The absence of many voices in protest

Australian medicine faces a life-threatening disease in the form of an unprecedented grab for control by governments. Its latest symptom is the potential hijacking of the profession’s control over self-regulation and education. These are slated to become the responsibilities of committees in which doctors will have less influence. The extent of the hijack will become clearer when the Council of Australian Governments establishes a national body to register and set competency standards for doctors and other health professionals, and a national accreditation body to establish standards for their education. With these developments, what will be the fate of medical boards, medical colleges and the Australian Medical Council?

This grab for control is a worldwide phenomenon, as “the regulation of the medical profession is subjected to unprecedented, and growing, public debate, increasing intervention in the daily professional activities of physicians, and increasing oversight by the central state”.* A recent World Medical Association press release warned that the WMA’s Secretary General believed that “. . . by steady steps, governments were taking away degrees of freedom from the profession’s self governing bodies. ‘And this is not a cosmetic change —it means democratic participation is being dismantled. We’ve seen it across Europe, we’ve seen it in New Zealand, in Hong Kong and elsewhere,’ he said. ‘This is something that is going on very silently, with small steps in many countries’”. And he may well have added we are seeing it in Australia.

But where are the many voices in protest? There seems to be little in the way of overwhelming public response to Australian medicine’s life-threatening disease. Could it be that doctors support the reforms, or have become fatigued by their never ending tussles with governments to maintain self-governance? The absence of many voices in public protest may well seal the fate of the profession’s independence.

* Moran M. The British regulatory state: high modernism and hyper-innovation. Oxford: Oxford University Press, 2003.