Ms PATTEN (Northern Metropolitan) (17:32:09): I rise to speak to this bill, the Health Legislation Amendment and Repeal Bill 2019. As many others who have spoken before me have said, this is an omnibus bill that covers a whole range of areas, particularly around information-sharing.
I will not go into those segments of the bill; I think they are largely uncontroversial. The bill is also said to strengthen existing tobacco and e-cigarette advertising prohibitions. It also repeals the Access to Medicinal Cannabis Act 2016, which will result in consequential amendments to other acts.
I would like to touch on the section repealing the Access to Medicinal Cannabis Act and speak about an amendment that I will bring to the house today. I would like to start by speaking on e-cigarette advertising. I note in the second-reading speech the minister refers to ‘the pervasive and harmful impact of smoking and tobacco and e-cigarette advertising’. Let us be quite clear about what an e-cigarette is.
For one, it is not a cigarette; it is a device. It is an electronic device, and we are comparing it with a combustible tobacco product. We are comparing an electronic device and saying that in itself this electronic device is dangerous. Even if you put water in it, somehow this is as dangerous as smoking and as tobacco. That is preposterous—absolutely preposterous.
In 2016 when we first had these conversations I tried very hard to convince this government that we should separate and we should regulate non-combustible nicotine products. The more I have learned since 2016 the more committed I am to the view that governments should be regulating this, not pushing it into the black market, which is exactly what we are doing now.
I have to admit—and I will say it under privilege—that I am a criminal: I vape and I do not have a prescription for it. According to Victorian law, if I want to use a vaping device and I want to use nicotine in it, I must get a prescription for it. I have to say that I will get a prescription for it. However, what that prescription provides me with is absolutely nothing except something to show customs.
When I go and buy from some Chinese company offshore a juice that I might use in the vaping device that I legally bought in Australia, that does not protect me. The government is not doing anything to protect me. This bill is not doing anything.
In fact I think Mr Limbrick’s amendments on allowing greater demonstration and display of these products would help protect the consumer. What I would like to see is this government regulate the industry and ensure that those devices that are being sold are safe and the e-juices—the juices that are being used in those devices—whether they contain nicotine or not, that we know what is in those juices and that there is some regulation about the packaging of those juices so that we do not have, as we did just some months ago, the very tragic circumstance where a young child died after consuming some juice that contained nicotine. That was absolutely tragic.
What we did is we said, ‘Let’s keep prohibiting it. Let’s keep having this product being sourced overseas’. Nicotine is a very, very addictive product. We know that. But do you know what? People smoke to get the nicotine but it is the smoking that kills them—it is not the nicotine.
We are seeing remarkable success in people moving from the very dangerous habit of smoking to get their nicotine to the far less dangerous—I am not saying it is harmless and I am not saying it is safe; I am just saying it is far less harmful—use of getting their nicotine through a vaping device. To lump these products in with tobacco is misleading, it is misguiding and it does not keep our community safe. I acknowledge that Victoria in actual fact has been one of the leaders in harm minimisation in tobacco.
I believe we were the first state to prohibit tobacco advertising at sporting events. We have been in the lead in this areas. Australia is considered a leader in harm minimisation around smoking, but we are losing that title of being one of the world leaders. We are also losing the battle on the cessation of smoking. Our smoking levels have plateaued, and they have for the last few years.
But guess what? In the countries where vaping is allowed and is legal—and in many cases, such as the UK and New Zealand, is actually endorsed by the government—they are seeing their smoking rates continue to decline.
I heard the federal Minister for Health just the other week at the press club. He announced that by 2025 we will have a target of 10 per cent smoking rates in Australia. That sounded familiar, because the health minister in 2010 said that by 2025 we would have smoking rates of 10 per cent. We have plateaued. New Zealand has got a towards zero goal by 2025. They estimate that less than 5 per cent of their community will use combustible tobacco to get nicotine. In Australia we have plateaued. Even the UK has less smokers.
If you look at somewhere like Japan, where they have the heat-not-burn tobacco products, they have seen an absolutely enormous drop in their smoking rates—a plummet in their smoking rates.
I understand that people say, ‘We don’t know enough about this product. There’s not enough research’. I can tell you that if we put that same test, we would not have a polio vaccination. We would not have the pill.
We know and the science tells us—and we can rely on the science—that this is not as harmful as copping a mouthful of carbon monoxide, tar and the thousands of chemicals that are in tobacco—those chemicals that we do not even list. We do not even care what the tobacco companies put in those products. We seem to care an awful lot about e-cigarettes. So I think we should not be banning e-cigarette advertising.
In many other countries they are doing quite the opposite. They are actually promoting e-cigarettes because they see them as a way of saving lives. They see them as a way of getting smokers off cigarettes. They see them as a way of saving the grief of families losing their parents and losing their children. But here we just get: ‘Just say no’. I am very supportive of the modest amendments that Mr Limbrick has put to this house.
In 2016 we recognised that there were some stores that were only selling vaping devices, and these were devices that were electronic devices. At the time the government said, ‘Well, they shouldn’t be able to display them. They shouldn’t be able to demonstrate them. They shouldn’t even be able to take them out of the box’.
We allowed for a grandfather clause for those existing stores, and now I understand that with this legislation, while that grandfather clause remains, any new stores and any new businesses that want to sell these devices must sell them like they are selling a tobacco product. Yet this device contains no tobacco. It actually contains no nicotine. It is an electronic device, and yet somehow we are treating it like a combustible tobacco product. It makes absolutely no sense, and I hope one day we will see some leadership in this area.
To turn to the repeal of the medicinal cannabis legislation, I would really like to commend the Victorian government for taking the lead with the introduction of the Access to Medicinal Cannabis Act 2016. It acted as a catalyst, and it certainly was the right thing to do at the time. It responded to the needs and demands of our community for access to this very good medicine, and the legislation that we developed really did nudge the federal government to jump up and act and introduce federal legislation—albeit not very good legislation federally, but legislation nonetheless.
So I think Victoria can be very proud for what we did at that time. The fact that we no longer need the legislation here and the fact that it is redundant is quite right. The fact is that it duplicates what is happening federally, and the fact is that it might sometimes mislead people into thinking that there are these two levels of regulation. It might look like it is an increased burden on the industry. That regulatory duplication might be seen as a disincentive to people wanting to get involved in the industry, whether that is as a medical provider, as a doctor or as someone growing cannabis. I agree.
That is why I would like to propose amendments to this bill, to further streamline access to medicinal cannabis in this state. I ask that my amendments be circulated.
Independent amendments circulated by Ms PATTEN pursuant to standing orders.
Ms PATTEN: My amendments are designed to streamline the prescribing pathway for medicinal cannabis. Given the government’s announcement about expanding some of the trials for young children with epilepsy, to further increase the access to medicinal cannabis and the fact that they recognise that by repealing the Medicinal Cannabis Act 2016 in Victoria, this again ensures that there is no duplication and ensures that there is no confusion and no increased burdens on industry by enabling people to do this.
Currently in Victoria state-level approval is required for federally authorised prescribers of THC products that are considered schedule 8. This is medicinal cannabis that may have a component of THC in it. This means that a medical practitioner has to apply separately to both state and federal departments for approval to prescribe medicinal cannabis.
While the federal TGA has improved its turnaround for approvals, and doctors tell me it is now about 2 to 3 hours, state-level approvals still can take a while. I appreciate that some of those turn around quite quickly, but there are circumstances where it has taken two to four days.
Generally the average time for the state approval is about 48 hours. This is 48 hours for a very sick patient. We might be talking about a patient who is undertaking chemotherapy, who is struggling to swallow food or who is struggling to keep food down, and the medicinal cannabis product could greatly alleviate that and bring great comfort to that person in a very difficult time of their life.
Forcing that very sick person to have to wait at least another two days for this product seems cruel, and it certainly is not compassionate, as I would like to think we are. Also, it is unnecessary. We have a federal approval system through the Therapeutic Goods Authority. These are products that are being approved. The prescription is being approved at the federal level, and yet that approval must be duplicated at a state level.
I have heard that some people are concerned that this would open it up to other cannabis products, that we might see Victorian doctors who did not have to get the double check off—one from the federal, one from the state—that they might all of a sudden start providing illicit products through their surgeries. This is not the case. These doctors must be approved. The prescriptions must be approved at that federal level.
We have seen that New South Wales and Queensland have streamlined this system by suggesting that the approval system at that federal level is appropriate. I put some exemptions to that. I have said in my amendments that when a doctor is prescribing the medicinal cannabis to a person who is drug dependent or when they are prescribing to supply for a clinical trial or they are prescribing to treat a child, then certainly the state should provide some approval in those circumstances. But in the other circumstances, where we have a very thorough and robust federal system, I see no reason why we would duplicate this red tape at a state level.
This model, as I mentioned, has already been introduced in New South Wales, and a simpler version has been introduced in Queensland. We are seeing various models where the states are removing themselves from the equation happening around Australia.
I think as Victoria steps out of regulating medicinal cannabis these repeals and these amendments make a lot of sense. It will slightly help those thousands of Victorians who want to access this material. It will slightly help those doctors who are considering prescribing it but who look at it and say, ‘If I prescribe OxyContin’ which is a schedule 8, ‘I must get approval from the state.
But if I am to prescribe medicinal cannabis, I must get approval from the federal government and approval from the state’. So it gives the appearance that somehow that medicinal cannabis product is more dangerous and more harmful than other schedule 8 products or other products that require state approval but do not require federal approval.
I understand that the government is not going to support this, but I implore them to look at streamlining systems so the thousands of Victorians who are not accessing medicinal cannabis through legal means can find greater ways. This would encourage more doctors to become prescribers, which would inevitably help the industry that is growing the medicinal cannabis in Victoria, and obviously it would help the patients who desperately want this product.
I would finally like to speak quickly to Ms Crozier’s amendments about further requiring reporting for the medically supervised injecting room in North Richmond. As many people know, this is a trial. It has just completed the first year of its trial. The legislation has very strict reporting requirements within it currently.
At one point when I was considering these amendments I thought, ‘Well, this is great, because I think the medically supervised injecting centre is doing extremely well. It is saving lives. We have not seen overdoses there. It is providing pathways to other health services. It is providing pathways to things like hepatitis C treatment and pathways into rehabilitation. Yes, maybe we should be shouting these successes from the rafters. But as I looked into this more deeply, the burden that this would place on a very small centre that is under trial and in a community health centre would be above and beyond its capability.
I would like to note that as of last Friday the centre reported that there were 2908 registered clients using the service; 61 823 visits to the service; and 1232 overdoses safely managed by the staff inside. Quite often the clients did not need opiate-reversing medication like Naloxone; they could just use oxygen. This has proved to be a remarkably successful service.
In speaking to the managers and the workers there, they convinced me of their considerable concerns about the overreach of Ms Crozier’s amendments.
As I have highlighted, we are seeing this government pushing us into black markets, and that does not make our community safer. Whether that is because patients cannot access medicinal cannabis easily or smokers cannot try a less harmful alternative to getting their nicotine, I am troubled by this legislation.
I will not oppose this legislation, but I implore this government to reconsider its position, to look at New Zealand, to look at the UK and to look at the success of alternative nicotine products when regulated and used safely.
Fiona Patten MP
Leader of Reason
Member for Northern Metropolitan Region
Speech given 17/10/19
