Anne Urquhart (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That the Senate take note of the document.

I won't take a long time, but I want to respond to the government response to the Senate Community Affairs References Committee 2020 inquiry into the current barriers to patient access to medicinal cannabis in Australia. We had a hearing in Melbourne on 29 January 2020. I want to focus on one recommendation in one area of this. I'm hoping that when Senator Siewert is finished she will seek leave to continue her remarks later, because I may want to come back at some other time. We heard evidence about Tasmania's nonparticipation in the scheme that was designed to streamline access to medicinal cannabis in appropriate circumstances. That evidence was from the President of the Royal Australian College of General Practitioners. He stated that the college found it 'odd' that, in Tasmania, GPs were not able to prescribe medicinal cannabis as GPs were in other jurisdictions. In fact, in Tasmania only specialists can prescribe medicinal cannabis. The report was tabled in March 2020.

At that same hearing Adjunct Professor John Skerritt stated that federal health minister Greg Hunt had committed to making access to safe medicinal cannabis medications available via those mechanisms to all Australians, but that Tasmania, unlike other states, had not signed onto the scheme at a COAG meeting of health ministers. Following that hearing, Senator Bilyk, who was also on the inquiry with me, and I wrote to the Tasmanian health minister, Sarah Courtney MP, in relation to our concerns around this issue. That letter was sent on 31 January 2020, a couple of days after we had the hearing in Melbourne. Nothing was received from Minister Courtney—no acknowledgement of receipt of the letter, nothing. On 14 July 2020 I sent a copy of the same letter to Minister Courtney, reminding her of the letter and requesting a response. At that time—I think it was the same day or the day after—I did get at least recognition that they had received the correspondence. But here we are in March 2021, and we still have no solid response to that correspondence.

Now we have the federal government response to the recommendations contained in the inquiry report. There were 20 recommendations in that report. Of those 20 recommendations, eight were noted, six were accepted, one was not accepted and five were accepted in part. The one I want to refer to here today is recommendation 11. That recommendation says:

The committee recommends that the Tasmanian Government immediately join all other jurisdictions in participating in the Therapeutic Goods Administration's single national online application pathway for accessing unregistered medicinal cannabis and reducing state-based requirements for medicinal cannabis approval.

That was the recommendation. The government response noted the recommendation and said:

The Commonwealth has a standing offer for Tasmania to join the online scheme, subject to Tasmania agreeing to process applications within a 48 hour time period. This condition was outlined to all jurisdictions upon the creation of the online portal in 2018. All jurisdictions currently participating in the online scheme agreed to this requirement prior to joining. Participating jurisdictions have been processing applications in a timely fashion, in some cases in a matter of hours.

The decision whether or not to take part in the national scheme is ultimately one for the Tasmanian government to make. The Commonwealth stands ready to work with the Tasmanian Government on joining the online scheme, subject to the condition outlined above.

On 9 March 2021—so just a few days ago—I wrote again to Minister Courtney regarding this and have requested an urgent response to my correspondence, given that it has now been well over 12 months since I initially wrote to her and have had no substantive correspondence. This is not the only piece of correspondence over a number of issues that I have written to Minister Courtney on and have not had the courtesy of a response.

While I've been waiting for the response from Minister Courtney many Tasmanians have been waiting for the relief that medicinal cannabis might bring to them. It seemed like at that time Minister Courtney didn't care about the suffering of Tasmanians. They had to go to a specialist to get a prescription for medicinal cannabis. The cost of that was out of the realms of those individuals, let alone getting a specialist appointment to do it. Well, finally today, guess what? The Premier of Tasmania, in a state of the state address, has announced that GPs in Tasmania will be allowed to prescribe medicinal cannabis.

I now look forward to getting a response from Minister Courtney; maybe she'll get to work and respond to me by writing a letter outlining the details of the scheme, which I understand will commence on 1 July this year. I am pleased that that is now happening in Tasmania, but I am very disappointed that many, many Tasmanians have had to wait for a very long time. I like to think that the numerous letters and prompts that I have sent to Minister Courtney may have had some effect and brought about some action on this matter.

Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

I rise to make a contribution on the government's response to the Senate Community Affairs References Committee report on barriers to patient access to medicinal cannabis. I chaired this inquiry and was quite frankly shocked by some of the evidence that we received and the impact of these barriers on Australians' access to medicinal cannabis. I'm pleased that the government has finally handed down its response, because this report made a number of what I consider to be very important recommendations that will help to improve the lives of many Australians hoping to be able to use medicinal cannabis to address their very significant health issues.

Throughout the inquiry the committee received evidence of inequitable access to medicinal cannabis across jurisdictions, with patients in rural and remote communities finding it particularly difficult to access medicinal cannabis in their areas, particularly if their local health professional is unwilling to consider prescribing it or does not have sufficient knowledge of it. The committee also received significant evidence from patients who were unable to meet the costs of travelling into cities to access health services or had to relocate to other regions in order to access medicinal cannabis. The lack of patient access is having a detrimental impact on the mental and physical wellbeing of patients and their families. This is a postcode lottery for many Australians, who shouldn't have to go through this in Australia. There are many barriers to access to medicinal cannabis, despite the fact that there is now supposed to be better access.

I was disappointed to see that the government only noted a number of important recommendations, including recommendations 1, 2 and 3 on training and accreditation processes for doctors. Recommendation 1 recommended the department develop targeted education and public awareness campaigns to reduce stigma around medicinal cannabis within the community. Globally and here in Australia COVID-19 has shown us that working through digital innovation has achieved positive outcomes by providing access to education, training and service delivery via telehealth and other platforms which are cost effective and efficient in connecting Australians, regardless of geographical distances. The government has no excuse not to look at how we can develop training programs to ensure that doctors are equipped to prescribe medicinal cannabis. One of the significant issues that we heard about was that doctors either are reluctant to prescribe medicinal cannabis or have a lack of understanding of medicinal cannabis, particularly as some doctors were trained before medicinal cannabis became known for its medicinal purposes and/or are sceptical about the evidence and they certainly need to understand better the evidence around medicinal cannabis.

Under recommendation 3, the committee recommended that the Australian Medical Council make mandatory the inclusion of modules on the endocannabinoid system and medicinal cannabis in curriculums delivered in medical schools, again because we need to ensure that doctors have training in and awareness of medicinal cannabis. Doctor education is critically important, both for medical students during their studies and for practising doctors seeking more information and training, and we believe that the government should be supporting this. I am particularly disappointed to see that the government did not accept recommendation 5, which stated that if the TGA failed to address barriers to regulation then a new independent regulator should be considered. The TGA has not fixed the barriers to regulation. It's still a hotchpotch in this country. It is clear that we haven't fixed the issues around regulation. Patients still rely on the black market to get access to this essential medicine. I'm calling on the government to either fix this mess pronto or overhaul the system and put in place an independent regulator immediately. Patients can't wait any longer.

We heard a lot of evidence—we had a day of hearings, as Senator Urquhart just said—and we got a number of submissions that articulated very clearly the problems on access and the fact that the current system makes access so expensive that people have to go to the black market. People don't want to go to the black market but they are suffering. People on low incomes in particular are not able to access medicinal cannabis easily, and it's very costly if they can. We heard a great deal of evidence about that.

This needs fixing. The government's response to this is inadequate because they fail to see the urgency of the need to fix access to medicinal cannabis. The regulations across the country are hotchpotch and they're nonsensical in many areas, including where fences are required for particular plants according to whether they're for medicinal cannabis purposes or for other purposes—same plant, different sized fences. Those sorts of things are just ridiculous. We need an independent regulator immediately.

Another recommendation that was only noted was recommendation 18, which recommended the implementation of a compassionate pricing model for patients facing significant financial hardship in accessing medicinal cannabis products to treat their health conditions. That goes to the point that I was just making: so many people cannot afford medicinal cannabis and they have to go to the black market. People were very distressed about having to do that and, of course, about the consequences for doing it. Cost is a hugely prohibitive factor for many, many patients. We heard from parents who talked about their son's or daughter's access to medicinal cannabis and the fact that they were having to go to the black market, which is appalling. We need readily available legal medicinal cannabis products through a regulated system, and government needs to ensure this happens.

There is a lot of concern in the community about the fact that this hasn't been fixed and the fact that the government need to do better. They have it in their remit to do it. I urge the government to, in particular, look again at recommendation 5, which talks about the need for an independent regulator. The Greens will continue to pursue this matter because it is urgent. I seek leave to continue my remarks later.

Leave granted; debate adjourned.