Abstract
History would suggest that when presented with issues of injustice and inhumanity, medicine must stand up and be counted or be held culpable.
The medical colleges in this country have increasingly accepted the important role that they have in matters of community concernstanding with the people they serve.
This College has, through General Council, the Executive, the Branches and Faculties, Sections and special interest groups been actively involved in health policy developments of interest to the Fellowship. These issues have covered a spectrum of activities from health financing and work-force through to social policy issues.
The General Council of the College is elected by the Fellowship, and democratic processes, likewise, elect Branch, Faculty, Section and special interest group representation.
In relation to the specific issues that Dr Samuell has raised, several points are relevant.
At all times the policy positions of this College are under the auspices of, supported and ratified by the governance bodies of the College.
The College's purpose in raising concerns about the Governor General's statements regarding child sexual abuse was to highlight the mental health aspects of the problem of child abuse and our community responses to it. Although controversial, the approach taken by the Executive has resulted in increased dialogue with the Patron's office and greater awareness of the issue of child sexual abuse.
The College has had a position statement in relation to the provision of services to people in detention approved by General Council since October 2000. It was upon this basis that the College became involved with a cross-college strategy to highlight the health issues related to detention, in particular as these relate to children. The cross-college position is based upon a growing body of evidence of the harm caused by detention, which is supported by most medical organizations in this country. The policy of this alliance is spelled out in the submission to the Human Rights and Equal Opportunity Commission enquiry available at http://www.racp.edu.au/hpu/policy/asylumseekers/release_children.htm#submission.
The College has never condoned or accepted violence as a strategy and the comments that suggested that violence in the environment of the detention centres was understandable, in no way condoned the behaviour that occurred. In relation to the government's media campaign- ‘Be Alert Not Alarmed’ -the College was merely pointing out the potential unintended negative outcomes of any government action in this area. This was not to suggest that no action should be taken, but that in responding to legitimate national security issues, the government needed to consider the psychological impact of any such action.
It must be remembered that, merely because an individual disagrees with a course of action taken by an organization involving many, many hundreds of Fellows, the action is not necessarily wrong nor is debate in relation to the potential alternatives problematic. It is hoped that, as the College becomes more relevant in the policy environment, these debates within the Fellowship remain rigorous and intellectually robust.