Thursday, 14 November 2019

 Mr QUILTY (Northern Victoria) (12:23): My question is for the Minister for Health. Safer Care Victoria, a government agency, recently convened an expert panel to consider issues related to paediatric chiropractic. The panel received 22 000 patient submissions from members of the public who had used these services. The submissions were 99.7 per cent positive. The panel also reviewed patient complaints, insurance claims data and medical literature for evidence of harm from paediatric chiropractic and found literally none. The recommendations provided by the panel do not seem to follow from the evidence provided. The recommendations seem to be intended to crack down on chiropractors, physios and other alternative health providers who provide safe and effective treatment. Will the minister tell us why a crackdown was recommended despite the evidence showing a safe and effective industry that satisfies customers?

 Ms MIKAKOS (Northern Metropolitan—Minister for Health, Minister for Ambulance Services) (12:24): I thank the member for his question. Firstly, I think what is implicit in that question and the way that it was framed by the member is really an attack on Safer Care Victoria, and I absolutely reject that. I take this opportunity to thank Professor Euan Wallace and Safer Care Victoria for this very important report that was recently considered by the COAG Health Council.

Can I say at the outset that the issues that came to light that led to me requesting this review related to a particular Victorian chiropractor undertaking a particular practice of spinal manipulation on an infant. I think the member may well recall the media attention that that matter received at the time. The review that was undertaken by Safer Care Victoria also involved input from a panel that included representatives from the chiropractic profession as well as consumer representatives, and it did give the community an opportunity to provide input. In fact, as the member alluded, there were a lot of submissions that were received and, yes, they were very favourable of parents being able to choose to access this type of treatment. It was very clear from the reports that I had that consumers were being encouraged by chiropractors in their clinics to send me and Safer Care Victoria pro forma submissions. So be it; that is fine. And of course members of the community are very entitled to express their view, but it is very important that we are very clear about this—that this was never intended to be a popularity contest. These are issues around safety and quality, and they are the issues that Safer Care Victoria worked on to address. I thank those members of the community who did provide input.

I am able to give you some more information about the findings. The review identified that there was poor evidence to support the use of spinal manipulation for the treatment of a number of specific conditions. In the absence of evidence of effectiveness, Safer Care Victoria took a first-do-no-harm approach in recommending against performing spinal manipulation on children under 12 years of age. The recommendations of the review both respect a parent’s or guardian’s right to choose appropriate healthcare options for their child whilst ensuring that children, particularly the young who are less able to communicate adverse effects, are safe. This review has provided valuable information to parents and guardians to help them to make informed choices into the future. (Time expired)

 Mr QUILTY (Northern Victoria) (12:28): In March the government promised the COAG Health Council that this review would be independent. I have now heard that the recommendations from the panel were actually rewritten after the review was completed without the knowledge of the panel or any further consultation. It is essential that independent reviews establish and stick to procedures to ensure that they maintain credibility. When stakeholder engagement is ignored and recommendations are arbitrarily rewritten, the credibility of recommendations is damaged. There are now suggestions that this review was tainted by bias because it deviated from the agreed method and abandoned the evidence. Were the recommendations of the Safer Care Victoria review into paediatric spinal manipulation rewritten after the panel had provided them?

 Ms MIKAKOS (Northern Metropolitan—Minister for Health, Minister for Ambulance Services) (12:28): I absolutely reject that assertion. I think that is a terrible slur on Professor Euan Wallace and Safer Care Victoria, which was established by our government to provide a clear focus on safety and quality in our health services. This process was never about a panel report or a panel review. It was not designed to be written by the panel. It is a report that was written by Safer Care Victoria, and the panel members understood that. I think it speaks volumes that this report was received and considered by the COAG Health Council with representation across the political divide just a couple of weeks ago, and the COAG Health Council have now asked the Australian Health Ministers Advisory Council to consider the findings and the recommendations of the review and provide further advice to ministers.

I can understand that there would be members of a profession, particularly the chiropractic profession, who are not happy with this report. I understand that, but I think it is very unhelpful for them to seek to attack the people who have undertaken a very thorough process. The findings that they have found about the lack of efficacy and claims that are being made are concerning, and I think that parents are entitled to know about the lack of efficacy. (Time expired)