Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Hansard source

In June, the Senate voted to improve access to medicinal cannabis for dying Australians. In particular, Labor and most of the crossbench voted to disallow the government's restrictions on access to medicinal cannabis under category A of the Special Access Scheme. I want to emphasise two things about category A from the outset of this debate. Firstly, this is a pathway for accessing therapeutic goods for people who are terminally ill. According to the Therapeutic Goods Administration—the TGA—category A is strictly limited to:

… patients who are seriously ill with a condition from which death is reasonably likely to occur within a matter of months, or from which premature death is reasonably likely to occur in the absence of early treatment.

We should be very clear in this debate that we are talking about dying Australians. Secondly, under category A of the Special Access Scheme, medicinal cannabis can only be accessed with a prescription from a doctor. We're not talking about illegal recreational use or inappropriate medicinal use; we're talking about dying patients who have a legitimate clinical need for medicinal cannabis as prescribed by their doctor.

In the debate in June, Labor did acknowledge the complexities of this issue. We acknowledged that some groups have raised concerns about the possible abuse of category A. We also acknowledged the need to strike a balance between access for dying patients and protection of the broader community. But, on balance, Labor was proud to stand up for the rights of terminally ill Australians who have been prescribed medicinal cannabis by their doctors. The Senate overwhelmingly agreed with Labor, voting 40 to 30 to disallow the government's restrictions. There ain't many votes in this place that unite Labor, the Greens, One Nation, Senator Lambie, Senator Hinch, Senator Gichuhi and Senator Leyonhjelm, but this one did exactly that. Among the crossbench, only the Nick Xenophon Team and Senator Bernardi supported the government. I would urge them to explain that vote and to reconsider their position today.

The Senate vote in June should have resolved this issue. Terminally ill patients should have had easier access to a prescribed therapy that can ease their suffering. But what we've seen from this government in the months since June is an attempt to block the parliament's will and to continue denying relief to dying Australians. Straight after the vote, we saw the health minister equate dying Australians and their families with drug smugglers. In the sort of temper tantrum that we saw from the Prime Minister on election night, the health minister said the disallowance was—and I quote from Fairfax—'Reckless and irresponsible,' saying it would put lives at risk and, potentially, make it easier for criminals to get drugs. It was a disgraceful slur for which the health minister still hasn't apologised. Mr Turnbull should be ashamed of the way his government has tried to scaremonger on this issue, stigmatising the dying people who are trying to access medicinal cannabis. Even worse, the government has put in place a new barrier to prevent people from accessing medicinal cannabis. In June, soon after the disallowance vote, the government wrote to medicinal cannabis importers, instructing them not to supply products to anyone holding a prescription under category A of the Special Access Scheme. This was despite the fact that the Senate had just voted to reopen that pathway. It says everything about Mr Turnbull. Instead of helping Australians with terminal illnesses and their families, his priority is to find a way to get around the Senate's decision to give dying Australians access to the pain relief they need.

That brings me to the bill before us today: the Medicinal Cannabis Legislation Amendment (Securing Patient Access) Bill 2017. Labor will support this bill which simply enshrines the intent of our disallowance vote in legislation. The bill would make two legislative changes to improve access to medicinal cannabis for terminally ill patients under category A of the Special Access Scheme. First, the bill would ensure that terminally ill patients can access imported medicinal cannabis products under category A. Again, this was the intent of the disallowance motion in June, but, because the government hasn't respected the parliament's will, this bill would amend the Customs Act 1901 to clarify that a licence, permission, consent or approval to import medicinal cannabis applies to category A as well as other pathways. Second, the bill seeks to ensure that terminally ill patients can access domestic medicinal cannabis products under category A when they become available. It would amend the Narcotics Drugs Act 1967 to add category A as one of the purposes for which the secretary of Health can grant a licence to manufacture medicinal cannabis in Australia.

I also want to use today's debate to make some broader comments on medicinal cannabis in Australia. Labor understand that medicinal cannabis can ease suffering for Australians who are dying. We also accept that there is evidence to support the use of medicinal cannabis for a number of other conditions, such as chemotherapy-induced nausea and vomiting, and multiple sclerosis spasticity symptoms. That's why Labor led the way and introduced legislation for a national medicinal cannabis scheme in 2015 and supported the government's legislation when it was finally introduced in 2016. Over time, medicinal cannabis should be treated in the same way as other medicines. Products will be assessed for safety by the TGA and, where they pass that test, they will be prescribed by doctors, dispensed by pharmacists and possibly one day subsidised by the Pharmaceutical Benefits Scheme. A system of licences has also been established to govern research, cultivation, production and manufacture of medicinal cannabis products in Australia. But the government remains sceptical of medicinal cannabis and they have been too slow to implement the national scheme. Labor is particularly concerned that the government has done little to ensure a consistent supply of regulated and affordable product. The government has also failed to drive consistency across states on the legal treatment of people currently accessing medicinal cannabis. Bill Shorten has written to Mr Turnbull three times urging action and offering support, but patients have seen no change. That's one reason why Labor is supporting the bill that is before us, because the government has failed time and time again to improve other pathways.

I'd like to give some context to why this is an important issue by sharing one family's experience. Lucy Haslam is a Tamworth advocate and a mother who has campaigned for the legislation of medicinal cannabis after her son Dan was diagnosed with terminal cancer. Dan passed away in 2015. Lucy has continued to push for better access to medicinal cannabis for patients. In February, on the first anniversary of the passage of the federal medicinal cannabis legislation, Ms Haslam wrote that little had changed. Because of the time, I can't read the entire letter, but I would like to share some excerpts from it. She wrote:

On the first anniversary of Australian medicinal Cannabis legislation which was supposed to be the "missing link" for Australian patients (according to the previous Health Minister Sussan Ley), I want to shout from the rooftops that nothing could be further from the truth. In fact, although it pains me to say it, it is coming very close to being an outright lie.

Off the back of strong public support for patients like my son Dan who sought relief from serious disease and symptoms with medicinal Cannabis, the Government rode the wave of popular opinion, made all the right sympathetic noises, and passed legislation to allow for the cultivation, manufacture, and research into Cannabis for therapeutic purposes.

That sounds wonderful and I used to feel very proud that Dan's courage to speak out had some impact for the welfare of other patients. I thought it a beautiful tribute that the Legislation was passed on the first anniversary of his death.

However, Ms Haslam said that this pride of passage of the legislation has been replaced by anger that little has changed in reality. She wrote:

People often say to me you must be very pleased with how things have progressed ... so let me honestly answer that right now:

Patients are still criminals. This includes the terminally ill and children with intractable epilepsy.

Patients are still reliant on the black market and will be for a long while yet. They are still taking medicine procured from illicit sources which is like playing the lottery ... the medicine could be contaminated, each batch is likely to contain different cannabinoids, there is no certainty that there will be continuity of supply, there is no appropriate supervision by health professionals, there is no practical and viable alternative.

The black market is thriving; in fact, compassionate suppliers cannot meet demand. This is compounded by police raids which seize the medicine destined for patients who are reliant upon it. What happens when a child whose epilepsy is controlled by illicit Cannabis cannot access their next supply because police have confiscated it? Who will take responsibility for that?

The score card for the Government is looking very sad. In fact, I would say that on all aspects I give them a fail.

Now I can immediately hear the gatekeepers and authors of the regulations jumping up and down and saying "but there is a pathway for patients to lawfully access medicinal Cannabis." I agree in theory, but the problem is in putting it into practice.

The Special Access Scheme (SAS) provides that pathway. Let me explain very briefly as the process is so convoluted that word limits make full explanation an impossible task in this context.

To begin the process the very sick patient needs to find a doctor who is happy to prescribe Cannabis and who has the time to firstly undertake the arduous time consuming process to become an "Authorised Prescriber". This involves applications to State and Federal agencies. Once approved the doctor must then demonstrate to a committee the evidence for the patient's illness. (A little difficult after decades of blanket prohibition making research illegal).

The very sick patient then needs to find the product overseas (bearing in mind these products are not allowed to be advertised). Once found, the patient must negotiate a price and apply to the TGA to have it approved and they must also apply for Federal and State permits to have it imported. The patient bears the full cost plus the doctor's costs.

If they are successful in getting "Special Access" the approval only lasts three months and they are only allowed three months' supply. Think on this for a while ... A sick person must apply repeatedly placing an enormous burden on someone who is already battling illness and possibly even dying. This was the reality for a young Queensland patient with a brain tumour who took nineteen months to navigate the SAS. He is now several months into his second application and supplies are exhausted.

So, on the topic of patient access I would definitely give the Federal Government a huge fail!

This is a firsthand account of why things need to change, bringing us back to the bill here today.

If the Senate supports this bill, it will be a step in the right direction. But I want to assure the patients and families who are listening that Labor knows that much more needs to be done to ensure safe and timely access to medicinal cannabis across Australia, where it is clinically appropriate. Unlike the government, Labor is committed to working with patients and clinicians to make that a reality.