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Thursday, 27 November 2008
Page: 7540

Senator XENOPHON (2:49 PM) —My question is to the Minister representing the Minister for Health and Ageing, Senator Ludwig. Attention deficit hyperactivity disorder is the most diagnosed childhood disorder in Australia. Research by Dr Constantine Berbatis of Curtin University has found that Australia, along with the United States, has amongst the highest rate of psychostimulant treatment for ADHD internationally. In the past, the UN has warned Australia about its high levels of drug use to treat ADHD. I draw the minister’s attention to articles published in the Advertiser and the Daily Telegraph on Monday, 17 November this year which reported financial links between the members of the panel currently preparing the national review of ADHD and the large pharmaceutical companies that provide psychostimulant treatment for ADHD. This panel, from the Royal Australasian College of Physicians, has been commissioned by the National Health and Medical Research Council to develop a new set of guidelines for the management of ADHD. Has the government investigated the veracity of these reports, and if they are true what action will the government take?

Senator LUDWIG (Minister for Human Services) —I thank Senator Xenophon for his question. The issue surrounds the raising of a conflict of interest. What I can say is that I understand that there are concerns in the media regarding conflicts of interest for members of the ADHD guideline development working party. The Minister for Health and Ageing advises that the current chair of the working party is Associate Professor David Forbes. Professor Forbes is a highly regarded paediatrician in the area of gastroenterology. His area of clinical practice and research is not associated with ADHD in any way, but he is very familiar with the NHMRC guideline review process.

Professor Forbes has declared that he has no pecuniary or professional interest in any companies involved in the development, manufacture, marketing and distribution of, or education about, drugs. In addition to the NHMRC recommended processes, the RACP have a rigorous process for the declaration of conflict or duality of interest for work that is in any way related to pharmaceuticals or their associated companies. This ensured that any potential conflicts were known by the RACP and all members of the working party.

In accordance with the NHMRC policies, a summary of the declarations of interest provided by each working-party member will be included in the guidelines once they have been finalised and approved by the NHMRC. The minister has been advised that the conflicts of interest declared by working-party members are consistent with the normal range associated with clinician review committees of this nature. These include private practice work relating to the diagnosis and management of ADHD, and the publication of booklets. (Time expired)

Senator XENOPHON —Mr President, I ask a supplementary question. I draw the minister’s attention to the evidence appraisal form used by the national inquiry into ADHD. This appraisal form favours large-scale studies with the emphasis on clinical impact. These evidence evaluation methods emphasise drug efficacy studies of the type that are funded by pharmaceutical companies. Does the minister agree that this emphasis may overlook research that reports on the social and educational interventions for ADHD?

Senator LUDWIG (Minister for Human Services) —I thank Senator Xenophon for the supplementary question. The Australian draft guidelines on attention deficit hyperactivity disorder, or ADHD, were developed for the Royal Australasian College of Physicians, the RACP, by independent scientific writers and released for public consultations on 28 June 2008. The public consultation undertaken by the RACP is part of an independent process for developing these guidelines to improve consistency in treatment and outcomes by providing guidance based on best practice and available evidence. All interested parties were of course encouraged to make submissions to the college on the draft guidelines. There were 70 submissions received. The college is now required to consider all the submissions it has received during the public consultation period before making a submission to the National Health and Medical Research Council for final approval. (Time expired)

Senator XENOPHON —Mr President, I ask a further supplementary question. Is the minister aware of concerns among non-medical experts on ADHD, such as Dr Linda Graham of the University of Sydney and her colleagues, that their research has been overlooked by the review? Will the minister explain why Australians should not be concerned that this report is only asking medical questions which will only get medical answers and could result in more drug use?

Senator LUDWIG (Minister for Human Services) —The Australian government is of course aware of community concerns about the possible overprescribing of medicines for children with ADHD and would be concerned if children who did not need medication for ADHD were being unnecessarily treated. Anyone who is concerned about the medicines they or their children are taking should consult with their doctor. We are waiting for the draft guidelines. I expect that the Australian guidelines will be finalised in the coming months. We are working under draft guidelines on attention deficit hyperactivity disorder at the moment and, as I indicated in my earlier response, there have been many submissions put forward in respect of this. The government does have concerns about the delay in getting those draft guidelines finalised and put into practice. There are alternatives to the treatment— (Time expired)