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Health - Medical Cannabis


Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Monday, 6 September 2021

Tags: Medicinal Cannabis, Health, Controlled Access Scheme, State Budget

Dr WOODRUFF - Minister, in Estimates last November I was told, I think by Mr Webster, that only 17 applications for medical cannabis had been approved out of 39 applications made in the previous year. Tasmania's Controlled Access Scheme was widely acknowledged as being overly restrictive and ideologically dominated. Even the federal health minister, Mr Hunt, has been publicly critical about Tasmania's slow progress in this area.

Can you please tell me how many applications have been made for medicinal cannabis, and how many have been approved from November 2020 to 1 July 2021, recognising that the introduction of the Special Access Scheme started on 1 July?

Mr ROCKLIFF - Commencing in 2021 22, we have committed $2 million over four years to amend the Tasmanian Controlled Access Scheme, allowing general practitioners to prescribe medicinal cannabis in line with the process in other states and territories, and using the Therapeutic Goods Administration (TGA) portal, resulting in improved access for Tasmanians.

We're committed to increasing access to medicinal cannabis. This includes authorising Tasmanian GPs to prescribe medicinal cannabis products, and allowing more community pharmacies across the state to dispense these products. From 1 July this year, Tasmania adopted the national streamlined online application pathway and 48 hour authorisation time frame. As in all other jurisdictions, Tasmanian GPs are required to seek approval from the TGA to prescribe medicinal cannabis products through this national pathway.

We've committed as a government to increasing access to medicinal cannabis in a responsible and evidence-based way. Cannabis will, however, continue to be an illegal plant in Tasmania when it is grown without a licence or a person is in possession of it without a prescription from a medical practitioner. As of 1 July 2021, I mentioned we've joined all other Australians' jurisdictions participation in the TGA portal. Between 1 July and 2 August 2021 the TGA have approved four applications from Tasmanian medical practitioners to prescribe schedule 4 cannabis product to a specific patient. Between 1 July and 2 August 2021 the TGA and a delegate of the secretary of health have approved two applications from Tasmanian medical practitioners to prescribe schedule 8 cannabis products to a specific patient. The ability to prescribe unproven cannabis products in Tasmania does not apply, that these products are safe for effective medicines.

Dr WOODRUFF - That wasn't the time period I asked. I asked from November 2020 to 1 July 2021.

Mr ROCKLIFF - I provided you 1 July to 2 August.

Mr WEBSTER - To correct that, there were 17 applications that were approved between July 2017 and November 2020. There were two further applications between then and, with the change of the scheme, on 1 July. It's 19 in total under the old scheme. In referring to it as the old scheme, further to the minister's answer, of course we have continued the controlled access scheme because it's the only Australian subsidised scheme. Public health patients who can't afford to pay for the prescriptions can still apply under what I'll call the old scheme and go through the process of being assessed by a specialist panel or they can use the TGA scheme, which is GP driven.

Dr WOODRUFF - Minister, on 1 July, as you say, Tasmanians have been able to access this TGA special access scheme, where GPs can prescribe registered and unregistered medicinal cannabis products, I understand Tasmanian authorisation is still required for the prescription as schedule med can product. Can you please tell me how many applications have been made by prescribers since 1 July and how many have been authorised? Is that four made and two authorised, which is what Mr Webster talked about before?

Mr ROCKLIFF - I have two applications from Tasmanian medical practitioners to prescribe schedule 8 cannabis products to a specific patient.

Mr WEBSTER - The authorisation for schedule 8 that we're do in Tasmania is in fact, that is the case in the majority of states and territories. For schedule 8 there is a local - if you like - a state and territory authorisation and a TGA authorisation. For schedule 4 it's a TGA authorisation.

Dr WOODRUFF - Minister, in relation to medicinal cannabis, the cost of medical cannabis products remains a big issue for many Tasmanians who need them. I understand Tasmania continues to provide subsidised access and, in fact, we're the only jurisdiction in Australia that does this. Can you please explain who's eligible for the subsidised access and how many patients are currently receiving these subsidies?

Mr WEBSTER - Eligible patients usually are those who are eligible for public health, who come through public hospitals. It could be any range of people. It's actually a clinical recommendation. They go through a process if their GP recommends it to a specialist, the specialist then recommends the prescription to a panel and the panel considers it as part of that. That's the core criteria. Anyone can apply through that but the key issue on the subsidisation is that it has to be an affordable scheme, so it tends to be those in receipt of the Health Care Card who are given priority through that process. It is open to all to apply: Nineteen applications have been approved for medicinal cannabis through that scheme because, if you like, it's the old scheme that I referred to. It's still open. It's the 19 who have applied since 2017 who have received that subsidy. Those who have applied under the new scheme, which is the TGA scheme, are required to pay for it themselves.

Dr WOODRUFF - Minister, medicinal cannabis is a proven, effective and safe treatment for some health conditions. It gives people lifesaving pain relief and manages some other conditions. Cannabis is also detectable in your system by roadside drug detection for many days after use, at very small levels. Currently, the DHHS website advises that people don't drive while they're being treated with medicinal cannabis. This is not a sustainable situation for many people who have long-term conditions. Are you, as the minister, working on a solution for people who have lost access to transport for fear of committing an offence?

Mr ROCKLIFF - We have to be guided by the medical advice at the time in relation to these matters, and of course safety would be paramount in this as well. I haven't been working on a solution to this question as yet. You've just presented it to me now. I am not sure whether it presented itself to the health executive at all. As I said, I will have to be guided by clinical and medical advice. It's also a matter for the police, as you'd appreciate.

Dr WOODRUFF - There are low levels that have no effect on a person's ability to drive a car and this is where we are getting to this difficult situation. I am asking, on behalf of people who are accessing and using medicinal cannabis, that you ask for some reinvestigation of the science about those lower levels and whether there are opportunities from other jurisdictions to find a suitable solution that is fair and safe.

Mr ROCKLIFF - We can look at that information and see what might be possible. Do you have any further advice, Mr Webster

Mr WEBSTER - The Royal Australian College of General Practice has guidelines around this. THC, as a product within cannabis, is shown to impair driving. Cannabidiols don't. There is a difference between medicinal cannabis and the taking of THC or pot for medicinal reasons.

Dr WOODRUFF - Tas Botanics is running a world class facility that produces medicinal cannabis in Tasmania. I understand it does not currently supply it domestically. Are you working with Tas Botanics and other companies, but especially Tas Botanics, to make available and affordable source of quality medicinal cannabis products locally?

Mr ROCKLIFF - That's a question for the Minister for State Growth, in terms of the growth of an industry.

Dr WOODRUFF - The product is going overseas, and to the rest of Australia. Can we get it here in Tasmania?

Mr WEBSTER - The Tas Botanic crop at Pontville is a high THC product which is not the product used in medicinal cannabis in Australia. The cannabidiol product, or the low THC product, is the product being grown by Tas Alkaloids in the north of the state.

Dr WOODRUFF - They produce both now, Tas Botanic. It has changed, it is very high quality.