Mark Butler (Hindmarsh, Australian Labor Party, Deputy Manager of Opposition Business in the House of Representatives) Share this | Link to this | Hansard source

I rise to speak on behalf of the opposition on the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021. I indicate that Labor will be supporting this bill. So far as the bill goes it is worthy legislation, but I do make the point 'only so far as it goes'. There still remains much to be done in the emerging area of the therapeutic use of medicinal cannabis. Frankly the government doesn't appear to be doing much in that area, particularly in the area of improving access for patients across the country to safe, affordable and effective medicinal cannabis products. The government has been dragging its feet for years in this area, most notably when it continued to resist the opposition's calls in the other place for a Senate inquiry into barriers against patient access to those safe, effective and affordable medicinal cannabis products. I foreshadow that I will move a second reading amendment at the conclusion of my remarks to draw attention to those deficits in this bill.

As I indicated, though, we will be supporting this legislation. The legislation implements a number of recommendations from the McMillan review of the original legislation that was passed in this place in 2016. That review was delivered in 2019, the year before last. It was a review that had been built into the 2016 legislation, which for the first time put in place a legal framework in Australia for the use of medicinal cannabis. Essentially, this bill streamlines various processes for industry participants. The hope is that that will have some downstream impact on patients, and there's something to say for that, but the bill is relatively limited in terms of the impacts for patients we can glean in the foreseeable future.

The first thing of note that the bill does is to consolidate the existing structure of three separate industry licences into a single licence. Currently, there are three separate licences under the original 2016 medicinal cannabis legislation: one for cultivation, one for production and one for manufacture. One of the recommendations of the McMillan review was that those three licences be consolidated into a single licence. Obviously, I think it goes without saying even if you're not particularly familiar with this industry that, for those industry participants who are integrated vertically and who do cultivation, production and manufacture, having a single licensing system will be a substantial efficiency measure, and that should flow on to patients. We support that measure. As I said, it was a recommendation from the McMillan review.

The second and perhaps slightly less impactful but nonetheless important provision in this bill is to relocate the timing of formal assessments of supply chains to a later period in the development of a business. This is so that the assessment of a supply chain will be undertaken at a time when an application for an actual payment is made, rather than at the earlier licensing stage. This means that the assessment will happen when a business is more fully formed and therefore the assessment can be more meaningful. Again, that's a provision we support. It was a recommendation from the McMillan review.

The bill also creates a perpetual, but revokable, licence. Currently, industry participants are only able to obtain a fixed-term licence for five years. If you're a good industry participant, which we can expect the vast majority of participants to be, then you have to go through the rigmarole of renewing a licence. The bill puts in place a perpetual licence which, obviously, can be revoked if there are grounds to do so. This avoids the need for regular applications to essentially relicence reputable operations. All of that, as I said on behalf of the opposition, is worthy reform.

The bill also inserts what it describes as an object to the act to reflect the first recommendation, recommendation 1 of the McMillan review, which, thankfully, was focused on patients—it focused directly on the needs of patients. As far as it goes, there's nothing to argue against it, but the concern is that simply putting a change into the objects of the legislation which says that patient access is important runs the risk of being mere symbolism if it is not accompanied by substantive reform to deal with what I think every member in this House understands are really substantial barriers to access. I'll talk a bit more about those barriers to access later in my remarks.

The concern that this provision is mere symbolism and the concern that this legislation really just deals with some worthy but pretty modest streamlining of measures that were imposed by the original legislation upon industry participants is not just a view of the opposition. It's been a view expressed by a number of patient advocate groups through the McMillan review process and as this bill has been out for consultation. Mills Oakley, for example, said in its submission, 'In our view, the most significant disappointment in the bill is its lack of real measures to improve patient access to affordable and domestically sourced medicinal cannabis.' The well-known patient advocacy group United in Compassion was a little bit more forthright in its view, indicating: 'From a patient's perspective, it'—the framework from the 2016 act—'has been a catastrophic failure. The illicit market is booming. Patients are still being locked up because they cannot afford or achieve legal access.' I think I'm right in saying these are concerns that all members of this place, on both sides of the House, would be receiving from patients across the country and across a very diverse group of patient cohorts.

Medicinal cannabis is a very fast-developing therapeutic product not just here in Australia but across the world—a product derived from the cannabis plant, which has some 80 to 100 different cannabinoids, only two of which are used for medicinal or therapeutic purposes as opposed to recreation. The first is formally called delta-9-tetrahydrocannabinol and is better known as THC. This is the cannabinoid in the cannabis plant that gives you the high, has the psychoactive and is generally the reason for people using this plant recreationally. But it also has medicinal or therapeutic uses and applications. The more predominant cannabinoid from the plant for medicinal purposes is technically called cannabidiol, or CBD. That is the one that most patients will be seeking to access through the framework that was created in 2016.

As I think all members of this place know and as we've had reinforced through the course of this pandemic, our outstanding medicines approvals authority, the Therapeutic Goods Administration, has responsibility for assessing and then approving therapeutic goods and registering those goods on the ARTG, the Australian Register of Therapeutic Goods. There is currently only one medicinal cannabis product that is actually registered on the ARTG and has been approved by the TGA, and that is Sativex, which is only approved for very limited use, particularly to deal with spasticity associated with multiple sclerosis. Other than that, there is no approved medicinal cannabis product under the TGA's regime, in spite of medicinal cannabis now being very widely used for a range of different purposes through the community.

The Australian Institute of Health and Welfare—funded, obviously, by the Commonwealth—conducts a regular National Drug Strategy Household Survey. It reported last year that as many as 600,000 Australians use cannabis for medicinal purposes—not recreational purposes but medicinal purposes. The institute further reported that less than four per cent of those 600,000 Australians are obtaining their medicinal cannabis product through legal pathways. That is a major concern. More than 96 per cent of the hundreds of thousands of Australians using medicinal cannabis are obtaining those products other than through the legal pathways established by this legislation, by the originating 2016 legislation and by the general TGA framework.

The only ways in which, at the moment, an Australian can obtain a medicinal cannabis product through the legal pathways are under two separate schemes operated by the TGA: the Special Access Scheme, which I'll come back to, and the authorised prescriber scheme. The authorised prescriber scheme, or the AP scheme, can involve the TGA approving a particular individual prescriber or medical practitioner and granting that practitioner authority to prescribe medicinal cannabis products for a class of person—not just an individual patient but a class of person. The usual example given is a paediatric neurologist who can prescribe medicinal cannabis products for children with very severe epilepsy, for example. This is not a part of the TGA's scheme that is commonly used, but it is open to some areas of medical practice.

The more common method is the Special Access Scheme. The Special Access Scheme, under the TGA framework, is there for what's described generally as exceptional clinical circumstances. This is where a medical practitioner takes a decision that there is no alternative therapeutic good available to their individual patient and so makes the clinical decision to give that patient a product that is not on the ARTG—one that has not been approved by the TGA for general prescription. This is a relatively cumbersome process in that a medical practitioner has to submit an individual application to the TGA for every individual patient. There's a reasonably quick turnaround here, but every doctor has to submit an individual application to the TGA for every single patient—whether that's a parent with an epileptic child, a terminally ill patient in excruciating pain or a patient with a condition for which there is emerging evidence that medicinal cannabis products can do good, and there are a range of those conditions, as most members of this House know.

At the end of 2019, there were some 18,000 patients in Australia who had received medicinal cannabis products through the Special Access Scheme. That sounds like a lot, but out of the 600,000 Australians that are using these products it's not many really. The TGA has its approval processes down to a much quicker turnaround. Those numbers have been climbing. I read a piece in the Australian Prescriber journal over the last couple of days which indicated that by the middle of last year there were about 4,500 approvals being granted by the TGA every month for the Special Access Scheme provision of medicinal cannabis products by a single medical practitioner to a single patient.

This does come with substantial cost to the patients. Not only are these products not on the ARTG; ipso facto they are obviously not on the PBS. The patients are paying for these products out of their own pocket. In that same study I described, in the Australian Prescriber, it was indicated that the average cost is somewhere between $5 and $15 per day for patients accessing medicinal cannabis products through the Special Access Scheme. That is an average. If you have conditions, such as epilepsy, that require relatively high doses of CBD, or medicinal cannabis, in your therapeutic good, then you are paying substantially more than $15 per day, day in, day out. This is a very substantial impost on families and patients across the country. The TGA, to their credit, have for some time been considering alternative ways of granting access to these products, through some sort of legal framework. Through the course of last year they had a consultation process underway around what is described as down-scheduling. That would mean that medicinal cannabis products would be available not just through schedule 4 of the TGA scheme, which requires an individual prescription by an authorised medical practitioner, but also through schedule 3, which is generally known as OTC, or over-the-counter, products at a pharmacy. They're generally behind the counter. You'll know them. They're not on the shelves at the front of the pharmacy, which is schedule 2. They're 'pharmacist only', so they're generally behind the counter. As with things like pseudoephedrine and ventolin, they generally involve a discussion between the customer and the pharmacist about the product.

A decision was taken by the TGA, after a draft decision and then a further consultation process in December last year, to down-schedule registered CBD products only—not THC products, which have a psychoactive element, but the CBD-only products, which would only be allowed to be, at a maximum, one per cent THC. The decision also indicated that only adults would be able to access a product through this schedule, schedule 3, and only up to 150 milligrams a day. That was an increase on the initial draft decision that limited it to 60 milligrams a day. They lifted it to 150 milligrams a day. A range of patient advocacy groups have indicated that that is a subtherapeutic dose. For many, many conditions 150 milligrams a day simply won't do the job. I make no criticism of the TGA for this. They work in a framework that requires them to assess the safety of a product and they have taken the view that that is the level at which they can be confident there are no safety concerns. All I do is make the observation that that simply doesn't do the job for many thousands of patients across the country. So that's the first point I'd make. It's potentially a subtherapeutic dose for many, many patients.

The other point I'd make is that, even though this decision has now been made and is in operation, there are actually no products on the register that activate the decision. There actually are no approved products that would be able to be sold by a pharmacist to a patient in accordance with this decision. So, until there is, this is very much an abstract decision of no particular impact for patients across Australia.

To get a product approved and put onto the ARTG and then to activate that ability to get it over the counter under schedule 3, subject to that dose limit of 150 milligrams a day, a company is going to have to put a product to the TGA for assessment. That will, under the existing framework, for very good reason, require substantial evidence of the efficacy and safety of that product. That potentially takes years of evidence gathering and clinical trials and many, many dollars, sometimes running to tens of millions of dollars, by the proponent company. So it is difficult to see products being approved by the TGA any time soon that will actually make that down-scheduling decision by the TGA something of real moment or of practical application for patients. I make the point that the TGA has been trying to make some changes that will accommodate the needs of patients, but it hasn't really been able to do anything that I think will have a real-world impact for those many hundreds of thousands of Australians who are using these products every day.

I acknowledge that the AMA has been critical of the down-scheduling decision, even though it won't have any practical implications for patients right now. I acknowledge the AMA takes the view that it's not optimal that patients will go directly to pharmacists for these therapeutic goods, if they ever come onto the market, instead of going to their doctor. The AMA is concerned that patients with potentially very serious conditions—because people with a range of very serious neurological conditions or painful conditions access MC products—might not end up going to their doctor and might instead go to the pharmacist. I think those concerns from the AMA and, to a lesser extent, perhaps, the College of GPs are concerns that need to be a prominent part of this debate as we move forward.

But I do make the point that these processes and the lack of affordable, safe, approved products available as part of the existing legal framework of the TGA and this legislation are all leading to the vast bulk of Australians using medicinal cannabis products to access them outside the legal framework. As I said, according to the AIHW, more than 95 per cent of the 600,000 Australians using these products are accessing them outside the legal framework. We've all heard these stories in our electorates. We've heard stories of veterans seeking medicinal cannabis products to help deal with PTSD. I'm sure all of us have heard stories of parents seeking to access medicinal cannabis products to help children with epilepsy in particular but other conditions as well. We've all heard stories of patients with excruciating and chronic pain caused by a range of conditions, some of them terminal, seeking to access medicinal cannabis products and far too often getting into trouble with the law because of the lack of a dependable supply of safe, affordable and effective products.

Now, I don't pretend this is easy. This is a relatively new product not just in Australia but across a range of jurisdictions across the world. There is still only an emerging base of clinical evidence. I don't pretend you can fix this overnight, but I do make the criticism, on behalf of the opposition, that the government seems too flat-footed on this issue. Other jurisdictions are ahead of where we are in trying to deal with these admittedly very tricky issues. As Olivia Newton-John said last year:

"Why not make it easier for people to get, particularly those suffering with pain? Why not make their lives a bit easier?"

In summing up, I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House urges the Government to implement reforms to significantly improve patient access to medicinal cannabis".

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

Is the motion seconded?

Linda Burney (Barton, Australian Labor Party, Shadow Minister for Families and Social Services) Share this | Link to this | Hansard source

I second the amendment and reserve my right to speak.

Ted O'Brien (Fairfax, Liberal Party) Share this | Link to this | Hansard source

I suggest the member for Hindmarsh is desperately looking for something to complain about here. He's right on one count, and that is the demand for medicinal cannabis in this country is significant and cannot currently be met by supply. He's also right that there is too high a number of people seeking access to medicinal cannabis outside the legal framework. However, what the member for Hindmarsh failed to say to the chamber was that it actually took a coalition government, in 2016, to introduce legislation in this chamber that brought about a regime in Australia in which licences and permits for the cultivation and production of medicinal cannabis would be made legal.

Now, the demand for medicinal cannabis wasn't suddenly new in 2016. It has been around for years. But, again, it took a coalition government to move forward and to take action. It's all well and good for the member for Hindmarsh to suggest the coalition is 'flat-footed', to use his words, despite previous Labor governments making no move in this regard. But we are talking, after all, about a drug that needs to be safe. We are talking about the TGA needing to ensure that the efficacy of this drug is safe for the Australian people. We also have an entire suite of international laws with which our country must comply. So does this take time? Well, it does. So if the opposition seem to have some crazy idea to rush through medicinal cannabis products without due diligence, I'd ask them to be more specific rather than making these motherhood statements of flat-footedness.

When we, as a government, introduced the law in 2016, we rightly inserted the need for a review. That review, the McMillan review, was tabled in this parliament in 2019. What we see today in the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 is the implementation of the recommendations from that review. Two measures in particular are worth noting. The first measure is the consolidation of the licensing structure that will come under just one single framework rather than the existing three separate licences with which those in the supply chain now have to deal. The second measure relates to the creation of a perpetual licence and permit structure. As a bill—and it's something, again, that the member for Hindmarsh failed to recognise—it strikes a balance between the need for safety and international legal compliance and the need to ensure that the supply chain is free to be productive and grow. Those who are operating within the relatively new medicinal cannabis sector in Australia are dealing with an embryonic industry. They need to have the room to grow. They need to be able to be productive. What we see with the consolidation of licences is a removal of the burden of red tape. What we see with perpetual licences is an opportunity for investors to take a longer-term view and therefore invest more. It's a pretty simple formula. The less red tape and the more investment, the greater the focus on this industry and the more it can grow, be productive and get products to patients who are in need.

We all know that the proponents of medicinal cannabis point to some pretty compelling evidence. I'm no doctor, so I won't make any claims, but what medicinal cannabis seems to be able to do in the areas of cancer, multiple sclerosis and epilepsy is quite extraordinary. This is why we need to do what we continue to do as a government—to free up this industry in a responsible fashion so it can attract investment and we can have product going to market. Let us not forget that medicinal cannabis, as an industry, should be within Australia's sweet spot. It comes to the intersection of two of our greatest strengths: agriculture and health care. It is within that sweet spot, within that intersection, that medicinal cannabis is being cultivated and produced for both medicinal and scientific purposes in this country. As a Queenslander, I'm proud to say that the greatest number of prescriptions are coming from our state. As the member for Fairfax, I'm also proud of MEDIFARM, which is one of the companies that are taking a lead in this space in Australia. This is not just a market for us domestically. It's an international market with exponential growth potential for Australian products overseas. I am delighted to commend the bill to the House.

Brian Mitchell (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

I am pleased to have the opportunity to speak on the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021. In my personal view, the current system for patients needing to access medicinal cannabis is far too complicated, and it has been for too many years. Hurdles have been put in the way of accessing this treatment that have been entirely unnecessary and served little purpose, other than to burden people with costs and inconvenience. We know that medicinal cannabis is already being used by hundreds of thousands of Australians to treat conditions such as epilepsy, multiple sclerosis and chronic pain and to reduce the effects of chemotherapy-induced nausea and vomiting. Those are just a few examples. The anecdotal evidence from the people suffering these conditions is overwhelmingly positive. Yet we, as legislators, and the medical community, as regulators, have continued to disbelieve those people for too long. 'Show us the evidence!' we demand when they tell us, straight to our faces, that medicinal cannabis has changed their lives and the lives of their loved ones for the better.

This bill implements recommendations of the McMillan review. It's another step in the right direction, at least. The final report of the review was tabled in parliament in September 2019 and contained 26 recommendations to 'improve the regulatory framework for the cultivation, production and manufacture of medicinal cannabis in Australia'. A key finding of the report was that industry participants, including producers and researchers, encountered numerous barriers to supplying legal medicinal cannabis under the current regulatory and licensing regime. Significant barriers remain to the development of an efficient and transparent research and manufacturing industry. These barriers increase risks and costs for Australian companies seeking to manufacture medicinal cannabis and delay the widespread availability of an affordable Australian-made treatment for patients. This bill aims to address these issues and that's why Labor is supporting it.

The two main measures in the bill are: (1) to consolidate the licensing structure into a single licence framework instead of the current three-licence structure to reduce regulatory burden on an industry which often undertakes activities across the three areas of cultivation, production and manufacture; and (2) to undertake assessments relating to supply chains later in the application process, at the consideration of application for a permit rather than at the earlier licensing stage. This is to support business investment certainty while maintaining regulatory oversight.

The amendments in the bill seek to strike a balance between mitigating the risk of diversion of cannabis to non-medical uses—that's a bit of a euphemism!—and Australia's obligations under international law, as outdated and burdensome as some of that international law now is. There is a need to ensure that medicinal cannabis regulation in Australia facilitates ease of compliance for industry participants; does not impede growth and productivity in the industry; and supports secure, local and affordable supply.

What this bill does not do is directly address the issue of patient access. The Morrison government is, quite frankly, dragging its flat feet on an issue that could make a real difference to the lives of Australians suffering from illness and chronic pain. The Senate Standing Committee on Community Affairs conducted an inquiry into barriers to patient access to medicinal cannabis in Australia which reported in March 2020. The government has had nearly a year to respond to the inquiry's recommendations, which are supported by patient advocates, but it has not done so. Some patient advocacy groups, such as United In Compassion, see the government's silence on this as evidence it's not serious about addressing patient access issues.

In my home state of Tasmania it's particularly difficult for patients to access medicinal cannabis products. In response to an online plea from 75-year-old Peter Fielding about the inhumane lack of availability of medicinal cannabis, a Tasmanian government spokesperson said that medicinal cannabis products were 'unproven'. Mr Fielding, who suffers terminal cancer, described his own experience in using medicinal cannabis: saying, 'Almost overnight I could eat again and my speech improved. Before medicinal cannabis, my pain level was eight out of 10. After cannabis, there were many days when I felt no pain at all.' When a patient tells us to our faces that the treatment transforms their life, who are we to state that the treatment is 'unproven'? The arrogance of such a position is astounding.

Under Tasmania's controlled access scheme there are currently fewer than 20 patients approved for the use of medicinal cannabis, despite thousands of Tasmanians wanting to access it. Getting approval is a burdensome process. You need to see a GP, who sends you to a specialist, who writes off for approval and, then, if it's approved, the specialist can provide a prescription. And if you're on the public waiting list to see a specialist, good luck on getting an appointment within months. Many Tasmanians have no option other than to break the law in order to access a product that improves their quality of life or the quality of life of loved ones in their care without the risk of addiction that exists with pharmaceutical painkillers—which are, ironically, much easier to access.

I have written to the Tasmanian Minister for Health on behalf of constituents who have been unable to access medicinal cannabis, despite it being recommended by their treating specialist. One constituent, Rosie, had her request straight-out denied by her GP, who refused to refer her to a specialist to seek a prescription. Instead, she's out of pocket by almost $300 every six weeks to cover the cost of the telehealth appointment with an interstate doctor to get a prescription for the cannabis oil product that she relies on for relief from chronic pain.

I do note that the Therapeutic Goods Administration recently approved low-dose cannabis oil to be bought over the counter at pharmacies. Again, this is a welcome step. Theoretically, it will mean that patients will no longer require a referral, specialist approval or a prescription to be able to legally acquire and use low-dose CBD. While this is a welcome change, it does not necessarily solve the wider problem of access. With no products approved to date for over-the-counter use, it could be another 12 months before patients are buying medicinal cannabis products from their local pharmacy.

I also note that, as far as I understand, it's a very expensive and time-consuming process for companies wanting to get on the approved list. By all means, we need to make sure that what's being sold is safe, but I have been told it can be in the millions of dollars just to get on the list to be approved. So companies in this field have to make the economic decision of whether is it worth their while to provide a product for which there may be a fairly low volume of sales.

I have two facilities in my electorate producing medicinal cannabis: Extractas Bioscience, a Tasmanian Alkaloids plant in the north of the state, and Tasmanian Botanics, in the south. The facility at Tasmanian Alkaloids was opened in mid-2020 and will produce nine million bottles of cannabidiol each year. It covers all aspects of the cultivation, extraction and bottling of medicinal cannabis. Tasmanian Botanics, similarly, produces a range of liquid products of various strengths and cannabinoid combinations. The security and stringent quality controls at these plants are something to behold. They is absolutely world class. However, the bulk of the products from both facilities serve the national and international markets, despite originating in a state where those who desperately want to access this product remain unable to do so with ease. It seems to me that both the Tasmanian government and the federal government are missing the potential and opportunity of medicinal cannabis both as a treatment to improve lives and as an economic contributor, particularly in the regions.

Australia, quite frankly, is way behind the eight ball. Our international competitors are leaping ahead in the development of medicinal cannabis and reaping the economic rewards as a result. It is long past time that we took off the blinkers, removed the barriers and allowed this industry to properly flourish. As I say, this bill is one step in that process, but it's taking far too long. I take the point the member for Fairfax made in his contribution that the coalition got the ball rolling in 2016, but I can only imagine what the reaction would have been from the coalition if a Labor government, prior to 2013, had tried to legislate for medicinal cannabis. I can only imagine what the political environment would have been like. Would it have been as reasonable as we, a Labor opposition, have allowed this to be? You haven't had any nonsense on our side of the chamber about legalising drugs, for instance, and that sort of ridiculous political showmanship that goes on. I am not sure that the same would have been able to be said if a Labor government had tried to legislate in this sphere before 2013, particularly with Tony Abbott as the then opposition leader. If a Labor government had been trying to legislate medicinal cannabis in that environment, would we have seen the sensible outcomes that we have allowed this government to proceed with? We know this should be a matter of science and medicine and economic contribution, not something to be caught up in the silly rhetoric of the so-called drug wars of the past. On that, I commend the bill to the House and look forward to further development in this area.

Dave Sharma (Wentworth, Liberal Party) Share this | Link to this | Hansard source

The Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 amends the Narcotic Drugs Acts 1967, which makes provision in relation to narcotic drugs in accordance with Australia's obligations under the Single Convention on Narcotic Drugs. In 2016, the Narcotic Drugs Act 1967 was amended to provide a framework for regulating cannabis cultivation, cannabis production, and manufacture and research, with the ultimate aim of providing Australian patients with access to medicinal cannabis for therapeutic purposes, which is what we're discussing here today. The 2016 amendments included a requirement for a review of the operation of the medicinal cannabis scheme after two years, and it was the health minister, the member for Flinders, Greg Hunt, who appointed Professor John McMillan AO to conduct the review, on which he reported in 2019. The McMillan review made 26 recommendations, and some of those were implemented in stage 1 revisions of the Narcotic Drugs Regulation 2016, and these amendments that we are discussing today are part of stage 2 of adopting Professor McMillan's recommendations.

This bill is intended to support the development of an Australian medicinal cannabis industry for the benefit of Australian patients, and, importantly, the bill also includes a clear statement of its purpose in that regard and an assurance that medicinal cannabis products will be available to patients in Australia for therapeutic purposes. I acknowledge the contribution of the member for Lyons in which he talked about constituents in his own electorate and elsewhere in Tasmania who have benefited from such products or have been told they would benefit from such products. I expect many members here have heard similar stories. I haven't had any personal experience with medicinal cannabis, but when I was the Australian ambassador to Israel I got to know someone who is known as one of the fathers of medicinal cannabis, Professor Raphael Mechoulam, who, at the Hebrew University in the 1960s and 1970s, helped to first isolate, structurally elucidate and then synthesise the main active principles of cannabis. Professor Mechoulam is now 90 years old. He is still in good health and still teaching from time to time at Hebrew University. He was seen as one of the gurus, if you like, or one of the go-tos for this industry.

I recall that, when I hosted a visit by the then New South Wales Premier Mike Baird, he brought with him Professor Mary O'Kane, who was then the New South Wales Chief Scientist, and they wanted to seek out Professor Mechoulam because of some of the stories that Premier Mike Baird had heard directly from constituents, particularly those who were suffering from cancer but also others who wanted to be able to access medicinal cannabis for therapeutic purposes and were frustrated about the inability to do so in Australia. I hope this bill goes some way towards addressing that. I know it moves the ball further down the field, perhaps not as far as some would like. I acknowledge the frustrations that the member for Lyons articulated, but I think the bill does get us closer to the purpose and seeks to strike a balance between facilitating not only the cultivation, production and manufacture of a cannabis drug but also ensuring that medicinal cannabis products are available to Australians with our obligations under international instruments, such as the Single Convention on Narcotic Drugs, to safeguard against illegal practices and to provide for safe and sustainable pathways for patient access to medicinal cannabis therapies.

This bill does a number of things to benefit Australian patients and improve access to medicinal cannabis. Firstly, it seeks to reduce the burden of regulation in the licence assessment process. It will replace the obligation for separate licences for any cultivation, production, manufacture and research activity with a single licence. Significantly, the majority of these single licences will be perpetual—that is, not requiring renewal, thus reducing the regulatory burden. So, rather than a business having to go through a regular licence renewal application and assessment process every few years for, potentially, multiple licences governing the cultivation, production, manufacture and research activity, they can do it once and it will be perpetual. This will help allow licence applicants and holders to appropriately manage their business investment and planning decisions, and the obligation to hold a permit for day-to-day operations, including specification of the allowed quantity of medicinal cannabis, will provide sufficient oversight. A number of businesses are interested in the cultivation and production of medicinal cannabis in Australia. In fact, as an agricultural producer and given our climate, terrain and topography, we're quite well suited to this. A number of producers in this area are interested in establishing operations in Australia, and this bill will help to facilitate that.

The bill maintains the current specified supply pathways for medicinal cannabis, including for clinical trials under the Therapeutic Goods Act and approvals and authorities under that act. These are supplemented by additional pathways for medical and scientific research additional to clinical trials, provided it does not involve administration to humans, and the development of a reference standard. There is also a separate regulation-making power to prescribe additional supply pathways anticipated to ensure compliance with the good manufacturing requirements under the Therapeutic Goods Act.

In addition to helping provide greater certainty to businesses and reducing duplicative processes with amendments to the licence regime, the bill reaffirms the government's commitment to patient availability of a safe, legal and sustainable supply of cannabis derived medicines. In doing so, as I said earlier, it seeks to strike a balance to ensure that medicinal cannabis products are available to patients for therapeutic purposes and make sure that Australia continues to honour our international obligations and we don't unwittingly create an industry in cannabis products for non-medicinal and unlawful purposes.

I am also aware that there are a number of patient classes. Cancer and palliative patients are an obvious class or category. For sufferers from epilepsy there have been medical trials, medical evidence and peer-reviewed papers to the effect that medicinal cannabis can help to reduce the frequency and lessen the severity of epileptic seizures as well. I have family friends with children who have suffered from epilepsy, and they are keen to get this approved.

With that, I think this bill strikes the right balance between helping improve patient access to medicinal cannabis, helping to allow an Australian industry to develop itself, helping to reduce the regulatory burden, and maintaining important safeguards and checks and balances to ensure that this industry is used for its proper purpose. I command this bill to the House.

Adam Bandt (Melbourne, Australian Greens) Share this | Link to this | Hansard source

I rise to speak on the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021. The Greens were part of the push in this place to start treating medicinal cannabis as a therapeutic drug. We worked together with other MPs across party lines—and I want to pay tribute here to our former leader, Richard Di Natale—because we know that medicinal cannabis is an important drug. It's an important drug that is used to treat or alleviate many health conditions, including, as has been mentioned, epilepsy in children and adults, multiple sclerosis, chronic pain, chemotherapy induced nausea and, of course, palliative care. We knew that Australia needed to make this drug available as a therapeutic drug.

Despite the steps that have been taken by the government and despite the limited amendments that have been put in this bill, most Australians who need medicinal cannabis still have no real way to access it. There is still a big black market in medicinal cannabis because the government has not taken the necessary steps to make it fully available and treat it as a legitimate therapeutic drug. The Greens will support this bill because it goes some small way to implementing a number of the recommendations from the review of the medicinal cannabis scheme that was undertaken by Professor John McMillan in 2019. But what the government has failed to address is the spotlight that has been shone on the government's current scheme by this parliament, which has suggested a number of very clear reforms that the government is refusing to implement.

The Senate Community Affairs Committee's inquiry into the current barriers to patient access to medicinal cannabis in Australia reported in March last year, almost a year ago. During that inquiry the parliament heard from patients across the country who are unable to access the medicinal cannabis treatments they need due to regulatory barriers and enormous cost. Cost is a hugely prohibitive factor for patients needing access to medicinal cannabis; they just can't afford it. Although the government has said, 'Look, we accept that it has therapeutic benefits and we will allow it to be placed on the register,' the cost is still so high that the people who need it just can't get it. It is completely unacceptable that people can be out of pocket thousands of dollars when trying to access legal medicinal cannabis products through a regulated system when the black market is far cheaper. Imagine if this were being done with respect to any other drug that the government had approved—a different drug that treats cancer or some other condition. If the government deliberately kept the cost of that drug so high, knowing that people would instead go onto the black market, there would be outrage. It would be a scandal. But that's what they're doing with medicinal cannabis.

The complexities in the system mean that, as the Senate committee heard, doctors are turning patients away because of the complexities of prescribing medicinal cannabis and their lack of knowledge. The parliament was told that last year when the Senate inquiry reported, but nothing has progressed to improve patient access to medicinal cannabis since the Senate inquiry reported. Despite it being almost 12 months, we still haven't seen the government's response to the report. The government hasn't even responded to that report. The committee said 12 months ago, 'The situation is so dire that, if it doesn't improve enough in 12 months, the government should consider establishing an independent regulator of medicinal cannabis.'

So we have the experts, the public and the majority of the Senate committee itself saying: 'We need to take action. We need to set up an independent regulator if you don't improve access. It is too expensive. It is too complex. People aren't getting these drugs that you've supposedly given the tick to but are basically keeping in a locked box so that people have no option other than to go onto the black market.' The government have been told, 'You need to fix the problem,' and they're not doing it. As a result, people are suffering. The system at the moment is broken, and it's the patients who are paying the price.

If medicinal cannabis works, as the government has admitted it does, it should make it available to people. You can't say, 'Yes, we accept that it works,' and then force people to spend thousands of dollars or go onto the black market. I repeat: imagine if you were doing that with any other drug that addressed cancer—if you said, 'We know this drug works, but we're going to force you to go onto the black market by keeping the price high and the system so complex.' That is what the government is doing, and it is causing pain. It is causing unnecessary pain.

We'll speak further on this when this bill reaches the Senate. Our health spokesperson, Senator Siewert, will address this in more detail. But one thing is crystal clear: although this bill could be supported for going some small way, what the government really needs to do is implement all of the recommendations of the Senate inquiry. Then we will ensure that everyone in this country has access to the medicinal cannabis that they need and doesn't have to go onto the black market.

Pat Conaghan (Cowper, National Party) Share this | Link to this | Hansard source

I'm happy to speak on the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021, but I note the member for Lyons's comments earlier. He raised a hypothetical and wondered how, if Labor had put this bill before the House back in 2013, the coalition would have received it. I was thinking that I would hope, and I would be sure, that the coalition would have taken a bipartisan approach to this, because I'm sure that we have all, in our other lives, come across people who have been in desperate need of medicinal cannabis—people who have children with cerebral palsy or epilepsy or know somebody who has been injured or has a chronic illness and who, since 2016, has been assisted by the introduction of the legislation allowing medicinal cannabis. So, if the member for Lyons is listening, I say to him: I understand some of your frustration as to the rollout and the extent that this bill goes to, but I am pleased to speak to it, because it does several things that will make life easier for those who are in need of this quite often life-changing medicinal cannabis.

In short, the recommendations are, firstly, to streamline the licensing structure in the act into a single licence, replacing the current three-licence structure, to reduce the regulatory burden for industry participants undertaking cultivation, production, manufacture and research; secondly, to create a perpetual licence and periodic permit structure to support the long-term nature of business investment decisions; and, thirdly, to reaffirm the government's commitment to patient availability of medicinal cannabis. What does that mean in the real world? What does that mean to the layperson, the person who is on the waiting list and the person trying to get medicinal cannabis through a doctor? It means certainty. It creates certainty for investors, it creates certainty for the agriculture industry or the growers and, most importantly, it creates certainty for the patient. They are all as important as each other and all are reliant on each other.

At a time when this government is talking about sovereignty in manufacturing and moving into manufacturing it is the perfect time to provide that certainty. It's the perfect time to say to a startup, 'We're reducing the red tape.' It's saying to someone who is going to invest in these types of businesses, 'We're cutting the red tape so you have certainty in what you're investing in.' It's also saying to those who rely on medicinal cannabis now: 'It will be there. The supply chain will be there in the future.' It gives confidence to investors and confidence to startups. There will be confidence in the supply and in the longevity and future of this industry, which could be not only nationwide but international. We could lead that international industry.

These small changes do a few things, but these are the two most important things. Certainty of supply means that people don't have to look elsewhere. I saw that firsthand prior to 2016. In my previous life I acted as a lawyer for a man who had never been in trouble. He was pulled over by the police and he had a bag of cannabis in his car. He was a farmer. He had been involved in a tractor rollover accident and had chronic pain. He had been addicted to the opioids he took to get over the pain. He made the decision that they didn't work and were not beneficial for his health. Somebody showed him how to make cannabis cookies. He said he would take only half a cookie at night because it did what it needed to do. It wasn't making him high and putting him into a different atmosphere; it was getting rid of the pain.

He told the police that that was what it was for, but he was still charged and put before the court. I'll give you insight into his character. He was so honest that the next day he took to the police station the cookies he already had and said: 'I'm telling you the truth. Here are the cookies.' Unfortunately, he then found himself on the other side of the charge desk. Even though the legislation hadn't come in, the magistrate understood the need for, and the importance of, medicinal cannabis. It was so pleasing back in 2016, when I was a defence lawyer, to see that the government recognised that as well. So that's one of the issues and the red tape that has been cleared that will allow the certainty of supply and the certainty for the consumer or the patient.

The other issue—and this is, again, a personal story—is a family who had a young child with cerebral palsy who would have severe epileptic fits every single day. Once this legislation was passed, it changed everything not just for that child but for that family in not having to see their child go through those fits hour after hour, day after day. By removing this red tape and creating that certainty, it alleviates any fear, any worry, that those families have—and those families are across Australia.

I hear the member for Melbourne's comments that some are still unable to access it. There is still work to do. But these few amendments go some way to abolishing the red tape and some way to being able to provide that service, provide that medicinal cannabis and provide that need for those people who have chronic pain or who need this to just get through life. I commend it to the House.

Rebekha Sharkie (Mayo, Centre Alliance) Share this | Link to this | Hansard source

I rise to speak on the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 and I rise to support this bill. This bill aims to cut red tape and reduce the regulatory burden for those who grow, produce, manufacture and conduct research regarding medicinal cannabis. It implements in part recommendations made by Professor John McMillan in the final report on Australia's medicinal cannabis regulatory framework under the Narcotic Drugs Act 1967, which was tabled way back on 5 September 2019.

If this bill passes—and I am hopeful it will—these businesses will face less duplication and require a single, ongoing medicinal cannabis licence. Permits required for day-to-day operations will ensure continued, proportionate and appropriate oversight of the industry. This change will assist businesses by streamlining and simplifying regulatory arrangements. Most importantly, it may indirectly help to reduce some of the costs which remain a barrier to access for some patients—in fact, many patients. These are people who need access to medicinal cannabis products to help manage chronic pain conditions such as multiple sclerosis, epilepsy and nausea induced by chemotherapy, and those who are, sadly, in palliative care settings.

What we know at the moment is that for many people the only things that are affordable are highly addictive opioids. They are on the PBS, with horrific side effects for many and, as I said, highly addictive. Cost is an important issue for some of my constituents who have written to me and who I have met with, because they cannot always afford medicinal cannabis products. One lovely gentleman that I sat down with advises me that these products help him to live with the symptoms of multiple sclerosis, which he was diagnosed with around a decade ago. When he has medicinal cannabis he is still able to work, but he can only take around one-third of what he needs and what is prescribed to him. That costs around $200 a week, around $800 a month or $10,000 a year as a participant in the NDIS. He can only afford a third of it and so he's not getting the true benefit simply because of cost. That is why this must be on the PBS.

I have also heard from constituents who are loving grandparents advocating for their granddaughter to have her medicinal cannabis, CBD, subsidised by the PBS so the family can afford treatment for her seizures. The little girl's name is Evelyn, the same as my daughter, and she is only four years old. She should be able to enjoy preschool without being disrupted by an upsetting seizure almost every day. Her grandparents tell me that these seizures have occurred at a remarkably lesser rate since Evelyn was prescribed medicinal cannabis oil. They have reduced to once every few months with this treatment. This is extraordinary. But purchasing the oil costs her parents around $180 every 10 days, or approximately $6½ thousand every year. This represents a huge cost burden for this family—and for any family in that situation. This is compounded by the need to care for Evelyn at home, at times, for health reasons.

The Pharmaceutical Benefits Advisory Committee considered putting medicinal cannabis on the PBS back in August last year, particularly products for use in such things as the treatment of paediatric epilepsy. The PBAC deferred its decision, to seek further clarity on the effectiveness, cost effectiveness and financial implications. While we all respect that the PBS sits well outside of this place and the responsibilities of the minister, we know that so many Australians are prohibited from having really life-changing health outcomes without this being on the PBS. I know that so many people are very hopeful that this can be on the PBS soon.

Sadly, my constituents are not alone in their hope or, indeed, their experiences. There was the recent Senate Community Affairs References Committee inquiry, which reported last March on the current barriers to patient access to medicinal cannabis in Australia. The committee's recommendations included education and public awareness to reduce stigma associated with the use of medicinal cannabis; better resources for patients; training for health professionals; compassionate pricing models or subsidies charged through the PBS; and other changes.

I am therefore pleased to see that the government is taking a step towards better supporting an innovative Australian medical cannabis industry by amending and streamlining the Narcotic Drugs Act 1967. I reiterate my support for this bill and I also encourage further work to implement last year's Senate committee recommendations in order to further improve safe and appropriate access and regulated patient access to medicinal cannabis in Australia.

Angie Bell (Moncrieff, Liberal National Party) Share this | Link to this | Hansard source

The Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 is relevant to Moncrieff on the Gold Coast not just because of the importance of the pharmaceutical needs of Australians but also because we have a medicinal cannabis facility operating at Southport in my electorate. It's called the THC Global Group. The health minister visited Moncrieff back in late August in 2019 and we toured that facility. Indeed, we opened that facility. It was great to have the health minister on the Gold Coast at that time.

The medicinal cannabis industry can grow in Australia—that pun was intended; I can see you smiling, Mr Deputy Speaker Gillespie! The industry can achieve better availability of important medicines for patients in Australia. A few statistics: as of 31 December 2020, 151 licences to cultivate, produce or manufacture medicinal cannabis in Australia have been granted since October 2016, 138 of which are currently in effect. Of the licences currently in force, there are 58 licences for cultivation of cannabis for medicinal use, 28 for cultivation for research and 52 for manufacture of medicinal cannabis products.

As I said, in August 2019 the health minister visited THC Global to listen to their industry insights. I welcome their continued success and, of course, the improved regulation of the sector that will be achieved by this bill. There were also the jobs that were delivered by the opening of that plant.

This bill makes a number of amendments to the Narcotic Drugs Act 1967, otherwise known as the ND Act. The Morrison government is delivering in response to the final report of the McMillan review, by Professor John McMillan AO, into the regulation of medicinal cannabis. The government's approach, as it is in other portfolios, is to maintain the good outcomes which the Australian community expects from regulation, whilst minimising the burden that regulations place on business and other organisations.

The government is implementing a second stage of reforms with this bill which will achieve a more efficient licensing structure in the ND Act, with one licence type rather than three. This is so that industry participants can undertake cultivation, production, manufacture and research under a single licence type. So it's cutting red tape. The long-term nature of business investment decisions in this area will be recognised with greater certainty in a licensing system. The bill will create a perpetual licence and periodic permit structure for the majority of activities for which a medicinal cannabis licence is required. Appropriate regulatory oversight, of course, will be maintained.

The Morrison government is committed to availability of a safe, legal and sustainable supply of cannabis derived medicines to patients. That's good news for Australians who need to access those medicines. To achieve that, the Department of Health needs suitable flexibility in administering this legislation, and unnecessary regulations must be removed. This is the kind of reform that makes Australia a better place to live and a better place to do business.

One of the efficiencies introduced in this bill is ensuring that risk assessments are timed right to avoid repetitive processes. Again, this is cutting red tape. Minor amendments to the ND Act will address issues identified through the administration of the scheme and the process of implementation of the recommendations, as I said earlier, of the McMillan review. Other recommendations from the McMillan review are also being implemented administratively and through business process reforms by the Department of Health. This includes reviewing and reforming medicinal cannabis permits issued under the ND Act, which can be done without legislative amendment. The medicinal cannabis industry also supports these changes, as recommended by the McMillan review.

I will just give some background on this bill. The Narcotic Drugs Act 1967 makes provision in relation to narcotic drugs in accordance with Australia's obligations under the Single Convention on Narcotic Drugs. In 2016, the act was amended to provide a framework for regulating cannabis cultivation, production, manufacture and research, with the ultimate aim of providing Australian patients with access to cannabis for therapeutic purposes. This is really important to a lot of Australians out there who may be suffering from pain.

Those amendments included a requirement for a review of the operation of the medicinal cannabis scheme after two years, and Minister Hunt appointed Professor John McMillan AO to conduct this review, on which he reported in 2019. The review made 26 recommendations, and some of those recommendations were implemented in stage 1 revisions to the Narcotic Drugs Regulation 2016. These amendments are part of stage 2 of adopting these recommendations.

The key change is the adoption of, as I said, a single and perpetual licence. The experience in the first years of the scheme has been that the requirement to have three separate licences to operate an integrated business has created unnecessary duplication. That was outlined to Minister Hunt and me when we visited THC Global Group back in 2019. This is both for industry and for government. While this would have worked well in a highly specialised industry, in reality most cannabis operators are integrated and involved in multiple licence areas.

Some of the recommendations will also be implemented in an alternative way through further changes to the regulation and administrative practice. For example, the recommendation relating to notified variations will be resolved by making the permit simpler and thus reducing the requirement for variations.

Finally, the bill makes a variety of technical and minor amendments to ensure that the administration of the act will be practical. Through the drafting process, some issues with the provisions which were not covered by the review were also identified and some of these will be addressed in the act. Some further issues will be addressed in the regulations themselves.

So the purpose of this bill is to amend the Narcotic Drugs Act 1967, to implement a number of these recommendations. The amendments will take effect on a date to be set by proclamation, but no longer than six months after royal assent. A delay in commencement is required to make the necessary changes to the Narcotic Drugs Regulation 2016 and to prepare administratively for the new framework.

The current plan is for commencement on 1 July this year. However, if passage of this bill is delayed until later, the ability to delay commencement will allow another date to be set. As licences run from various times there's no critical requirement for commencement to occur from the start of the financial or calendar year. It's not anticipated that the full six months would be required, and if 1 July is not feasible then another date will be determined at that time. The main change is to adopt, as I said, one single licence—this government is all about cutting red tape—which will make it easier for those in business. There are also some measures which implement other review recommendations as well as some minor amendments to ensure that the framework operates effectively and efficiently.

A question from the Australian public might be: will the changes make it easier for patients to get access to cannabis? At a Commonwealth level, patient access is regulated primarily through the Therapeutic Goods Act 1989, whereas the Narcotic Drugs Act regulates the source material that can be used in medicinal cannabis products. The changes in this bill will streamline and reduce regulatory burden on licences, which will improve the supply of source material. The single licence framework will replace what is currently there, which is three licences under that act. I can't stress enough how that will make it easier for medicinal cannabis producers to do business in this country. It will basically take away the duplication process for them and make it easier not just for them to do business but for patients to access their products.

I'd like to explain a little bit more about the perpetual licence and what that is. Currently a licence is granted for a fixed period of time, combined with the periods of time required to set up and commence an operation. This has led to the need for licences to be extended even before operations have begun. Reflecting that the licence is more about the suitability of a licence holder and their arrangements and that actual day-to-day activities are controlled by permits, a licence will be granted on a perpetual basis except for particular research licences. Instead of examining whether a licence holder is still suitable to hold a licence at a renewable stage, a continual monitoring and audit process will identify any issues. If necessary, compliance action, including the suspension or revocation of that licence, will be taken. It should be noted, however, that licences that authorise non-commercial research will be time limited.

You might ask what changes will be made to possible supply pathways for manufactured cannabis drugs. Under the revised approach to permitted supplies for manufactured cannabis drugs, such drugs will now be supplied for research other than a clinical trial. That, again, is good news for Australians who may be suffering from pain, and these products will assist them. Licensees will be able to more readily access testing services, reference standards may be developed and supplied, and scientific research which does not involve administration to humans may now be conducted, which is great. However, as per the current legislation, supply to pharmacists for compounding or supply under Special Access Scheme A and supply for therapeutic veterinary use is not permitted.

Just to finish, I will answer the question as to whether cannabis will now be supplied for scientific research. Licensees will now be authorised to supply medicinal cannabis for research purposes such as for reference standards and other research activities where cannabis is not administered to humans. This will reduce the reliance on imported cannabis which is currently being used for these purposes. I support this amendment bill and I commend it to the House.

Susan Templeman (Macquarie, Australian Labor Party) Share this | Link to this | Hansard source

I want to talk about the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 in human terms, with the experience of one family in my electorate as an example. Stephen Taylor has two daughters now in their 20s, Morgan and Ariel, who both suffer from the chronic autoimmune condition Crohn's disease. Mr Taylor and his wife, Karen, spent many years watching their suffering, before he made the decision to grow cannabis in his backyard to help his daughters.

The sisters had been repeatedly hospitalised with Crohn's disease. They had serious side effects from the pharmaceutical drugs. Ariel had her colon removed, and Morgan had a stoma bag attached to her small intestine at the time of the court case—he did grow the cannabis, and he did get charged. He entered a not guilty plea and, without spoiling the end to the story, I want to say that he was given a good behaviour bond and didn't face any jail time. But the point is that he could have, and he spent many, many months, and his family—I had discussions with his daughter Morgan about it—were in absolute horror at what the consequences might have been, when he was doing something that was in the medical best interests of his daughters. When he was defending the case he said: 'I honestly believe it's our human right. It's proven worldwide, and there are so many other families who are hoping to access cannabis. That's what we're fighting for. We will get to the truth behind it.'

Stephen and his wife had started researching the uses of medicinal cannabis when they couldn't find a doctor willing to take on the extensive TGA process to legally access medicinal cannabis. They both saw this as the only thing they could do, and they chose juicing because it is associated with greater access to the healing cannabinoids than more common forms of medicating. So it was done by looking at the best research they could get their hands on. They also saw really terrific effects on their daughters, and they continued using it.

I tell that story because it is just an example of what many families go through in the Blue Mountains and the Hawkesbury. They still don't feel it's something that is necessarily widely understood or accepted, because there is still such a stigma around people accessing cannabis. It shouldn't be hard. This should be like any other medicine, used for its therapeutic purpose in the form that works best. But unfortunately this legislation does very little to increase access, which is why I support the amendment moved by the shadow health minister, Mark Butler, to highlight our concerns about the slow pace at which this government is moving on something so fundamental—in Mr Taylor's words, a human right to access a medication that can alleviate symptoms.

I first got to understand how medicinal cannabis works thanks to another constituent in my electorate, who happens to be one of the leading experts working at the Lambert Initiative for Cannabinoid Therapeutics at Sydney university, Professor Iain McGregor. I was privileged to be able to work with the Lambert institute team when they were just establishing, a few years ago, thanks to a very generous legacy that they were given by the Lambert family. Professor Iain McGregor estimates that as many as 100,000 people in the country may be using illegal cannabis for medical problems because it is so hard to access legally. He describes a massive discrepancy between what Australians are doing covertly and the overt approved system.

I was on a Zoom with a group of people a couple of weeks ago. The words that were said about this issue several years ago still apply today. Cannabis is still very difficult to access. I want to go through some of the things that are proving problematic. Professor McGregor makes it very clear that juicing cannabis gives a very different cannabinoid profile than smoking cannabis. There might be some people who still don't quite see the difference. One is administering, often as a liquid, for medicinal purpose, as opposed to recreational use, and of course this legislation is not about that. We are talking about this in the context of medicinal cannabis. The science behind it, as Professor McGregor says, is that juicing is a positive thing to do, because you don't get nearly as much of the intoxicating element, which is the THC, and you get another component of the cannabinoid, which is the THCA, which has very strong anti-inflammatory properties in the gut. I don't think anyone should be in any doubt as to the variety of medicinal effects that medicinal cannabis can have. There is ongoing research, and I would absolutely hold the view that we need to keep researching and keep investing in research so that we continue to understand the what and where of how this can best alleviate pain and discomfort—and we're talking for people whom, often, nothing else will help.

Since 2016, when we first had a framework around medicinal cannabis, industry members have said that they have encountered a number of challenges with the licence and permit scheme. Only a very small part of that issue is addressed here today, with the single licence for production. There are organisations still who have had applications pending for years—some for more than two years—and industry members have reported delays, inconsistencies and an overall lack of transparency in the process. So they're the big systemic issues, and they have made it much harder and, more importantly, more expensive and riskier for Australian companies to cultivate and manufacture medicinal cannabis. These issues have delayed the widespread availability of an affordable Australian-made product.

If this legislation takes a tiny step towards making it more accessible and more affordable to grow and produce, that's a good thing, but there are so many other elements that need to be fixed. Fixing the licensing issues, by making it easier for companies to operate, should ultimately translate into a higher-quality and lower-cost medicine for Australian patients. But that doesn't mean that patients will be easily able to access it. At this stage, until products are approved, there's the Special Access Scheme—I think it's called the Special Access Scheme because you have to be pretty special to be able to work your way through it, for a start. It's described as being for, I think, exceptional circumstances, and all approved options have to be exhausted before doctors can even apply for access to the product.

The powerful words that have been used when there have been hearings and reports on this come from a mother—from Lucy Haslam, the director and co-founder of United in Compassion. Her experience is a lived experience; it comes from the experience of her son Dan. She talks about things that we all know:

The process is too protracted, the products are shrouded in mystery, doctors can't advertise they're prepared to prescribe and patients still find it easier to go to the black market.

That is not something that any of us here would be wanting to see happen, so to put things in place to make that not the case is absolutely vital. Her criticism of the government is that it does talk big about this being a potential export industry, saying that we could be potentially one of the biggest exporters, but you have to make it so that your own patients in Australia can have an easy path to access it. We shouldn't make it easier to export it than to allow access to it here.

The issue around access is really—and I think we are seeing it in this bill—the government dragging its feet on it. I would certainly like to see it made much easier. It is disturbing when you talk to people working in this area and they tell you that the illicit market is booming and that patients are still being locked up because they can't afford to access it or can't achieve legal status to access it. There is a view that some specialist clinics are essentially extorting patients, because they have made a business out of doing the applications that most GPs are not necessarily equipped to do or find very challenging to do in the time they have available. That won't be the case with every GP, but it is certainly a specialist area. Until GPs are given the support they need to be able to go through the process, it is a complex route, and supply to patients through the legal route is inconsistent. As Lucy Haslam says, she is fairly certain that, were it any other medication, it would be immediately addressed by the Therapeutic Goods Administration at the behest of the government.

There is another group of people for whom this can be a really useful medicine, and that is veterans who are suffering PTSD. Lucy Haslam made the point in the United in Compassion submission that she is still contacted by veterans who cannot got DVA to cover the cost of legally prescribed cannabis where it's prescribed for PTSD. DVA will sometimes fund it, if it's prescribed for pain, but not for PTSD. This is a very narrow way of thinking what a medicine is for and what it is not for. The consequence of that is that veterans are being charged with illicit use or, worse still, with criminal convictions for doing what they have to do. They are doing what they have to do to try and deal with the consequences of what they experienced in their service to this country. The very least we can do is ensure a legal pathway for the alleviation of their symptoms where medicinal cannabis is effective for that.

There is another group, and I don't think I'm the only one who has had contact with them—that is, the parents of children with epilepsy. There are so many stories and examples of young children, particularly those with intractable forms of epilepsy, who actually rely on a friendly market supplier because the hospital system just doesn't know how to fund and access the product, other than a very few deals that have been done. It isn't one-size-fits-all.

The work of the Lambert institute is so important in identifying the different forms that medicinal cannabis can take. It's really looking at the quantities, the type, the method of administration—all of those sorts of things we're building a body of research up about—but we need that to be reflected in the legislation that we pass here. And we need access to be made easy so that, as science develops, people don't have to come back to us for additional legislative support. We need something that is forward-thinking in the way that it looks at things so that over time, as we learn more about medicinal cannabis, we know that patients' needs can be met.

At the end of the day, the problem that I see with this bill is that it doesn't address directly these issues of patient access or even of some of the stakeholders who are involved in that process. I was hoping we would see a bill that would make it easier for patients to access it. For those who have advocated for this—those who, like Mr Taylor, have spoken out about their family circumstances, have revealed really private, personal details about what they have experienced, who have actually been willing to be out there and be test cases in the courts on this stuff—you would really hope that we could do better by them than just a few administrative things. It is time to do something comprehensive. I know I am probably asking a lot from those opposite, but it's time for some forward-looking vision. I don't see a lot of that from them, but surely this is one occasion where we can really put the needs of patients ahead our ability to be able to say, 'We've got rid of a bit of red tape.' Let's not just get rid of a tiny bit of red tape. Let's make it so that people who need this medicine can access it when they need it without jumping through a million hoops, without having to turn to the black market, without having to grow it themselves and put their families at risk.

Scott Buchholz (Wright, Liberal Party, Assistant Minister for Road Safety and Freight Transport) Share this | Link to this | Hansard source

I acknowledge all of the contributions that were made in this House today on this debate, and I offer a local contribution. I have in my electorate a gentleman in his late 70s who is suffering from Parkinson's disease. He's highly intelligent. Now, there are many forms of intelligence. On the academic intelligence side, he is extremely well read. He is held in high regard. He does an enormous amount of work for universities. He has a special interest in logistics with Defence. Unfortunately, whilst his mind is sharp, his body is failing him in the way of this degenerative disease. The shaking, which is a symptom of Parkinson's disease, is off-putting to the point he tends to become more recluse. We have the fortune of hearing him through the telephone. One of the previous speakers mentioned the black market. He may or may not get access to some medicinal cannabis, but you can see within an hour a marked improvement.

I would have been one of the first spear-chuckers to defend the medical fraternity in this space and to make sure we go through the appropriate trials, and we will. Deputy Speaker Gillespie knows full well what some of those concerns are. But, as far as the government are concerned, we do want to reduce the red tape to allow people to progress. Part of that are the people who are going to make capital investments in this area. I suggest to the people who have made a contribution to this debate that some of those investments will be to the tune of many hundreds of millions of dollars to advance the medicinal cannabis sector. All strength to their arm. I appreciate the support that has come from the other side of the chamber.

The Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021 amends the Narcotic Drugs Act to support and innovate the Australian medicinal cannabis industry for the benefit of Australians and patients by implementing three specific factors. The first measure is reducing the burden of regulation and the licensing assessment process, which is very important, by providing a single medicinal cannabis licence to replace the current suite of licences required for cultivation, production, manufacturing and research. Those will be bundled and replaced with one licence. The second measure is providing greater certainty to businesses and reducing duplicate processes by providing for the single licence to be permanent rather than recurring. The third measure is reaffirming the Australian government's commitment to patients of a safe, legal and sustainable supply of cannabis derived medicines, which will be in either liquid form or capsule form.

These changes maintain the careful balance the act strikes between facilitating cultivation, production and manufacturing of medicinal cannabis and implementing Australia's obligations under the Single Convention on Narcotic Drugs to safeguard against illegal practices and to provide for safe and sustainable pathways for patients to access medicinal cannabis therapies. I thank the members for their contributions to this debate.

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Hindmarsh has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. The immediate question is that the words proposed to be omitted stand part of the question.

Question agreed to.

Original question agreed to.

Bill read a second time.