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Health Legislation (Miscellaneous Amendments) Bill 2022

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Tuesday, 16 August 2022

Tags: Health, Legislation

Dr WOODRUFF (Franklin) - Mr Speaker, we are pleased to support this Health Legislation (Miscellaneous) Amendments Bill. I also thank all the staff who provided us with advice in the briefings that we had on this bill about three months ago now. We do not have any concerns with the minor amendments that are being made to a number of bills to provide consistency with the updated definitions and language, modernising and bringing them into national regulations and standards of language that is being used in these bills that are referred to in the acts that are referred to here.

I wanted to mention a little bit about section 38H, clause 32, which relates to the dispensing of monitored medicines and the whole monitoring of medicines, and to say that this is a critical issue because we have drugs in the community registered and available upon prescription that can do great good; they save people's lives and they reduce suffering. They can also be very harmful if they are taken at the wrong times and at the wrong quantities. I commend the people involved in the work, the Office of the Chief Psychiatrist, the Chief Psychiatrist, and other people who worked in Tasmania to introduce the real-time prescription monitoring system which we have had in place since 2009.

We were the first state in Australia and we led the charge on the real-time monitoring of prescription medicines. In particular, we were ahead of the curve in Australia in controlling the misuse of opioids and doing what we can to reduce levels of overdose and accidental deaths that come from the use of some pain medications in the wrong quantities or in the wrong combinations - things such as oxycodone, morphine and fentanyl. Fentanyl in particular was being heavily prescribed and over-prescribed, and led to many deaths around Australia and in Tasmania until the real-time prescription monitoring system, and the DORA, which is the clinical facing component of that, came online and was available to prescribers and pharmacists in 2011. Until then, sadly people lost their lives, and that could have been avoided.

There is no doubt that - as I understand it - this amendment is to enable regulations to be prepared so that there can be circumstances where the requirement for a dispenser to dispense a monitored medicine and in accordance with a prescription of a person, the dispenser must take all reasonable steps to check the monitored database for information in relation to the person. That is what it is in the act at the moment, and this amendment adds a subsection which says that the regulations may prescribe circumstances in which the dispenser need not comply with that section, which becomes subsection (1). I understand that is specifically going to be prepared in relation to aged care homes and other places where there is the regular provision of those sorts of prescription medications.

Clearly, there will be a lot of interest in how those regulations are prepared and how it will be governed, and that there will be the appropriate checks and balances. There is no doubt that we need a lot of checks and balances when there are facilities that have these potentially dangerous and harmful drugs on their premises in quantity - and not only in aged care. Ambulance stations are another example and that was tragically raised in the coronial inquest into the death of a paramedic who had access and purposely misused the availability of drugs, and it led to the tragic loss of his life. The regulation of medications within Ambulance Tasmania has been very important in safeguarding the mental health and lives of people who are working as paramedics.

Like Ms Dow, I cannot talk on this bill in a week where nurses are striking in the North West Regional Hospital later this week. Paramedics are striking. The ANNF and members have been out on the streets, in hospitals and out at the front of hospitals for months now, doing what they can. They are doing everything, to try to get through to this Premier and Minister for Health and make him understand that coffee and biscuits and incremental change is not going to be good enough. The Premier talked this morning in response to the question we asked about the changes that are needed in the health system. Although he talked about a whole range of good things that are happening, they are just the everyday business of Government. They are tidying stuff that frankly ought to have been done ten years ago. These are the sorts of things that people have been talking about for ages. That is the small stuff.

We are talking about needing funding for hundreds more paramedics. The Premier, the Minister for Health and previous Ministers for Health have also trotted out this figure of 240 something full time equivalent paramedics who have been employed since 2014. Where are they, when, after Friday and Saturday night, there are empty stations around the state. Where are those people? Are they some of people who are leaving Tasmania? Maybe, they did get a job and they left. We know from the National Health Service and the Facebook posts they are doing in the south west of the UK that they are actively focusing on Australian paramedics to recruit them to the UK, to the NHS. They need paramedics. We are training them and we are not giving them a career. We are not giving them conditions and we are not paying them relative to what they ought to be able to get for the work that they do, for what they can get in another state or in another country.

We are literally training people up in Tasmania, in good faith -people who want to live and work here and they have to leave the state. They cannot afford it. It is so stressful. They cannot stand going to a shift on a Friday night, knowing how many calls will be coming through the station and that they will be forced to sit all night, ramped in a corridor in the Royal Hobart Hospital or the LGH. That is their job. That is what they do when they go to work; they sit in a corridor. Instead of being out attending to the urgent calls and being there, for people like the elderly gentlemen who died because he did not get an ambulance to his house and was left lying on his own all night unattended. They did not get there on time because they were sitting in a corridor, and it drives people to utter despair. They are so stressed that they are forced to leave the profession and to leave the state. I have personally spoken to two people, recently, who have left or who are leaving Tasmania for that reason.

On top of that, you have the housing crisis and you have a Government that is refusing to do the minimum things that we can do. These are solutions to what seems like an unsolvable problem. There are really important things that we can do about the housing crisis in Tasmania, and yet the Liberal Government keeps refusing to do them. We can change the situation where you have hundreds and hundreds of Airbnbs, night after night, sitting with enormous price tags for the owners to make money. Meanwhile, that house is not in the market and people cannot afford to rent a property or buy a property, and people like paramedics and nurses have to leave. They cannot afford to live in a state where the housing prices are the highest in the country but the salary package is the lowest in the country. Why would they stay here? Why wouldn't they reverse that trend on both sides and move to Melbourne or Sydney or another place and have cheaper housing and a better paid job that is more commensurate with the amount of work they put into it?

This is the critical issue and when you have New South Wales making a commitment to employ 2000 more paramedics, and Victoria made a commitment in their last budget to put $760 million into paramedics, when scaled down to the size of Tasmania, we are talking about, yes, we need 200 paramedics. That is actually what we need. It is not a choice unless the Premier is continuing to trade-off putting people's lives at risk every single day, which is what happens when people do not get the care in the time that they need.

We will continue to work with the nurses and the paramedics and all the other staff who work in hospitals. It is because of the COVID-19 pandemic that these things have become even more critical than they were before. That is yet another thing that the Premier could choose to do to reduce the impact of COVID-19 infection on hospitals. The recent modelling that was just released shows if we did introduce a mask wearing mandate indoors, we would be cutting the risk of COVID-19 cases between now and November by 20 per cent. This was Australian research that was done: a 20 per cent reduction in COVID-19 cases. Would we not like to do that in Tasmania, have 20 per cent fewer people between now and November who are infected and worse, reinfected or re reinfected with the virus? Each time a person gets reinfected with COVID-19 that increases their risk of a serious health outcome.

The Australian Bureau of Statistics research released yesterday has shown that Australia has had in the period of COVID-19 a 14 per cent increase in people who have died of diabetes and a 20 per cent increase in people who have died of dementia. We can do something about this. We can cut those figures because it is avoidable if you do not get infected in the first place.

The United Kingdom, the United States and Australia are showing an identical trend. The UK data released this week shows a 4 per cent increase in all deaths because of COVID 19. These are huge numbers and they are people who are dying unnecessarily. They end up in ambulances; they end up in hospital; they take up a bed; they need to recover and it takes a very long time if they are able to recover.

This is something that the Premier, Minister for Health, can be doing to reduce the pressure on the health system. People can wear masks indoors. Mandate wearing masks indoors while this COVID-19 pandemic has the amount of virus circulating that it is. Reduce the risk of reinfection and reduce the risk from that of serious health outcomes.

We very much support the changes to do with the definition of paramedics. We wonder why it did take so long because I understand this is a change that brings us into a similar line to other medical professions and other registered professions. I wonder why it has taken since 2018 for that change to be made law because it enables private paramedics, those working in communities, to not have a different or restrictive purpose, and I understand it increases the opportunity for a person to be employed in a range of paramedical services which is obviously desirable.

I will finish up here and thank the staff who provided us with that briefing again and encourage the minister to put his energies into changing the things that can be changed. It has been too long for this Liberal Government to be under-funding every single year the health system for us to have to suffer through any carping for the newly elected Labor Government about why things are not being done at that level when we have had radio silence for the last eight years with the Morrison and previous prime ministers' Liberal Governments about exactly the same issues. So why is there a difference between one day and the next? It is shameful to really start to point the finger to Canberra when you were not prepared to do that earlier.