Public Health and Wellbeing Amendment Bill 2022

 

Ms PATTEN (Northern Metropolitan) (15:09): I would like to rise to speak quite briefly on this bill. It is a fairly varied bill, but it does deal with notifiable diseases and bloodborne diseases and it certainly looks at the gathering of testing data et cetera. So it does go to various places, as Ms Crozier spoke about just earlier.

But I think the area that I would really like to touch on is the repeal of references to HIV and hepatitis C. I know that there are so many people who will be incredibly grateful about this amendment to this piece of legislation. This just takes us another step towards removing the stigma and discrimination against people who have HIV and hep C, and it is a stigma that can be fatal. It is a stigma that sometimes means people do not seek the help that they need.

They get ostracised from their families. We saw that people with HIV, particularly in the earlier days, were not dying from HIV, they were dying from suicide, and they were dying because of the stigma, the discrimination and the shame imposed upon them for contracting HIV. So this is a good development. This is a very positive part of this legislation. As I say, there have been in numerous areas numerous changes to legislation over the last two terms that the government has put forward that go more and more towards removing that stigma around HIV. I am grateful for it, and on behalf of the HIV-positive community I express their thanks for this.

HIV now is treated much like diabetes. It is something you will have for the rest of your life, but it is not what is going to kill you; you are not going to die from it. And in fact most people who are taking the medicine as prescribed will not even test positive. They will have such a low viral load that it will not even show up in a test, and it would be next to impossible to transmit HIV when they are taking the medication, as they are now. We also have things like PEP and PrEP, which are other preventative tools to stop people from contracting it in the first place, or if they feel they have been exposed, they have those tools to help them not fully contract HIV. So this is a really welcome amendment.

I have to say I have been involved around HIV since the late 1980s, and I do not think any of us thought in the late 80s that we would be talking about HIV in the way that we are talking about it today—that we would be talking about HIV not actually being transmissible and people living full lives, never going from HIV to AIDS. Now, that is in this country, and we are one lucky country for that. Many other countries are still struggling with this and we have still got a long way to go globally, but here in Australia we have done a remarkable job to fight HIV.

I would just like to comment quickly, given Ms Crozier’s comments, around testing and sex workers. Now, sex workers were the first cohort of people to be cognisant of the risk of HIV. Long before the community was aware of it we saw the sex worker community become very aware of it and very concerned about it. We saw almost 100 per cent of sex workers using safe sex practices, as I said, back as far as 1987, 1988, in Australia. The Australian sex workers were right at the front of this, from prevention and also looking after their own health through sexual health testing, as they will continue to do under a decriminalised model. Sex workers will continue to look after their health, and I think it also should be noted that there has never, ever been a transmission of HIV from a sex worker to a client—ever—in Australia. There is not one single reported case of a sex worker transmitting HIV to a client or during their work. So it is an unnecessary concern, and it goes I think very much to the judgement and stigma that people place on sex workers, that somehow sex workers cannot be trusted, even with their own health, and that somehow the government must control them because these—most sex workers are female—women are fallen. There is a considerable amount of moral judgement placed on them in this regard.

There is nothing to be afraid of. When you speak to all of the transmissible disease experts, from the Burnet Institute even to the Melbourne Sexual Health Centre—they were saying the three-monthly compulsory testing was unnecessary and expensive and sex workers were seeking to look after their own health. They did not need legislation to do that.

The other point I would just like to touch on is—because I am sure Dr Ratnam will be speaking soon; she is putting up amendments in relation to drug checking and drug notifications—as many of you would be aware, she and I have jointly sponsored a bill on pill testing. That sits on the notice paper, and it may be something that we debate before the end of this term. But what we are seeing is a growing amount of evidence—not just international evidence, where pill testing has been undertaken and has been regular practice for many years, even decades, but even within Australia. The ACT has been conducting and supporting pill testing for a number of years now; in fact there will be a festival in the ACT next month where there will be a pill-testing facility established. The concept of pill testing is supported by the Australian Medical Association, the Royal Australian College of General Practitioners, the Royal Australasian College of Physicians and just about every single alcohol and other drug expert and person who works in that field. So we are going to be seeing festivals come back, thankfully, and I am sure we are all very happy to see that the festival season will hopefully be almost as normal as possible come the end of this year.

What we see from pill testing is it is almost a loss leader, and I have witnessed this not just in Australia but also overseas, where you will have someone coming in, bringing in their pill to be tested. Now, the machine that goes ‘ping’ does the testing and lets them know what is in that substance, and we know that if that substance is not found to be what that person thought it was or is found to be something dangerous, guess what, that person does not consume that substance and that substance is disposed of. But most importantly as part of that process they get to speak to a health practitioner—and it is phenomenal; you cannot get some of the young people out of the tent because they have so many questions around drug use. They have so many questions about the interactions between various drugs, whether that is prescription medication or recreational drugs, as it were. It is that education that happens at that point, and we know that actually it prevents deaths. It is a very sensible approach.

In Dr Ratnam’s amendments there is also an amendment where if a bad batch of drugs were found in our community, then this would require the police to report on that. Now, we saw this in Chapel Street where a number of people died unnecessarily because we did not get out there on the radio and tell people. We did not get out there on the social media to warn people about a very bad batch of NBOMe which was being sold as MDMA, and we saw people die as a result.

Contrast that to about six years ago in the Netherlands where there was a similar, deadly batch of illicit substances going around. Now, they have an early warning system, so of course it went out on the news. It went out on all of the social media networks, and that prevented possibly hundreds—well, hundreds of injuries, if not deaths. We could and we should be doing that in Australia. It makes absolutely no sense that we are not doing it.

So this is harm reduction, and I think when I have listened to debates over the last seven years no-one seems to have opposed harm reduction—except when it comes to illicit drug use. Then it is just this proposal—and it is a preposterous proposal—that we just tell people to say no, that all drugs are dangerous, so you must just say no.

It is not happening. And it does not matter how many penalties you put around drug use, the number of people who are using drugs does not decline. What does decline is the safety. What does decline is the ability for that person to seek help. So I think largely this bill is uncontroversial and welcome in regard to HIV and hepatitis C. But certainly I welcome Dr Ratnam’s amendments to this bill, and I commend the bill.

 

Fiona Patten MP
Leader of Reason
Member for Northern Metropolitan Region
Second reading speech 7/4/22