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Health – Medicinal Cannabis


Rosalie Woodruff MP

Rosalie Woodruff MP  -  Monday, 23 November 2020

Tags: Medicinal Cannabis, Controlled Access Scheme, Health

Dr WOODRUFF - Moving to medicinal cannabis. Under the controlled access scheme to medicinal cannabis in Tasmania, many patients seeking to access medicinal cannabis must be referred to a specialist, who must then make an application to the Health Department for assessment by a multi-disciplinary expert panel of clinicians.

In March 2020, a Senate Community Affairs References Committee released their report, Current Barriers to Patient Access to Medicinal Cannabis in Australia. A key recommendation from that report was that GPs in Tasmania should be permitted to prescribe medicinal cannabis, in line with other jurisdictions without the need for further approvals. I should note that we are the only state with the dubious infamy of being singled out in this report. Minister, why has Tasmania chosen to continue with this incredibly burdensome and bureaucratic process that requires two medical professionals to make a referral and then a further assessment by a multi-disciplinary expert panel of clinicians in the department?

Ms COURTNEY - Our controlled access scheme has been set up to ensure that Tasmanians are enabled to access medicinal cannabis products in a safe and clinically sound setting. The CAS is specifically designed to support the safe and appropriate use of unproven medicinal cannabis products, through a rigorous assessment of applications, informed by evidence and expert and clinical advice. To protect patient safety, Tasmania's scheme requires that standard, evidence-based treatments be exhausted before any unproven or unregistered medical cannabis is tried.

The Tasmanian Government is the only government in Australia to subsidise the cost of highly expensive medical cannabis products and make their potential benefits accessible to Tasmanians, not only those who can afford to pay.

I will continue to support the judgement of our specialist clinicians and I will always take advice from the experts on this matter. My advice is that we have support for the controlled access scheme of the AMA, RACGP Tasmania as well as Epilepsy Tasmania on the mechanism of our scheme. I will continue to make sure that we look at all current available evidence and make decisions based on that advice.

Dr WOODRUFF - Can you tell me how many times the multi disciplinary expert panel has rejected an application that was recommended by the treating health professional?

Ms COURTNEY - We have at the table now, Deputy Secretary, Dale Webster who is the Deputy Secretary of Community and Mental Health and Wellbeing. I will ask Mr Webster to provide you with further detail.

Mr WEBSTER - Thank you, minister. Since 17 November, 17 applications have been approved for 16 patients. Thirty-nine applications have been submitted by a relevant medical specialist for 28 patients, as I said resulting in, 17 approvals for 16 patients.

Dr WOODRUFF - Sorry can you say that more slowly, that last part.

Mr WEBSTER - So, 39 applications submitted by relevant medical specialists for 28 patients, resulting in 17 approvals for 16 patients.

Dr WOODRUFF - Does that mean that in 22 cases they were rejected?

Mr WEBSTER - Not rejected; they are sent back if there are other appropriate medications that need to be trialled and clinically acceptable then advice is given back. The application is generally not rejected; they are sent back for further assessment for other clinical pathways.

Dr WOODRUFF - From the patient's point of view that would be a rejection.

 

Dr WOODRUFF - Minister, the Senate Committee Report Current Barriers to Patient Access to Medicinal Cannabis in Australia March 2020, states that the Tasmanian Government made a sovereign choice not to take part in the streamlined access process that was agreed to by COAG health ministers in April 2018. To be clear, Tasmania is the only state that has not agreed to participate in the special access scheme for medicinal cannabis through the National Therapeutic Goods Administration.

It was further reported in that senate report that the federal Minister for Health, Mr Hunt, has, quote - 'committed to continue to raise the issue of medicinal cannabis access in Tasmania at every opportunity he has'. Minister, can you confirm that you are being lobbied by the federal health minister, Mr Hunt, to adopt the streamlined access process that was agreed to by COAG in 2018?

Ms COURTNEY - Minister Hunt and I have a range of conversations about a range of matters. I am not going to go into the conversations that Mr Hunt and I have. I acknowledge the Tasmanian Government is the only government in Australia to subsidise the cost of highly expensive medical cannabis products. I outlined the process in a previous response and the deputy secretary has provided data on it. In my previous answer I also said we will continue to monitor this situation. The Controlled Access Scheme (CAS) was stood up prior to me being minister and my advice is, as I said in my previous response, that the model we have here in Tasmania is supported by the AMA, RACGP Tasmania, as well as Epilepsy Tasmania. I can assure you we will continue to engage with experts in this area to ensure we are always taking learnings on board regarding access to medical products, but I am not going to pre-empt the future.

Dr WOODRUFF - Minister, can you understand that suffering patients, families with suffering children do not want a hand out. They don't want free medicinal cannabis. If we are the only state, if that the is reason for holding back on allowing access, people don't want that. They simply want the access. A person living in any other state in Australia is able to access medicinal cannabis through one system, through the Therapeutic Goods Administration. This Government in Tasmania is blocking the right of suffering patients to access medicinal cannabis. Can you consider how important it is to reverse this decision which we have been sticking to. I assumed it was because of the previous health minister. You have the opportunity to make a huge difference in people's lives. It is all very well having a system that is resourced but if no one every gets approved to use it, it costs effectively nothing. People don't want the free drugs. They want access to the drugs that anyone else in Australia could get for the same condition. Will you change the system we have and move to the rest of Australia?

Ms COURTNEY - My advice is that we have a clinically appropriate system. I am advised the system that was stood up was based on clinical advice.

Dr WOODRUFF - Can I respectfully ask you to get some other advice, and to listen to the medical practitioners in every other state of Australia who have got on board with this? For some reason our AMA and RACGP are out of step with the rest of the country. Can I suggest that you look into that please as a matter of priority for patients who are desperate, like Lyn Cleaver and her son. It is painful hearing these stories and having no change year on year. It is something you can do something about.

Ms COURTNEY - I acknowledge we have people in Tasmania who have an enormous amount of suffering because of their conditions. We work really hard to be able to support them.

As I said in my previous answer, Dr Woodruff, I will continue to take advice from the professionals in this space. We know a lot of research continues to be done in this area, and I'll continue to take the advice of experts. I can't pre-empt the future. What I can say, is we'll continue to do that because I don't think anybody wants to see Tasmanians suffering unnecessarily.

Dr WOODRUFF - You're the one who can do something about that. You're in charge.

Ms COURTNEY - I take the Minister for Health role very seriously. I know these are very complex matters and the conditions some Tasmanians suffer from are very complex. I take advice from the experts. As I have outlined, the position is supported by a number of stakeholder groups and I will continue to engage with them. I commit to you, Dr Woodruff, that I will continue to engage in an open way about this matter.

Dr WOODRUFF - And with your federal health minister, who is trying to change your mind.