On Tuesday 17 September 2019 the Queensland Parliament debated two bills, the Medicines and Poisons Bill 2019 and the Therapeutic Goods Bill 2019, in cognate. As commonly happens for crossbench MPs in Queensland, I didn't get an opportunity to speak on the bill after debate was guillotined.
Below is the speech I had planned to give:
New prescription monitoring scheme
First of all I note that the AMA support for the Real Time Prescription Monitoring (RTPM) scheme, including the requirement for prescribers to obtain an approval before prescription of controlled drugs (referred to in the Bill as s8 medicines) and particular s4 medicines to drug dependent people.”
This new system appears to simplify and improve the efficacy of the process for prescribers to check the relevant database for drug dependence.
Privacy concerns
I note privacy concerns that will necessarily arise from monitoring system: as recommended by Royal Australia & NZ College of Psychiatrists. The database should only be accessible during the prescription process, and not by third parties such as WorkCover or other insurers.
Rollout
It is also vital that the government provide the necessary support and resources to support the rollout of this new system. Eg by incorporating the new real-time prescription monitoring system into existing prescribing systems and working with prescribers to determine a phase-in period for compliance.
Also encourage the government to work with other jurisdictions to enable cross-jurisdictional information sharing as soon as practicable, and establish real-time prescription monitoring systems in emergency departments and hospitals, given they are increasingly prescribing monitored substances.
Without these measures, the new system will be far less effective.
Funding for support services
Assuming the Real Time Prescription Monitoring scheme is effective, it will create an important opportunity for much needed additional health interventions for people struggling with drug dependence.
The government needs to recognise this opportunity, and take immediate steps to increase investment in drug and addiction support services. In other jurisdictions, when doctors have suddenly refused to prescribe certain drugs to some people, they turned to more harmful sources of opioids, and if there aren’t enough adequately funded treatment services to support those patients, this could end up increasing rather than averting harms.
Ultimately, we need our governments to take a population based planning approach to provision of drug and alcohol support services.
Medicinal cannabis
I strongly welcome the Bill’s intention to streamline access to medicinal cannabis by treating it as other Schedule 4 or 8 medicines and allowing non-specialist medical practitioners to prescribe the drug without requiring approval from Queensland Health.
I am regularly contacted by constituents who have found medicinal cannabis an incredibly effective and useful treatment, but found the regulatory system clunky and frustrating to navigate.
This is another good step in streamlining access to medicinal cannabis, but in long term should be seeking to fully legalise cannabis, which would not only help facilitate access to medicinal cannabis, but reduce law enforcement costs, free up funding for education and treatment, and ultimately deliver better outcomes for communities.
As many of you will know, I’ve been advocating for this alongside a whole range of other harm reduction measures to change how we deal with drug use in Queensland, including pill testing, fully funded opioid replacement therapy and safe injecting facilities. It’s my firm belief that drugs are a health issue, not a criminal one.
This is why I am somewhat disappointed by the inclusion of punitive measures in this bill, like an offence for self-prescribing or self-administering certain medicines. I would agree with the Medical Insurance Group Australia’s recommendation that this offence be replaced by education, counselling and, if necessary, referral to the Medical Board.
I’ve also heard from some members of the community who are concerned about whether the Bill will create additional offences or penalties for people using cannabis for medicinal purposes, without a prescription. I would appreciate clarification from the Minister about how these new provisions apply to those users of medicinal cannabis, and in particular whether it creates additional offences or penalties for these people that they’re not currently subject to.
Patient Delivered Partner Therapy
One concern from the Submissions that doesn’t seem to be addressed is whether Patient Delivered Partner Therapy (PDPT) of azithromycin, for uncomplicated genital chlamydia infection, will be allowed under the Act. That is, will prescribers still be able to provide an additional prescription to a patient to give to their sexual partners without the partner consulting a doctor?
This was raised in submissions on the bill by the Sexual Health Society of Qld, and Professor Jane Hocking & Dr Jane Goller from the University of Melbourne. I would appreciate clarification from the Minister on this issue, given that it could affect health professionals’ ability to effectively minimise the spread of infection.
Closing
As a whole, I will be supporting this Bill and welcome a number of the changes it will bring to streamline and improve regulation of poisons, medicines and therapeutic goods.