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ABC News
an hour ago
- ABC News
Calls for 'wild west' of online sperm donation to be regulated due to 'lifelong consequences'
A leading Australian fertility lawyer is urging governments to regulate the "wild west" of online semen donation, accusing them of being "asleep at the wheel" as women continue to turn to websites and apps to seek donors. Stephen Page is calling on health ministers to look at regulating the space as part of the three-month rapid review of the nation's fertility sector that was sparked by the second Monash IVF mix-up. "There's no regulation, you can set up a website, you can set up an app and bang the drum and get men coming along saying that they will be donors, either by AI (artificial insemination), or NI (natural insemination, or what we used to call sex)," he said. One sperm donation Facebook group, which has more than 21,000 members, asks questions around insemination methods people are comfortable to use, including NI. Last year, ABC's Background Briefing investigated Facebook group sperm exchanges and the "known donor" movement as "wait times and costs see more Australians turn away from traditional sperm banks". The sites are used by some single women and lesbian couples seeking to start a family without the big expense and delays of going to fertility companies, which can involve long wait times to access donor sperm. But Mr Page, who is also on the Fertility Society of Australia and New Zealand (FSANZ) board, cited risks including the lack of a cap on the number of families a donor can donate to through social media and concerns women could be exploited. He said the need for reform was urgent. "It worries me greatly. There's been all this attention about IVF clinics and let's be clear, I think much of that is warranted, but what really worries me is these sites and apps being unregulated," he said. Mr Page said donors should have to provide the site or group's administrator with ID verification, such as a driver's licence or passport. It should then be passed on to a regulatory authority, and if the donor has surpassed the limit on how many families he can create, "remove him from the site", Mr Page said. Donors should also have to declare sexually transmitted infection status, he added. The Brisbane-based lawyer, who made it clear he was not speaking on behalf of FSANZ, believes if social media groups or sites failed to adhere to a proposed code of practice, then they should be shut down. "You can't control people on the phone, you can't control if they meet in the pub or the corner store, but you can certainly control how they communicate through an app or website, which is how most people communicate," he said. "We can't have children waking up in the morning discovering that they've got 57 siblings because there's been a failure of political will to regulate these apps and websites. Asked if any other country regulated this area, he replied: "No, not as far as I'm aware." Adam Hooper, who started Sperm Donation Australia on social media in 2015 because he believed in "known donation", said regulations would "put people in danger". "If regulations are brought in (it) will turn into the dark web where children will never know their donors (sic) identities," Mr Hooper told the ABC in response to a series of questions. "Sperm Donation Australia gives the best advice and goes above and beyond anywhere in the world for a free platform. "Recipients are told to visualise STD tests before commencing." Mr Hooper said regulations did not change human behaviour. "As adults, we all have sexual education," he said. "Their (sic) is people on dating apps right now have (sic) unprotected sex." In response to claims the online semen donation world was the "wild west", he said the "society we live in as a whole is the bigger issue and the real wild west". Mr Hooper said Sperm Donation Australia kicked people out of the group for "lots of reasons", including unreliability, being caught out lying, and having judgemental views on sexuality. "We have a very low tolerance for misbehaviour of any sort," he said. Rebecca Kerner, the chair of the Australia and New Zealand Infertility Counsellors Association (ANZICA), backed Mr Page's call for action. She wrote to Federal Health Minister Mark Butler on behalf of ANZICA several times in 2023, concerned about the lack of regulation and the need for a national donor conception register. ANZICA wrote to Mr Butler again recently, further advocating for reform. Ms Kerner said it was only by establishing a national register that family limits on sperm donors could be monitored and maintained. Without it, she said the risks of psychological distress among donor-conceived children were extreme. "We need to start listening and hearing from people who are conceived in this way," Ms Kerner said. "It is about the potential impact of having large donor sibling groups. For some donor-conceived people, they can certainly feel like they've been cloned. Emily Fae, a Perth-based donor-conceived person and a co-founder of Donor Conceived Australia, said the government has a "duty" to step in. "I absolutely agree that the online donor space is the wild west," she said, adding that donors can lie about themselves, how many children they have fathered, or conceal serious genetic conditions. "Unregulated donation creates lifelong consequences for the donor-conceived people involved. "We deserve accurate medical history, the right to know our genetic relatives, and safeguards against preventable harm." A federal health department spokeswoman said the three-month review agreed to by the nation's health ministers into the assisted reproductive technology (ART) sector would be led by the Victorian government. The spokeswoman said the government was aware of the concerns raised by ANZICA about semen donors advertising online. "Health ministers will consider the outcomes of the review in the coming months, as a matter of priority," she said.
ABC News
2 hours ago
- ABC News
Cancer rates are rising for generation X and millennials. What can we do about it?
A disturbing generational shift appears to be underway in the rates of cancer in people in their 30s and 40s. Cancers that have always been far more prevalent in older people are now affecting younger people in higher and higher rates. This increased risk is likely to follow them for the rest of their lives. So what do we do about it? Remember during COVID how we talked about bending the curve? Well, this trend is going to be a very hard one to bend. But it's not a hopeless task. There are ways to change the steep cancer trajectories that generation X and millennials might be on. They include screening at younger ages, earlier detection and possibly most importantly of all, more assertive preventive strategies by governments and regulators. To understand what we can do, it helps to have a clearer idea of the new challenges we're facing. What hasn't changed is that increasing age is still the major risk factor for cancer. The older you are, the more likely you are to develop cancer. That's thought to be due to the time needed for the multiple genetic mutations which transform a healthy cell into a malignant one. So, in crude numbers, most people with cancer are older. What has changed is a dizzying and scary increase in the rates of cancer in the under 50s. It's happening in at least 10 different types of cancer. You can see the rise in figures provided to Four Corners by Cancer Australia. It's not just Australia. US research using large datasets found rises in about half the cancers they record in their cancer registries. The actual numbers of young people with cancer are still low relative to older people, but they're unlikely to stay low. The upward trajectory we're hoping to bend will likely rise inexorably as gen X and millennials age (more research on millennials is needed, but the signs are there). It's because of what's called the cohort effect. If researchers are right, the rise in younger adults will get worse as it's compounded by the effects of aging. One of the US's leading cancer bio-statisticians, Philip Rosenberg, says what he's seeing is "astonishing". "If things stay on their current trajectories, then we can expect that they would continue to experience those proportionate increases as they get older." He says rates of cancer for people born in the 70s could be double those born in the 50s. The other disturbing feature of some of these early-onset cancers is that they tend to be diagnosed at a later stage than tumours diagnosed in older people. That means they're more likely to have invaded the surrounding tissues and spread, leading to more surgery, chemotherapy and radiation therapy, and ultimately poorer outcomes. This puts more urgency on doing something to bend the trajectory downwards to stop or slow this inexorable rise. The reasons these cancers are being diagnosed at a late stage aren't clear. One possibility is people and their doctors not thinking that certain symptoms such as lumps, discomfort or bleeding could be cancer when someone is young and as a result delaying appropriate tests. Professor Jon Emery who studies cancer in general practice at the University of Melbourne, isn't so sure that's happening — at least in bowel cancer. He's studied time to diagnosis in Victorian general practices in people over and under 50 and found no delays in younger adults. Another and chilling reason may be that early-onset tumours are not the same as cancers in older people. They may be more aggressive to start with. Anecdotally, there are people who haven't delayed their diagnosis, yet have advanced cancer from the get-go. If this is true, then it has enormous implications for bending the trend. How can we find these cancers in young people earlier? One way is to reduce the age of cancer screening. The national bowel cancer screening program, in response to the rise in early-onset cancers, now starts at age 45 instead of 50. But is that early enough especially since between 45 and 49 you have actually got to ask or agree to participate? The breast screening program still only begins at 50 despite 20 per cent of breast cancers being detected in women under 50. Women between 40 and 49 can have free screening mammograms but again they have to ask to participate. A significant percentage of lung cancer these days occurs in people who've never smoked, particularly women. And while the data can be hard to dissect, organisations such as the Lung Foundation believe the rates in younger "never smokers" are rising. But the lung cancer screening programme, which has just begun, is only for present and past heavy smokers aged between 50 and 70. Given the trends in early-onset cancers, shouldn't we be doing a lot better? "Well, we don't lower the age of screening because it's not that simple," says Dorothy Keefe of Cancer Australia, who herself is an oncologist. "It has to be safe and effective." What Professor Keefe is referring to is the risk of unnecessary tests and invasive treatments — weighing up the harms against benefits. That's because screening isn't diagnosis. It's about finding abnormalities in healthy people who have no symptoms. These abnormalities might not be cancerous or never turn out to be malignant. At a minimum, a person with an abnormality will undergo a further diagnostic test like a colonoscopy or biopsy. Even with the rise in early-onset cancers, these abnormalities found during screening are more likely to be cancer in older people than younger ones. And even once you've done a biopsy and it looks cancerous, there's no guarantee with some of these lesions that they'll turn into cancer. Increasing, screening can mean younger people are subjected to invasive tests and even treatments that they might not have ever needed. It could also mean longer public waiting lists for colonoscopies due to increased demand. In the end though, changing screening programs is about governments deciding on the cost and resource availability. And even if screening was expanded to younger ages, the bottom line is that at the moment only four cancers are screened for. Those are bowel, breast, cervix and lung. One reason we don't screen for all cancers is that you need simple, cost-effective, reliable tests to determine who needs further testing and who doesn't. That technology doesn't exist yet for most cancers. Another reason is that detecting cancers earlier doesn't always make a difference to the outcome. With some cancers diagnosing early could just mean you spend more years with the knowledge that you have cancer, being subjected to treatments with side effects that could have been as effective later in the course of the disease. So the end point is the same. That may be true, say, of ovarian cancer. With those limitations, it still means that something needs to be done for the broad range of cancers on the rise. For that, what we're left with at the moment is to do better with people who have developed symptoms. Are we doing enough to catch cancer early enough once it's causing problems? That puts the onus on health professionals such as GPs. Norman Swan investigates whether ultra-processed foods, stress, or exposures dating back to childhood, could be behind the surge. Watch now on ABC iview. If you have symptoms, the process is entirely different from screening healthy people. It's about targeted diagnosis, often with blood tests, imaging and biopsies. "The people that you talk to, the young people with cancer, they actually do have symptoms," Professor Keefe argues. "One of the problems is that they have symptoms that aren't easily recognised because of their young age as being associated with cancer." The first stop that most of us have (after Google) when we have an unexplained symptom is our general practitioner. Could GPs be making diagnoses sooner? Professor Jon Emery studies the diagnosis and treatment of people with cancer in general practice — or primary care. He argues that GPs face a needle in a haystack problem with early-onset cancers. "Diagnosing cancer in general practice is challenging," he says. "If we think about a change in bowel habit, which is a common symptom of bowel cancer. Let's say there are a hundred people over 50 who come to see their GP with a change in bowel habit, about three to four of those will actually have bowel cancer. If you're over 70, it'll be about six (in a hundred). "But in under 50-year-olds, a hundred people presenting to their GP with a change in bowel habit, less than one of those will actually have a bowel cancer. So that's part of the challenge." Dr Emery thinks one answer is a process he calls safety netting. It's about all of us getting better at recognising symptoms that we should see our GP about without delay. Bleeding and symptoms you've never had before are examples. It also involves doctors making use of the simple tests they do have if they're uncertain there's an issue, having follow up checks, and ensuring the patient knows to come back if the symptom doesn't go away or returns. "It never should be said that someone is too young to have cancer," Professor Keefe says. "What we need to do is make sure that everybody to whom a patient might present has knowledge of what symptoms are red flags and what symptoms should trigger some sort of investigation." Dr Emery is also working on using artificial intelligence to analyse complex patterns of symptoms in someone's history to raise red flags across a number of cancer types that GPs might not have otherwise noticed. In the near future, blood tests which can measure cancer markers and make detection easier may be shown to be accurate and usable in the population at large. We assume that early detection will bend the curve downwards but can't be certain. All this adds up to prevention strategies being essential. To prevent cancer you really want to know what's caused it — and when. Sure, we can put the responsibility for this onto individuals — not smoking burnt plants, eating more veg, keeping our weight down and getting the recommended amount of physical activity. That will likely make a difference to cancers that are strongly lifestyle in origin like uterine and liver, but our lifestyle has been pretty lousy for a long time and the causes of early-onset cancers may be beyond individual control. Given cancer can take decades to develop, decades in a 30-year-old takes you back to early childhood or even your mum's pregnancy. One theory is that back then, something happened to mothers' and kids' microbiomes — the bugs in their bowels. Eating ultra-processed foods, antibiotic use, and increased caesarean births (where babies don't acquire the normal microbiome) potentially made our guts more vulnerable to dangerous bacteria. Then there's damage from chemicals all those years ago, which might only be emerging today. "We have a blind spot around environmental chemicals and cancer," says Christos Symeonides, a paediatrician who works with the Minderoo Foundation on the health effects of chemical and plastic exposures. And it's a big blind spot with micro and nano plastics in our food and drinking water, and persistent chemicals like PFAS in products like cosmetics, non-stick frying pans and stain resistant fabrics. Much is still unknown, and there's little transparency. While some chemicals have been restricted or banned, there are still thousands that haven't been properly assessed for their health impacts — and that's just those used in plastics. "We would want to have a system where we know what we're exposed to," argues Dr Symeonides."Right now, I have a deep interest in plastics and the chemicals in certain plastics, but I can't tell you what chemicals have been used in any plastic that you show me and the brand that produced that plastic product. They also don't know which chemicals are sitting in the plastic that they use to make their product." Dr Symeonides says that given the potential impacts are irreversible, governments and regulators shouldn't be waiting for conclusive proof to mitigate the risks. "The precautionary principle indicates that where you do have uncertainty and where, the potential impacts are irreversible or serious, then that could be grounds for acting before you wait for conclusive evidence of harm." These concerns aren't new. In the course of researching this issue we found a Four Corners from 1975 which ironically sounded the alarm about toxins in plastics, particularly PVCs which were known to be hazardous and persistent. It's hard to avoid the conclusion that today's 30 and 40-year-olds could be paying the price for slow regulation many years ago. These are difficult issues. But do we really want to be asking in 40 years' time when today's kids are adults, whether we could have done more to prevent cancer in their generation? Watch Four Corners' full investigation, Generation Cancer, on ABC iview.
ABC News
2 hours ago
- ABC News
Documents reveal childcare workers without knowledge or training to keep kids safe
Children are being exposed to childcare staff who lack basic training in first aid, child protection or hygiene practices. In some cases these failures have resulted in serious injury and presented "suffocation risks", documents have revealed. Experts say the failures are driven by substandard training, lax and poorly resourced regulation and the rapid expansion of private operators cutting corners to protect their bottom line. These failures are part of a deepening childcare crisis in Australia. The revelations follow an ABC investigation that uncovered how thousands of students are enrolling in fast-tracked childcare courses, some buying fake qualifications, others using the sector as a pathway to permanent residency. The scale of the problem is laid bare in a cache of regulatory documents seen by 7.30. Across centre after centre, the same issues repeat: educators entering services without the knowledge or training to keep children safe. They include: ● Educators failing to follow safe-sleep guidelines, including placing babies face-down or wrapped unsafely. ● Children left alone in bathrooms and outdoor areas. ● Injuries and other serious incidents not reported to families, despite mandatory reporting laws. ● Staff without child protection training and unable to recognise signs of harm, or who to report it to. ● Staff with expired or missing Working With Children Checks. ● Poor understanding of hygiene and health, including unwashed hands, expired asthma plans and mishandled medication. ● Educators falling asleep on shift. A regulatory insider, who has visited dozens of childcare centres, said many educators don't know the basic rules for keeping children safe. "There are no real consequences for services that breach [safety standards]," the official said, speaking on the condition of anonymity. "They get a letter, make a few changes on paper, and we close the case. It doesn't change anything. "Unless approved providers are held accountable — and most of them never even set foot in a service — nothing will change." The childcare crisis was thrust into the national spotlight with the arrest of Joshua Dale Brown, a Melbourne childcare worker charged with more than 70 child abuse offences, including against babies as young as five-months-old. Since 2017 Mr Brown worked at 20 different centres, all for-profit — including nine run by Affinity Education, four by the ASX-listed G8 Education, which operates more than 20 brands (since Brown's arrest, G8's shares have tanked almost 20 per cent), and one owned by Only About Children, a subsidiary of US-listed Bright Horizons. His case follows mounting public alarm over the state of the sector, fuelled by a series of ABC investigations including Four Corners' 'Betrayal of Trust' and multiple 7.30 reports revealing a litany of abuse, cover-ups, the rise of private operators putting profit first, and a regulatory system failing to protect children. Governments have since introduced reforms but the crisis is far from contained. Among some of the more damning cases exposed in the regulatory documents is that of 3 Bears, a private operator run by Dinh Trang, who operated three centres over a decade before being shut down in 2024. In that time, the services racked up 363 breaches. The 3 Bears rap sheet is long: "Inadequate knowledge of the requirements under the child protection law, inadequate health and hygiene practices, inappropriate educator interactions with children, inaccurate record keeping in relation to enrolment records, children's attendance records, staff and students records and records of educators working directly with children." In July 2023, the regulator asked for proof that staff had completed safe-sleep training. One educator had completed the full 85-minute course. Two submitted certificates showing it was done in just two minutes. Others hadn't done it at all. The consequences of poor training were soon evident. In September 2023, a child at the centre suffered a serious knee injury, requiring specialist surgery. Staff told the child to elevate their leg — no first aid, no ambulance. The parents called emergency services when they arrived and saw how serious the injury was. Then in February 2024, a child with known dairy and nut allergies had a severe allergic reaction, including swollen lips, welts, and distress. Educators treated it by applying moisturiser for dry skin. The regulatory documents are damning — and they all point to the same failure: A broken system where underqualified staff are tasked with protecting children, and little is done to stop it. Mr Trang denies any wrongdoing. At Bright Achievers, which is also privately owned, regulators found staff lacked any evidence of child protection training, failed to follow basic hygiene practices, and had no systems in place to manage food safety — posing direct health risks to children. At Squiggler Academy, compliance reports include children seen eating by the regulator without washing their hands, and educators failing to prompt them. Medication logs were incomplete, and one child's asthma plan had expired a year earlier. When asked if asthma plans existed, the responsible person replied, "I don't think so." No staff had up-to-date asthma or anaphylaxis training. At Shepherd Early Learning in Mays Hill an emergency action notice in 2024 revealed several issues after a regulatory inspector visited the centre. Those issues include a toddler found being face down with a hooded jumper on. In another room there was a similar issue where a child was asleep with a hooded jumper on, lying face down. The centre did not respond to questions. "This presents a potential suffocation risk," the document states. It said that in a cupboard accessible to children a can of Glen 20 was stored and that the child-safe lock on the cupboard was broken. An electrical outlet in the cot room was uncovered and in the children's bathroom plastic bags were stored in open containers accessible to children. In April 2024 the family of a child complained that clothing was placed directly into the child's bag with faeces on it and not into a plastic bag, raising hygiene concerns. Bright Achievers, Squiggler Academy and Shepherd Early Learning in Mays Hill were all contacted for comment but did not respond. At the now closed Strawberry Fields Early Learning Centre in Kanwal, NSW a compliance notice was sent by the regulator listing issues relating to safe-sleep, including that "an enrolled child was put to sleep with a dummy chain which became wrapped around his neck". At the same centre a child was locked in a shed and left unsupervised. The nominated supervisor told the regulator they were aware of the incident but did not follow mandatory reporting obligations. At G8 Education's First Grammar in Sydney's Condell Park, a child was left unsupervised for 20 minutes in 2022 and found playing in an outdoor trough of rainwater that had not been drained. The child's parents were not notified in the required time. G8 Education posted a net profit of more than $67 million on the back of revenue of more than $1 billion last year. In 2020 G8 Education admitted it had underpaid 27,000 workers by up to $80 million. Five years on, the case is still under investigation. The regulatory documents, reported between 2020 and 2024, were released in response to a powerful parliamentary order brought by NSW Greens MP Abigail Boyd. "There's this trail of a lack of understanding of all the people involved in these centres. They don't understand the regulations, they don't understand what their requirements are. And the consequences of that can be catastrophic." Veteran Melbourne childcare worker turned childcare trainer Lynette Rieck says it is these types of serious incidents which can quickly turn into tragedy. "The elderly and children are the most vulnerable members of our society and we are letting our children down," Ms Rieck said. "If you judge a society by the way we treat our children, we ought to be ashamed of ourselves. "I've been in this industry for quite a while and I've seen quite a lot. I've seen a massive amount of change and it is not good enough. "I've got children and I've got grandchildren … and they are being let down by the adults who they are supposed to trust." Watch 7.30, Mondays to Thursdays 7:30pm on ABC iview and ABC TV.
