Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

I would like to congratulate the previous speaker for her contribution to the debate and for the role she played in the round table that was conducted. The member was very involved in the whole process and made an enormous contribution to the report that we have before us today in the parliament.

The committee became very concerned about some of the treatments that were being proposed and some of the advertisements that were being circulated. I think it was the member for Lyne who, one day in the committee, raised concerns about signs on the side of the road. We became very concerned about the fact that there were all these treatments and advertisements, but we were not too sure how effective they were. That was coupled with the fact that many members in this House had received complaints about some of the clinics that were providing these services. The New South Wales Health Care Complaints Commission have previously conducted an inquiry into some of the practices of these clinics. As such, it was felt that it was worthy of the committee’s time to take a look at them and see exactly how effective these clinics were in delivering what they promised.

The purpose of the clinics that we were looking at was to look at erectile dysfunction, and the committee was looking at the treatment and the management of erectile dysfunction in Australia. In recent times, as I have already mentioned, a number of erectile dysfunction clinics have been established. These clinics have caused concern to some of the people that have visited. The first concern I would like to place on the table is that when people contact one of these ED clinics they do not receive a holistic approach. If a man is suffering from erectile dysfunction, the first thing he should do is visit his doctor, because it can be a symptom of a much more serious illness. It can be an early marker for chronic lifestyle and other diseases, such as cardiovascular, diabetes, depression, excessive use of alcohol, smoking, prostate problems, neurological disorders, hormone imbalance and the side effects of other medications and stress. That is just a few of the diseases that it could be an indicator of. I feel that when you are looking at treatment options for erectile dysfunction the first thing a man should do is visit his local GP and talk to them about his problems.

There are many treatments available. There is the non-invasive treatment such as oral medication—Viagra is the most commonly known one; there are injectable treatments like Carverject, which has also been a long-term marketed product; and there are surgical treatments such as penile prostheses and vascular surgery, which goes back to the linkage between chronic disease and ED. Most of these commercial ED clinics prescribe treatments that are different to those above: nose sprays, gels, applications, lozenges or penile injections.

There have been mixed reports about the success of these treatments, and that is what concerned the committee. There does not seem to be the amount of transparency that there should be around these treatments. Whilst the committee felt that we did not have the expertise to make a judgement about the competing treatments, we all felt very strongly that the first port of call should be a qualified medical practitioner and that a full health check was needed prior to actually making a decision about whether or not the appropriate treatment was the spray or the gel, or trying one of the more traditional treatments—or whether it was a mark of some more serious health problem.

One of the issues that were discussed during this roundtable that we had was the fact that men are not proactive about maintaining their good health. They tend to neglect their health. They feel that there is some stigma attached to visiting their doctor. They think that they are invincible. One of the best messages that can come out of this is the message that I started with: the need for men to have good ongoing health checks. We were given considerable anecdotal advice about men not being likely to visit GPs. But those over 40 years of age, in actual fact, do listen to their GPs and are happy to consult. I feel that it has to be put that this is not something that they need to be embarrassed about. This is just another health problem.

There has been a telephone survey of men in Australia called ‘Mates.’ It found that men did visit their GPs. The survey asked questions mainly focusing on reproductive health but there were also a broad range of questions about lifestyle, sexual behaviour and general health. The answers suggested that almost 90 per cent of men aged over 40 visited a GP once a year. But it found that men were also very concerned about developing reproductive health problems. Around 80 per cent were concerned about developing erectile dysfunction. The survey identified that men are selective—and this is the point that I was trying to make—about which topics they choose to raise with their GP. Embarrassment alone should not deter men from discussing all of their health problems with their GPs. The most important message out of this is that you need to get treatment for erectile dysfunction from your GP. Mention it to your GP. Talk about it with your GP. Do not be selective in the topics that you raise with your GP.

One of the things that were discussed at our roundtable was whether or not telemedicine was appropriate. Given what I said about men being selective about the issues that they will raise with their GP, telemedicine gives men some sort of anonymity. They can do things in a way such that they do not have to disclose their identity to the same extent. I would like to emphasise that this is a problem, because men are not getting this holistic treatment that I referred to previously.

The committee believed that the health system needs to better identify erectile dysfunction as an early warning sign of more serious conditions; it is, as I have already stated, an underlying symptom of cardiovascular problems and diabetes. This cannot be done if men are not visiting their GPs. The committee felt that we needed to implement a targeted health program to better inform men about underlying conditions associated with ED. There have been a lot more health promotions directed at men. The prostate cancer group—in particular the one that exists in my area—ran a program called ‘A little prick’, which encouraged men to have a PSA test. Men are becoming more aware of and more familiar with discussions and issues to do with men’s reproductive health.

The downside of telemedicine that is operated through these ED clinics is that they tend to treat erectile dysfunction in isolation and they do not target it as primary health linked in a holistic health way. I feel—as does the committee—that the Minister for Health and Ageing should ask the state and territory medical boards to review the adequacy of the national policy in relation to technology based consultations. I am a very strong supporter of telemedicine but I think it has to be done in conjunction with a holistic approach to medicine, particularly in this area.

The inquiry conducted by the committee—and the committee’s report—raised a number of questions. I am not convinced that the ED clinics that operate in Australia are properly regulated. The commercial ED clinics treat men in isolation. We looked at the e-records system, and I think that there are some concerns about that. There are also some concerns about the compounds and the fact that they can be exempt from the TGA.

Whilst we did not make any recommendations, this report raises a lot of questions. I think that it is worth the minister and the parliament having a considered evaluation of the ED treatments and ED clinics that are provided around Australia. We need to be mindful that any medical treatment that is provided should be holistic and that all aspects of a person’s health should be considered when looking at prescribing a treatment for a person who is suffering from erectile dysfunction.

Debate (on motion by Mr Melham) adjourned.

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