Interview - Dr Bill Glasson, AMA President, with Grant Goldman, Radio 2SM - AMA's objection to the availability of the morning-after pill without a prescription; concerns that obstetricians are increasingly being replaced by midwives in NSW hospitals

GOLDMAN: Well, women now have access to the Morning-After Pill without a prescription. That happened pretty quickly, didn't it? The National Drugs and Poisons Committee made the decision to allow pharmacists to sell the emergency contraceptive over the counter.

The AMA President, Bill Glasson, is on the line. Morning, Bill.

GLASSON: Morning, Grant. How are you?

GOLDMAN: Very good. Bill, you've opposed this move. You say it makes women less responsible. In what manner?

GLASSON: Well, I think in isolation of a doctor, I think it does, Grant. And at the end of the day, there's a number of issues. If a woman has unprotected sexual intercourse, particularly with a person that they may not know at all, then essentially the issues relate first of all to the unwanted pregnancy, and then the ongoing issues in relation to did the partner in fact have some sort of sexually transmitted disease such as herpes or AIDS or whatever. And there's also psychological implications of having an unwanted pregnancy.

So we feel that to have this emergency contraception in isolation of the doctor is really not the way to move forward. And also, we'd hate to think that this is being used as a form of contraception. And that's the other issue, that this is emergency contraception, but if it's sort of available freely over the counter. The question is: are women going to use this as just a form of contraception when they decide that, you know, they're going to have sexual intercourse and then, yes, we're going to have the pill in the morning.

GOLDMAN: Yes, cleaning up after the event, so to speak.

GLASSON: Absolutely.

GOLDMAN: I've got to ask the question: the National Drugs and Poisons Committee, would they have made this decision in consultation with governments or even the AMA?

GLASSON: Look, we've clearly signalled to them over the past six months that we do not support - we knew there was a move in that direction and we said that we didn't support it for the reasons I've outlined. And, also, we indicated that pharmacies are not the place where you can get sexual health counselling, and the pharmacists would agree with that as well. I mean, you can talk about the drug or whatever, but as far as a counselling session, that's not the place.

And so we signalled that clearly to the National Drugs and Poisons Committee that that was not the way forward. But despite that, as usual, they often don't take much advice, and they just move ahead anyway.

GOLDMAN: Yes, and also taking doctors out of the equation, yet again here: midwives have been given the authority to deliver babies in New South Wales hospitals when a doctor is not on duty. Gee, I would have thought that's pretty dangerous.

GLASSON: Grant, that's a sad day. It's a sad day for obstetrics and particularly for the mothers of Australia. I mean, we've been forewarning to the Government the fact that this crisis in obstetrics is on our doorstep, and here we are now trying to solve the problem by bringing in obstetric midwives, who by the way are highly skilled and highly trained, but they are not doctors.

And, as you know, in obstetrics, it's 90 per cent clear sailing, but there's 10 per cent panic where a decision has to be made on the spot, now, because either the mother or the baby is in jeopardy. And that's why you need highly skilled, highly trained obstetricians, or GP obstetricians as well in rural Australia who can actually provide these services. I think it's a sad day for obstetrics in Australia, and a sad day for the mothers of Australia.

GOLDMAN: Because of that 10 per cent panic you talk about there, I guess that has a lot to do with medical insurance too and a lot of the reasons why even GPs are getting out of obstetrics and therefore leaving a hole in the marketplace.

GLASSON: You're absolutely right. You know, at the end of the day, we've forewarned them, we've said it was coming, let's get this problem sorted out. But you might have seen the other day that obstetricians in New South Wales are now getting a $140,000 premiums from one of the MDOs... those crisis situations. And so, for the standard delivery, okay, the obstetrician may not necessarily have to be standing beside the mother, but needs to be just outside the door, I can tell you, because things go wrong very quickly in obstetrics, and unless you're there to act quickly, then either the mother or baby or both end up compromised.

GOLDMAN: Good to have you on the program this morning. Thanks, Bill. Appreciate that.

GLASSON: Thanks, Grant. Any time, mate.

GOLDMAN: Bye. Bill Glasson from the AMA, the AMA president, doing a great job, too.

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