Dean Smith (WA, Liberal Party) Share this | Hansard source

For me, nothing demonstrates the capacity for community opinion to change and evolve more than the issue of medicinal cannabis and its use in our community. I hear very regularly people's personal accounts of loved ones, people in their friendship circles, who are benefiting from access to medicinal cannabis. I readily admit that, on this particular issue, I come with little personal experience. So I'm inclined to trust the position of those in our community who are trusted to make difficult decisions around access to drugs—the Therapeutic Goods Administration and, indeed, the government and the Honourable Greg Hunt, who, as the current Minister for Health, has responsibility for health matters.

But that's not to say that my opinions won't evolve or change over time. As a member of the Senate Community Affairs Committee, I regularly sit in the Senate estimates process—probably on 15 occasions now since I've been a senator—and I've regularly heard Senator Di Natale's questioning of health officials from the Department of Health and the Therapeutic Goods Administration around the access arrangements. I don't doubt his great passion and sincerity in the issue; Senator Di Natale was, of course, a general practitioner before coming to the Senate.

That said, it is wise to adopt a precautionary principle when it comes to giving people access to medicinal cannabis. And it is important to clear up some of the facts, to correct the public record, in regard to some of the media commentary that occurred around the 'securing patient access category A' issue in this parliament back in June. In June, we did talk about the disallowance motion which effectively has given passage to the bill we are talking about now. Key among these points for me is the allegation that has been made that the Office of Drug Control is breaching legislation in not permitting the import of medicinal cannabis products for use in Special Access Scheme category A.

Those who have paid attention to this particular allegation would know that the allegation rests on a misinterpretation of a letter that was sent to existing importers, under the bulk import policy, reminding them that their existing import permissions are conditional for supply under Special Access Scheme category B and authorised prescriber schemes. This letter was necessary as at least one importer interpreted the disallowance motion that was agreed to in June as meaning that they could supply under the securing patient access arrangements category A. So what we had was a situation where an importer misinterpreted what the disallowance motion meant, which made it necessary to write to every importer to make it very clear what the arrangements were. This particular importer would have breached the conditions of their permission and potentially been subjected to regulatory action under the Customs Act of 1901.

This letter did not say they could not import for the purposes of supplying under SAS category A. The Office of Drug Control has always given SAS category A import applications a one-day priority processing time and continues to do so for medicinal cannabis products that are characterised under the SAS category A. Since the disallowance motion, though there have been five notifications to the TGA, the office has only received and processed one import permission application for SAS category A. To discharge its regulatory obligations set out in regulation 5 of the Customs (Prohibited Imports) Regulations 1956, the office must necessarily make an assessment of each SAS category A importation. In addition, the scheme established by the government, with bipartisan support, in October 2016 ensured access to medicinal cannabis for terminally ill patients.

I think it is important on matters such as this to lean heavily on the advice of those in our community who are trusted with looking after our health. On this issue I would argue that the view of the established medical community in our country—indeed, they are same people that the Greens and Labor would go to, and then they would come back to in this place with numerous quotes about why the AMA's views on particular issues should be heeded to. For consistency sake, if you are going to stand behind the views of the AMA on some issues then it's important perhaps to stand behind the AMA on issues of great sensitivity like issues of medicinal cannabis.

On that point, I think it is worth noting that in June 2017, with the disallowance motion having been debated, AMA President Dr Michael Gannon said—these are his quotes now; and I think this is particularly important given some of the discussions that have happened in recent days in this building around the mental health and wellbeing of people:

And let's not forget, we're talking about cannabis, we're talking about a substance that, used in the form it's used by most people, is a major source of mental illness in our community. It's absolutely essential that we're assured that whatever's being brought into the country, whatever's being brought in for prescription is safe…

Those are not my words and not the words of well-meaning senators. They are the words of the Dr Michael Gannon, the president of the Australian Medical Association. In that same Sky News interview in June of this year, he went on to say:

…we're satisfied with the process being put in chain by Minister Hunt and the Government using the Therapeutic Goods Administration, using appropriate care and diligence that is used for all other therapeutic products.

… … …

The Australian community would be outraged if prescription medication was rushed in, if someone said that it was okay to use. The Australian people would be outraged if new operations got brought in or, for that matter, new foodstuffs were brought in without appropriate care and safety.

Dr Gannon is saying that if you have a regulatory regime that keeps the community safe, that does allow for products to be brought to market and that does allow for products to be given to people to support their care, then it's important that there be some consistency around that regime in order to not only relieve people of pain and suffering but also protect them and others from unsafe products

I argue that a consistent national regime is important. I accept the point that Senator Leyonhjelm was making—that it's important that the regime be as responsive as it possibly can. But I would argue that, on this particular issue, the regime is a good one, is responsive and is meeting community expectations. What gives me confidence in arguing the government's position is that it is built on the clear medical evidence informed by the attitudes of those people who are trusted in the medical profession to provide advice to government. The government continues of course to take advice from the TGA and the medical profession, including the Australian and New Zealand Society of Palliative Medicine, which I think is a particularly important organisation when considering the safe and proper medicinal use of cannabis. It is taking the advice of the Australasian College of Physicians and the Royal Australian College of General Practitioners. The advice is that it is potentially dangerous to patient safety to allow access to medicinal cannabis products through the Special Access Scheme category A. Unlike other registered medicines, they are prescribed through this scheme with one medical exception: no medicinal cannabis product has been subjected to a full safety, quality and efficacy assessment by a competent medicines regulator anywhere in the world. There is not easily accessible evidence of safety available to guide prescribing conditions in accordance with doctors' medico-legal obligations to their patients.

I think this is the most important point in the brief time that is available to me: terminally ill patients already have access. This does not mean that terminally ill patients cannot have access to medicinal cannabis products. Where doctors have educated themselves and demonstrated a clear understanding of the risk or benefit profile, they gain timely approval from the Therapeutic Goods Administration to prescribe the medicine under the SAS B category. This happens in as little as one day. Let me paraphrase: the current regime protects safety, protects patient safety, puts requirements on medical practitioners, and that regulatory process is achieved within one day. The argument that ill people are suffering delays in regards to the use of medicinal cannabis in their care is not true. That statement provided to me by the Minister for Health demonstrates that point very clearly.

Let me end where I started. I'm lucky enough that in my family and in my circle of friends they are not suffering illness where they require medicinal cannabis. Would my attitude be different if I had a personal experience much closer to these sorts of issues? It may well be, but on this issue and at this particular point in time I think the Australian community should trust the advice of the government, which is informed by specialist medical practitioners and the Therapeutic Goods Administration to ensure that Australians don't just get the best possible care but are protected from unsafe and unproven medical products.