure that we can strengthen the reliability and confidence that the public can have in health practitioners. In fact, the level of confidence that the public has in its health practitioners, the confidence that they will adhere to the highest standards of quality and public safety, is of supreme importance in ensuring that we have a health system that we can rely on. In fact, public safety and quality service provisions are now pre-eminent parts of today's registration provisions in all of the current acts right around this country and, of course, in other countries too.

It is important in communities such as ours that we have structures in place to ensure that, and that is why we have strong regulation legislation generally and other systems, such as the Health and Community Services Complaints Commissioner, that monitor these matters from the point of view of the consumer. You need to have both systems working together to ensure that these things are in place.

The committee highlighted some issues and made recommendations in terms of increased provisions in relation to registration of previously unregistered health practitioners and it also made a recommendation about new registration of Chinese medicine and therapists. The committee also rightly pointed out that most practitioners are doing the right thing but, of course, we have to be very careful to ensure that all practitioners—every one—are doing the right and proper thing because this is when people are at their most vulnerable. The report outlines some shocking cases of very vulnerable people being used by charlatans in the most reprehensible way, so I am really pleased to see those issues being highlighted.

I must say that I have to pick up the member for Hammond. I am not sure whether he meant to put chiropractors in the same basket or even suggest that they are in the same basket.

Mr Pederick: No, no; not at all.

The Hon. L. STEVENS: He is saying that he did not and I am pleased to hear that, because I am sure that people do know that chiropractors are registered in this state and all other states of our country and other developed countries. Of course, there are often professional boundaries between health practitioners about who does things best but, in fact, chiropractors are registered and have strong legislation in this state. Their legislation is in line with the model legislation that we have for all our health practitioners. Certainly, I have a very competent chiropractor—my whole family does—and I know that they come under the umbrella of registered health practitioners in this country.

In relation to the Health and Community Services Complaints Commissioner, I am pleased to hear the comments of all members of the committee and I have read the report. That piece of legislation has huge powers for the commissioner. She virtually has the powers of a royal commission in terms of what she can do in following any complaints that come to her attention—and the complaints are very wide. This was deliberately done, understanding that many people are in a very vulnerable position and are powerless when they come up against a health system or health professionals. That legislation has been structured around those very things.

I was concerned to read that there was no naming of these particular bogus practitioners who were mentioned and were investigated by the committee. Those powers are in the current act and, in fact, the health commissioner is protected from any action that she may take in the public interest as a result of complaints that she deals with. So, the powers are there. Natural justice is important, but public safety is more important.

I am really pleased that the Social Development Committee is going to follow up on this, and I congratulate it for doing so and not just leaving it as a report that it has presented to the parliament—end of story. I am really pleased that it is going to follow this through. Everybody needs to be kept up to the standard and I am pleased that the committee is going to do this with the Health and Community Services Complaints Commissioner. I am sure that she will want to respond in a most positive way to any feedback and suggestions that the parliamentary committee might make.

Finally, I would like to make a comment about one of the recommendations, which the Minister for Health has not accepted. This was a recommendation about the arrangements that had been put in place in the Health and Community Services Complaints Act about protocols between registration boards and the commissioner. I think, from memory, the committee found them confusing and asked the minister to look at them again.

I would just like to say that these new arrangements have been accepted well by all the registration boards; in fact, the Medical Board, in at least one or, I think, two of its annual reports, has spoken positively about that system and how the board is working very well with the complaints commissioner to enable it to quickly deal with the ownership of complaints (or parts of complaints) so that the business can proceed smoothly and people can get resolution as quickly as possible. With those words, congratulations again to the committee. In my retirement, I look forward to keeping an eye on what happens in the future in relation to these matters.

Dr McFETRIDGE (Morphett) (11:37): I congratulate the Social Development Committee on this report. I have not read it in detail, but certainly the recommendations are such that I will be taking them into serious consideration in forming policy framework for the Liberal Party. I also congratulate the member for Little Para (Hon. Lea Stevens) for what she has done in this place when she was the minister for health and for the way in which she has diligently contributed by using all her effort and intellect to improving the lives not only of her constituents but also the people of South Australia. She will be sadly missed by me. I do not consider many people in this place as friends, but I consider the member for Little Para to be a friend, having been on the Aboriginal Lands Parliamentary Standing Committee for a number of years now, and, Lea, I will miss you.

This report is very important. It highlights the extreme dangers to which some people unwittingly put themselves, with all the best intentions. What happens in most of these cases is that you have people peddling false hope and outcomes which are completely unrealistic or depend upon some psychosomatic effect and their need to control people. They take advantage of people suffering from ill health, families in distress, or individuals in distress. We need to regulate these people. We need to ensure that, if these people are caught acting in an inappropriate way, they need to be punished, and certainly naming and shaming is something I would be prepared to look at in relation to people who are using the vulnerability of others for their own benefit.

Certainly in veterinary medicine—and as many people would know, I had a veterinary practice for many years—we used to see them all the time, particularly in racehorse work you would see the witchdoctors, as we used to call them. They would come in, these tiny little guys, some of them ex-jockeys, and they would try to manipulate horses' legs, backs and necks. It was really a joke that people were paying money for someone to come along with an old billiard ball on the end of a stick and rub it over their horse's back and pretend that they could make this horse better. It was a shame.

There are some alternative therapies such as acupuncture. I have used a lot of acupuncture on horses, cattle and dogs. Certainly, acupuncture is one of those areas where there are many non-believers, but I am certainly one of those people who believes in the power of acupuncture. Magnetic pulse therapy, magnetic therapy is another area which I have used, and I certainly do believe there are justifiable physiological and biochemical bases on which to look at the effects of those particular areas of medicine, both veterinary and human medicine.

The super clinics which we are getting—they call them 'poly clinics' in England—will have a lot of allied health professionals who should never be confused with a lot of these quacks, soothsayers and witchdoctors who are out there. The allied health professionals will be the chiropractors, podiatrists, physios, nutritionists—and the range goes on. They are highly qualified and well trained people and should never be confused with people such as the fellow you see on the advert for a private health fund slapping two fish together over someone's back, and you think what sort of outcomes will there be. Unfortunately, there are people who believe that there are people who can wave their hands over them or somehow remove foreign bodies or tumours just through some mystical intervention, and so we do need to ensure that these people are controlled, particularly when they are charging large sums of money.

A friend of mine was dying of lung cancer. He underwent all the traditional therapies here. He was doing a fair bit of trade in China. He went to China and came back with this herbal solution. He called it his 'Chinese mud'. He would mix the potion up and drink it, but, unfortunately, as I think we all expected, it did not do him any good. That is not to say that there are not potions and lotions out there, or bush medicines as our Aboriginal friends tell us, that do work, because many of our medicines have been derived from natural herbal remedies which have been discovered and used over many years.

The fact is that people are vulnerable and people will take advantage of them. For instance, the drowning man clutching at a straw syndrome will take advantage of any opportunity to get some extra time to recover or to perhaps eliminate the disease or the cancer. However, in most cases, it does not happen. We do need to control people who are offering false hope. This report outlines a number of things that are involved in doing that and certainly the legislation is one which I have said I will look at. Should we be elected in March next year—possibly April next year if there is a double dissolution—we will be looking at that, as well as ensuring that the other recommendations of the committee are considered.

Reports such as these do not sit on the shelf. Many people think that committees do this work, listen to people, and then the report gets put on the shelf. This does not happen. It has not happened with any of the committees that I have been involved with, and I would expect that all the committees of parliament do work very hard. If you read the paper at the moment it says that we are not sitting until March next year and we are all going on holidays, you would think that is the case, but I know that each and every person in this place does work very hard, not just in this chamber but, more importantly, out with their constituents and out in their electorates. Having been here nearly eight years, I can vouch that every member in this place works very hard and serves their electorate to the best of their ability.

Can I say that I think the Labor Party is misinformed; it needs to change some of its ways, but that is life. We will find out in March whether the people of South Australia think that. The opportunities are there for us to improve the quality of this state, and the committee work is part of that. I congratulate the committee members on their hard work and the result in terms of this report.

The Hon. R.B. SUCH (Fisher) (11:45): I welcome this report. I congratulate the member for Taylor for being one of the principal people involved in bringing about the inquiry by the Social Development Committee. She knows that I have had an interest in this matter, because we know of one character around Adelaide, Warwick Raymont, who calls himself Dr Raymont. He was described in court as a 'fantasist', which I think is a lovely term. He has engaged in various practices, including counselling, and he has claimed to have discovered, I think, global warming, pesticides in milk and all sorts of things.

The important thing is that—and this is where change is required—Australians are very gullible when it comes to people presenting themselves as having particular qualifications. There is nothing to stop you calling yourself 'Dr' in this society. In fact, a lot of people use the courtesy title of 'Dr'—vets and chiropractors. Very few of them have a doctorate, a PhD, or an equivalent in science or medicine. Even our friendly GPs are not doctors in the true sense; they are medicos with two bachelor degrees, which is like saying that you have been twice to year 12. However, that is not the same as having gone on to complete, say, an honours degree, or something like that.

We grossly abuse the courtesy title 'honorary PhD'. I saw a publication recently commemorating women who had achieved in South Australia; and that booklet, put out by the state government, continues the fallacy and misrepresentation where that title is assigned to someone. It is used—or should be used—only in and around the campus. It is a university courtesy title, really, which acknowledges that someone has made a contribution to the university or the community. It is not a substantive degree. It has no substance to it other than the fact that it is recognition of someone having contributed to the university or to society at large. People in our society, even in the media, are largely ignorant of some of these things.

The number of medical practitioners who have a genuine doctorate in medicine in South Australia is probably fewer than 20. I am only guessing, but it would be very few. I imagine that people, such as engineers, get a little annoyed because, generally speaking, they are the smartest people at university if you go strictly on IQ.

Members interjecting:

The Hon. R.B. SUCH: Engineers are generally the smartest people at university, if you go on straight IQ. In South Australia we have more than 6,000 engineers but they do not get any title. They do not get any recognition much at all, yet every aspect of our life depends on what they contribute. You do not find engineers going around calling themselves 'Dr Blogs' or whoever.

Likewise, pharmacists is another professional group that is overlooked in our community. They have a lot more expertise in drugs, and so on, than the average GP. That is not putting the GP down, but if you have spent five years in training as a pharmacist on medicines and pharmaceuticals you will know a lot more than someone who has done a short course as part of their training to be a medico.

As well as professional people who give themselves a title, we have all these other people. I mentioned the fantasist before, but we have other people in the community who are literally preying on those who are sick. There have been some disgraceful cases where some of them have also used their treatment as an excuse for sexually taking advantage of people who are desperate and dying, and that, to my mind, is about the lowest sort of behaviour you can possibly get.

What we need, I think, is to toughen up in terms of how people use titles and how they describe themselves. I think that the people who do not do the right thing and who try to present themselves as having qualifications that they do not have should be dealt with severely. There is a classic case at the moment. The billboards that used to advertise 'longer lasting sex' have now been converted and advertise 'longer lasting love'. That program is an absolute scam. The person who is running it is a medico, but he is making millions of dollars by giving people—men, in particular—false hope that, with a nasal spray, they can cure their sexual problem, which is usually erectile dysfunction. The danger is that people may think that, by following that quackery, it might help them or save them when they should be going to a properly qualified medical specialist (in that case a urologist), not to some quack where they are charged a fortune for something that is of no benefit to them.

I commend this report; and, again, I acknowledge the role of the member for Taylor in helping to bring it about. I would like to see the government really tighten up on the way in which people misuse and abuse titles in our society in order to fool people, particularly in the medical field.

Mr PENGILLY (Finniss) (11:51): My contribution will not be a long one. However, I have noted the comments made this morning, particularly by the member for Taylor. I thought that she articulated the comments extremely well and in a very relevant manner. I have also picked up on what others have had to say in this place. I would particularly like to pick up on what the member for Morphett had to say about the Hon. Lea Stevens who will depart this place tomorrow afternoon.

I had a lot to do with the Hon. Lea Stevens when she was minister for health. When she became minister, she met with the chairs of the regional boards from across South Australia, and the first time I think she felt a degree of trepidation because I think she believed that we were a mob of Liberal stooges (which we probably were), but there was one exception.

The Hon. Lea Stevens put a huge effort into building a relationship with us. We gave her our trust, and she delivered that trust back to us. She talked with us in an atmosphere in which she knew that we would not go out and use it politically against her, and we did not. She had the confidence to raise issues with us that were beneficial to her both in her role as minister and in her dealings with a number of bureaucrats in the department of health and human services, as it was then, who were giving her advice that we thought was nonsense and not in the best interests of regional South Australians. We could talk to Lea Stevens about that, and we developed a great working relationship.

In addition, she rejected much of the Menadue report. She would not adopt it because she did not believe that it was in the best interests of rural and metropolitan South Australia, and I commend her for that. However, I find it most unfortunate that her successors have adopted much of the Menadue report, which was a lot of nonsense, and put in place supposed outcomes for the people of South Australia that I think are disastrous, and I am referring to the removal of the local health boards, the regional boards and so on and the putting in place of these health advisory councils which, despite the best intention of some of their members, are totally useless.

I wish the Hon. Lea Stevens all the best for her retirement, and I hope that she and Michael have a great time. Her contribution to the report we are discussing today would have been made in the best interests of everybody, as Lea did. I will miss her being in this place and, if her successor is anywhere near half as good as Lea, they may be of some use, but she was dudded and shafted by the Rann government. I hope that in her retirement Lea enjoys herself.

The Hon. P.L. WHITE (Taylor) (11:54): I thank all members—members of the committee and other members—who spoke on this motion. It is pleasing to hear that they agree with the recommendations of the report and are keen to see them enacted. I thank the member for Fisher for a couple of things but particularly for reminding me (because I neglected to mention it in my contribution) about the work we did around the title of 'Dr'.

The importance of what people in this field call themselves relates to the way in which consumers interpret the title 'Dr'. In fact, there is an assumption by them that, if the title 'Dr' is before someone's name, there is a qualification and that that person is answerable to some accreditation process and some body.

As we found during the inquiry, many of these types of people who portray themselves as possessing the title 'Dr' have no such legitimate qualification. As the member for Morialta stated, you can very easily get a piece of paper via the internet to portray yourself as having some accreditation that you actually do not.

I thank the member for Morphett for pointing out that, even though parliament will have risen, our committee will still be working on this reference, in the sense that we will be following up on action taken by the Health and Community Services Complaints Commissioner next Tuesday, when we call her before our committee to explain her follow-up on the cases that were identified in our report. Some subsequent action has been signalled by the health minister (Hon. John Hill), and some action—for example, on the title of 'Dr'—is being taken up at a national ministerial level.

I thank members for their contribution, and I believe that, should the recommendations put forward in this committee's report be implemented, we will have all done a bit more to ensure that people can have faith that these sorts of charlatans of whom we spoke are eradicated.

Motion carried.

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