Dr SOUTHCOTT (4:30 PM) —I would also like to address the motion put forward by the member for Throsby concerning the myelographic dyes Myodil and Pantopaque. As we have heard, these dyes containing Iophendylate were used in myelography to visualise the spine in patients with severe back symptoms. Their use assisted doctors to treat and manage many patients at a time when there were few other options available. These days, of course, doctors use other new technologies, such as non-invasive MRI and CT scans, to diagnose and manage patients and, appropriately, use of both of these dye products in myelography has been largely superseded. At the time these dyes were first marketed, alternative technologies were not available, and we must remember that many patients did benefit from their use.

Adhesive arachnoiditis is a potentially painful and disabling inflammation of the arachnoid membrane of the spine. It has a variety of causes, many of which may have also been relevant to patients being investigated for back problems, for example trauma and surgery to the spine. It is not known how many sufferers of this condition there are in Australia. Estimates we have from scientific papers are that the incidence of this condition following myelography is uncommon or rare. Although adhesive arachnoiditis very rarely occurs if precautions are followed with the use of these dyes, it is known that failure to observe basic precautions—for example, removing the dye at the end of the procedure and ensuring correct positioning of the patient—can increase the risk. There have been court cases in Australia in relation to this issue, and redress through the courts or medical practice complaints mechanisms operated by the states and territories is an appropriate way to deal with allegations of practice issues concerning myelography and these dyes.

We have also heard that both agents were available before the introduction of a regulatory program for therapeutic products in Australia. One product was removed from the market for a time and was subsequently required to be evaluated before formal re-entry to the market. When general marketing approval was granted, it was subject to the provision to doctors of appropriate warning statements about the use of these dyes. For the other product, warning information and guidance on use had been available to doctors since the early 1970s.

A complicating factor is that lumbar puncture is often done as part of myelography. When this is considered with other potentially confounding factors linked to the occurrence of arachnoiditis, it is clear that for some patients it is, and always will be, difficult to ascribe a cause to their symptoms. Let me be clear that I do sympathise with the sufferers of this condition, but I must reiterate that there is no basis to conduct an inquiry into the availability and use of the dyes in Australia. These dyes were used to assist doctors to diagnose and manage serious conditions of the spine. There was no alternative at the time they were introduced to the market, nor for many years thereafter. Information was provided to doctors about the risk of these dyes and how to avoid adverse effects of such procedures, such as arachnoiditis. It is the role of the treating doctor to assess the risks and benefits of treatments for their patients and to make the best decision keeping their patients' interests in mind. These dyes offered substantial benefits which must not be forgotten. I regret that their use as part of myelography procedures, and often in association with back surgery or back disorders, is claimed to be linked to recurring pain and disability in some individuals.

The DEPUTY SPEAKER (Hon. I.R. Causley)—Order! The time allotted for private members' business has expired. The debate is interrupted in accordance with standing order 104A. The debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.