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PARLIAMENT OF TASMANIA
LEGISLATIVE COUNCIL
REPORT OF DEBATES
REVISED EDITION
The
President,
Mr
Farrell
,
took
the
Chair
at
11
a.m.,
acknowledged
the
Traditional
people and read Prayers.
QUESTION UPON NOTICE
Mrs Hiscutt
(by leave) tabled the answer to question 46.
46. PESRAC - Tasmanian Residents - COVID-19 Emergency Management Act
Ms WEBB
asked the Leader of the Government in the Legislative Council, Mrs Hiscutt -
(1)
(a)
Are
Tasmanians,
who
under
normal
circumstances
return
to
Tasmania
between
semesters,
considered
Tasmanian
residents
under
current
Emergency Management Act COVID-19 emergency powers; and
(b)
if
not,
when
did
this
non-residency
classification
come
into
effect
and
how were those affected advised?
(2)
Under what circumstances would permission to return to Tasmania be denied?
(3)
What
types
of
evidence
of
residency,
other
than
those
in
the
evidence
of
residency
list
as
referred
to
in
the
'Applying
to
the
Deputy
State
Controller
for
recognition
as
a
Tasmanian
resident'
section
of
the
Government's
coronavirus
website,
can
returning Tasmanian students provide?
(4)
How
many
times
have
applications
been
made
where
returning
Tasmanian
students
were
unable
to
provide
evidence
of
residency
to
the
satisfaction
of
the
Deputy State Controller and were refused entry to Tasmania?
(5)
(a)
How
many
times
have
applications
been
made
where
returning
Tasmanian
students
were
able
to
provide
evidence
of
residency,
other
than
those
on
the
evidence
of
residency
list,
to
the
satisfaction
of
the
Deputy State Controller and were granted entry to Tasmania; and
(b)
what types of evidence did these successful applications include?
Answer tabled.
RECOGNITION OF VISITORS
Laura Moore
Mr
PRESIDENT
-
Honourable
members,
I
welcome
Laura
Moore
to
the
Chamber.
Laura
is
the
executive
assistant
to
the
member
for
Rosevears;
she
has
a
number
of
business
administration
qualifications
and
broad
executive
administration
support
experience
gained
over
many
years
in
the
fast-paced
media
environment.
Her
previous
employment
provided
her
with
strong
administration,
social
media
and
secretarial
support
skills
and
enabled
her
to
build
strong
relationships
with
the
local
business
community,
service
organisations
and
community
groups.
Laura's
ability
to
adapt
quickly
and
to
connect
with
a
broad
spectrum
of
the
community
will
provide
great
support
to
the
member
for
Rosevears.
Laura
is
pleased
to
join
the
Legislative
Council
team
and
looks
forward
to
supporting
the
member
for
Rosevears
in her new role.
Honourable
members,
if
you
think
Laura
looks
familiar,
she
was
at
one
time
a
weather
presenter
for
Southern
Cross
Television
and
she
joins
the
Legislative
Council's
growing
stable
of fallen media stars.
Laura
will
be
joining
us
today
to
observe
proceedings.
I
am
sure
all
honourable
members
will
give
her
a
warm
welcome
and
trust
that
you
enjoy
your
time
with
the
Legislative Council. Welcome.
Members -
Hear, hear.
George and Paul Willows
Mr
PRESIDENT
-
We
also
have
joining
us
in
the
President's
Reserve
this
morning
George
Willows
and
his
father,
Paul,
who
are
here
for
a
reason
that
will
become
obvious
shortly
as
we
move
into
the
first
business
of
the
day
and
that
is
the
special
interest
speech.
To
reveal why George and Paul are with us, I invite the honourable member for Launceston.
SPECIAL INTEREST MATTERS
George Willows - English Leicester Sheep Stud
[11.07 a.m.]
Ms
ARMITAGE
(Launceston)
-
Mr
President,
I
welcome
George
and
his
dad
here
today.
It
is
wonderful
to
have
them
here.
Today
I
speak
about
an
extraordinary
young
man
who
goes
to
school
at
Scotch
Oakburn
College
in
Launceston,
George
Willows,
who
is
now
in
grade
6,
farms
a
heritage
breed
stud
of
English
Leicester
sheep
at
his
parents'
farm
'Everton',
in
Evandale.
The
English
Leicester
is
a
very
rare
breed
of
sheep
first
developed
by
eighteenth
century
breeding
innovator,
Robert
Brakewell.
George
describes
English
Leicesters
as
being
great
mothers
who
have
attitude
but
can
handle
tough
conditions.
They
are
slow
growing,
but
this
results
in
a
much
more
unique
and
flavoursome
meat.
Their
wool
is curly, long and dense and is a sought-after product for crafters, felters and weavers.
At
school
George
is
a
diligent,
conscientious
and
hardworking
student
with
a
particular
interest
in
how
to
apply
learning
creatively
to
his
farming
practices,
such
as
relating
maths
investigations
to
his
stock
currency
and
spreadsheets.
According
to
George's
year
4
teacher,
George
is
a
leader
in
teaching
others
how
technology
can
be
personalised
to
learning
needs,
having
conducted
investigations
into
how
his
own
learning
could
be
improved
by
using
novel
approaches to the application of certain technologies regarding visual processing.
On
the
farm,
George
also
takes
a
leadership
role
in
looking
after
his
English
Leicesters.
The
stud
named
'Nant'
after
his
maternal
grandfather's
Bothwell
property,
now
known
as
Nant
Distillery,
has
been
built
up
to
a
flock
of
52
ewes,
12
rams
and
60
lambs.
George's
grandfather,
Ian
Campbell,
first
bought
the
stud
of
English
Leicester
sheep
when
he
was
a
student
at
Scotch
Oakburn
in
1945.
Before
Ian
passed
away
around
11
years
ago,
he
was
adamant that his precious stud should be preserved.
At
the
tender
age
of
eight,
George
took
up
the
gauntlet
and
channelled
his
Dad-pa's
passion
for
the
rare
breed.
George
is
also
not
shy
to
take
on
the
hard
work,
doing
almost
all
the
electronic
tagging,
vaccinating,
weighing,
crutching,
drenching,
milking,
feeding,
treating
mastitis, record keeping and showing.
George
is
a
fierce
competitor
at
the
Tasmanian
shows,
having
competed
since
2017.
Anyone
in
the
industry
will
tell
you
how
much
work
goes
into
preparing
for
competitions
and
George
is
not
afraid
to
take
up
the
challenge.
Two
months
before
a
competition
George
will
pick
his
entrants,
spend
hours
teaching
them
to
be
handled
and
walked
on
a
lead,
as
well
as
how
to
stand
calmly
for
inspection.
Anyone
who
has
even
spent
a
few
moments
with
sheep
will
understand
just
how
wilful
they
are
by
nature.
The
fact
that
George
takes
the
time
to
get
to
know
his
entrants,
train
them,
and
positively
reinforce
their
behaviour
shows
just
what
a
patient person George is.
Closer
to
the
competition,
George
undertakes
all
the
grooming
duties
-
teeth,
feet,
ears,
faces
and
noses
-
and,
on
the
day,
George
coordinates
and
organises
with
his
helpers
to
make
sure
all
his
entrants
are
where
they
need
to
be.
You
certainly
get
a
sense
of
all
the
leadership
qualities
George
possesses
at
school
and
in
competitions,
knowing
all
of
the
thought
and
preparation that happens behind the scenes.
In
addition
to
the
Tasmanian
shows,
George
has
competed
in
past
Australian
sheep
and
wool
shows.
In
2019,
all
his
hard
work
reached
a
high
point
when
his
best
ram,
Benny,
was
awarded
reserve
champion
in
the
English
Leicester
class.
This
win
resulted
in
George's
first
sale,
and
has
opened
the
door
to
further
competitions
in
the
future.
Ultimately,
I
am
told,
George
wants
to
be
a
builder
and
a
farmer.
He
takes
a
practical
approach
to
his
learning
on
the
farm
with
his
dad
Paul
who,
needless
to
say,
is
incredibly
proud
of
everything
George
has
already achieved.
Mr
President,
it
is
so
fantastic
to
see
our
young
people
-
particularly
George,
here
-
with
so
much
dedication,
ambition
and
skill.
George
is
a
wonderful
example
of
a
person
with
humility,
achieving
great
things
by
working
hard,
taking
responsibility,
and
leading
by
example.
I
am
sure
we
will
hear
many,
many
more
stories
of
George's
successes
in
years
to
come.
I
commend
you,
George,
on
the
work
you
have
done,
and
thank
you
very
much
for
coming down today.
Members
- Hear, hear.
Reclink Australia
[11.12 a.m.]
Ms
HOWLETT
(Prosser)
-Mr
President,
I
thank
the
member
for
Launceston
for
sharing the lovely story of George with us - really lovely. Congratulations, George.
I
rise
to
discuss
some
of
the
terrific
work
provided
by
Reclink
Australia
in
Tasmania.
Reclink's
programs
are
evidence-based,
innovative
community
sport
and
recreation
programs.
Reclink
engages
some
of
the
most
at-risk
and
disadvantaged
people
in
our
communities,
including
those
with
mental
health
illness
and
drug
and
alcohol
addiction,
and
those
with
experience
of
domestic
violence,
homelessness,
long-term
unemployment,
social
isolation
and social economic disadvantage.
Research
from
the
Centre
for
Sport
and
Social
Impact
at
La
Trobe
University
shows
that
every
dollar
invested
in
a
Reclink
sports
program
generates
at
least
$8.94
million
in
social
value,
including
improved
physical
and
mental
health,
employment
outcomes,
lower
crime rates, and reduced risk of suicide.
Reclink
works
in
partnership
with
more
than
450
community,
government,
and
private
organisations
across
Australia,
with
74
member
organisations
in
Tasmania.
Some
of
its
member
organisations
include
TasTAFE,
migrant
resource
centres,
Anglicare,
the
Salvation
Army, Life Without Barriers, City Mission and Colony 47.
Programs
are
run
statewide,
working
with
some
of
our
most
disadvantaged
and
remote
communities,
such
as
New
Norfolk,
George
Town,
Brighton,
Bridgewater,
Burnie
and
Devonport.
Reclink's
mission
is
to
respond,
rebuild
and
reconnect.
It
seeks
to
give
all
participants
the
power
of
purpose.
In
the
last
financial
year,
Reclink
delivered
over
650
sport,
recreation
and art participation opportunities in Tasmania alone.
Reclink's
benefits
to
individuals
are
immeasurable,
and
I
urge
members
to
read
its
annual
report,
which
is
full
of
stories
about
recovery,
a
lot
of
personal
stories
about
reconnecting, and ultimately, wellbeing.
I
would
like
to
take
the
time
to
share
a
story
from
a
very
brave
individual
named
Cameron which reflects on the impact Reclink has had on his life -
●
From
the
age
of
8
to
28,
my
life,
and
my
mentality,
have
been
negatively
skewed
by
the
experiences
of
my
childhood,
my
transition
into
adulthood
and
the
constant
of
my
environment
and
those
who
have
I
chosen
to
associate with.
●
What
I
experienced
as
a
young
bloke
is
as
traumatic
as
it
gets.
And
I’ve
always
felt
like
that
has
been
a
fair
excuse
for
my
choices,
behaviors
and
the
gross
hatred
I
have
held
towards
people;
the
lack
of
trust
I
have
had
for
people in positions of authority; my inability to recognize happiness.
●
Scariest,
saddest,
and
most
important
to
the
last
20
years
of
my
life:
I
hated
myself.
●
Booze
wasn’t
enough
to
mask
how
low
I
felt.
Ecstasy
either.
You’d
think
speed would have pulled me up? Nope.
●
Ice
is
the
drug
that
had
me
most
removed
from
this
world
and
the
pain
I
was
in.
And
as
I
made
my
way
through
this
drug
cycle
of
inevitable
doom,
my
behaviors became more out of touch with a reality that I had never known.
●
I
stole
cars.
I
robbed
people.
I
was
in
and
out
of
prison.
I
became
numb
to
EVERYTHING: love, pain, discipline.
●
Living
a
pain
free
life,
by
way
of
addiction,
is
great.
Numb
is
a
good
feeling;
but
it
could
no
longer
be
at
the
expense
of
hurting
other
people
for
my
next
hit,
my
freedom,
and
the
one
thing
I
cherish
most
in
this
world:
a
relationship with my kids as a role model and father.
●
The
decision
to
walk
another
path
meant
embracing
my
pain
and
doing
it
in
a
clean environment.
●
Walking
into
the
Salvation
Army
Bridge
Program
was
one
of
the
toughest
days
of
my
life.
My
only
comfort
was
that
these
people
knew
how
to
deal
with pain like mine.
●
I
spent
12
weeks
as
a
live-in
participant,
where
I
was
solely
committed
to
improving
myself
as
a
human.
The
staff,
and
participants
of
this
program,
have
been
the
shining
light
I
required.
Shining
in
their
care
and
positivity.
But also shining brightly onto the areas I needed to improve.
●
The engagement of a psychologist has truly saved my life.
●
As
an
ice
addict,
I
would
often
hear
from
people
that
I
would
die
if
I
continued to use.
●
Death
wasn’t
even
registering
as
a
concern
for
me,
even
though
on
reflection
it seemed a likely outcome.
●
Being
able
to
verbalise
my
pain
and
experiences
to
someone
whose
sole
interest
is
helping
me
overcome
the
hatred
I
had
for
the
world,
and
myself,
has been the most powerful thing I could do.
●
During
a
Reclink
structured
program
as
part
of
the
Bridge
After
Care
Program
-
Croquet
at
Government
House
–
I
had
what
can
only
be
described as a utopian experience.
●
The
setting
of
the
Croquet
green
at
Government
House
captivated
me
in
a
way
I’d
never
experienced:
perfectly
maintained
grass,
gardens
and
the
most
magnificent
trees
-
with
the
shape
of
their
foliage
dangling
in
front
of
your face for you to sniff and play with.
●
I hadn’t experienced anything this naturally pure. It was breathtaking.
●
I
even
got
to
meet
the
Governor
herself.
Her
Excellency.
I
remember
telling
myself
'Her
Excellency,
don’t
call
her
anything
else'.
So,
after
I
called
her
‘Darlin,
and
she
didn’t
bat
an
eye
lid,
I
was
only
slightly
relieved!!
The
fact
she
continued
chatting
to
me
as
if
we
were
chums
from
another
life
only
added to the outer body experience I was living.
●
After that encounter, I found myself standing back and taking it all in.
●
We
were
joined
on
this
day
by
a
disability
group
from
Li-Ve
Tasmania.
And
what
struck
me
about
the
staff
and
participants
of
that
program
was
the
HAPPINESS
in
which
they
lived.
This
group
were
faced
with
more
barriers
and
challenges
in
their
life
than
I
ever
had.
And
whilst
I
had
spent
decades
wallowing
in
my
own
pain,
these
guys
and
girls
were
LIVING,
through
a
Reclink sport and recreation structured program.
●
I
can
still
remember
the
feeling
of
that
day.
It
was
the
first
time
in
as
long
as
I
could
remember
–
my
earliest
childhood
memories
-
that
I
was
anxiety
free.
No looping, yelling thoughts of self-loathing. No hate or rage.
●
What
I
was
involved
in
on
that
day
was
about
more
than
just
this
secret
garden;
this
was
a
realization
that
I
was
finally
surrounded
by
an
environment
that
I
could
be
myself
in.
One
that
embraced
me
and
would
pick me back up if I fell.
●
But
what
had
me
feeling
like
I
was
dreaming,
or
in
some
alternate
universe,
was the fact that I was recognizing HAPPINESS – my own secret garden.
●
This
was
a
true
turning
point
in
my
life,
and
you
know
what
–
I
am
finally
hearing the rest of that song too.
Reclink
undoubtably
continues
to
have
a
positive
impact
across
the
Tasmanian
community,
and
I
commend
everyone
involved
for
their
ongoing
efforts
in
changing
the
lives
of so many individuals.
Movember and Mental Health
[11.20 a.m.]
Dr
SEIDEL
(Huon)
-
Mr
President,
the
keen-eyed
honourable
members
of
this
House
may
have
noticed
a
slight
but
unusual
growth
of
facial
hair
on
the
member
for
Elwick
and
myself.
I
assure
honourable
members
that
this
is
entirely
seasonal,
but
also
for
a
very
good
cause.
It
is
not
intended
to
be
fashionable,
although
my
four-year-old
son
said
just
last
night,
'Oh,
Dada,
now
you
look
like
a
real
man!'.
It
is
the
season
of
Movember.
Every
year
since
2003,
men
around
the
world
grow
moustaches
to
raise
awareness
of
men's
health
issues.
Although
we
have
done
this
now
for
a
month
every
year
for
well
over
a
decade,
our
work
is
nowhere near to being done. That is why, in 2020, we are doing it again.
Movember
is
quintessentially
Australian,
conceived
by
Melburnians
Travis
Garone
and
Luke
Slattery
in
2003.
It
has
now
become
a
fixture
in
the
health
awareness
calendar
worldwide.
Back
in
2003,
though,
the
two
friends
inspired
others
to
charge
$10.00
for
growing
a
moustache
for
one
month
in
order
to
raise
funds
for
prostate
cancer
awareness.
They
found
30
of
their
friends
daring
to
'Grow
a
mo'.
The
next
year
they
already
had
450
'mo
brothers';
they
raised
$54
000.
In
2005,
over
9000
mo
brothers
raised
$1.2
million.
The
following
year,
the
Movember
Foundation
was
set
up
as
a
registered
charity.
The
official
tag
line
'Changing
the
Face
of
Men's
Health'
soon
resonated
internationally.
The
campaign
was
launched
in
New
Zealand,
in
the
United
Kingdom
and
in
Spain.
To
date,
there
are
active
campaigns
in
21
countries
worldwide.
Movember
has
raised
over
$730
million
and
funded
over
1000
men's
health programs.
Honourable
members,
growing
a
mo
is
prickly,
yet
fun.
Talking
about
men's
health
issues
is
actually
neither.
We
can
have
a
laugh
about
how
somebody
looks,
but
we
all
turn
quite
sombre
once
we
look
at
the
statistics
on
men's
health
in
Australia
and
in
our
state
in
particular.
And
it
is
not
all
about
cancer
and
cancer
awareness
-
coronary
heart
disease
remains
the
leading
cause
of
death
for
males
by
far.
Males
feel
invincible,
even
on
a
bad
day.
A
good
dose
of
male
optimistic
bias
means
that
going
to
the
doctor
to
have
a
heart
check
is
just not something my species considers necessary.
Men
literally
need
to
be
dragged
into
the
doctor's
office,
often
by
their
partners,
friends,
their
parents,
and,
increasingly,
by
their
concerned
children.
The
life
expectancy
of
a
boy
born
in
regional
Tasmania
is
now
79.2
years,
the
second
lowest
in
the
country.
Yet
if
you
were
born
in
Hobart,
your
life
expectancy
is
an
extra
year,
not
too
bad
for
a
slightly
different
postcode
in
the
same
state.
However,
the
gap
is
actually
widening,
based
on
the
most
recent
data
from
the
Australian
Bureau
of
Statistics
-
ABS
-
released
last
month.
Compare
that
further
to
the
life
expectancy
of
a
boy
born
in
East
-
it
is
actually
an
extra
five
years,
just
like
that.
If
you
want
to
see
hard
proof
of
health
inequality,
here
it
is,
in
black-and-white hard data.
I
am
not
here
to
accept
the
status
quo.
I
will
not
accept
we
cannot
overcome,
or
at
least
mitigate,
the
complex
social
determinants
of
health
in
our
state.
For
that
we
have
our
work
cut
out,
for
that
we
have
to
prioritise
health
on
a
policy
and
political
level.
Currently,
we
do
neither.
Health
budgets
have
become
sandpits
for
creative
accountants.
Health
policies
have
been
written
by
spin
doctors
rather
than
real
doctors.
Health
care
has
become
transactional.
The
needs
of
the
patient
are
no
longer
at
the
centre.
It
is
about
the
headline
in
the
media,
not
the
accomplished
health
outcome.
We
are
failing
Tasmanians,
and
we
are
failing
men
in
particular.
This
becomes
even
clearer
when
we
look
at
suicides
in
Tasmania.
More
than
350
suicides
were
reported
over
five
years
from
2012
-
four
times
as
many
Tasmanian
men
died
by
suicide
compared
to
women.
The
highest
rate
was
among
those
aged
45
to
54
years.
But
it
is
not
only
about
adult
men.
Suicide
is
the
leading
cause
of
death
in
teenagers
and
young
men
between
the
ages
of
15
and
24
years.
Imagine
a
young
life
lost.
At
what
stage
are
we
getting
serious
about
what
our
priorities
are?
At
what
stage
are
we
getting
serious
about
what
matters to our communities?
I
will
continue
to
raise
awareness
on
health
issues
and
health
inequalities.
Every
November
from
this
year
on,
and
for
as
long
as
I
am
in
parliament,
I
will
grow
a
mo
and
update
this
Chamber
on
the
progress
we
have
made
in
our
state
-
and
progress
we
will
have
to
make.
I
thank
the
members
for
Hobart
and
McIntyre
for
also
supporting
this
cause
through
a
generous donation this year.
Mr Valentine
- I just won some friends.
Dr
SEIDEL
-
I
gently
encourage
other
members
of
this
Chamber
to
follow
their
example. It is for a good cause. It is for a necessary cause. Let us make this work together.
Riverside High School - Redevelopment
[11.26 a.m.]
Ms
PALMER
(Rosevears)
-
Mr
President,
I
thank
you
for
the
lovely
warm
welcome
you
gave
Laura
Moore
when
we
first
arrived
here
today.
I
am
exceptionally
honoured
that
a
local
Launceston
businesswoman
who
is
so
respected
in
our
community
has
come
on
board
with
the
Legislative
Council
team
to
work
with
me
in
the
electorate
of
Rosevears,
which
is
also her home as well. Laura, lovely to have you here.
Mr
President,
smell
can
be
quite
a
powerful
stimulant.
It
can
revive
long-forgotten
memories
and
take
you
right
back
to
moments
in
your
life,
whether
those
moments
be
good
or
indeed
bad.
Last
month
I
had
the
opportunity
to
tour
my
old
school,
Riverside
High
School.
What
a
privilege
for
me,
as
a
former
student,
to
share
in
the
completion
of
the
school's
huge
redevelopment
and
to
have
my
young
son,
Charlie,
join
me.
I
attended
there
from
grade
7
through
to
grade
10,
commencing
in
1983
and
graduating
in
1986.
I
did
very
well
in
music,
drama
and
English,
not
so
well
perhaps
in
the
areas
of
science
and
maths.
Under
the
watchful
eye
of
then-principal
Ken
Hudman,
I
had
the
most
wonderful
memories
of
teachers
who
nurtured
and
inspired,
but
were
also
pretty
direct
and,
at
times,
brutally
honest.
When
my
mother
went
to
see
my
science
teacher
about
my
miserable
results,
he
told
her not to worry: 'Joanne will never work in the sciences. She is a people person.'.
While
many
things
have
changed
since
those
days,
the
smell
of
school
has
not.
I
was
immediately
taken
straight
back
to
the
1980s,
when
musk
perfume
ruled
and
the
cool
kids
-
of
whom
I
was
not
one
-
always
had
little
meat
pies
for
lunch.
Gone,
however,
were
the
old
grey
lockers
and
the
cold
lino
corridors
-
instead
replaced
with
durable
carpet
-
and
along
the
walls
were
lockers
in
shades
of
pinks
and
blues.
The
music
area
looked
more
like
a
recording
studio,
with
soundproof
booths
filled
with
instruments
-
vibrant
learning
spaces
with
great
natural
light.
As
for
the
canteen,
let
us
just
say
there
was
more
on
the
menu
than
little
meat
pies and hot cheese rolls. In fact, the school now boasts a cafe, which I believe serves salads.
There
is
a
new
foods
room,
which
I
used
to
call
the
home
economics
room,
which
has
been
designed
to
meet
industrial
standards.
How
incredible
for
our
kids
looking
at
a
career
in
the
hospitality
industry
to
have
access
to
such
a
facility.
A
new
senior
school
specially
designed
for
grades
9
and
10,
to
give
them
a
place
that
is
more
age
appropriate.
The
beautiful
art installations certainly captured the attention of my son.
Perhaps
a
stand-out
for
me
is
the
development
of
a
care
centre.
This
provides
a
student
support
area,
with
the
name
reflecting
the
school
values
of
courage,
aspiration,
respect
and
endeavour.
It
was
awesome
watching
the
current
year's
prefects
hosting
all
the
guests
who
were
enjoying
the
tour.
They
were
immaculately
presented,
and
they
knew
their
stuff,
but
it
was
the
pride
they
had
in
their
school
that
left
such
a
lasting
impression
on
me.
I
am
so
proud
of
my
old
school.
Along
with
many
other
former
students
from
decades
gone
by,
we
felt
so
connected
to
our
old
stomping
ground,
having
been
given
the
opportunity
to
walk
the
same
corridors we walked as kids.
I
offer
my
congratulations
to
principal
Natalie
Odgers,
and
thank
her
for
including
all
of
us oldies in the new beautiful-looking school and keeping us connected to our roots.
One
can
only
imagine
how
trying
it
was
for
teachers
and
students,
and
indeed
parents,
to
work
and
learn
in
the
middle
of
a
building
site,
but
their
patience
and
their
ability
to
adapt
has
certainly
paid
off
-
and
now,
what
an
incredible
learning
space
for
these
young
Tasmanians.
My
old
school
of
Riverside
High
has
a
long
history
of
achievement.
Who
knows
what
future
leaders,
athletes,
academics
or
indeed
future
educators
are
currently
walking
those
corridors?
Advancing Women in Industry Program
[11.31 a.m.]
(Murchison)
-
Mr
President,
today
I
wish
to
speak
about
a
successful
pilot
program
designed
to
support
women
who
are
interested
in
moving
into
the
mining,
manufacturing
and
energy
sectors.
Step
In
-
Advancing
Women
in
Industry
is
a
program
that
provides
participants
with
an
understanding
of
these
sectors,
as
well
as
industry-recognised
qualifications, which is an advantage when applying for positions in these sectors.
Shannon
Bakes
of
labour
hire
firm
Protech
-
or
formerly
of
that
company
-
initiated
the
program
when
he
recognised
a
problem
looming
with
a
shortage
of
workers
for
some
big
projects, which had either just started, or hopefully were soon to commence.
He
realised
that
women
were
an
untapped
resource
that
could
help
fill
the
shortfall
with
appropriate
encouragement
and
support,
and
so
Step
In
was
born
in
collaboration
with
the
Tasmanian
Minerals
and
Energy
Council,
Skills
Tasmania,
Elphinstone,
Grange
Resources,
SRTA Life and Rescue, and Productivity Improvers.
The
program
was
facilitated
by
Productivity
Improvers
and
involves
training
in
the
LEAN
method,
seminars
with
industry
leaders,
and
site
visits
to
places
including
Grange
Resources' Savage River mine.
The
20
participants
also
secured
units
of
competency
in
working
at
height,
confined
spaces
and
gas
detection.
The
participants
were
a
mix
of
younger
women
and
a
group
of
older women who wanted to do something for themselves.
One
of
the
participants
had
already
secured
a
job
when
the
celebration
day
was
held
on
11
September
to
present
their
statement
of
attainment
certificates.
I
was
extremely
pleased
to
be part of presenting the certificates to these women. That was a job in the sector.
I
would
like
to
recognise
Shannon
and
also
Michael
Bonney,
who
is
the
director
of
Productivity
Improvers,
for
standing
with
us
and
supporting
efforts
to
increase
the
numbers
of
women
in
such
male-dominated
workplaces.
It
was
through
the
support
of
others
like
Shannon
and
Michael
that
women
are
enabled
to
secure
higher
paid
and
often
more
secure
employment.
Sommer
Jeffrey
from
Devonport
completed
the
program
and
said
she
has
always
wanted
to
get
a
job
driving
huge
mining
trucks,
and
hopes
that
Step
In
will
bring
her
closer
to
her goal.
When interviewed by
The Advocate
after receiving her certificate, she said -
If
you're
looking
at
a
career
(in
mining
or
manufacturing),
then
definitely
do
this
course
because
it's
an
amazing
opportunity
to
show
up
the
boys
so
we
can do it too.
The
presentation
ceremony
was
held
at
the
Tasmanian
Minerals
and
Energy
Council
in
Burnie,
and
was
hosted
by
the
former
commercial
manager
at
Grange
Resources,
Jess
Richmond. She said -
Make
sure
you
take
the
opportunities
and
connections
you
make
through
this program and really grab hold of them and drive your own career.
People
Improvers
and
Protech
have
been
keeping
in
regular
contact
with
the
participants
since
the
completion,
and
are
committed
to
continuing
to
support
the
women
while tracking their journeys.
Two
months
after
the
formal
completion,
they
are
pleased
to
report
-
and
I
am
pleased
to inform the House that -
●
five
women
already
are,
or
are
listed,
to
contract
to
Grange
Resources
through contract hire;
●
two women have applied for and/or been interviewed by the Hellyer Mine;
●
two women have commenced directly with Grange Resources, truck-driving;
●
one woman has commenced in construction;
●
one woman has commenced in the VET training sector;
●
one
woman
has
been
interviewed
by
Hydro
Tasmania,
and
one
has
been
interviewed for an apprenticeship with William Adams;
●
one woman is seeking an electrical apprenticeship;
●
one
woman
has
decided
to
return
to
the
field
of
hospitality
on
the
west
coast,
where she came from.
●
one
woman
has
had
an
interview
with
Epiroc,
which
I
spoke
about
in
this
place
a
little
while
ago,
but
has
decided
to
pursue
a
career
in
dental
health
instead; and
●
one
woman
is
undertaking
on
a
heavy
rigid
licence
for
large
vehicle
driving
in construction or logistics.
Undertaking
the
Step
In
Program
has
resulted
in
16
of
these
women
having
applied,
been
interviewed,
or
commenced
employment
in
a
sector
they
previously
did
not
feel
equipped for, which is a huge tick for a program that only had 20 participants.
All
they
needed
were
some
formal
qualifications,
some
encouragement,
some
introduction
and
some
inspiration.
Step
In
provided
all
these
things.
The
NW
Industry
Inclusion
Group
intends
to
build
on
this
amazing
work
by
seeking
funding
and
industry
support
to
deliver
similar
programs
on
the
west
coast
and
in
Circular
Head,
and
working
with
partners to explore similar programs aimed at years 11 and 12 women.
I
hope
we
will
receive
support
for
these
programs
in
Thursday's
budget.
It
is
something
I
will
be
looking
for.
People
Improvers,
as
the
lead
agency,
will
maintain
a
mailing
list
of
women
around
the
state
who
are
interested
in
accessing
such
training
and
can
be
contacted
via
their
website
or
the
Facebook
page.
I
encourage
members
to
take
a
closer
look
at
this
innovative
and
successful
program
and
particularly
commend
Shannon
and
Michael
for
their
commitment to improving employment opportunities for north-west coast women.
RECOGNITION OF VISITOR
Tilly Diane
Mr
PRESIDENT
-
Honourable
members,
I
draw
your
attention
to
a
very
special
guest
in
our
Gallery
for
the
first
time
-
the
reason
being
that
our
special
guest
is
only
three
days
old
and
is
welcome
to
the
Chamber.
We
had
Ivy
a
short
time
ago
but
now
we
have
Tilly
Diane
[ok]
joining
us
today.
I
am
sure
members
will
welcome
Tilly.
She
may
not
remember
this
day, but it is wonderful to see so many young ones coming into our Chamber.
Members
- Hear, hear.
END-OF-LIFE CHOICES (VOLUNTARY ASSISTED
DYING) BILL 2020 (No. 30)
Consideration of Amendments made in the Committee of the Whole Council
[11.37 a.m.]
Mr GAFFNEY
(Mersey) - Mr President, I move -
That
the
bill,
as
amended
in
the
Committee,
be
now
taken
into
consideration.
Motion agreed to.
Suspension of Standing Orders
Mr GAFFNEY
(Mersey) - Mr President, I move -
That
so
much
of
Standing
Order
No.
284
be
suspended
in
respect
of
this
bill
so
as
to
allow
the
amended
clauses,
new
clauses
and
long
title
references
only to be called without a need for the amendments to be read again in full.
[11.37 a.m.]
(Murchison)
-
Mr
President,
I
want
to
speak
briefly
on
that
motion
because
I
acknowledge
we
do
not
normally
do
this.
Normally,
the
amendments
are
read
but
I
do
appreciate
the
work
the
Clerks
have
put
in
to
circulate
all
the
amendments
as
a
comprehensive
set
so
we
have
had
time
to
look
at
them.
Thus,
I
am
happy
to
support
this
motion
to
suspend
standing
orders.
It
would
normally
require
us
to
read
all
of
them
and
would take some time.
Motion agreed to.
Mr GAFFNEY
(Mersey) - Mr President, I move -
That the amended clauses, new clauses and long title references be read.
Motion agreed to.
Amended clauses, new clauses and long title references read.
Amendments agreed to.
Third Reading
[11.41 a.m.]
Mr GAFFNEY
(Mersey) - Mr President, I move -
That the bill, as amended in the Committee, be now read the third time.
Before
the
bill
is
read
for
the
third
time,
I
thank
very
much
the
members
of
this
place.
I
believe
the
Committee
stage
debate
was
robust,
informative
and
respectful.
Overall,
I
am
very
pleased
with
the
outcome
and
grateful
to
the
members
for
Huon,
Nelson,
Montgomery,
Murchison,
Hobart
and
Rumney
-
who
caused
about
140
of
those
amendments,
thank
you
for
that
-
for
their
considered
efforts
in
presenting
amendments
or
new
clauses
in
order
to
address
the evolution of the 144-clause bill to its current form.
I
have
genuinely
appreciated
the
contributions
of
all
members
in
this
place
throughout
the
second
reading
and
Committee
stages.
Mr
President,
there
have
been
moments
of
reflection
and
clarity
for
all
of
us
as
we
have
carefully
reviewed
the
comments
of
others.
I
thank
all
honourable
members
for
their
thoughts,
their
questions
and
feedback
through
the
entire
process,
which
I
acknowledge
has
been
relatively
extensive
and
has
involved
considerable
lobbying
from
stakeholders,
some
with
opposing
views.
I
look
forward
to
providing a few brief words after contributions from those members who wish to speak.
[11.42 a.m.]
(Murchison)
-
Mr
President,
I
appreciate
the
fact
that
we
have
had
some
time
since
our
last
sitting
to
fully
consider
the
whole
bill
as
amended.
I
certainly
appreciate
that,
because,
as
you
have
just
heard,
it
was
significantly
amended.
It
is
not
common
to
have
a
private
member's
bill
emanate
from
this
place
-
those
that
have
in
the
past
have
not
been
so
complex,
nor
contested
pieces
of
legislation
generally.
This
House
spent
many
hours
-
I
am
sure
the
Clerks
have
a
full
record
but
I
have
not
counted
them
up
-
debating
the
principle
of
the
bill
and
the
many
days,
including
additional
sitting
days,
to
consider the bill in the Committee stage.
Many
amendments
have
been
made
to
this
bill.
While
the
overall
number
is
not
really
important,
a
number
of
significant
policy
issues
were
extensively
debated
and
subsequently
defeated.
The
debate
has
been
important,
informative
and
on
the
record
for
all
who
wish
to
consider
it
and
view
it.
I
think
it
should
be
helpful
for
the
other
House
in
considering
the
bill
as it will, I expect, be presented to it.
I
also
appreciate
the
fact
that
members
did
not
support
the
suspension
of
standing
orders
when
we
last
sat,
as
with
such
a
heavily
amended
bill
we
do
need
time
to
properly
consider
the
whole
bill
as
amended.
I
also
appreciate
the
Clerks
putting
together
and
circulating
a
complete
list
of
the
amendments
that
were
agreed
to.
This
has
certainly
assisted
in
the
process
of
full
consideration
of
the
bill
as
amended
before
it
was
finally
agreed
to
and
transmitted to the House of Assembly for further consideration.
As
I
stated
in
my
second
reading
contribution,
I
have
always
struggled
with
the
ethics
of
voluntary
assisted
dying
and
ensuring
the
rights
and
safety
of
vulnerable
citizens
and
health
professionals.
Throughout
this
process,
this
uncertainty
has
remained.
I
have
done
all
I
can
to
ensure
this
bill
is
as
robust
as
it
can
be
at
this
time,
through
amendments
and
measures
to
address
some
of
the
areas
on
which
I
have
received
consistent
feedback.
I
respect
those
who
hold
the
view
that
you
cannot
make
such
a
process
rigorous
enough
to
protect
the
vulnerable,
including
those
with
disability,
the
aged
or
who
are
vulnerable
in
other
ways.
I
also
acknowledge
and
respect
the
views
of
those
who
hold
legitimate
concerns
regarding
the
role
of,
and
involvement
of,
health
professionals
in
such
a
process,
both
those
who
are
willing
to
participate
and
those
who
will
choose
not
to.
I
appreciate
and
accept
that
the
majority
of
Tasmanians
want
voluntary
assisted
dying
to
be
a
legal
option
if
they
are
facing
death
from
a
terminal
condition.
I
also
acknowledge
the
debate
regarding
access
for
residents
of
aged
care
facilities,
where
the
owners
or
operators
have
stated
they
will
not
support voluntary assisted dying in their facility.
I
agree
that
if
that
is
legal,
it
should
be
universally
accessible
and
as
this
bill
stands,
this
is
not
likely
to
be
the
case.
Members
will
recall
I
suggested
a
potential
option
to
achieve
this
but
decided
not
to
proceed
with
proposing
additional
amendments
at
this
point.
This
is
a
matter
that
could
be
considered
either
in
the
House
of
Assembly
when
it
is
debated
there
or
during the initial three-year review that is part of this bill.
My
key
concern
has
been,
and
continues
to
be,
the
role
of
and
impact
on
health
professionals.
This
concern
extends
to
both
those
who
seek
to
be
involved
and
those
who
hold
a
conscientious
objection.
I
believe
that
we
will
see
impacts
on
both
these
groups
of
health
professionals
and
it
will
be
vital
to
be
alert
to
these
impacts
and
to
ensure
appropriate
and adequate physiological support is provided.
It
is
also
important
that
there
is
a
clear
message
to
the
community
that
even
if
this
bill
passes
to
and
through
the
House
of
Assembly,
access
to
voluntary
assisted
dying
will
still
be
some
time
away
as
we
know
there
is
much
to
be
done
by
government
departments,
including
the
establishment
of
a
commission
for
voluntary
assisted
dying,
development
of
Tasmania-specific
training
programs,
development
of
the
required
processes
and
forms
to
record and progress the provisions of this bill, and many other measures that need to be done.
It
is
also
important
to
assure
the
public
that
whilst
a
person
will
not,
in
the
absence
of
an
exemption
from
the
commission,
be
able
to
formally
commence
the
formal
request
for
voluntary
assisted
dying
at
that
time,
the
option
to
access
this
can
be
discussed
with
health
professionals at any time once this becomes a legal option.
As
with
all
contentious
legislation
where
ethics
are
challenged,
misinformation
often
reigns
supreme.
I
hope
all
members
will
be
sure
to
be
factual
in
their
communications
regarding
the
reality
of
this
bill
when
describing
it
to
the
members
of
the
community
and
call
out
mistruths
that
we
will
no
doubt
continue
to
see
in
the
debate
in
the
House
of
Assembly
with a range of interest groups. I will not stand in the way of this bill despite my reservations.
[11.48 a.m.]
Mr
GAFFNEY
(Mersey)
-
Mr
President,
I
am
actually
excited
to
have
the
privilege
of
making
a
brief
contribution
and
provide
the
conclusion
in
this
place
to
the
third
reading
of
the
Tasmanian End-of-Life Choices (Voluntary Assisted Dying) Bill, for many reasons.
To
be
completely
frank,
there
were
times
throughout
the
journey
of
researching,
constructing,
preparing
and
presenting
the
bill
for
debate,
when
I
was
not
completely
certain
I
would
have
the
opportunity
at
this
time.
Of
course,
I
was
always
hopeful
the
bill
would
progress
to
this
stage
and
beyond
but
there
was
-
and
is
-
no
guaranteed
outcome.
It
would
not
have
been
wise
of
me
to
make
assumptions
in
respect
of
the
responses
of
members.
In
some
ways,
it
is
almost
a
'pinch
me'
moment.
After
two
years
of
regular
and
extensive
contact
with
international,
national
and
state
medical,
ethical
and
legal
experts,
hundreds
of
hours
of
drafting
and
review
by
the
Office
of
Parliamentary
Counsel,
community
forums
across
the
state,
numerous
briefings
and
very
rigorous
debate
in
this
place,
the
bill
has
been
strengthened and prepared for the final vote for the members in the Chamber today.
The
intent,
content
and
integrity
of
the
bill
have
been
refined
and
reinforced
by
valuable
amendments
that
have
undergone
very
thorough
debate.
Indeed,
some
amendments
and
new
clauses
which
were
suggested
and
defeated
were
debated
from
pillar
to
post.
It
is
also
an
exciting
day
for
so
many
people.
As
members
and
those
watching
may
recall,
in
my
second
reading
speech
-
which
seems
like
an
eternity
ago
-
I
spoke
of
the
extensive
history
of
the
bill
and
its
predecessors
in
this
state.
It
has
been
a
long
journey
with
some
considerable
bumps
in
the
road
since
the
first
bill
of
this
nature
was
tabled
in
2009,
or,
even
before
that,
when
a
parliamentary euthanasia committee inquiry was held in 1998.
I
acknowledge
once
again
the
efforts
of
those
who
have
worked
on
the
development
and
presentation
of
previous
bills,
and
the
tabling
and
discussion
of
each
iteration
of
voluntary
assisted
dying
legislation
that
has
led
us
closer
to
this
day.
Just
a
few
weeks
ago,
the
bill
was
voted
into
the
Committee
stage
which
in
itself
was
an
achievement.
To
members
in
this
place,
to
those
who
assisted
in
the
research
and
development
phases
of
the
bill,
to
those
who
have
worked
tirelessly
to
educate
and
advocate
for
your
community
such
as
Dying
with
Dignity
Tasmania
and
Your
Choice
TAS,
I
say
thank
you.
To
Tasmanians
who
may
be
listening
who
may
seek
assessment
for
the
VAD
process
in
the
future,
I
hope
this
legislation
most importantly allows comfort and solace for the challenges that lay ahead of you.
I
thank
everyone
for
their
efforts
and
their
patience.
To
the
Premier,
to
the
Government
and
to
the
members
in
the
other
place,
I
offer
my
support
and
assistance
whenever
and
wherever
it
may
be
desired.
In
recent
weeks
I
have
been
heartened
and
encouraged
by
a
number
of
requests
from
members
of
parliament
for
further
clarification
regarding
the
bill,
and in recent days I have been able to provide advice and information as requested.
This
process
has
been,
by
virtue
of
its
seriousness
and
significance,
a
substantial
and
lengthy
endeavour.
I
am
grateful
to
see
the
bill
presented
here
today
for
the
third
reading.
For
the
record,
as
entrenched
in
Hansard
,
I
want
to
publicly
recognise
Bonnie
Phillips,
my
most
amazing
friend
and
work
colleague,
who
has
been
forever
a
source
of
strength,
encouragement and reason. Words cannot express my depth of gratitude.
Members
-
Hear, hear
Mr
GAFFNEY
-
To
Mr
Phil
Spratt,
who
is
a
more
recent
addition
to
the
team,
you
have
assisted
us
greatly
in
this
process
and
I
thank
you.
To
my
wife,
Mel
and
my
family,
from
my
heart
I
thank
you
for
your
support
through
this
challenging
journey.
Like
other
families
in
Tasmania,
the
Gaffney
clan
will
continue
to
do
whatever
we
can
to
face
the
challenges
that
lay
ahead
of
us.
Finally,
after
a
very
long
road,
I
have
done
my
job
and
so
have
the
members,
my
colleagues
and
my
friends
in
this
Chamber.
I
am
so
proud
how
we
have worked and showcased our parliament to the rest of the world.
I
encourage
the
Premier,
the
Government
and
members
of
the
House
of
Assembly
to
sensitively
and
effectively
progress
this
legislation
in
a
timely
manner
so
all
Tasmanians
who
have
been
invested
in
this
journey
from
the
very
beginning,
can
take
pride
in
the
Parliament
of
Tasmania
and
understand
this
legislation
is
simply
aimed
at
helping
individuals
suffering
intolerably to find peace in a manner of their choosing surrounded by their family and friends.
I
encourage
all
members
in
this
place
to
vote
in
support
of
the
End-of-Life
Choices
(Voluntary Assisted Dying) Bill.
Mr
PRESIDENT
-
Honourable
members,
before
I
put
the
question,
I
commend
the
member
for
Mersey
for
the
amount
of
work
he
and
his
team
have
put
into
getting
this
bill
to
Chamber,
and
I
also
thank
every
member
for
the
respectful
way
and
amount
of
work
everyone
put
into
their
contributions
for
this
very
challenging
piece
of
legislation.
I
also
mention
the
wonderful
job
our
Chair
and
Deputy
Chair
did
of
keeping
control
through
what
was
a
very
complex
Committee
stage,
as
we
have
been
reminded,
with
the
number
of
amendments,
and,
of
course,
our
Clerk
and
Deputy
Clerk
for
doing
the
work
they
had
to
do
to
get
the
bill
into
the
order
in
which
it
is
presented
to
us
today.
It
shows
the
Legislative
Council
in
a
very
good
light
and
all
members
should
be
proud
of
what
they
have
done
through this process.
Bill read the third time.
MOTION
International Year of the Nurse and the Midwife
[11.55 a.m.]
(1)
That the Legislative Council notes:
(a)
The
World
Health
Organization
has
declared
2020
as
the
International Year of the Nurse and the Midwife;
(b)
Nurses
and
midwives
make
a
significant
contribution
to
all
areas
of
health
care,
wellness
promotion
and
illness
prevention, often working in challenging circumstances;
(c)
Nursing
and
midwifery
care
is
predominantly
provided
by
women;
(d)
Nurses
and
midwives
constitute
more
than
50
per
cent
of
the health workforce in many countries;
(e)
The
world
needs
nine
million
more
nurses
and
midwives
if
it is to achieve universal health coverage by 2030;
(f)
In
remote
areas,
nurses
and
midwives
are
often
the
first
and only point of care in their communities;
(g)
Strengthening
nursing
and
midwifery
will
assist
in
promoting
and
achieving
the
United
Nations
Sustainable
Development
Goals
(SDGs)
5
(Achieve
gender
equality
and
empower
all
women
and
girls)
and
8
(Promote
sustained,
inclusive
and
sustainable
economic
growth,
full
and
productive
employment
and
decent
work
for
all),
and
support other SDGs; and
(2)
That
the
Legislative
Council
recognises,
highly
values
and
thanks
all
Tasmanian
nurses
and
midwives
for
their
hard
work,
dedication and commitment to all areas of practice.
I
am
pleased
to
speak
on
this
motion
that
recognises
the
role
and
contribution
of
nurses
and midwives to the health and wellbeing of all citizens of the world.
When
I
initially
put
this
motion
on
notice,
it
was
before
the
impact
of
COVID-19
was
truly
apparent.
When
the
World
Health
Organization
-
WHO
-
made
a
decision
to
declare
this
year,
2020,
as
the
International
Year
of
the
Nurse
and
the
Midwife,
little
did
it
-
or
we
-
know
what
was
ahead
for
our
highly
regarded
and
highly
valued
professionals,
who
care
for
us
at
our time of need, our highly skilled, dedicated, professional and caring nurses and midwives.
Mr
President,
I
take
this
opportunity
to
speak
about
the
challenges
this
year
has
delivered
to
all
nurses
and
midwives,
acknowledge
their
contribution
to
our
health
and
wellbeing,
and
speak
to
other
aspects
of
challenges
facing
the
world,
especially
in
terms
of
workforce and resourcing challenges facing nursing and midwifery.
In
speaking
to
(1)(a)
of
the
motion,
I
note,
as
I
mentioned,
that
WHO
has
declared
2020
as
the
International
Year
of
the
Nurse
and
the
Midwife.
Every
year,
nurses
and
midwives
are
recognised for their work, professionalism and service, through two different events.
International
Day
of
the
Midwife
is
celebrated
each
year
on
5
May.
International
Nurses
Day
is
celebrated
on
12
May,
the
anniversary
of
Florence
Nightingale's
birth.
This
year was also the 200th anniversary of that date.
In
light
of
the
significant
anniversary
of
Florence
Nightingale's
birth,
WHO
declared
that
2020
would
be
the
International
Year
of
the
Nurse
and
the
Midwife.
While
no-one
could
have
foreseen
how
this
year
would
unfold
when
the
announcement
was
made,
in
many
ways
it could not have been more timely.
Each
year
the
day
is
recognised
with
a
theme.
This
year
the
theme
was,
'Nursing
the
world
to
health'.
Again,
very
relevant
given
that
nurses
around
the
globe
have
been
at
the
forefront of the fight against COVID-19.
Their
commitment
and
dedication
to
those
they
care
for
has
significantly,
and
certainly,
been
highlighted
throughout
the
COVID-19
pandemic.
However,
rather
than
being
able
to
celebrate
this
international
acknowledgement
of
the
professions
of
nursing
and
midwifery,
nurses
and
midwives
are
working
harder
than
ever,
in
very
frightening
and
challenging
and
times
and
circumstances.
There
was
no
time
or
opportunity
to
have
a
celebratory
event
in
person as COVID-19 spread quickly and destructively around the world.
Right
from
the
start
of
the
outbreak
in
Australia,
nursing
organisations
stepped
up
and
were
involved
in
implementing
strategies
to
contain
the
virus.
Indeed,
thousands
of
nurses
around
the
world
volunteered
to
assist,
in
any
way
they
could,
with
many
coming
out
of
retirement
or
planned
absences
from
the
workplace
-
a
clear
and
unsurprising
demonstration
in
itself
of
the
courage
and
compassion
of
the
nursing
and
midwifery
professions.
This
came
at considerable cost, with many nurses and midwives losing their lives.
While
we
have
been
fortunate
in
that
regard
in
Australia,
our
healthcare
workers
have
concerns
regarding
the
safety
of
caring
for
patients
with
COVID-19,
which
partly
relates
to
the highly publicised reports of healthcare workers dying from the virus overseas.
This
is
particularly
important
in
Tasmania
where
we
have
an
ageing
workforce,
with
many
currently
practising
nurses
and
midwives
at
risk
of
serious
health
outcomes
if
they
were
to contract COVID-19.
The
concern
has
also
caused
high
levels
of
anxiety
in
many
health
workers
around
the
use
of
personal
protective
equipment
-
PPE
-
outside
the
government
guidelines.
Many
were
seeking
exemptions
from
being
involved
in
the
care
of
patients
with
COVID-19
in
the
early
days of the outbreak.
I
acknowledge
the
reports
of
healthcare
workers'
deaths
overseas
generally
do
not
actually
explore
whether
the
infection
was
contracted
caring
for
patient
or
through
community contact, or whether appropriate PPE was worn.
However,
we
do
know
that
in
the
case
of
the
North
West
Regional
Hospital
outbreak,
most transmission was within the hospital, in their work setting.
It
goes
without
saying
that
being
in
such
close
contact
with
COVID-19-positive
patients
and
providing
direct
health
care
increases
the
risk
of
transmission,
even
when
using
all
the
appropriate PPE. This was demonstrated in the Australian experience.
Of
the
Australian
cases,
it
was
reported
that
as
at
the
end
of
August,
some
70
per
cent
of
the
second
wave
COVID-19
infections
in
health
workers
in
Victoria
was
acquired
through
their
work.
Doctors
comprise
5
per
cent
-
106
health
worker
cases
through
July
and
August
and
63
doctors
are
thought
to
have
been
infected
at
work
in
this
period.
Nurses
make
up
around
40
per
cent,
or
922,
of
those
healthcare
workers
and
those
who
care
for
older
people
make
up
another
40
per
cent,
924.
It
is
not
because
they
are
not
doing
the
right
thing;
it
is
because the risk of exposure and infection are just so very real.
As
I
stand
here
today,
I
note
and
acknowledge
the
extraordinary
efforts
by
the
Victorian
Government
in
containing
its
COVID-19
outbreak
-
it
is
11
days
in
a
row
of
what
they
are
calling
the
'double
doughnut'
-
zero
cases
and
zero
deaths.
I
know
the
impact
COVID-19
has
had
on
the
mental
health
and
wellbeing
of
many
people
in
our
state,
particularly
our
health
professionals.
Every
day
I
see
those
figures,
I
feel
I
just
want
to
cry
tears
of
relief
again
and
again
and
again.
Talking
to
my
family
in
seeing
the
little
boys'
faces
on
FaceTime
when
they
are
actually
out
at
the
pub
having
a
parmie
and
chips
is
a
delight
to
behold
that
I
never
thought
I
would
appreciate
as
much
as
I
do
now.
I
am
just
hoping
to
be
able to visit them soon.
To
think
that
Victoria
can
go
from
700
and
whatever
cases
down
to
zero,
and
stay
at
zero,
with
so
many
tests
being
done
is
a
true
testament
to
the
people
of
Victoria
and
the
leadership
of
Dan
Andrews,
Brett
Sutton
as
his
chief
health
officer
and
everyone
who
worked
on
that.
I
keep
thinking
there
will
be
a
day
when
there
are
one
or
two.
There
will
be,
I
am
sure
there
will
be,
at
some
stage
with
returned
travellers
or
whatever,
but
I
want
to
commend
them.
So
many
nurses
and
other
health
professionals
have
been
deeply
impacted
by
that.
I
have
a
son
who
is
a
doctor.
He
worked
on
the
COVID-19
ward,
and
he
worked
in
the
COVID-19
testing
stations.
Thankfully,
he
has
not
contracted
COVID-19,
but
the
risk
is
very
real.
Even
my
family
there
who
could
have
potentially
visited
him
because
they
live
within
the
5-kilometre
radius
did
not
because
it
put
them
at
risk.
It
has
been
a
really,
really
tough
time for everybody, all Victorians.
Mr Valentine
- They have a few more than 500 000 to deal with too, haven't they?
-
That
is
right.
They
have
all
sorts
of
density
issues
and
people
who
come
from
non-English-speaking
backgrounds,
to
whom
it
is
more
difficult
to
get
the
messages
to.
We
did
not
have
those
same
challenges
in
our
state,
which
we
can
only
be
thankful
for,
that
we
did
not
have
to
deal
with
some
of
those
very
difficult
challenges.
However,
I
know
the
pressure
that
was
on
the
nurses
in
the
North
West
Regional
Hospital
and
the
North
West
Private
Hospital
at
that
time.
We
can
only
imagine
how
that
must
be
even
more
so
for
all
the
medical
staff
-
and
the
nurses
and
midwives
-
who
have
worked
in
Victoria
during this period.
In
Tasmania,
we
saw
all
staff
from
the
North
West
Regional
Hospital
and
the
North
West
Private
Hospital
and
their
households
quarantined
for
14
days
during
the
outbreak
on
the
north-west
coast.
This
was
indeed
a
worrying
time
for
our
healthcare
workers,
but
also
for
their
families.
During
the
outbreak
-
I
am
sure
members
will
recall
the
decision
to
close
the
two
hospitals
and
the
related
medical
services
impacted
approximately
1300
staff
and
their
household
members,
an
estimated
total
of
about
between
3000
and
4000
people.
That
is
a
lot
of
people
in
our
community.
As
the
Leader
knows,
it
is
a
significant
number
of
people
who were directly impacted; it took a lot of people out of the workforce.
This
was
an
unprecedented
action.
I
hate
using
that
word
but
it
is
appropriate
at
times;
it
is
a
bit
overused
this
year.
That
has
never
been
done
in
this
state
before;
we
have
never
closed
down
a
hospital.
There
are
some
hospitals
in
this
state
you
simply
could
not
close.
You
could
not
close
the
Royal;
you
really
could
not
close
the
LGH.
But
we
were
lucky
to
be
able
to
do
that
because
we
were
fortunate
to
be
able
to
transfer
the
care
of
the
patients
who
did
need
ongoing
care
to
the
Mersey
Community
Hospital
and
the
Launceston
General
Hospital.
I
am
really
grateful
the
Premier
was
willing
to
take
that
action
and
take
it
so
decisively
and
quickly.
It
was
not
easy
for
anyone
who
was
impacted
by
this,
but
I
am
eternally grateful that decision was made.
Again,
I
wish
to
acknowledge
the
extraordinary
efforts
of
nurses
and
midwives
at
both
the
Mersey
Community
Hospital
and
the
Launceston
General
Hospital
who
took
care
of
our
north-west
residents
and
birthing
women
at
an
extremely
stressful
and
anxious
time
for
all.
It
was
really
tough
on
the
midwives
of
the
LGH
as
you
cannot
put
off
a
birth
-
those
women
had
to
move
up
with
their
families
to
live
in
a
hotel
while
they
awaited
the
birth
of
their
baby,
sometimes
with
other
children.
Some
of
them
did
not
have
a
lot
of
family
support
back
on
the
north-west
coast
and
the
children
were
not
allowed to visit their mum in hospital.
Their
partner
was
limited
in
the
support
he
could
provide
during
that
period.
The
midwives
were
looking
after
women
from
the
Launceston
area
-
the
normal
catchment
area
-
as
well
as
women
from
the
north-west
and
everyone
was
anxious,
everyone
was
nervous,
everyone
was
worried
about
a
COVID
case
coming
from
the
north-west.
We
were worried about it.
I
commend
and
acknowledge
all
medical
staff
in
this
enormously
stressful
and
difficult
time,
but
we
are
talking
about
nurses
and
midwives,
who
were
looking
after
cardiac
patients
who
came
from
the
north-west;
again,
the
stress
was
enormous
for
all
of
them.
In
Tasmania,
by
21
April,
a
total
of
114
people
had
acquired
COVID-19
associated
with
the
north-west
outbreak,
including
73
hospital
staff
members,
22
patients,
and
19
others,
including
household
contacts.
We
had
the
highest
per
head
of
population
infection
and
death
rate
at
this
time
in
the
nation.
We
were
the
pariah
of
the
nation.
Unfortunately,
this
led
to
some
very
unfortunate
vilification
of
our
dedicated
and
caring
nursing
and
midwifery
staff
from
fellow
Tasmanians
and,
even
worse,
the
unsubstantiated
and
untrue
public
assertions
by
the
national
Chief
Medical
Officer
and
the
Prime
Minister.
This
was
a
disgraceful
slur
and
significantly
impacted
all
healthcare
workers
in
this
region
and
caused
significant
harm.
I
still
do
not
believe
there
has
been
a
full
and
proper
apology
for
those
comments,
but
it
was
the
most
disgraceful
display
by
the so-called leaders of this country.
Unless
you
were
a
frontline
worker
at
the
time,
you
cannot
really
appreciate
the
stress
and
anxiety
associated
with
working
in
an
environment
with
a
deadly
virus,
especially
when
many
of
the
health
workers
were
in
'at
risk'
categories
themselves.
Mr
President,
I
personally
thank
all
our
healthcare
professionals,
especially
our
nurses
and
midwives
in
this
year
that
was
set
aside
to
recognise
their
work
and
role
in
caring
for
us
in
our
time
of
need.
I
believe
we
should
unite
and
stand
behind
and
beside
our
nurses
and
midwives
who
continue
to
work
under
extraordinary
pressure
at
times
-
in
fact,
most of the time.
As
we
know,
even
before
COVID-19,
our
nurses
and
midwives
were
working
under
extreme
pressure
through
years
of
underfunding
of
health
services.
The
rates
of
overtime,
including
double
shifts,
have
been
for
a
very
long
time,
and
continue
to
be
in
many
places,
unacceptable.
This
is
not
at
all
good
for
the
general
or
mental
health
and
wellbeing of our nurses and midwives.
The
Government
has
an
obligation
to
properly
fund
the
health
system
and
ensure
there
is
an
adequate
workforce
to
avoid
the
need
for
double
shifts
and
overtime
as
the
norm.
Again,
I
will
be
looking
forward
to
what
we
see
in
the
budget
on
Thursday
in
relation
to
funding
of
health
services,
and
then
of
course
budget
Estimates.
This
leads
me to point (1)(b) of the motion -
Nurses
and
midwives
make
a
significant
contribution
to
all
areas
of
health
care,
wellness
promotion
and
illness
prevention,
often
working
in challenging circumstances;
As
I
said,
this
year,
instead
of
celebrating,
nurses
and
midwives
around
the
world
are
working
harder
than
ever,
often
in
tragic
circumstances
to
care
for
people
wherever
they
are
in
the
world.
Despite
this,
nurses
and
midwives
have
still
been
acknowledged
in other ways.
Here
in
Tasmania,
for
example,
the
Australian
Nursing
and
Midwifery
Federation,
Tasmania
Branch
in
collaboration
with
the
New
Zealand
Nurses
Organisation
held
an
online
candlelit
vigil
on
the
evening
of
12
May
to
commemorate
the
dedication
of
colleagues lost to the virus all around the world, because we are one united profession.
During
2020,
we
have
been
reminded
more
than
ever
that
nurses
play
a
critical
role
in
health
promotion,
disease
prevention,
and
the
delivery
of
primary
and
community
care,
as
well
as
in
emergency
settings.
In
some
communities,
nurses
and
midwives
may
be
the
only
health
professionals
people
see,
and
so
their
initial
assessment,
care
and
treatment
are
vital.
We
saw
nurses
and
midwives
return
to
the
workforce
to
ensure
there
were
enough
to
provide
the
care
needed
by
Tasmanians.
They
worked
in
COVID-19
testing
clinics
outside,
in
the
winter,
literally
working
in
wind
tunnels,
for
days
on
end.
The
day
I
had
my
test
in
Burnie,
before
I
came
back
to
parliament,
the
tunnel
was
direct
north
to
south.
The
wind
was
howling through by the old Parkside building.
Mrs Hiscutt
- I can confirm it is the same over here.
-
The
nurses
were
there
day
in,
day
out,
and
I
commend
all
the
members
of
the
public
for
fronting
up
and
being
tested.
It
was
so
important
to
our
effort.
These
nurses
were
really
finding
it
pretty
tough,
because
it
was
winter,
and
then
it
was
moved
down
to
Wrest
Point,
which
is
just
as
bad
down
there,
because
you
have
that
wind
straight
off
the sea. Anyway, it is always cold in the winter.
Nurses
also
ran
drive-through
immunisation
clinics
to
ensure
as
many
people
as
possible could have access to the flu vaccine in a timely manner.
According
to
the
Australian
Department
of
Health
National
Health
Workforce
Data,
in
2019
the
Nursing
and
Midwifery
registered
workforce
was
399
364,
with
5532
non-practising
-
comprising
300
040
registered
nurses,
62
281
enrolled
nurses,
as
well
as
22
574
with
dual
registration, and 5586 registered as a midwife only.
This
workforce
covers
some
27
areas
of
work,
ranging
from
aged
care
and
medical
-
which
are
the
main
job
settings,
80
000
-
through
to
community
nursing,
child
and
family
health (including prenatal and postnatal care), research and health promotion.
Nurses
and
midwives
are
seen
as
people
who
devote
their
lives
to
caring
for
mothers
and
children,
giving
life-saving
immunisations
and
health
advice,
looking
after
older
people
and generally meeting everyday essential health needs.
We
know
that
maternal
and
neonatal
outcomes
are
better
with
care
provided
that
is
from
a
known
midwife,
providing
continuity
of
care.
Maternal
satisfaction
with
childbirth
is
also
greater, and successful breastfeeding enhanced in these continuity-of-care models.
They
also
play
a
vital
role
in
shaping
the
overall
health
and
wellbeing
of
their
communities, and will be a key to the achievement of universal health coverage.
The
World
Health
Organization
is
a
collaboration
partner
with
the
global
Nursing
Now
Campaign,
which
aims
to
improve
health
globally,
by
raising
the
status
and
profile
of
nursing,
strengthening
the
profession,
and
maximising
its
contribution
to
achieving
this
universal
health coverage.
Along
with
the
International
Council
of
Nurses,
this
partnership
released
the
State
of
the
World's
Nursing
Report
-
2020
on
World
Health
Day,
7
April.
This
report
provides
a
compelling
case
for
the
value
of
the
nursing
workforce
globally.
Global
strategic
directions
have
been
set
out,
with
four
broad
overarching
themes
to
work
towards
to
improve
global
health. They are -
●
ensuring
an
educated,
competent,
motivated
workforce
within
effective
and
responsive health systems at all levels and in different settings;
●
optimising
policy
development,
effective
leadership,
management
and
governance;
●
maximising
the
capacities
and
potential
of
nurses
and
midwives
through
professional
collaborative
partnerships,
education
and
continuing
professional
development; and
●
mobilising
political
will
to
invest
in
building
effective
evidence-based
nursing and midwifery workforce development.
Nursing
organisations
and
other
stakeholders
have
been
engaged
with
this
process
of
shaping the future of health care and will continue to do so.
Part
(1)(c)
of
the
motion
states
that
nursing
and
midwifery
is
predominantly
provided
by
women.
Nursing
remains
a
highly
gendered
profession,
with
approximately
90
per
cent
of
the
nursing
workforce
being
female,
and
as
such
attracts
all
of
the
associated
workplace
biases,
such
as
the
gender-based
pay
gap
and
few
leadership
positions
in
health
being
filled
by women.
There
are
legal
protections
in
place
in
most
countries
covering
hours
and
conditions,
but
there
is
not
necessarily
equity
across
regions.
Nurses
and
midwives
are
at
the
forefront
of
caring
for
people
who
are
often
very
vulnerable,
stressed,
in
pain,
and
under
the
influence
of
drugs and/or alcohol. The risk of abuse and assault is very real.
It
is
almost
horrifying
to
note
that
according
to
a
World
Health
Organization
report,
only
37
per
cent
of
countries
have
measures
in
place
to
assist
in
prevention
of
attacks
on
health workers.
As
with
many
female-dominated
positions,
nursing
struggles
to
attract
male
recruits,
although
men
have
been
taking
care
of
patients
and
have
been
in
the
health
industry
all
around
the
world
as
far
back
as
medieval
times,
where
there
is
recorded
evidence
of
male
skill and care.
Interestingly,
there
are
male
patron
saints
of
nursing,
among
them
St
Camillus,
who
came
to
understand
suffering
and
illness
as
both
a
patient
and
a
servant
in
a
hospital
for
incurables.
After
becoming
a
priest,
he
founded
a
religious
order
to
serve
prisoners
and
to
nurse
people
dying
with
the
plague.
St
John
of
God
is
said
to
have
turned
his
life
into
caring
for
the
indigent,
unwanted
and
infirm.
However,
the
nursing
profession
itself
remains
predominately
female,
and
honouring
and
recognition
of
women
who
have
given
so
much
in
this field is very limited.
The
dominance
of
women
in
the
nursing
and
the
midwifery
professions
can
be
attributed
in
part
to
issues
such
as
status
and
pay.
It
is
also
a
result
of
the
gender-role
stereotyping
of
the
profession.
Although
the
number
of
males
in
nursing
has
been
increasing
recently, feminisation of nursing is still the norm.
Florence
Nightingale
considered
nursing
as
a
suitable
job
for
women
because
it
was
an
extension
of
their
domestic
roles.
I
am
not
overly
a
fan
of
Florence,
I
must
say.
Her
image
has
portrayed
a
nurse
as
a
subordinate,
nurturing,
domestic,
humble,
self-sacrificing
individual.
I
was
never
so
confident
as
when
I
was
accused
of
being
the
most
insubordinate
person this obstetrician had ever met when I stood up to him -
Members
interjecting.
-
We
were
having
a
discussion
about
a
particular
matter
regarding
the
care
of
a
woman,
and
he
said
that
to
me.
Without
thinking
-
it
was
the
middle
of
the
night
when he said that - I said, 'Why, thank you.'.
To
me
it
was
the
biggest
compliment
he
could
have
paid
me
-
that
I
was
not
subordinate
to
him.
I
was
a
professional
in
my
own
right,
caring
for
a
woman
in
the
way
that
was
most
appropriate.
He
was
a
locum
who
should
have
known
better.
I
do
not
think
he
came
back.
Midwives are terrible, aren't they?
Mr Valentine
- Maybe he learned from the experience.
-
I
am
hoping
he
did.
I
could
tell
you
the
whole
story
at
another
time
because it was quite funny.
That
image
that
has
been
portrayed
through
Florence
Nightingale's
stance
and
the
way
she portrayed nursing has done a big disservice to nursing over the years in that regard.
The
social
construction
of
what
it
means
to
be
a
nurse
has
typically
been
the
opposite
of
characteristics
attributed
to
men
in
society.
Sadly,
and
inappropriately,
men
who
enter
nursing
typically
face
questions
about
their
masculinity
or
their
sexuality.
That
is
fundamentally
wrong
and
flawed.
There
are
many
fantastic
male
nurses.
We
just
do
not
have
many of them.
An
article
in
the
Health
Science
Journal
examined
gender
perceptions
for
both
female
and
male
students
in
relation
to
male
nursing
roles
in
Turkey,
and
noted
that
sociologists
had
described
sex
role
socialisation
as
being
'instrumental'
for
men,
and
'expressive'
for
women.
The
characteristics
of
instrumental
socialisation
include
aggressiveness,
and
the
ability
to
compete
and
to
lead,
and
to
wield
power
to
accomplish
tasks.
These
are
attributes
that
have
traditionally
been
accepted
as
male
traits,
while
expressive
socialisation
includes
learning
to
nurture,
to
be
affiliative,
and
to
be
sensitive
to
the
needs
of
others,
which
are
more
often
seen
as
female
personality
traits.
Therefore,
in
patriarchal
cultures
such
as
Turkey,
the
value
given
to women and their place in society is naturally reflected in the nursing profession.
This
also
presents
particular
problems
to
the
image
of
nursing
as
a
career.
The
article
concluded
that
nursing
continued
to
be
seen
as
a
female-dominant
position,
especially
by
male students, despite the increasing numbers of men in nursing -
Having
physical
power
was
seen
as
a
reason
for
male
students
to
occupy
administrative
positions.
Masculinity
and
dominant
characteristics
of
the
male
students
possibly
affect
their
desire
to
occupy
administrative
positions
after
graduation.
Further
studies
need
to
describe
the
reasons
for
males
to
choose
nursing
as
a
career
and
their
positions
in
their
workplaces
after
graduation.
That
is
part
of
the
reasons
behind
the
gender
pay
gap
in
nursing,
that
even
though
it
is
predominantly
a
female
workforce,
more
men
who
take
on
nursing
end
up
in
the
higher
paid
administrative and senior management roles.
A
separate
study
commissioned
by
the
Nursing
Now
Campaign
looked
at
barriers
to
health
leadership
positions
and
described
not
only
a
'glass
ceiling'
for
women,
but
also
a
'glass
elevator'
for
men,
saying
men
hold
disproportionately
higher
numbers
of
senior
nursing
and
management roles.
I
have
spoken
regularly
before
about
the
gender
pay
gap
and
this
reality
sits
below
the
gender
pay
gap
in
a
female-dominated
sector.
While
in
some
industries,
the
gender
pay
gap
is
narrowing,
which
is
a
really
positive
thing,
it
has
increased
in
the
healthcare
and
social
assistance sector, the sector that employs more women than any other.
Financy,
a
website
dedicated
to
women's
finances,
said
in
2018
that
the
healthcare
and
social
assistance
sector
has
the
biggest
pay
gap
increase
of
any
industry.
We
clearly
have
work
to
do
there.
While
there
are
significantly
fewer
men
in
the
sector,
they
tend
to
occupy
more leadership positions according to the founder of the website, Bianca Hartge-Hazelman.
The
Sydney
Morning
Herald
reported
on
this
in
October
2018,
providing
the
example
of
a
neonatal
nurse
who
was
then
working
in
a
major
neonatal
unit
in
This
is
where
they
have
the
sickest
babies.
The
nurse,
whose
name
was
Emma,
worked
shifts
and
regularly
had
to
resuscitate
really
sick
tiny
newborns
as
part
of
her
job.
This
work
took
a
physical
as
well
as
emotional
toll
on
her.
She
believed
she
was
underpaid
compared
to
the
male-dominated
trades
such
as
construction,
because
she
is
paid
less
than
a
construction
worker.
How
can
that
be
the
case
when
she
is
saving
babies
lives
day
in,
day
out?
We
saw
a
little
baby
in
the
Chamber
here
today.
Three
days
old
-
you
know
how
precious
they
are.
Sadly,
it
appears
gendered
notions
of
nursing
and
nurses
are
still
standing
in
the
way
of
efforts to improve the standing and attractiveness of nursing as a career.
A
study
commissioned
by
the
Royal
College
of
Nursing
in
the
United
Kingdom
found
the
pay
of
registered
nurses
is
81
per
cent
of
the
sector
average,
which
includes
health
professionals,
allied
health
professionals,
health
managers
and
directors,
and
therapeutic
and
technical staff.
They
found
also
the
pay
of
registered
nurses
is
characterised
by
little
variation
in
earnings
across
the
nursing
workforce,
despite
the
wide
range
of
roles,
responsibilities
and
levels
of
seniority.
This
suggests
there
is
a
low
scope
for
progression
and
higher
earnings
across
nursing
careers,
and
career
structure
is
one
of
those
things
that
is
a
significant
deterrent.
They
also
found
among
nurses
the
gender
pay
gap
amounts
to
17
per
cent
on
a
weekly
basis - 17 per cent. Female nurses make up less than a third of senior positions.
As
a
society
we
continue
to
see
care
giving
as
a
naturally
feminine
skill
or
characteristic
while
nursing
is
a
highly
clinically
skilled
line
of
work,
and
all
nurses
are
required
to
have
degrees, according to one of the authors of the report I just mentioned.
If
we
are
to
meet
the
increasing
need
and
demand
for
nurses
worldwide,
we
need
to
improve
wages
and
conditions
and
ensure
the
profession
is
being
sufficiently
valued
and
receives the recognition it deserves.
Point 1(d) of the motion states -
Nurses
and
midwives
constitute
more
than
50%
of
the
health
workforce
in
many countries;
Nurses
and
midwives
account
for
approximately
50
per
cent
of
the
global
health
workforce
and
as
a
percentage
of
total
health
professionals
-
that
is,
medical
doctors,
nurses,
midwives,
dentists and pharmacists - nurses make up just under 60 per cent globally.
This
workforce
is
expanding
in
size
and
professional
scope
according
to
a
World
Health
Organization
report.
However,
the
expansion
is
not
equitable
and
some
populations
are
getting
left
behind.
Data
from
191
countries
show
a
global
supply
of
28
million
nursing
personnel.
This
would
indicate
a
density
of
36.9
nurses
per
10
000
population,
but
there
are
wide
variations
across
the
regions.
Over
80
per
cent
of
the
world's
nurses
are
found
in
countries that account for half the world's population.
In
2018,
it
was
estimated
to
be
a
global
shortage
of
just
under
6
million
nurses,
with
almost
90
per
cent
of
that
shortage
being
in
low
and
middle
income
countries,
where
the
growth in nurses can barely keep up with the population.
Countries
in
the
African,
South-East
Asian
and
eastern
Mediterranean
regions
and
some
parts
of
Latin
America
have
a
low
density
of
nursing
personnel
-
less
than
10
per
10
000
population.
Australia,
most
of
the
Americas
and
most
of
the
European
region
have
a
higher
density
of
nurses
ranging
from
between
75
to
99
to
100
plus
per
10
000
population.
From
10
per
10
000
population
to
up
to
over
100,
that
is
a
significant
difference
in
our
countries.
The
international
mobility
of
the
nursing
workforce
is
increasing
-
COVID-19
excepted
-
which
adds
to
further
challenges
to
an
equitable
distribution
and
retention
of
nurses
in
the
regions
where we need them the most.
One
could
argue
we
should
not
be
looking
to
recruit
nurses
and
midwives
from
other
countries
who
have
limited
capacity
to
educate
and
train
their
own,
as
they
are
needed
in
those
countries.
We
should
be
training
and
employing
more
of
our
own
nurses,
rather
than
taking
them
from
developing
nations,
the
same
with
medical
professions.
Additional
investments
in
nursing
education
in
lower
and
middle
income
countries
is
needed.
We,
as
a
wealthy
nation,
should
support
this.
The
World
Health
Organization
recommends
the
implementation
of
a
global
code
of
practice
to
improve
the
monitoring
and
regulation
on
international
nurse
mobility.
This
is
referred
to
in
the
World
Health
Organization
report,
State
of
the
World's
Nursing
Report
2020
,
and
supports
my
previous
comment.
The
report
suggests
-
[countries
that
are]
over
reliant
on
migrant
nurses
should
aim
towards
greater
self-sufficiency
by
investing
in
more
domestic
production
of
nurses.
Countries
experiencing
excessive
losses
of
their
nursing
workforce
through
out-migration
should
consider
mitigating
measures
and
retention
packages,
such as improving salaries, pay equity and working conditions.
We all have a responsibility in that as a country, even as a state, in our recruitment.
There
is
a
chronic
undersupply
of
nurses
and
midwives
that
would
be
needed
to
achieve
universal health coverage. As point (1)(e) states -
The
world
needs
9
million
more
nurses
and
midwives
if
it
is
to
achieve
universal health coverage by 2030;
The
World
Health
Organization
estimates
the
world
needs
18
million
more
health
workers
to
achieve
this,
and
that
is
approximately
half
the
shortfall
of
9
million
health
workers
who
are
nurses
and
midwives.
The
State
of
the
World's
Nursing
Report
2020
calls
for
an
urgent
investment
in
the
profession
in
order
to
deliver
universal
health
coverage
and
recognises
the
unique
role
that
nurses
play,
as
evidenced
by
the
courage
and
compassion
on
display
around
the
globe
during
the
current
COVID-19
pandemic.
It
also
calls
for
a
massive
acceleration of education, training and leadership in the sector.
The following recommendations were made to all countries -
●
to increase funding to educate and employ more nurses
●
strengthen capacity to collect, analyse and act on data about health workforce
●
educate
and
train
nurses
in
the
specific
technological
and
sociological
skills
they need to drive progress in primary health care
●
establish
leadership
positions,
including
a
government
chief
nurse,
and
support leadership development among nurses.
Tasmania has a chief nurse and midwife, which is great, to -
●
to
ensure
primary
healthcare
nurses
work
to
their
full
scope,
improve
working
conditions
-
including
safe
staffing
levels
-
their
salaries
and
rights
to occupational health and safety, and
●
strengthen
the
role
of
nurses
in
care
teams
by
bringing
different
sectors
(health,
education,
immigration,
finance)
together
with
nursing
stakeholders
for policy dialogue and workforce planning.
The
World
Health
Organization
report
states
the
global
nursing
workforce
is
just
under
28
million,
of
which
19.3
million
are
professional
nurses.
The
report
suggests
that
despite
an
increase
of
4.7
million
nurses
between
2013
and
2018,
there
was
still
a
shortfall
of
5.9
million,
with
the
greatest
gaps
to
be
found
in
places
including
Africa,
South-East
Asia,
Latin
America
and
the
eastern
Mediterranean
region.
To
meet
the
United
Nations
Sustainable
Development
Goal
3
-
good
health
and
wellbeing
-
the
World
Health
Organization
estimates
the world will need an extra 9 million nurses.
The
report
revealed
more
than
80
per
cent
of
the
world's
nurses
work
in
countries
that
are
home
to
half
the
world's
population.
One
in
eight
nurses
practices
in
a
country
other
than
the
one
they
were
born
or
trained
in;
as
I
mentioned
earlier,
this
is
problematic.
Many
high
income
countries
have
to
rely
on
international
nursing
mobility
due
to
low
numbers
of
graduate
nurses
and
the
ability
to
employ
new
graduate
nurses
in
the
health
system.
We
need
to
focus
more
on
training
our
own.
Ageing
also
continues
to
threaten
the
nursing
workforce,
with one in six of the world's nurses expected to retire in the next decade.
To
prevent
a
global
shortage,
the
report
estimates
countries
facing
shortages
will
need
to
increase
their
total
number
of
nurse
graduates
by
up
to
8
per
cent
per
year,
along
with
taking
steps
to
improve
employment
opportunities
and
retention.
I
think
that
in
a
wealthy
country
such
as
the
one
we
live
in,
we
could
actually
train
more
than
we
need
and
support
them
to
practise
in
other
countries.
Achieving
universal
health
coverage
will
depend
on
there
being
sufficient
numbers
of
well-trained,
educated,
regulated
and
well-supported
nurses
and
midwives
who
receive
pay
and
conditions
in
line
with
the
quality
services
and
care
they
provide.
Mr President, point (1)f) of the motion states that -
In
remote
areas,
nurses
and
midwives
are
often
the
first
and
only
point
of
call in their communities;
Australian
national
health
workforce
data
in
2016
showed
that
72
per
cent
of
the
nursing
workforce
worked
in
major
cities
-
18
per
cent
in
inner
regional,
8
per
cent
in
outer
regional
and
2
per
cent
in
remote
and
very
remote
areas.
Many
remote
rural
towns
have
limited
or
no
health services and rely on the health services and health professions from surrounding towns.
In
these
situations,
rural
and
remote
nurses
are
often
the
first
to
respond
to
offsite
calls
and
medical
emergencies
and
will
go
above
and
beyond
to
give
the
highest
level
of
care
to
the
bigger,
broader
communities
they
work
in.
They
have
to
cope
with
fewer
resources
than
in
the
larger
centres.
They
may
work
as
part
of
a
very
small
team,
often
remaining
available
24
hours
a
day,
seven
days
a
week.
This
was
referred
to
in
an
article
from
Healthcare
Australia
from
its
website
titled,
'What
makes
our
regional
and
remote
nurses
so
important'.
It
suggests
that
nurses
who
work
in
regional,
rural
and
remote
areas
play
a
vital
role
in
closing
the
health
gap for Australians living in challenging geographical regions.
According
to
the
Australian
Institute
of
Health
and
Welfare,
individuals
who
live
in
these
areas
tend
to
have
a
shorter
life
expectancy
and
higher
levels
of
disease
and
injury.
They
acknowledge
that
poor
health
outcomes
in
these
regions
are
most
likely
due
to
a
range
of factors, including education, employment, lower income and access to healthcare service.
When
asked
what
motivates
remote
area
nurses
to
be
involved
in
this
line
of
work,
the
answers
vary
from
experiencing
rural
and
remote
cultures
to
making
a
difference
in
disadvantaged communities.
A
remote
placing
offers
a
rich
experience
for
nurses
who
get
to
practise
a
broad
range
of
skills
not
offered
in
an
urban
practice
or
in
hospitals.
Health
Times
,
a
publication
for
health
professionals,
stated
the
following
in
an
article
on
remote
area
nursing,
after
speaking
to
a
registered
nurse
on
a
placement
in
a
township
near
Uluru
that
has
a
small
clinic
with
a
general
practitioner
only
two
days
a
week
and
a
rotating
staff
of
three
nurses.
This
clinic
mostly
deals
with
the
health
of
tourists
and
resort
staff
and
any
emergencies
are
flown
to
Alice Springs, someone comes in, they are often stabilised and transferred out.
When
one
of
the
nurses
was
asked
what
she
considered
to
be
the
best
and
worst
part
of
the
job,
she
said
that
meeting
the
local
personalities,
experiencing
the
outback
lifestyle,
driving
a
four-wheel
drive
ambulance
with
the
entire
family
of
the
sick
person
in
the
back,
which
was
very
funny,
and
using
car
headlights
to
direct
a
plane
onto
a
tarmac
at
some
ungodly
hour
and
many
other
experiences
-
you
have
to
be
all
things
to
all
people
at
that
point.
The
worst
was
a
plane
not
being
able
to
land
or
pilots
not
available,
the
lack
of
equipment,
and
missing
family
and
friends,
but
they
are
very
dedicated
people
who
work
in
these remote settings. When asked what she would change, she said -
I
don't
think
you
can
change
much.
You
need
more
experienced
people
and
facilities
out
there
with
more
planes
and
pilots.
You
need
to
wait
for
the
transfer
of
sick
patients
until
a
pilot
has
had
the
required
hours
of
rest
between
flights.
So
there
is
often
delay
but
most
people
living
remotely
want to live there and they understand that there have to be compromises.
Remote
area
nurses
and
midwives
work
in
diverse
contexts
and
have
a
major
influence
on
the
roles
they
undertake.
They
are
usually
required
to
have
at
least
three
years
nursing
experience
beforehand,
beyond
their
training
or
their
degrees,
and
they
are
already
multiskilled and generally highly regarded in their communities.
It
is
certainly
not
a
work
environment
that
appeals
to
all
nurses
or
midwives
but
it
can
be,
and
generally
is,
extremely
rewarding
work.
You
just
have
to
make
do
and
deal
with
whoever presents for care until additional assistance arrives, if it is needed.
Mr President, (1)(g) of the motion states that increasing -
…
nursing
and
midwifery
will
assist
in
promoting
and
achieving
the
United
Nations
Sustainable
Development
Goals
(SDGs)
5
(Achieve
gender
equality
and
empower
all
women
and
girls)
and
8
(Promote
sustained,
inclusive
and
sustainable
economic
growth,
full
and
productive
employment
and
decent
work for all), and support other SDGs …
The
2030
agenda
for
sustainable
development
was
adopted
by
all
United
Nation
member
states
in
2015
and
provides
a
shared
blueprint
for
ending
poverty
and
working
towards a sustainable future for all countries, developing and developed.
A
collection
of
17
broad
and
interlinked
goals,
known
as
the
sustainable
development
goals, form part of the 2030 agenda.
For those who may be unfamiliar with the 17 Sustainable Development Goals -
1.
No poverty
2.
Zero hunger
3.
Good health and wellbeing
4.
Quality education
5.
Gender equality
6.
Clean water and sanitation
7.
Affordable and clean energy
8.
Decent work and economic growth
9.
Industry innovation and infrastructure
10.
Reducing inequality
11.
Sustainable cities and communities
12.
Responsible consumption and production
13.
Climate action
14.
Life below water
15.
Life on land
16.
Peace, justice and strong institutions
17.
Partnerships for the goals.
Two
years
later,
in
2017,
these
sustainable
development
goals
were
made
more
actionable
when
the
United
Nations
adopted
a
resolution
that
identified
specific
targets
for
each goal, along with indicators to use to measure progress against these targets.
The
World
Health
Organization's
State
of
the
World's
Nursing
Report
2020
identifies
that
a
global
investment
in
nursing
education,
jobs
and
leadership
is
needed,
as
I
mentioned
earlier,
so
that
universal
health
coverage
and
sustainable
development
goals
targets
are
achieved,
particularly
Goal
5,
Achieve
gender
equality,
and
empower
all
women
and
girls,
and
Goal
8,
Promote
sustained,
inclusive
and
sustainable
economic
growth,
full
and
productive employment, and decent work for all.
Targets
for
Goal
5
include
ending
all
forms
of
discrimination,
violence
and
exploitation
of
women
and
girls,
and
that
is
particularly
important
when
you
reflect
on
the
comment
that
not
all
jurisdictions
have
laws
protecting
health
workers
from
assault
or
other
forms
of
violence;
eliminating
harmful
practices
such
as
child
early
and
forced
marriage,
and
female
genital
mutilation;
increasing
value
of
unpaid
care
and
promoting
shared
domestic
responsibilities;
ensuring
full
participation
of
women
in
leadership
and
decision-making;
ensuring
access
to
universal
reproductive
rights
and
health;
fostering
equal
rights
to
economic
resources,
property
ownership
and
financial
services
for
women;
promoting
empowerment
of
women
through
technology;
and
adopting,
strengthening
polices
and
enforcing
legislation
for
gender equality.
In
Australia,
and
Tasmania,
we
have
achieved
many
of
those
actions
and
outcomes,
but
there
are
still
areas
where
we
need
more
work
ourselves.
We
should
not
just
be
looking
to
other
countries
to
say,
'Well,
you
are
not
doing
that
so
well,
are
you?'.
We
need
to
look
inwardly as well.
As
nurses
and
midwives
represent
a
large
portion
of
the
women
who
make
up
the
healthcare workforce, they will play an important role in achieving these targets.
As
I
mentioned
previously,
midwifery
care
includes
proven
interventions
for
maternal
and
newborn
health,
as
well
as
for
family
planning,
and
could
avert
over
80
per
cent
of
all
maternal
deaths,
stillbirths,
and
neonatal
deaths.
If
we
have
enough
midwives
in
these
developing
nations
in
particular,
they
can
avert
80
per
cent
of
all
maternal
deaths,
stillbirths,
and neonatal deaths. There are still women dying in childbirth around the world.
We
must
ensure
equitable
access
to
midwifery
care
for
all
child-bearing
women
and
their
families
as
a
priority.
This
means
training
and
educating
locally
based
midwives
who
can
provide
culturally
sensitive,
quality
care
and
improve
outcomes
for
all
women
and
babies.
Providing
women
and
girls
with
equal
access
to
education,
technology,
health
care,
decent
work,
and
representation
in
political
and
economic
decision-making
processes
will
also greatly improve global health outcomes.
Being
involved
with
the
Commonwealth
Parliamentary
Association,
attending
some
of
the
functions
we
have
had,
when
you
are
hearing
from
women
from
these
other
developing
nations,
some
of
the
things
they
have
to
deal
with
in
their
reproductive
rights,
and
even
for
a
woman
to
stand
for
parliament.
It
was
horrifying
to
hear
one
speaker,
one
young
woman,
talk
about
how
the
only
way
she
was
likely
to
get
elected
was
if
she
provided
sexual
favours
to
all
the
male
chiefs.
That
is
the
sort
of
pressure
that
some
of
these
women
are
under
in
these
areas.
The
importance
of
and
value
gained
through
the
education
of
girls
and
women
are
significant.
Goal
8
pertains
to
sustained
economic
growth
and
decent
work
for
all.
For
at
least
developed
nations,
the
economic
target
is
to
attain
at
least
7
per
cent
annual
growth
in
the
gross
domestic
product.
Achieving
higher
productivity
will
require
diversification,
entrepreneurship, and innovation.
It
will
also
mean
ensuring
women
and
girls
are
given
access
to
education
and
the
opportunity
to
participate
in
the
economy
and
the
making
of
economic
decisions.
There
is
no
doubt that investing in nurses and midwives is good value for money.
The
report
of
the
United
Nations
High
Level
Commission
on
Health
Employment
and
Economic
Growth
concluded
that
investments
in
education
and
job
creation
in
the
health
and
social
sectors
result
in
the
triple
return
of
improved
health
outcomes,
global
health
security
and inclusive economic growth.
Australia
is
one
of
193
countries
that
adopted
the
2030
agenda
in
September
2015.
Implementation
of
the
agenda
is
led
by
the
Department
of
Foreign
Affairs
and
Trade
and
the
Department
of
Prime
Minister
and
Cabinet,
with
different
federal
government
agencies
responsible for each of the goals.
Unfortunately,
Australia
is
not
on
track
to
achieve
a
sustainable
deal
on
goals
by
2030.
In
2020,
Australia's
overall
performance
in
the
SDG
index
is
ranked
37
out
of
166
countries,
down
from
eighteenth
out
of
34
countries
in
2015.
I
hope
that
shocks
a
lot
of
members
here
because
it
is
pretty
shocking
we
have
gone
backwards.
Clearly,
we
need
to
be
much
more
focused on meeting our commitments and obligations in these important areas.
I will close with comments related to point (2) of the motion -
That
the
Legislative
Council
recognises,
highly
values
and
thanks
all
Tasmanian
nurses
and
midwives
for
their
hard
work,
dedication
and
commitment in all areas of practice.
A
lot
has
changed
since
this
motion
was
first
put
on
the
Notice
Paper.
The
International
Year
of
the
Nurse
and
the
Midwife
was
declared
with
the
intent
of
it
being
a
year-long
effort
to
celebrate
the
work
of
nurses
and
midwives
and
advocate
for
increased
investments
in
the
nursing
and
midwifery
workforce.
Those
needs
still
remain
but
we
have
not
had
much
of
a
celebration.
The
advent
of
COVID-19,
though,
has
highlighted
both
of
these.
Nurses
and
midwives
play
a
vital
role
in
providing
health
services.
These
are
people
who
devote
their
lives
to
caring
for
mothers
and
children,
giving
life-saving
immunisations
and
health
advice,
looking
after
older
people
and
generally
meeting
essential
health
needs
every
day.
They
are
often
the
first
and
only
point
of
call
in
their
communities.
But
this
is
not
the
time
for
lip-service
and
merely
providing
accolades
and
pats
on
the
back.
It
is
a
time
to
guarantee
staffing
ratios
for
nurses
and
midwives
across
all
sectors
and
ensuring
safe
work
environments
for
all
our
nurses and midwives. This will require legislative and policy support.
We
have
an
opportunity
to
leverage
the
evidence
in
the
State
of
the
World's
Nursing
Report
2020
and
encourage
the
Government
to
invest
in
the
education
of
nurses
and
health
workers
to
meet
domestic
demand
and
respond
to
changing
technologies
and
strengthen
nurse
leadership.
The
report
highlights
some
key
areas
of
concern
for
many
low-
and
middle-income
countries.
However,
we
cannot
become
complacent
in
a
high-income
country
like
Australia,
where
we
have
an
ageing
nursing
workforce
and
an
over-reliance
on
international
recruitment.
Both
pose
a
threat
to
our
attainment
of
nursing
and
midwifery
workforce requirements.
We
should
always
acknowledge
and
appreciate
the
anxiety
many
healthcare
workers
have
been
feeling
following
the
COVID-19
outbreak
around
the
globe,
as
well
as
here
in
Tasmania.
The
mental
and
physical
health
of
all
our
nursing
and
midwifery
staff
must
be
a
top priority to ensure they can continue to provide the quality care we all need.
We
know
and
have
heard
in
the
Public
Accounts
Committee
inquiry
into
the
COVID-19
response
that
frontline
health
workers
are
at
risk
of
physical
and
mental
consequences
directly
as
a
result
of
providing
care
to
COVID-19
patients.
These
impacts,
particularly
the
mental
health
impact,
can
be
enduring
if
adequate
support
and
care
are
not
provided
to
our
highly
valued nurses and midwives.
During
the
early
stages
of
the
pandemic,
shortages
of
drugs
and
life-saving
equipment,
as
well
as
a
lack
of
knowledge
when
faced
with
a
new
virus,
resulted
in
high
rates
of
transmission
of
COVID-19
in
healthcare
workers.
As
I
noted
earlier,
we
saw
this
occur
on
the
north-west
coast
in
April.
We
heard
a
lot
about
shortages
of
protective
equipment,
which
posed
a
significant
risk.
Contracting
the
infection
results
in
missing
work
days,
quarantining
and
increasing
the
risk
of
transmission
to
family
members.
Clearly,
a
combination
of
increased
workloads,
shortages
of
available
healthcare
professionals,
the
risk
of
transmission
and
any
lack
of
resources
severely
affects
the
physical
and
mental
health
of
healthcare
workers and places healthcare systems under extreme pressure.
We
saw
health
professionals
in
other
countries
having
to
make
terribly
difficult
decisions
about
which
patients
they
could
treat
and
provide
the
highest
level
of
intensive
care
to
and
which
ones
they
had
to
let
die.
No
health
professional
ever
wants
to
be
faced
with
such a situation, but they have been in this last few months.
BioMed
Central
is
a
UK-based
producer
of
scientific
journals
which
recently
ppublished
a
review
of
a
number
of
studies
on
the
physical
and
mental
health
impacts
of
COVID-19
on
healthcare
workers.
In
one
study,
out
of
230
healthcare
workers
who
responded
to
the
mental
health
assessment
scales,
53,
or
23
per
cent,
had
psychosocial
problems.
Among
the
53
medical
staff,
more
females
-
90.57
per
cent
-
than
males,
9.43
per
cent,
and
more
nurses,
81.13
per
cent,
than
physicians,
18.9
per
cent,
suffered
from
mental
health issues due to the infectious outbreak.
The psychological impact on healthcare workers includes the following conditions -
●
overall anxiety: between 23 and 44 per cent;
●
severe anxiety: 2.17 per cent;
●
moderate anxiety: 4.78 per cent;
●
mild anxiety: 16.09 per cent;
●
stress disorder: 27.4 to 71 per cent;
●
depression: 50.4 per cent; and
●
insomnia: 34 per cent.
Anxiety
in
females
was
higher
than
in
males,
and
in
nurses
higher
than
doctors.
When
you
have
a
predominately
female
workforce,
that
is
a
lot
of
people
who
are
feeling
the
psychological impacts of COVID-19.
The
study
found
that
frontline
healthcare
workers
engaged
in
direct
COVID-19
patient
care
were
at
greater
risk
of
depression,
anxiety,
insomnia
and
stress.
That
is
not
surprising,
but I think we need to recognise it.
Nurses
generally
spend
more
time
at
the
bedside
of
these
patients,
which
is
likely
to
contribute
to
that
reality.
We
need
to
be
aware
of
this,
and
alert
to
the
ongoing
needs
of
nurses and other health professionals placed in this situation.
With
the
opening
of
borders
here
in
Tasmania,
there
is
a
high
anxiety
among
health
workers.
We
must
ensure
they
are
adequately
resourced
and
that
they
have
plenty
of
staff
available
-
including
surge
capacity
to
meet
any
increased
need
and
demand.
We
must
ensure
adequate
supports
are
in
place,
including
to
support
the
mental
wellbeing
of
all
our
health
professionals.
Mr
President,
I
am
sure
you
and
all
members
join
me
in
thanking
all
our
nurses
and
midwives
for
their
selfless
commitment
to
caring
for
others
and
the
quality
care
they
deliver;
for
their
professionalism
and
dedication
to
high
standards
of
care
and
practice
in
a
year
that
has
been
like
no
other
we
have
seen
in
our
lifetime,
when
nurses
and
midwives
have
been
required to step up rather than celebrate.
Let us thank them all from the bottom of our hearts.
As
we
thank
and
acknowledge
them,
let
us
commit
also
to
ensuring
they
are
adequately
supported
and
resourced
to
continue
to
provide
the
quality
care
we
all
expect,
and
that
we
educate
and
employ
as
many
nurses
and
midwifes
as
we
need
to
avoid
the
need
for
double
shifts and overtime wherever possible.
I
personally
thank
all
my
nursing
and
midwifery
colleagues
of
the
past.
They
are
a
very
special bunch. I look forward to other members' contributions.
[12.47 p.m.]
Mr
GAFFNEY
(Mersey)
-
Mr
President,
my
contribution
is
not
quite
as
long
as
the
member
for
Murchison's,
but
I
thank
her
so
much
for
that
really
in-depth
position
on
the
International Year of the Nurse and the Midwife.
I
am
pleased
to
add
my
support
to
the
motion,
as
the
proud
uncle
of
a
Tasmanian
health
services
registered
nurse
who
is
completely
committed
to
her
vocation,
and
indeed
her
patients,
and
as
a
member
of
the
community
who
continues
to
be
thankful
for
and
incredibly
impressed
by
the
efforts
of
our
nurses
and
midwives
in
this
state,
and
across
Australia
and
globally.
It
is
a
well-known
and
oft-repeated
fact
that
those
who
serve
as
nurses
across
so
many
fields
of
expertise
-
ICU,
recovery,
emergency,
medical,
surgical,
theatre
and
maternity
to
name
but
a
few
-
are
regarded
as
being
among
the
most
trusted
people
in
our
communities,
and there are many good reasons for that.
When
people
are
giving
birth,
or
are
sick
or
injured,
they
are
at
their
most
vulnerable
-
sometimes
separated
from
loved
ones,
and
in
need
of
support
and
a
sense
of
safety.
In
addition
to
the
expert
and
professional
healthcare
that
nurses
and
midwives
provide
to
patients,
their
ability
to
read
people
and
assist
in
a
supportive
and
tailored
manner
are
what
patients often remember the most about these interactions in hospitals and clinics.
In
an
open
letter
to
midwives
commemorating
the
World
Health
Organization
International
Year
of
the
Nurse
and
the
Midwife,
Her
Royal
Highness,
the
Duchess
of
Cambridge, wrote -
The
founder
of
modern
nursing,
Florence
Nightingale
-
whose
200th
anniversary
we
celebrate
…
once
said:
'I
attribute
my
success
to
this:
I
never
have
or
took
an
excuse'
and
it
is
that
mantra
that
I
have
seen
time
and
time
again
in
all
of
my
encounters
with
you.
You
don't
ask
for
praise
or
recognition
but
instead
unwaveringly
continue
your
amazing
work
bringing
new
life
into
our
world.
You
continue
to
demonstrate
that
despite
your
technical
mastery
and
the
advancement
of
modern
medicine,
it
is
the
human
to
human
relationships
and
simple
acts
of
kindness
that
sometimes
mean
the
most.
According
to
the
Australian
College
of
Nursing,
2020
is
the
first
year
the
profession
has
been
recognised
on
a
global
scale.
Mr
President,
with
the
events
of
this
year,
could
there
ever
have
been
a
better
time
for
a
reminder
of
the
vital
contribution
that
nurses
and
midwives
make
in
our
communities?
I
imagine
that
our
healthcare
professionals
have
not
been
in
such
sustained
and
crucial
need
since
wartime.
The
pressure
these
men
and
women
have
been
under for such a long period cannot be underestimated.
It
has
been
an
extremely
challenging
year.
These
are
people
who,
in
their
daily
practice
under
ordinary
circumstances,
are
regularly
required
to
work
extended
hours
in
sometimes
less
than
ideal
clinical
settings,
and
with
rapidly
changing
priorities.
We
know
2020
has
been
an
extraordinary
and
difficult
year
for
so
many
-
but
what
have
those
who
have
been
on
the
front
line
have
been
dealing
with
in
terms
of
the
unknown,
patients'
fears,
the
greater
risk
of
self-contamination
for
many,
the
inability
to
save
a
patient
-
whether
due
to
lack
of
equipment
or
dealing
with
a
presentation
too
advanced
to
treat
-
is
almost
unimaginable.
The
physical
and
mental
load
is
something
most
of
us
will
never
experience
or
understand.
I
salute
our
nurses and midwives and associated personnel for their incredible efforts.
As
members
may
be
aware,
2020
was
selected
by
the
World
Health
Organization
as
the
International
Year
of
the
Nurse
and
the
Midwife
in
honour
of
the
200th
anniversary
of
Florence
Nightingale's
birth,
and
to
recognise
the
critical
contribution
both
professions
make
to
global
health.
A
number
of
events,
conferences
and
forums
were
scheduled
to
celebrate
and
recognise
nurses
and
midwives
in
every
country.
The
Australian
College
of
Nursing
is
currently
heavily
involved
with
the
three-year
Nursing
Now
Campaign,
and
the
Nightingale
Challenge,
which
is
a
leadership
and
development
program
for
nurses
and
midwives
under
35.
The
aim
is
to
encourage
20
000
young
nurses.
Pleasingly,
27
295
nurses
and
midwives
from 719 employers and 71 countries have accepted the Nightingale Challenge.
The
challenge
seeks
to
promote
work
at
the
top
of
the
scope
of
nursing
practice,
raising
the
profile
of
the
profession,
and,
as
mentioned,
leadership
development
through
formal
courses,
mentoring,
shadowing,
or
learning
from
other
professionals
or
sectors.
I
feel
sure
that
the
ripple
effect
of
initiatives
of
this
nature
will
be
felt
throughout
our
hospitals
and
health sector for years to come.
It
is
a
pleasure
to
make
this
brief
contribution
in
genuine
support
of
the
motion,
and
indeed
our
hardworking
and
dedicated
nurses
and
midwives
during
this,
the
International
Year
of
the
Nurse
and
the
Midwife.
I
thank
the
member
for
bringing
this
motion
to
the
Table,
and offer my gratitude and encouragement to Tasmania's nurses and midwives.
[12.52 p.m.]
Mr
VALENTINE
(Hobart)
-
Mr
President,
I,
too,
support
the
motion.
It
was
quite
fascinating
to
listen
to
the
member
for
Murchison
bringing
out
some
of
the
statistics
and
issues that nurses are facing in our community.
For
the
World
Health
Organization
to
declare
this
year,
2020,
as
the
International
Year
of
the
Nurse
and
the
Midwife,
I
do
not
think
there
would
be
any
other
year
that
would
be
as
momentous
as
this,
if
I
can
put
it
that
way,
where
the
work
of
our
nurses
and
midwives
-
and
nurses
in
particular,
because
the
COVID-19
situation
has
certainly
put
a
spotlight
on
how
much we need the nursing profession.
Nurses
are
the
first
to
hold
us
when
we
come
into
this
world,
and
quite
often
I
am
sure
they are the last to hold our hand as we go, in many cases.
We
look
back
on
our
moments
in
hospital,
and
I
am
sure
every
one
of
us
has
had
time
in
hospital,
where
it
has
been
so
comforting
for
us
to
have
a
listening
ear.
You
have
the
doctors
coming
in
and
providing
their
prognosis,
then
the
doctor
has
to
go
to
the
next
person
on
their
round.
Quite
often,
it
is
the
nurse
who
is
left
to
perhaps
explain
a
little
more,
or
be
there
in
a
sense
of
being
a
comfort
for
those
who
might
have
some
bad
news
that
has
just
been
delivered to them. We just need to recognise the value of that particular profession.
The
honourable
member
talked
about
the
staffing
ratios.
How
many
times
have
we
all
been
in
hospital
and
nurses
have
just
been
run
off
their
feet?
I
have
had
a
few
sessions
over
my
life,
some
more
serious
than
others,
and
the
nurses
have
always
been
there.
With
the
amount
of
demand
on
the
nursing
profession,
it
is
important
they
can
actually
undertake
their
role
in
a
way
where
they
can
deliver
quality
care
and
not
be
overrun
or
have
to
limit
the
level
of
care
they
are
able
to
provide
simply
because
there
are
too
many
patients
or
the
demands
on
them
are
too
high.
We
need
to
understand
and
make
sure
we
are
providing
the
right
level
of
employment for people at their highest level of need when they are in hospital.
As
a
community
we
can
all
benefit
if
we
have
good
staff
ratios.
Often,
nurses
are
the
closest
to
us
on
our
medical
journeys.
They
are
often
there
to
administer
drugs
the
doctors
have prescribed and to make sure that is properly controlled.
They
sometimes
have
the
toughest
jobs
as
people
lose
capacity.
Through
the
voluntary
assisted
dying
bill,
we
have
heard
so
many
different
stories
about
people's
last
moments
and
last
weeks
in
their
life
with
examples
brought
or
sent
to
us
of
what
people
have
had
to
endure.
Quite
often
they
lose
capacity
and
where
they
cannot
properly
look
after
themselves,
it
is
the
nurses
in
our
hospitals
providing
essential
support.
Sometimes,
providing
the
support
they
provide is just not easy.
I
am
sure
they
go
home
at
night
and
it
affects
them.
It
must
affect
them.
Their
mental
health
is
really
important.
So
we
are
not
talking
only
about
the
staffing
ratio
-
we
also
need
to
look
at
their
access
to
support
when
they
need
it
when
they
find
themselves
in
those
mentally
challenging
circumstances
and
finding
it
hard
to
cope
with.
Maybe
they
have
avenues
of
support,
because
I
know
from
my
own
trips
to
hospital,
there
are
other
patients
you
can
hear
are getting to a really difficult stage and it is the nurses who are there to help them through it.
I
simply
want
to
say
to
nurses
in
support
of
the
motion:
thank
you
for
your
dedication
to
your
patients;
thank
you
for
your
commitment
to
due
process
to
keep
us
safe;
thank
you
for
your
resilience
when
it
does
not
all
go
to
plan;
and
thank
you
for
who
you
are
and
your
resolve to make a difference when it matters.
I support the motion.
[12.59 p.m.]
Dr
SEIDEL
(Huon)
-
Mr
President,
I
know
we
do
not
have
much
time,
but
of
course
I
will support the motion of the member for Murchison.
Mr Valentine
- There is always after lunch.
Dr
SEIDEL
-
Very
good.
Well,
I
might
start
by
saying
nurses
are
the
backbone
of
our
healthcare system. Full stop. They are.
Without
our
fabulous
nurses,
what
do
we
actually
do?
I
do
not
think
much.
I
am
not
just
saying
this
-
it
is
what
the
evidence
suggests:
a
health
system
focused
on
very
strongly
trained nursing workforce has better health outcomes. Full stop. In any environment.
My
best
teachers
in
my
medical
career
were
actually
nurses.
Not
doctors,
they
were
nurses -
Dr
SEIDEL
-
My
medical
students
do
listen
to
them
and,
to
be
frank,
some
of
my
most
intimidating
teachers
were
midwives
-
mmost
intimidating,
and
now
I
am
sitting
next
to
one
again. You are telling me off again - some things never change.
Sitting suspended from 1.00 p.m. to 2.30 p.m
.
QUESTIONS
Medicinal Cannabis - Eligible Conditions - Post-Traumatic Stress Disorder
Ms
RATTRAY
to
LEADER
of
the
GOVERNMENT
in
the
LEGISLATIVE
COUNCIL,
Mrs HISCUTT
[2.31 p.m.]
Mr
President,
I
think
this
question
is
quite
timely,
given
the
member
for
Windermere's
notice of motion. He must have been reading my mail.
With limited access to medicinal cannabis for various medical conditions -
(1)
Can
the
Leader
please
advise
if
PTSD
is
one
of
these
conditions
that
is
not
identified as an eligible medical condition?
(2)
What
are
the
eligible
medical
conditions
that
qualify
for
access
to
Tasmanian
prescribed medicinal cannabis?
(3)
Can
the
Leader
please
confirm
that
Tasmania
is
the
only
state
not
to
allow
general
practitioners to prescribe medicinal cannabis for PTSD sufferers?
ANSWER
Mr President, I thank the member for McIntyre for her very timely questions.
(1)
The
Medical
Cannabis
Controlled
Access
Scheme
allows
Tasmanians
with
a
serious
illness
that
has
not
responded
to
conventional
therapies
to
access
unregistered
medical
cannabis
products
when
prescribed
by
a
suitably
qualified
relevant
medical
specialist.
The
CAS
is
specifically
designed
to
support
the
safe
and
appropriate
use
of
unproven
medical
cannabis
products
through
the
rigorous
assessment
of
applications
informed
by
evidence
and
expert
clinical
advice.
This
is
the
same
process
applied
to
all
other
unproven
medicines
accessed
through
the
public health system in Tasmania.
(2)
To
protect
patient
safety,
Tasmania's
scheme
requires
that
standard
evidence-based
treatments
be
exhausted
before
any
unregistered
and
unproven
medical
cannabis
is
tried.
The
CAS
is
not
condition-specific
and
any
relevant
medical
specialist
present
and
practising
in
Tasmania
may
make
application
to
access
these
unproven
medical
products
for
their
patients
in
accordance
with
the
scheme requirements.
(3)
It
is
important
to
note
that
the
Tasmanian
Government
is
the
only
government
in
Australia
to
subsidise
the
cost
of
highly
expensive,
unregistered
medical
cannabis
products
and
make
their
potential
benefits
accessible
to
all
Tasmanians,
not
just
those
who
can
afford
to
pay.
Tasmania
continues
to
work
collaboratively
with
the
Commonwealth
and
with
other
states
and
territories
to
encourage
the
development
of
high-quality,
evidence-based
clinical
guidelines
to
ensure
access
to
these
medical cannabis products is safe and effective.
The
requirement
for
CAS
applications
to
be
submitted
by
a
relevant
medical
specialist
ensures
that
patients
are
reviewed
by
an
expert
in
the
relevant
field
of
medicine.
This
ensures
the
management
of
their
condition
is
optimised
with
existing
proven
therapies
before
resorting
to
unapproved
medical
cannabis
products.
This
is
not
uncommon
for
highly
specialised
products
such
as
some
cancer medications.
The
Department
of
Health
advises
it
is
not
in
a
position
to
comment
on
the
precise
prescribing
requirements
in
other
states
or
territories
for
PTSD
medications
although
it
would
appear
at
least
one
other
jurisdiction
recommends
referral
to
an
appropriate specialist.
Ms Rattray
- No consistent approach?
Mrs
HISCUTT
-
Tasmanian
GPs
remain
engaged
in
the
CAS
by
virtue
of
the
referral
of
a
patient
to
a
relevant
medical
specialist
when
a
medical
condition
is
unresponsive
to
evidence-based
proven
therapies.
This
is
the
established
clinical
practice
pathway
for
assessment
of
any
treatment
of
a
refractory
medical
condition,
not
just
unapproved
medical
cannabis products.
This
approach
was
strongly
supported
by
public
health
experts
and
key
stakeholders,
including
the
Tasmanian
branches
of
the
Australian
Medical
Association
and
the
Royal
Australian College of General Practitioners during the development of the scheme.
Launceston General Hospital - Survey - Queensland Consulting Firm
Ms
ARMITAGE
to
LEADER
of
the
GOVERNMENT
in
the
LEGISLATIVE
COUNCIL, Mrs HISCUTT
[2.35 p.m.]
Will
the
Leader
please
advise
-
and
this
is
a
question
I
have
asked
a
couple
of
times,
and
I am really hoping to have a straight answer this time -
(1)
Why
was
a
Queensland
firm
called
Insync
engaged
to
conduct
a
survey
on
behalf
of
the
Launceston
General
Hospital
Emergency
Department
-
LGHED
-
attendees
earlier this year, instead of engaging a Tasmanian firm?
(2)
Will the Leader please further advise -
(a)
When was Insync engaged by the department?
(b)
What is, or will be, the term and total cost of their contracted work?
ANSWER
Mr President, I thank the member for her Launceston for her question.
(1) and (2)
The
LGH
Emergency
Department
conducts
annual
experience
and
engagement
surveys
as
a
mandatory
requirement
under
the
Australian
Commission
on
Safety
and
Quality
in
Health
Care,
National
Safety
and
Quality
Health
Service
-
NSQHS
- Standards Action 1.13.
The
NSQHS
Standard
Action
1.13
stipulates
the
mandatory
requirement
for
health services -
●
to
have
processes
to
seek
regular
feedback
from
patients,
carers
and
families
about their experiences and outcomes of care;
●
to use this information to improve safety and quality systems.
Benchmarking
and
comparison
to
other
health
services
nationally
is
also
a
mandatory requirement under the NSQHS Standards.
Sourced
as
part
of
a
quotation
process
by
the
Tasmanian
Health
Service,
the
current
provider
is
able
to
provide
benchmarking
with
other
healthcare
services
to
ensure
comparison
of
quality
of
care,
and
identify
specific
areas
of
improvement
to dedicated services such as emergency departments.
Presently,
the
Emergency
Department's
survey
cost
component
per
annum
is
$12
911,
excluding
GST.
This
arrangement
ensures
the
LGHED
staffing
resources
are
focused
on
patient
clinical
care
as
much
as
possible.
I
am
advised
that
patient
experience surveys have been undertaken by Insync in 2019 and 2020.
I
am
advised
that
if
Emergency
Department
staff
were
required
to
attend
to
the
distribution,
collection,
correlation
and
reporting
of
ED
surveys,
it
is
estimated
it
would cost approximately $30 000 to $40 000.
Launceston General Hospital - Survey - Queensland Consulting Firm
Supplementary Question
Ms
ARMITAGE
to
LEADER
of
the
GOVERNMENT
in
the
LEGISLATIVE
COUNCIL, Mrs HISCUTT
[2.38 p.m.]
I
am
sorry
to
have
to
stand
again,
but
that
last
comment
-
I
do
not
think
the
question
has
been
fully
answered,
which
means
that
I
will,
unfortunately,
have
to
ask
another
follow-up
question.
To
insinuate
that
I
am
expecting
Emergency
Department
staff
to
do
the
survey
themselves,
when
I
mentioned
last
time
that
it
was
insulting,
is
again
an
insult
-
please
take
back to the minister that I would not expect the department to do its own survey.
My
main
question
was,
and
my
follow-up
question
will
be,
whether
a
Tasmanian
firm
-
basically
your
answer,
and
it
is
a
shame
we
do
not
have
the
answers
given
to
us
when
you
are
actually reading them out, which would be very useful, to actually know what was said.
The
fact
that
Insync
is
capable
of
doing
it
-
I
am
sure
many
Tasmanian
firms
are
capable of doing it as well. I will do some follow-up questions about the tender process.
Mrs
Hiscutt
-
Can
I
just
assure
the
member
that
I
will
take
a
copy
of
that
Hansard
to
make sure the minister gets it?
Hydro Tasmania - Annual Report 2019-20 - Generation Asset Writedown
[2.39 p.m.]
As
noted
in
Hydro
Tasmania's
recently
released
2019-20
annual
report,
a
significant
writedown of generation assets are recorded due to reductions in future expected revenue.
Hydro
Tasmania's
overall
book
value
declined
by
$219
million
in
2019-20.
Hydro's
balance
sheet
suffered
further
loss
following
a
$249
million
decline
in
2018-19.
This
means
Hydro
has
lost
$467
million,
or
23
per
cent,
of
value
in
two
years.
These
losses
are
not
attributed to trading losses.
The
annual
report
2019-20
notes
Hydro's
generation
assets
were
marked
down
by
$870
million,
to
a
figure
below
cost
-
incidentally,
the
same
level
recorded
15
years
ago
when
Basslink commenced.
Losses
are
also
associated
with
the
onerous
contracts,
with
the
latest
value
of
Hydro's
onerous contracts being $260 million -
(1)
Please
provide
a
detailed
explanation
of
the
$870
million
writedown
of
generation
assets in 2019-20.
(2)
What triggers the need for generation assets to be revalued?
(3)
As
noted
in
the
annual
report
statement
of
corporate
intent,
huge
returns
to
government
will
require
increases
in
borrowings
-
what
impact
is
the
current
dividend
policy
having
on
upgrade
maintenance
and
investment
in
generation
assets?
(4)
(a)
With
regard
to
the
onerous
contracts
that
make
up
the
$260
million-
contract
value
noted
in
the
annual
report,
how
many
contracts
comprise the total of onerous contracts?
(b)
Please
indicate
what
has
been
purchased
by
each
of
the
contracts
-
for
example, large generation certificates for electricity and gas et cetera.
(c)
Do
the
contracts
noted
in
(4)(b)
cover
specific
quantities
to
be
purchased?
If
yes,
what
are
these
quantities?
If
no,
please
provide
details to clarify in each instance.
(d)
What
is
the
value
of
each
onerous
contract
which
comprises
the
total
of $260 million.
ANSWER
Mr President, I thank the member for Murchison for her question.
(1)
The
writedown
of
generation
assets
was
the
result
of
lower
market
and
forecast
energy
prices.
The
market
and
energy
prices
used
in
the
valuations
are
subject
to
volatility causing movement of the valuation of the generation class assets.
(2)
The
trigger
is
a
requirement
to
be
compliant
with
the
relevant
Australian
accounting standard.
(3)
Hydro
Tasmania
has
invested
over
$1
billion
into
maintaining
and
upgrading
its
generation
assets
since
2008
and
is
planning
to
spend
more
than
$1.1
billion
on
those
assets
over
the
next
10
years.
Sustaining
the
performance
of
the
existing
Hydro
power
asset
base
for
the
long
term
is
fundamental
to
Hydro
Tasmania's
primary purpose and underpins the shareholders' energy policy.
Borrowing
levels
are
driven
by
the
planned
expenditure
mentioned
above,
coupled
with
the
forecast
operating
performance
of
the
business.
The
amount
of
dividend
paid
under
the
policy
is
a
product
of
the
underlying
performance
and
does
not
impact
the
level
of
investment
on
upgrade
maintenance
and
investment
in
generation
assets.
Hydro
will
continue
to
work
with
its
shareholders
to ensure these investments are made in a financially prudent manner.
(4)
(a)
There are 52 contracts that comprise the balance of onerous contracts.
(b)
Onerous
contracts
include
gas
contracts,
lease
liabilities
and
large
generation certificates.
(c)
The
onerous
contracts
that
relate
to
the
wind
power
purchase
agreement
-
the
LGCs
are
for
the
four
wind
farm
outputs,
so
the
quantities
will
fluctuate
due
to
the
wind
variability.
All
other
volumes
are
specific
to
each
individual
contract.
Details
regarding
the
contracts are commercial-in-confidence.
(d)
Contracts
involving
third
parties
and
specific
details
of
each
contract
are commercial-in-confidence.
Cigarette Vending Machines
Mr
DEAN
to
LEADER
of
the
GOVERNMENT
in
the
LEGISLATIVE
COUNCIL,
Mrs
HISCUTT
(1)
How many cigarette tobacco vending machines are there in the state?
(2)
Where are they?
(3)
How
are
they
policed
so
that
they
are
only
accessed
by
persons
18
years
and
older?
(4)
How
much
are
the
machines
used?
What
is
the
quantity
of
product
either
monthly, annually accessed through those machines?
ANSWER
(1)
The
answer
to
this
question
is
zero.
The
last
cigarette
vending
machine
in
which
was
located
in
the
Huon
Valley
Council
area,
was
removed
in
February 2020.
(2) to (4)
The
answer
to
question
(1)
means
that
the
answer
to
questions
(2),
(3)
and
(4)
is
'not applicable'.
[2.44 p.m.]
This
is
a
follow-up
question
in
regard
to
community
access
to
weekly
antenatal
and
extended
midwifery
services
at
the
North
Eastern
Soldiers
Memorial
Hospital
and
the
minister's answers received on 21 October.
(1)
Can
the
Leader
advise
when
the
community
will
be
advised
of
the
outcome
of
the
review
of
the
fortnightly
trial
to
determine
whether
clinical
and
community
needs
are being met and when will the outcomes be relayed to the community?
(2)
Regardless
of
any
review
outcomes,
I
ask
again
on
behalf
of
the
community,
will
the
minister
guarantee
access
to
midwifery
services
will
not
be
cut entirely from this community?
ANSWER
(1)
The
Tasmanian
Health
Service
advises
that
the
review
of
the
fortnightly
clinic
trial
is
expected
to
be
completed
in
coming
weeks,
and
any
outcomes
will
be
publicly communicated.
(2)
There
is
no
intention
to
discontinue
the
provision
of
midwifery
services
at
the
North Eastern Soldiers Memorial Hospital.
Marinus Link
It
is
noted
in
Hydro
Tasmania's
recently
released
2019-20
annual
report,
a
significant
writedown of generation assets was recorded due to reductions in future expected revenue.
Noting
that
the
Marinus
Link
business
case
is
based
on
estimates
of
future
electricity
price -
(1)
Will TasNetworks review the business case, and if not, why not?
ANSWER
(1)
TasNetworks
has
recently
reviewed
the
economic
case
for
the
Marinus
Link.
Details
of
this
work
are
contained
in
the
Regulatory
Investment
Test
for
Transmission Supplementary Analysis Report.
The
updated
modelling
undertaken
by
TasNetworks
clearly
demonstrates
the
role
that
Marinus
Link
can
play
in
the
future
National
Electricity
Market
-
NEM
-
which is consistent with the findings of the 2020 ISP.
The
benefits
provided
by
Marinus
Link
are
predominantly
in
providing
access
to
Tasmania's
dispatchable
hydro
capacity
and
high-quality
wind
resources,
which
will
lead
to
price
savings
for
customers
in
the
NEM
compared
to
a
situation
where Marinus Link is not commissioned.
Mr
DEAN
to
LEADER
of
the
GOVERNMENT
in
the
LEGISLATIVE
COUNCIL,
Mrs
HISCUTT
According
to
the
answers
provided
by
the
minister,
Ms
Archer,
on
24
September
2020,
the
Screen
documentary
Wild
Things
engaged
eight
Tasmanian
filmmakers
and
one
emerging
filmmaker
attachment.
Additionally,
the
minister
advised
in
her
answers
that
producers
are
contractually
required
to
make
the
film
in
accordance
with
an
approved
script, budget and schedule. Will the Leader please advise -
(1)
The
dates,
times
and
location
when
filming
for
the
Tasmanian
element
of
the
film
was undertaken?
(2)
The scheduled dates and milestones and/or events?
(3)
The
names
of
the
eight
Tasmanian
filmmakers
and
the
emerging
filmmaker
attachment?
(4)
Was
any
of
the
$50
000
paid
by
Screen
to
360
Degree
Productions
paid
ANSWER
(1)
Ascertaining
exact
dates
and
times
would
be
administratively
onerous,
involving
the producer reviewing two years of invoices, production diaries and accounts.
However,
we
can
provide
the
following
general
information
of
Tasmanian
filming,
if
that
suits
you.
If
you
do
not
quite
like
the
answer,
you
might
want
to
rephrase it and put it on the Notice Paper -
●
December 2018 - Tarkine rain forest blockade
●
February 2019 - Huonville fires aftermath
●
March 2019 - Tarkine marathon and Launceston Airport
●
April 2019 - Stop Adani convoy departure
●
October
2019
-
Tarkine
Big
Canopy
Campout
event;
various
Tarkine
●
November 2019 - BioBlitz at the Tarkine
●
February 2020 - several days in the Tarkine
●
March 2020 - Magistrates Court and doctor's surgery
●
April and May 2020 - drone filming in the north-west forests.
(2)
The key schedule dates for the filming productions are as follows -
●
December 2018 to December 2019 - incidental critical filming
●
January 2020 - commenced the principal photography
●
April 2020 - commenced post-production
●
June 2020 - complete rough cut
●
July 2020 - complete fine cut
●
July 2020 - commenced sound post-production
●
September 2020 - physical delivery
●
November 2020 - final acquittal.
(3)
The
names
of
the
Tasmanians
who
worked
on
the
film
is
personal
information
within
the
meaning
of
the
Personal
Information
Protection
Act
2004
and
the
Right
to
Information
Act
2009,
and
will
not
be
released.
Screen
understands
that
at
least
11
Tasmanian
crew
members
were
hired
by
the
production,
in
addition
to
the
emerging
filmmaker
attachment.
The
funding
contract
commits
the
filmmaker
to
a
minimum
spend
on
Tasmanian
goods
and
services,
including
on personnel.
(4)
Screen
funding
was
a
contribution
of
less
than
10
per
cent
towards
the
total
project
budget.
The
producer
has
advised
that
no
person
from
the
Bob
Brown
Foundation
was
employed
on
the
production,
and
no
payments
went
to
the
However,
the
production
filmed
one
event
in
the
Tarkine
organised
by
the
Bob
Brown
Foundation,
to
which
a
small
amount
was
paid
for
accommodation
and
meals,
only
for
crew
members
who
stayed
at
the
independent
facility
at
which
the
event took place during filming.
MOTION
International Year of the Nurse and the Midwife
Resumed from above.
[2.51 p.m.]
Dr
SEIDEL
(Huon)
-
Nurses
are,
of
course,
health
professionals
in
their
own
right.
They
are
not
just
a
supporting
act
for
doctors
or
other
healthcare
providers,
yet
we
often
take
them
for
granted.
Work
hours,
pay,
professional
support,
career
development
-
too
often
nurses
are
being
told
to
put
up
and
shut
up.
It
desperately
needs
to
change.
Double
shifts
are
too often expected, and too often the norm.
Honourable
members,
how
do
we
expect
our
nurses
to
function
in
a
high-pressure
environment?
Normal
shifts
and
normal
working
hours
in
any
health
environment
are
pretty
much
full-on
already.
Double
shifts
must
be
the
rare
exemption,
and
unfortunately
they
are
not.
Professional
support,
counselling
and
CPD
too
often
come
short,
due
to
the
commitment
to
provide
clinical
nursing
services.
CPD
time
and
training
time
must
be
protected.
Support
and counselling must be offered.
I
do
not
want
our
nurses
who
work
at
the
coalface
to
burn
out.
I
do
not
want
them
to
leave
their
profession
because
they
do
not
feel
supported.
The
member
for
Murchison
already
mentioned
the
substantial
pay
gap.
How
can
we
allow
that
to
be
the
case?
It
is
2020,
after all.
Good
health
systems
are
built
on
the
foundation
of
a
strong
nursing
workforce,
but
what
we
do
is
actually
workforce
guessing,
not
workforce
planning.
Too
often
we
rely
on
agency
nurses
and
on
nurses
who
have
trained
overseas
as
a
quick
fix.
Overseas-trained
nurses
are
now
subject
to
certain
visa
requirements;
often
they
are
employer-sponsored.
Those
nurses
feel
that
they
are
not
allowed
to
complain,
regardless
of
shift
allocation
or
pay.
They
deserve
much better than that.
Nursing
as
an
academic
discipline
is
under-represented
in
academic
discourse.
I
call
it
academic
discrimination.
We
need
more
academic
leadership
programs
for
nurses,
and
we
certainly
need
more
conjoined
university
appointments.
It
is
time
to
take
the
academic
career
path in nursing seriously.
Workforce
planning
usually
does
not
feature
in
media
headlines,
but
we
need
to
do
a
far
better
job
here.
For
example,
in
a
previous
question
time,
I
asked
how
many
nurse
endoscopists
were
employed
by
the
THS
over
the
last
five
years.
I
asked
that
in
the
context
of
waiting
times
for
bowel
cancer
screening.
The
answer
was
zero
-
zero
nurse
endoscopists
were
employed,
yet
we
could
have
trained
up
nurses
to
do
exactly
that
over
the
last
five
years. Why didn't we?
Why
do
we
not
appreciate
nurses
as
a
solution
to
the
problems
our
health
system
has
been
facing
for
years?
It
is
not
only
nurses
in
our
hospitals.
Our
community
nurses,
our
child
health
nurses,
our
palliative
care
nurses
are
doing
an
outstanding
job,
day
in
and
day
out.
They need support and a genuine career path.
The
member
for
Murchison
raised
nursing
ratios
in
aged
care
facilities.
You
do
not
need
a
royal
commission
to
tell
you
that
this
should
be
different.
We
cannot
expect
our
nurses
to
care
under
the
most
challenging
of
circumstances.
It
is
time
for
our
nurses
to
expect
parliamentarians
to
care.
That
is
why
laws
should
be
legislated
here
in
and
nationally.
It
is
time
for
us
to
give
back
to
our
fabulous
nurses
and
our
fabulous
midwives.
It
is
time
to
change
the
conversation
and
it
is
time
for
us
as
parliamentarians
to
show
we
care
for them too.
[2.55 p.m.]
member
for
Murchison
for
bringing
this
motion
on
and
for
her
comprehensive
and
extensive
coverage of her motion. It was very detailed.
When
the
World
Health
Organization
designated
2020
as
the
International
Year
of
the
Nurse
and
the
Midwife,
I
doubt
that
it
would
quite
have
known
how
appropriate
this
year
would have been for that due recognition.
We
have
seen
nurses
and
midwives
all
over
the
world
bravely
leading
the
global
response
to
COVID-19
from
the
front
line,
attending
work
while
the
rest
of
us
were
staying
home, throwing themselves headlong into the care of patients facing unprecedented illnesses.
The
theme
for
the
year
is
'A
Voice
to
Lead
-
Nursing
the
World
to
Health'.
It
is
a
wonderful theme that goes to the very heart of what it means to be a nurse and a midwife.
To
all
the
nurses
in
as
well
as
around
and
the
world,
we
all
say
thank
you.
You
do
such
an
extraordinary
job
and
we
owe
you
such
a
debt
of
gratitude
in
this
year of all years.
Nurses
and
midwives
are
so
often
the
face
of
our
health
care.
They
are
the
professionals
interpreting
medical
information
for
families
and
loved
ones.
They
provide
emotional
support,
coordinate
services
for
their
patients
and
take
it
upon
themselves
to
ensure
their patients are feeling supported and comforted.
Put
bluntly,
health
services
simply
would
not
and
could
not
function
without
the
crucial
role
they
play.
In
we
have
over
8500
nurses
and
midwives,
and
I
am
advised
that
we
are
blessed
with
one
of
the
highest
proportions
of
nurses
and
midwives
as
a
percentage
of
These
nurses
and
midwives
work
across
a
range
of
healthcare
settings,
primary
health
clinics
in
our
EDs
and
our
ICUs,
within
our
immunisation
clinics,
our
aged
care
facilities
and
the
list
goes
on.
Within
these
care
settings
they
undertake
a
variety
of
roles:
delivering
care,
educating
the
next
generation
and,
taking
lead
roles
in
managing
the
services
of
our
hospitals.
Again, we could go on here for hours about what they do.
The
point
is
that
the
role
of
a
nurse
or
midwife
is
clearly
not
a
one-track
career.
Nursing
is
a
varied,
exciting
and
challenging
profession.
We
must
encourage
and
support
the
next
generation
of
nurses
and
midwives,
and
I
can
assure
the
Chamber
that
this
is
exactly
what the Tasmanian Government is committed to doing.
The
Tasmanian
Health
Service
has
added
more
than
850
FTEs
of
nursing
workforce
since
2014.
It
is
an
extraordinary
rate
of
recruitment,
I
am
sure
you
will
all
agree,
strongly
In
particular,
I
am
proud
of
the
way
our
Government
has
expanded
the
number
of
graduate
nurses
that
we
take
on.
These
extra
positions
mean
more
opportunities
for
Tasmanians,
and
we
are
looking
at
how
we
can
create
more
opportunities
for
nurses
and
midwives
to
upskill
and
pursue
their
chosen
field,
especially
in
the
nurse
practitioner
space
which I know the member for Murchison is very passionate about.
This
year
in
the
International
Year
of
the
Nurse
and
the
Midwife,
we
acknowledge
the
extraordinary
work
of
our
nurses
and
our
midwives.
We
applaud
them
for
their
bravery
every
day
but
especially
so
in
the
face
of
the
COVID-19
pandemic.
We
are
so
lucky
to
have
every
single
one
of
them
in
our
health
system
and
in
our
community,
and
we
thank
them
all
once
again for their efforts in 2020.
The
Government
certainly
notes
the
member
for
Murchison's
motion
and
the
comprehensive coverage of her motion.
[2.59 p.m.]
Mr
DEAN
(Windermere)
-
Mr
President,
I
strongly
support
this
motion.
Like
just
about
every
other
Tasmanian,
I
respect
our
nurses
and
our
midwives
and
all
those
people
working
in
this
area.
They
do
an
incredible
job.
They
work
in
extremely
difficult
situations,
which
has
been
borne
out
over
previous
months
dealing
with
COVID-19
situation
we
are
confronting.
I
have
spoken
to
Emily
Shepherd
-
most
people
here
would
know
Emily,
who
is
doing
extremely
well
in
her
position
in
the
union.
Listening
to
some
of
the
issues
they
are
currently
confronting,
it
is
just
quite
incredible
that
they
can
continue
to
do
their
work
and
do
it
to
the
best
and
the
high
standard
they
do.
They
are
doing
wonderful
work,
wonderful
things,
and
I
certainly
commend
them.
They
are,
I
might
say
to
the
member
for
Huon,
considerably
higher
on the status ladder than are we.
[3.00 p.m.]
(Murchison)
-
Mr
President,
I
thank
members
for
their
contributions
and
their
support
of
this
motion.
I
know
that
even
those
who
have
not
spoken
would
support
the
motion,
I
am
sure,
in
principle.
It
was
only
at
lunchtime
-
we
were
having
lunch
together,
as
it
turns
out,
but
it
made
me
think
back
to
any
time
a
group
of
nurses
gets
together,
the
stories flow, and we started telling a few stories related to midwives during lunch.
It
is
funny,
whenever
I
used
to
go
out
before
I
was
in
this
role,
even
on
holiday
with
my
family
somewhere
on
the
mainland,
if
you
got
chatting
to
another
mum
because
she
had
little
kids,
they
would
say,
'What
do
you
do?'
I
would
say,
'I'm
a
midwife'
and
so
you
would
get
the
whole
birth
story,
without
fail,
because
there
is
almost
a
sign
on
your
forehead,
'Spill
your
guts here.'
I
used
to
say
that
to
lots
of
people
and
I
used
to
say
it
all
the
time
because
that
was
the
thing
-
nurses
have
that
approach
where
we
are
counsellors,
we
are
people
who
always
listen
and
do
not
judge
because
you
cannot
judge.
If
you
are
a
judging
person,
you
are
in
the
wrong
profession
as
a
nurse
and
midwife
because
you
have
to
take
whoever
comes
through
the
door.
That
is
why
we
are
lucky
in
to
have
a
universal
healthcare
system
that
provides
for
that.
I
was
reflecting
on
how
we
can
go
for
many,
many
months
and
not
see
each
other,
and
you can pick up as if the last conversation you had occurred only a couple of days ago.
When
I
think
about
some
of
my
midwife
friends
on
the
mainland
at
the
moment
-
a
woman,
Andrea
Quanchi,
a
fabulous
midwife
who
does
an
enormous
amount
for
midwifery
and
midwives
in
terms
of
homebirth.
Her
daughter
is
now
a
homebirth
midwife
as
well.
The
work
she
did
advocating
for
women
and
the
role
we
both
played
in
the
College
of
Midwives
trying
to
promote
models
of
care
for
women
including
continuity
of
care
and
care
from
a
known midwife has had more beneficial outcomes for mothers and babies.
An
enormous
amount
of
work
has
been
done.
There
is
still
unfinished
business
in
terms
of
professional
indemnity
insurance.
Midwives
still
cannot
get
professional
indemnity
insurance
even
if
you
had
a
million
bucks
to
pay
for
it.
Why?
I
will
not
go
into
all
that
now,
Mr
President.
It
is
a
matter
that
really
needs
a
separate
debate
because
it
is
an
important
issue
that
prevents
so
many
midwives
being
able
to
operate
in
homebirth
and
even
birth
centre
birthing, which should be an option for a lot of women in our country and our state.
Luckily,
my
own
daughter
gave
birth
in
Launceston
Birth
Centre
almost
a
year
ago
this
week.
I
was
lucky
enough
to
be
there
and
share
that
really
special
occasion
with
her,
but
they
had
almost
closed
the
centre
down
because
of
a
lack
of
midwives
to
support
and
continue
to
work in it because of some of these restrictions.
Whilst
support
has
been
provided
to
enable
midwives
to
continue
to
practice,
there
are
so
many
restrictions.
Effectively,
you
have
to
have
no
assets
at
all
so
that
there
is
nothing
-
the
family
home
has
to
be
in
the
partner's
name
to
try
to
protect
the
assets
of
the
midwife
because
she
cannot
get
insurance.
This
is
not
because
midwives
are
negligent
-
they
are
not.
There
are
negligent
midwives,
yes;
there
are
negligent
doctors,
yes;
there
are
negligent
nurses,
yes.
They
are
by
far
the
minority
and
they
should
be
held
to
account,
but
the
midwives who offer this sort of service are not that -
-
That
is
right,
yes.
The
choices
are
restricted
way
too
much.
I
am
really
grateful
my
daughter's
midwife,
Emma,
who
moved
from
to
work
at
the
birth
centre
in
Launceston,
was
able
to
provide
that
opportunity
for
her.
As
the
Leader
said,
there
is
so
much
work
to
be
done
in
the
area
of
nurse
practitioners.
I
worked
at
a
national
and
state
level
in
the
College
of
Midwives;
I
was
state
president
for
a
number
of
years,
and
I
was
also
on
the
national
executive
for
a
period
-
those
things
I
gave
up
when
I
joined
this
place.
At
times
an
enormous
amount
of
work
goes
on
with
very
little
reward.
We
cannot
seem
to
break
through
on
some
of
these
areas.
When
I
first
started,
you
could
get
professional
indemnity insurance, then it dried up overnight.
I
thank
the
member
for
Windermere
for
mentioning
the
fact
that
it
is
a
really
well-regarded
profession,
right
at
the
top
of
the
tree.
It
is
interesting
there
is
so
much
respect
for
nurses
and
midwives
in
our
broader
community.
The
majority
are
women,
but
we
see
so
little
respect
for
women
in
our
community
in
so
many
areas.
We
did
not
have
to
watch
much
on
television
last
night
to
understand
how
bad
this
is
at
the
highest
levels
in
our
Parliament
of
It
does
not
make
sense
to
me.
We
have
huge
respect
for
nurses
and
midwives,
the
majority
of
whom
are
women,
and
generally
almost
zero
respect
in
the
highest
places
in
our
country for women.
What
is
that
about?
Anyway,
it
is
getting
slightly
off
the
track
of
the
International
Year
of the Nurse and the Midwife, but they are such highly regarded and respected professionals.
The
gender
pay
gap
-
I
thank
the
member
for
Huon
for
raising
that
-
is
absolutely
an
area
that
needs
to
be
addressed,
as
are
the
career
pathways
within
nursing
and
midwifery.
They
are
at
a
very
flat
structure
with
very
little
opportunity.
Workforce
planning
and
workforce matters like that, as well as career pathways, absolutely need further work.
As
we
celebrate
the
role
and
participation
of
nurses
and
midwives
in
our
community,
let
us
not
forget
those
really
important
aspects.
Let
us
not
forget
they
work
in
extraordinary
circumstances.
You
never
know,
particularly
at
the
front
line
in
the
Department
of
Emergency
Medicine,
whether
one
of
your
family
members
could
be
brought
in
in
really
bad
shape
and
you
could
be
working
at
the
time.
In
we
know
so
many
of
our
patients
personally.
You
have
a
friend
or
woman
who
comes
in
to
birth
who
has
a
tragic
outcome
or
serious
complication,
and
you
are
required
to
go
and
assist
even
though
they
may
be
a
friend
of yours, because that is the nature of our small communities.
There
are
enormous
pressures
and
strains.
We
cannot
afford
to
overlook
this.
As
we
celebrate
this
year,
there
will
perhaps
be
a
lot
more
reflection
next
year,
hopefully.
I
ask
all
members
-
and
I
am
sure
all
of
you
know
a
nurse
or
midwife
-
to
contact
them
today
and
just
say
thank
you.
Just
text
message,
phone,
whatever,
just
say
thank
you,
and
ask
them
to
pass
it
on
to
their
colleagues,
because
that
way
they
will
know
our
parliament
respects
and
thanks
you.
I
ask
all
of
members
-
just
one
nurse,
one
midwife,
and
send
a
message
to
them
and
thank
them,
not
just
for
what
they
have
done
in
the
past,
but
for
what
they
will
do
in
the
future.
Thank
you,
Mr
President,
and
members
for
their
contribution
to
and
support
of
the
motion.
Motion agreed to.
MOTION
Medical Cannabis - Legalisation
[3.09 p.m.]
That
the
Legislative
Council
calls
upon
the
Government
to
further
consider
the
legalisation
of
medicinal
cannabis
having
regard
to
laws
which
apply
in
other
Australian
jurisdictions,
with
a
view
to
allowing
the
prescribing
of
medicinal
cannabis
under
proper
process
to
those
patients
whom
it
would
benefit,
and
also
prevent
these
patients
and
carers
from
having
to
act
unlawfully for treatment.
Mr
President,
I
thank
the
members
for
giving
me
the
time
to
give
notice
of
this
motion
on
Friday,
30
October.
I
thank
members
for
that.
I
did
that
because
this
is
a
fairly
important
issue.
It
is
one
of
those
fairly
emotional
matters
when
you
start
to
look
at
some
of
the
issues
and
some
of
the
concerns
people
have
been
confronted
with
around
this
state.
When
you
talk
to
somebody
who
is
involved
in
it
and
they
are
talking
to
you
in
tears,
it
does
get
to
you.
You
cannot help but feel for them.
As
members
would
have
assumed,
this
motion
follows
the
emotional
email
I
received
from
Lyn
Cleaver
regarding
the
tragic
reality
of
caring
for
a
son,
now
29
years
of
age,
suffering
from
severe
refractory
epilepsy.
No
legal
drug
has
been
able
to
provide
help
or
relief
for
the
management
of
this
severe
illness
which,
sadly,
is
aggravated
by
an
acquired
brain injury.
However,
I
have
given
much
time
to
the
subject
of
this
motion
over
a
longer
period.
It
is
not
just
coming
from
the
letter
I
received
from
Lyn
Cleaver.
I
have
been
looking
at
this
for
a
long
time
and
I
have
discussed
it
with
a
number
of
people
and
with
other
members
of
parliament as well, both in this and the other place. It is a matter of great concern.
I
refer
members
to
my
adjournment
speech
of
29
October
this
year.
While
I
would
like
to
read
it
again,
because
it
sent
a
powerful
message
to
all,
and
hopefully
to
the
Government,
I
will
not
do
so
other
than
to
repeat
some
of
the
substantial
points
coming
from
it
to
put
my
position forward in what I believe is to be the right way.
Lyn
Cleaver
is
no
different
from
all
mums
and
dads
in
wanting
what
is
the
best
care
and
treatment
of
her
son.
He
is
in
a
desperate
situation,
requiring
the
most
effective
management
of
his
most
serious
illness,
which
has
gone
on
now
ever
since
he
was
six
years
of
age.
It
has
gone on over many years.
Jeremy
has
trialled
many
anticonvulsant
medications,
many
of
them
without
success.
His
carer
and
loving
mum
has
now
taken
a
course
to
care
for
her
son
that
could
see
her
incarcerated.
This
is
the
desperate
situation
she
finds
herself
in.
The
fact
is
medicinal
cannabis,
cannabinoid,
gives
Jeremy
relief
and
it
gives
the
family
relief.
It
is
without
known
side effects.
Jeremy
has
been
treated
by
specialists,
neurologists
and
by
everybody
else
right
to
the
top
of
the
medical
services
in
this
state,
and
wider.
There
was
support
for
the
family
to
access
medicinal
cannabis
for
his
care
but
while
supported
by
the
TGA
-
the
Therapeutic
Goods
Administration
-
it
has
not
been
supported
by
Tasmanian
Medicines
Access
and
Advisory
Committee, known as TMAAC.
On
29
August
2020,
Lyn
Cleaver
was
made
aware
that
the
latest
application
by
another
neurologist,
Dr
Aaron
de
Souza,
had
also
been
rejected.
I
understand
the
TGA
-
and
that
is
how
I
will
refer
to
the
Therapeutic
Goods
Administration
from
hereon
-
gave
its
approval
to
the
application
-
that
is,
access
for
Jeremy
to
cannabinoid
medicine.
As
I
said,
my
understanding is that it was rejected by TMAAC.
It
is
important
to
look
at
the
TGA
position
and
how
it
sits
in
this
whole
thing.
The
TGA
is
Australia's
regulatory
authority
for
therapeutic
goods.
It
carries
out
a
range
of
assessment
and
monitoring
activities
to
ensure
therapeutic
goods
available
in
are
of
an
acceptable
standard,
with
the
aim
of
ensuring
the
Australian
community
has
access
within
a reasonable time to therapeutic advancements.
I
understand
that
after
several
applications,
access
to
this
form
of
medication
was
approved by the TGA.
I
now
take
a
look
at
TMAAC's
position.
When
I
first
started
to
look
at
TMAAC
I
googled
it
to
do
some
research
but
it
was
difficult
to
find
anything
about
TMAAC.
I
was
frustrated
and
my
staff
were
too.
We
contacted
the
Parliamentary
Library;
whose
staff
I
commend
for
the
work
they
do
and
the
way
in
which
they
went
about
this.
They
too
were
stumped
to
some
degree
in
getting
good
information.
In
fact,
they
went
back
through
Hansard
to
previous
discussions
that
had
taken
place
in
relation
to
this
body.
They
came
up
with some evidence and information out of those processes and -
Mr
DEAN
-
I
have
moved
on
from
the
TGA;
I
am
now
on
to
TMAAC,
which
is
the
Tasmanian Medicines Access and Advisory Committee. Sorry about it that.
Mr
DEAN
-
You
did,
and
I
appreciate
and
thank
you
for
that
because
it
was
just
a
difficult
situation.
Yes,
I
thank
you,
member
for
Murchison,
for
providing
some
support
here
as well in trying to get to the bottom of this.
Mr
DEAN
-
Thank
you.
I
went
ahead
and
using
that
information,
I
wrote
what
I
thought
was
a
reasonable
position
and
understanding
of
TMAAC.
Among
all
this,
I
also
wrote
to
the
Department
of
through
the
minister
to
find
out
more
about
this
organisation.
Lo
and
behold,
this
morning
I
received
some
documentation
from
the
department
or
the
minister,
and
I
thank
them
for
that.
However,
that
was
a
couple
of
weeks
ago
so
it
has
taken
a
little
while
for
the
information
to
come
through.
I
just
want
to
quote
the
information that came back. I think it is fairly important to put this on the record -
The Tasmanian Medicines Access and Advisory Committee is -
●
The
Tasmanian
Medicines
Access
and
Advisory
Committee
(TMAAC
)
is
a
multidisciplinary
committee
consisting
of
statewide
representation
of
medical,
nursing,
pharmacy,
consumer
and
Department
of
representatives.
Medical
representation
is
from
a
variety
of
medical
and
surgical
specialties
and
TMAAC
will
also
nominate
additional specialists who may be consulted and/or co-opted, when relevant.
●
The
committee
considers
application
for
new
medicines
to
be
added
to
the
Tasmanian
medicines
formulary,
including
assessing
the
risk
associated
with
any
pharmaceutical
company-funded medication access program.
●
When
a
required
medicine
is
not
formulary-listed
and
the
prescriber
considers
a
formulary
application
for
a
patient
group
is
not
warranted,
a
THS
prescriber
can
apply
to
TMAAC
to
use
the
medicine
for
a
specific
indication
in
a
single
patient
(individual
patient application that is known as an IPA).
●
TMAAC
has
delegated
authority
from
the
secretary
for
for
review
of
applications
made
under
the
Controlled
Access
Scheme
for
unregistered
cannabinoid
medicines.
These
applications
are
assessed
in
line
with
established
TMAAC
processes
for
assessing
applications
for
unregistered
medicines.
Unlike
other
medicines
these
applications
are
concurrently
assessed
by
a
delegate
of
the
secretary
for
under
the
Poisons
Act
1971
to
streamline
both
of
the
necessary
application
processes
required
for
cannabis
●
Approved
IPAs
are
valid
for
a
time
period
set
by
the
committee
or
may
be
approved
for
ongoing
use.
Extensions
to
time
limit
approvals
are
considered
by
the
committee
on
request
of
the
prescriber
after
the
initial
approval
period.
Importantly,
TMAAC
approval
of
medicines
via
either
approval
of
a
formulary
listing
or
an
IPA
allows
for
supply
of
the
medicine
through
a
THS
pharmacy.
This
supply
mechanism
ensures
that
patients
are
able
to
access
medicines
at
a
subsidised
cost
equal
to
the
cost
of
a
Pharmaceutical
Benefits
Scheme
(PBS)-listed
medicine.
This
pathway
is
only
available
to
THS
specialists
and
supply
can
only
occur
through
a
THS
pharmacy
on
prescription
from a THS prescriber.
●
The
TMAAC
process
allows
equitable
access
for
THS
patients
to
non-PBS
medicines
which
have
been
approved
to
be
prescribed
in
safe,
efficacious
and
cost-effective
circumstances.
The next dot point is -
●
TMAAC
is
Tasmania's
representative
on
the
national
Council
of
Australian
Therapeutic
Advisory Groups (CATAG).
●
Adoption
of
a
CATAG
guiding
principle
for
the
roles
and
responsibilities
of
drug
and
therapeutics
committees
in
Australian
public
hospitals
ensures
that
the
activities
of
the
committee are in line with nationally agreed best practice principles.
And the last dot point is -
●
The
Chief
Medical
Officer
within
the
Department
of
is
the
executive
sponsor
of
the
committee,
and
the
committee
has
reported
obligations
to
the
chief
executives
of
the
THS hospitals.
I
thought
it
was
fairly
important
to
put
that
on
the
record
because,
as
I
said,
we
have
to
understand
it.
It
is
not
easy
to
understand
the
position
and
where
it
sits,
and
what
is
happening. It has the right to overrule the Therapeutic Goods Administration.
I can skip the next few pages I have written - and thanks, as I said, to the library.
If
we
get
back
to
Jeremy's
issue,
TMAAC
clearly
stated
that
Jeremy
-
this
is
on
my
advice
-
must
trial
and
fail
all
conventional
medicines
before
being
considered
for
a
medicinal
cannabis
prescription.
On
my
advice,
he
still
had
not
tried
three
available
drugs.
The
evidence
is
that
these
drugs
cause
agitation,
behavioural
issues
and
suicidal
ideation.
Lyn
Cleaver
also
says
that
Jeremy
is
extremely
medication-sensitive,
and
previous
drugs
taken
have
caused
serious
behavioural
problems.
The
family
has
had
to
work
with
that
-
and
in
fact Jeremy has had to work through that as well.
One
remaining
drug
to
be
trialled
has
a
warning
of
possible
blindness.
Jeremy
is
noncompliant
and
non-verbal,
so
any
eye
testing
would
be
useless
to
monitor
his
eyesight.
Again, this is all on advice I have received, and I have no reason not to accept it.
I
ask
a
rhetorical
question:
would
you
take
this
risk,
with
your
son
or
daughter
already
suffering
serious
health
issues,
when
another
product
is
working
-
albeit
it
is
an
illegal
product, as in their case?
In
2014,
the
Legislative
Council
Government
Administration
Committee
A
inquired
into
the
use
of
medicinal
cannabis.
The
member
for
Murchison
and
I
think
the
member
for
and
others
would
have
been
involved
in
this
robust
inquiry.
It
generated
quite
a
large
report, which is available if members want to look at it. I had a good look at that report.
I
am
just
going
to
refer
to
one
or
two
recommendations
from
that
report.
Others
might
want to talk more about it. The committee made the following recommendations -
(1)
The
Tasmanian
Government
introduces
legislation
to
immediately
provide
protection
to
individuals
who
are
currently
using
medicinal
cannabis
from
criminal
charges
associated
with
possession
and
administration
of
medicinal
cannabis
on
compassionate grounds.
-
Before
you
go
off
(1),
the
Government
did
not
support
that.
Its
response
was
that
the
police
will
not
progress
a
charge,
a
prosecution,
with
it.
If
you
have
a
law
that
the police are going to ignore, that is just stupid.
(2)
The
Tasmanian
Government
develops
a
legislative
framework
to
enable
the
use
of
medicinal
cannabis
under
medical
supervision,
including
the
preparation,
cultivation
and
supply
of
medicinal
cannabis.
This
is
all
about
the
medical
profession
having
a
big
say,
a
big
involvement,
in
this.
It
is
not
a
matter
of
a
family
member
simply
saying,
'We
do
not
want
to
try
these
other
drugs.
We are not interested in that. We are going to go down the illegal pathway.'
That
is
not
the
case.
That
is
not
what
is
happening.
It
just
is
not.
I
think
probably
some
people
in
the
Government
who
are
opposed
to
it
are
probably
looking
at
it
from
that
perspective, or that point of view. I would ask them not to.
(3)
The
Tasmanian
Government
support
a
cooperative
approach
between
Tasmanian
research
institutions
and
mainland
jurisdictions to facilitate clinical research in this area.
Once
again,
I
am
not
sure
where
they
went
there,
but
the
member
for
Murchison
might
tell
us
a little more on that.
The fourth recommendation -
(4)
The
Tasmanian
Government
adopts
a
cooperative
approach
with
other
states
and
territories
in
relation
to
the
legalisation
of
the
prescription,
administration,
possession
and
cultivation
of
cannabis for medicinal use.
Medicinal use: it was not quoted twice there, I have repeated it a second time.
Recommendation (5) -
Cultivars
of
cannabis
containing
low
levels
of
THC
should
not
be
treated
in
the
same
way
as
cultivars
of
cannabis
containing
high
levels
of
THC,
in
terms
of
the
national
classification
system
of scheduling of medicines.
The last one -
(6)
The
Tasmanian
Government
engages
with
companies
which
have
the
appropriate
expertise
and
capacity
to
progress
the
cultivation,
extraction
and
processing
of
cannabinoids
within
the
existing and/or future regulatory framework.
These
are
the
committee's
recommendations.
The
committee
called
many
witnesses
as
part of the inquiry it conducted back in 2014, and we have not seen much progress since.
A
Senate
committee
held
an
inquiry
into
current
barriers
to
patient
access
to
medicinal
cannabis
in
March
this
year.
Well,
that
is
when
the
inquiry
came
out,
I
think.
In
March
this
year the final report was handed in.
I will just refer to two of the recommendations from that report.
Recommendation 11 -
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.
A
very
strong
recommendation
made
by
the
Senate,
by
that
committee
-
again,
supported by much evidence in that committee making that recommendation.
Recommendation 20 from that inquiry -
The
committee
recommends
that
the
Australian
Government,
through
COAG,
encourage
a
review
of
state
and
territory
criminal
legislation
in
relation to:
●
amnesties
for
the
possession
and/or
cultivation
of
cannabis
for
genuine
self-medication
purposes; and
●
current
drug
driving
laws
and
their
implications
for
patients
with
legal
medicinal
cannabis prescriptions.
A very, very strong recommendation, and it speaks for itself.
Mr
President,
why
is
so
different
to
the
rest
of
the
country
when
it
comes
to
accessing medicinal cannabis?
This
is
a
sad
situation.
If
Lyn
and
Jeremy
lived
in
another
state,
other
than
they
would
have
access
to
this
medicine.
The
family
would
be
able
to
live
close
to
a
normal
life,
and
without
Jeremy
suffering
in
the
way
he
would
without
access
to
an
illegal
substance
that
his
mother
is
prepared
to
put
her
credibility
and
reputation
on
the
line
for,
as
I
said,
in
risking prosecution and jail.
She
fears,
Mr
President,
a
police
car
driving
up
her
laneway.
She
fears
that,
because
she
has
openly
said
that
she
produces
this
product,
and
produces
the
oil
for
medicinal
reasons.
She does not hide that.
She
fears
when
that
police
car
will
drive
up
her
lane
one
day
and
confiscate
a
product,
which is a medicine, and is helping.
I
will
refer
to
some
of
those
and
in
doing
this,
Mr
President,
I
refer
to
the
Victorian
health legislation where they have put a succinct explanation together on their website -
Commonwealth legislation
Commonwealth
legislation
restricts
the
cultivation,
manufacture,
supply
and
use
of
narcotic
drugs
in
accordance
with
international
obligations
in
these
areas.
It
also
ensures
that
therapeutic
goods
sold
in
meet
suitable
standards
of
safety,
quality
and
efficacy,
and
places
restrictions
on
the
importation of controlled medicines.
That is administered by the federal Office of Drug Control -
●
[It]
provides
the
Commonwealth
government
with
powers
to
meet
international
obligations
relating to the regulation of drug manufacture.
●
The
amended
the
Narcotic
Drugs
Act
1967
to
allow
for
the
cultivation
and
manufacture
of
cannabis
for
medicinal
and
related
scientific
purposes
●
Establishes
a
comprehensive
national
licensing
and
permit
scheme
to
regulate
the
cultivation,
production
and
manufacture
of
cannabis
in
for
medicinal
and
scientific
purposes.
The Therapeutic Goods Act 1989 -
●
Administered by the Commonwealth Therapeutic Goods Administration, TGA
●
Provides
a
regulatory
framework
to
ensure
therapeutic
goods
supplied
in
(such
as
medicinal cannabis) meet acceptable standards of quality and safety.
.
●
S
ets
out
how
to
apply
for
a
medicine
to
be
approved
and
registered
in
the
Australian
●
Provides
a
number
of
mechanisms
to
enable
access
to
unapproved
therapeutic
goods,
including the Special Access Scheme and Authorised Prescriber Scheme.
●
The
TGA
have
also
compiled
,
defining
the
quality
requirements
required
by
all
unapproved
medicinal
cannabis
products
available
in
What
is
the
position
in
other
states
and
territories?
I
will
keep
this
fairly
succinct.
In
the
necessary
Commonwealth
and/or
state
government
approvals
-
that
is,
TGA approval in their case.
●
New
South
-
any
doctor
in
New
South
can
prescribe
medicinal
cannabis
for
a
health
condition
if
they
believe
it
is
an
appropriate
treatment
option
and
they
have
obtained
the
relevant
approvals.
You
need
to
see
the
New
South
government's
Centre
for
Medicinal
Cannabis
Research
and
Innovation for more details. There are a lot more details there to cover that -
●
-
any
registered
medical
practitioner
in
can
prescribe
medicinal
cannabis
for
any
patient
with
any
condition,
if
they
believe
it
is
clinically
appropriate
and
have
obtained
the
required
Commonwealth
and/or
state approvals.
●
South
-
patients
in
South
can
access
medicinal
cannabis
on
prescription
from
their
authorised
medical
practitioner,
if
appropriate.
The
medical practitioner must have the relevant approvals.
●
Western
-
any
medical
practitioner
in
Western
can
prescribe
medicinal
cannabis
if
they
believe
it
is
suitable
for
the
patient
and
again, they have the necessary approvals.
●
Australian
Capital
Territory
-
the
health
practitioner
can
prescribe
medicinal
cannabis
if
they
believe
it
may
be
effective
for
the
condition
of
the
patient
they and have Commonwealth and territory approvals.
●
The
Northern
Territory
is
a
little
different.
Patients
in
the
Northern
Territory
can
access
medicinal
cannabis
through
an
Australian
doctor
who
is
authorised
by
the
TGA.
The
Northern
Territory's
Department
of
recommends
that
patients
are
referred
by
a
GP
to
an
appropriate
specialist,
Ms
-
That
was
the
reference
in
the
question
that
I
asked
at
question
time,
where
it
said
at
least
one
other
jurisdiction
recommends
referral
to
an
appropriate
specialist.
Mr
DEAN
-
In
a
GP
can
refer
you
to
a
relevant
medical
specialist.
The
medical
specialist
can
then
prescribe
medical
cannabis
in
limited
circumstances,
where
it
is
clinically
appropriate
and
conventional
treatment
has
been
unsuccessful.
The
specialist
must
receive
the
relevant
approvals,
must
be
approved
by
the
TGA,
then,
it
appears,
by
the
state
committee
of
TMAAC.
It
appears
it
can
override
the
TGA
-
if
the
Leader
is
able
to
provide
any response the Government might want to make.
Mr
DEAN
-
I
do;
I
have
the
list
here
somewhere
but
I
am
not
sure
if
I
can
find
it
quickly. I certainly have it.
We
will
go
now
to
the
Royal
Australian
College
of
General
Practitioners.
It
has
said
that
further
research
into
the
safety
and
effectiveness
of
medicinal
cannabis
products
is
needed
because
the
current
evidence
is
limited.
I
think
we
all
accept
that.
It
then
goes
on
to
say -
…
but
the
organisation
does
suggest
there
is
a
possible
role
for
medicinal
cannabis products in a number of areas.
Mr
DEAN
-
Yes,
absolutely
well
respected.
You
cannot
get
any
rungs
higher
on
a
ladder than where the RACGP is. I am a great one on this status level.
I
want
to
quote
from
an
article
on
thegreenfund.com
website,
'Why
Are
Tasmania's
As
the
recent
into
barriers
facing
the
Australian
medical
cannabis
landscape
outlined,
is
now
the
only
state
which
doesn't
utilize
the
online,
expedited
and
simplified
application
process
that
is
SAS-B Portal route.
As
a
result,
Tasmania's
medical
cannabis
prescriptions
are
seriously
lagging,
as
is
their
latest
information.
The
most
recent
patient
data
available
says
that
as
of
November
2018,
only
seven
patients
have
been
prescribed
medicinal
cannabis products.
It
has
gone
up
from
there;
I
am
not
quite
sure
what
it
is,
but
once
again
the
Leader
might be able to come up with the current figures as of today or yesterday -
To
put
this
number
in
perspective,
,
one
of
Australia's
leading
medical
cannabis
companies,
is
prescribing
between
500-600 patients across the country every single month.
By
not
adopting
the
online
SAS-B
Portal
method,
Tasmanian
patients
who
desperately
need
medical
cannabis
products
have
largely
been
unable
to
do
so.
One
of
these
patients
was
Jeremy
Bester,
a
28-year-old
Tasmanian
man
who
suffered
from
severe
refractory
epilepsy.
Jeremy
began
using
cannabis
as
a
treatment
in
2014
as
a
last
resort
when
all
other
medicines
had
proved
ineffective,
and
to
his
and
his
mother's
surprise,
cannabis
use
resulted
in
an
immense
improvement
in
Jeremy's
condition.
This
prompted
Jeremy's
mother,
Lyn
Cleaver,
to
begin
purchasing
the
plant
online,
and
eventually,
growing it herself.
Ms.
Cleaver
gained
firsthand
insight
into
the
difficulties
that
arise
when
trying
to
follow
the
legal
route
to
be
prescribed
cannabis
in
as
her
applications
have
been
rejected
on
numerous
occasions.
Moreover,
even
if
she
were
approved,
she
would
be
looking
at
a
'$60,000
to
$100,000
annual
price
tag
for
a
legal
prescription
for
Jeremy'
while
her
home-grown
method
'costs as little as $20 per week.'
Perhaps
an
unexpected
benefit
of
being
so
far
behind
the
rest
of
the
country
is
that
we
have
been
afforded
the
opportunity
to
watch
and
learn
about
what
is
-
and
what
is
not
-
working
around
the
country
where
access
is
not
as
restricted.
We
can
learn
from
that.
I
am
not
sure
we
need
to
continue
learning
from
it
for
the
next
20
years.
There
comes
a
time
when
you
have
to
say,
enough
is
enough.
You
have
enough
information,
you
have
enough
evidence
and you need to move forward.
Medicinal
cannabis
products
are
incredibly
expensive.
For
example,
the
neurologist
advised
Lyn
Cleaver
that
a
legal
cannabis
prescription
would
have
cost
the
THS
between
$60
000
and
$100
000
annually.
I
am
not
quite
sure
where
that
figure
comes
from
but
that
is
what
I
have
from
my
research.
These
costs
are
prohibitive
for
patients,
with
many
of
them
being
on
a
disability
support
pension.
The
cost
varies
for
the
condition
being
treated
and
some
people
are
managing
to
afford
their
medicinal
cannabis
product.
Many
patients
are
not
refilling
their
scripts
due
to
cost
and
are
returning
to
the
green
market.
That
is
not
what
we
want.
There
is
no
reason
to
think
it
will
be
any
different
in
Many
patients
will
not
be
able
to
afford
the
products.
The
clinics
operating
on
the
mainland
are
sometimes
charging
several
hundred
dollars
just
for
the
consultation
and
application
processes,
with
an
added
cost
for
the
medicine.
Some
of
the
products
are
quite
weak
and
patients
are
consuming
more,
higher
cost
prescriptions.
Supply
is
inconsistent
with
the
imports,
with
patients
sometimes
waiting
days
or
weeks
for
the
medicine
or
not
getting
it
at
all
and
having
to
change
brands
or
medicine types. Identifying a willing GP or specialist is also difficult.
While
I
accept
we
need
to
demonstrate
care
in
the
prescribing
and
use
of
medicines,
there
comes
a
time
in
the
life
of
a
person
for
some
element
of
risk
to
be
taken
to
bring
relief
from
suffering
and
to
restore
some
quality
of
life.
The
risk
levels
need
to
be
minimised
and
that
is
the
position
we
have
with
medicinal
cannabis.
There
have
been
many
trials,
much
research
has
been
done
and
it
is
being
used
to
provide
support,
relief
and
control
of
illnesses
where traditional medicines have not successfully worked.
It
is
accepted
-
I
accept
it,
and
I
think
we
all
do
-
that
more
research
is
required
in
this
area
and
that
is
being
done.
Nobody
is
saying
we
should
stop
our
research.
Nobody
is
saying
that at all.
I
will
talk
about
a
personal
situation.
Very
briefly
-
and
I
do
not
want
to
identify
the
person
-
I
have
a
good
friend
suffering
from
a
terminal
sickness
whose
life
expectancy
is
very
short
and
who
has
had
access
to
medicinal
cannabis.
The
family
says
that
has
given
him
relief
and
some
improved
life
quality.
It
is
not
good
but
an
improvement
on
where
he
was.
My
position
is,
'Isn't
it
good
in
that
situation
that
a
person
can
get
some
relief,
some
better
quality
in
their
life
at
that
stage
with
what
is
happening?'
Does
it
matter?
In
my
view
it
does
not. It is helping.
Ms
-
Having
it
in
a
controlled
environment
or
a
controlled
process
would
have
to be a better outcome.
Mr
DEAN
-
That
is
the
ultimate
and
that
is
what
these
people
are
about.
They
are
saying
there
needs
to
be
a
controlled
proper
access
to
this
product.
That
is
what
they
want.
They
do
not
want
to
have
to
sneak
around
as
Lyn
Cleaver
probably
does,
and
has
said
she
has
done,
looking
to
see
who
is
next
coming
up
the
laneway.
That
is
not
what
should
be
happening.
Ms
-
Also
having
access
in
that
controlled
process,
you
would
expect
it
would
assist
in
the
research
because
people
would
possibly
be
willing
to
partake
in
the
research.
It
would add value to the information.
Mr
DEAN
-
I
go
back
to
this
family
because
they
are
well
known
now
in
for
what is happening, and to some extent on the mainland.
Lyn
Cleaver
said
to
me
the
other
day
-
and
I
went
to
her
about
this
motion
again,
as
I
should
have
done
and
I
did
-
'Ivan,
I
have
to
say
that
when
your
name
was
mentioned
I
really
had
second
thoughts
about
going
anywhere
near
you
because
of
your
background.'.
She
said,
'I did not know -
Mr
DEAN
-
whether
I
should
do
that
or
not.'.
She
explained
to
me
how
uncomfortable
she
felt
about
doing
that.
I
am
very
pleased
she
did
and,
as
she
said,
she
is
pleased
she
did
as
well
in
all
those
circumstances.
I
think
I
can
blame
our
past
member
for
Rosevears
for
that,
who
also
was
assisting
the
Cleavers
in
going
down
this
path.
I
think
it
was
Kerry
who
recommended
Lyn
have
a
talk
to
me,
that
I
would
see
things
not
in
the
way
of
the
law,
as
it
were, when I was a police officer.
People
ask
me
whether
I
support
cannabis
use
generally.
No,
I
do
not,
not
at
this
time;
not
at
all.
I
cannot
support
that;
I
experienced
many
cases
as
a
detective
where
in
many
instances
cannabis
was
the
cause
of
a
very
serious
crime
because
a
person
was
either
high
or
they
was
committing
a
crime
to
access
cannabis
or
the
money
to
get
cannabis.
I
experienced
quite
a
lot
of
that,
but
the
jury
is
still
out
on
that.
That
is
where
I
sit:
I
support
medicinal
cannabis
use,
properly
authorised
by
doctors
-
those
people
who
have
the
background
knowledge
to
understand
and
to
prescribe
it
and
know
what
traditional
medicines
are
doing.
I
support that.
It
is
not
good
enough
for
us
to
fiddle
while
burns,
knowing
people
are
suffering
and
that
we
have
people
prepared
to
act
in
a
criminal
way
to
relieve
that
suffering.
I
urge
the
Government
to
treat
this
issue
as
a
high
priority
and
to
make
access
to
medicinal
cannabis
-
with
a
doctor
or
medical
intervention
-
realistic
and
achievable
and
in
doing
so
to
also
consider the laws in place in the rest of the country.
In
conclusion,
I
paraphrase
a
request
made
by
a
provider
of
medicinal
cannabis
for
a
demonstration
of
humanity
and
support
for
those
people
forced
by
an
uncontrolled
love
of
a
family member to defy the law; I am just paraphrasing comments passed to me -
It
is
important
we
voice
the
need
for
a
patient
register
exemption
for
medicinal
cannabis
and
for
self-supply
of
cannabis
therapy
whereby
patients
would
register
with
the
support
of
their
treating
doctor
and
be
known
to
police,
with
documentation.
I
understand
patients
who
have
recently
been
raided
were
advised
that
if
they
could
supply
documentation
to
police
that
their
medicine
had
been
supported
by
way
of
medical
intervention,
it
would
be
protected
from
confiscation.
If
such
course
is
taken
on
this
advice,
if
correct,
the
medicine
(medical
cannabis)
would
be
protected
from
confiscation
and
patients
and
carers
would
also
be
protected
from
charges
of
possession,
cultivation
and
administering
medicinal
cannabis.
We
would
also
like
a
review
of
the
controlled
access
scheme
and
medicinal
cannabis
access
in
We
need
a
roundtable
where
all
stakeholders
can
come
together
and
discuss
medicinal
cannabis
access
generally
in
So
far,
the
end
user
has
been
ignored
in
this
whole
process.
That was the end of that conversation and my paraphrasing of that position.
This
was
raised
with
me
by
a
family
in
a
very
desperate
situation.
In
my
opinion
this
is
a
sound
position,
and
I
call
on
the
minister
and
the
Government
to
bring
together
all
stakeholders
for
the
purpose
of
a
comprehensive
discussion
on
medicinal
cannabis
before
more
carers
and
parents
are
hurt
and
continue
to
suffer.
Please
do
not
procrastinate
on
this
matter
any
longer.
We
know
of
one
family
openly
defying
the
law
because
of
a
love
for
a
family member. There would be others and it is not an acceptable situation.
I commend this motion to the House and ask members for their support.
[3.50 p.m.]
(Murchison)
-
Mr
President,
I
thank
the
member
for
Windermere
for
bringing
this
motion
on
for
debate.
It
has
been
a
matter
raised
again
recently
after
many
times, not just by the Cleavers, but by others who have an interest in this area.
The
member
for
Windermere
referenced
a
number
of
the
recommendations
made
by
our
committee
inquiry
in
2014.
That
is
six
years
ago
and
the
government
at
the
time
made
commitments
to
participate
in
the
trials
with
New
South
This
in
many
respects
made
sense,
because
it
is
a
bigger
jurisdiction
and
you
could
do
with
more
people
and
all
that
sort
of stuff.
But what has happened since then?
In
a
big
fat
zero.
Why,
if
there
was
ever
a
policy
intent
-
which
clearly
there
is
not,
and
it
is
definitely
a
policy
issue.
It
was
a
policy
issue
of
the
then
minister
for
Mr
Ferguson,
not
to
progress
with
a
legislative
framework
-
he
was
also
minister
for
police
at
the
time
-
even
to
deal
with
providing
some
relief
for
those
who
are
already
using
illegal
product
to
care
for
their
young
children
with
intractable
epilepsy
or
older
young
adults,
as
in
The
sad
reality
about
all
this
is
that
the
people
who
are
using
medicinal
cannabis
are
often
at
the
end
of
their
life,
wanting
it
for
the
treatment
of
symptoms
like
intractable
nausea
with
chemotherapy,
to
stimulate
their
appetite
when
they
are
on
chemotherapy
because
they
cannot
eat.
It
is
also
used
for
pain
in
the
end-of-life
care
and
for
intractable
epilepsy
where
almost
all
of
them
have
tried
almost
every
medication,
if
not
every
medication,
without
or
with
limited
relief.
The
side
effects
of
medication
have
been
such
it
is
not
worth
them
taking
it because it has such a negative impact.
These
medications
we
are
talking
about
are
really
toxic
medications.
They
are
not
a
bit
of
Panadol
here
or
something
like
that,
which
can
be
toxic
in
its
own
right,
but
these
are
really
heavy
duty
drugs
causing
really
serious
side
effects
-
the
member
for
Windermere
talked about some of those side effects.
If
you
get
any
medicine,
there
is
always
an
insert
in
the
packet
that
tells
you
about
the
side
effects
and
all
drugs
have
side
effects.
Panadol
has
side
effects.
Aspirin
has
side
effects.
Antibiotics
have
side
effects,
but
we
take
them
when
we
need
them.
I
am
aware
of
that.
It
is
a
risk
assessment
you
make
with
your
health
professional
that
it
is
the
most
appropriate
medication.
The
contraceptive
pill
has
side
effects.
So
is
having
a
baby
if
you
do
not
take
it,
for
example.
You
have
to
weigh
those
things
up.
Here
we
have
a
situation
where
through
a
policy
position,
we
have
people
who
have
generally
tried
a
whole
range
of
other
toxic
substances
and
we
are
saying
no.
Well,
the
Government
effectively
through
its
policy
settings
is
saying
no,
you
cannot
take
this
substance.
There
is,
in
some
schools
of
thought,
limited
research
around
the
overall
long-term
effects
of
this,
whereas
there
is
a
lot
of
research
as
our
committee
found
about
the
shorter
term
use
and
shorter
term
effects.
Of
course,
you
cannot
get
long-term
effects
unless
you
can
do
studies
over
a
long
period
and
if
it
is
an
illegal
product, how do you do long-term studies?
It
is
like
chasing
your
tail
all
the
time.
The
fact
that
these
people
generally
are
using
it
because
they
have
run
out
of
other
options
-
it
is,
I
suggest,
disgraceful
we
are
not
offering
this
option.
We
offer
to
treat
the
cancer,
for
which
they
often
need
or
want
to
take
medicinal
cannabis
to
manage
the
side
effects.
Chemotherapy
is
totally
toxic.
It
is
designed
to
kill
cells;
that
is
what
its
purpose
is.
But
you
take
medicinal
cannabis,
which
is
not
high-THC
marijuana
-
and
for
those
who
have
read
the
report,
which
some
of
you
would
not
have
done,
there are two main components of cannabis.
One
is
THC,
which
is
the
hallucinogenic
aspect,
and
the
other
is
the
CBD.
There
are
other
cannabinoids
in
medicinal
cannabis,
but
CBD
does
not
have
the
hallucinogenic,
addictive
sort
of
impact
that
THC
can
have.
If
you
go
back
in
history,
even
to
biblical
times,
cannabis
was
used
back
then
but
it
did
not
have
the
high
THC
levels.
It
had
a
higher
CBD
and
lower
THC.
It
has
been
bred
over
the
centuries,
because
when
someone
figures
out,
'This
has
a
nice
effect,'
you
breed
your
plant
to
make
sure
you
get
more
of
a
nice
effect.
You
do
not
have to do that. You can breed the plant to have different proportions of THC and CBD.
Most
of
these
people
with
intractable
epilepsy
do
need
some
THC
in
the
medication,
but it is not at a level that causes the big high you can get from a high-THC product.
I
think
the
member
for
McIntyre,
through
interjection,
mentioned
about
the
consistency
in
a
regulated
environment.
I
cannot
understand
why
the
Government
will
not
proceed
down
the
path
of
a
regulated
framework
for
people
under
the
care
of
their
medical
practitioner,
as
we
suggested
in
our
committee
report.
It
is
not
like
a
person
just
going
out
and
growing
their
own.
You
would
have
a
product
produced
that
is
consistent,
that
is
tested,
so
every
time
you
purchase
that
product,
you
know
what
you
are
getting.
You
know
the
concentration
of
CBD
and THC, for example.
Without
any
regulation,
what
you
get
is
people
growing
it
-
because
they
have
no
other
option
-
with
no
quality
control,
and
you
really
do
not
know
what
you
are
getting
because
seasonal
variations
can
occur,
as
well
as
different
plants
-
it
depends
on
where
you
are
buying
your
seed,
or
your
seed
stock.
You
can
get
different
levels
of
CBD
and
THC,
so
you
do
not
always know what the effect will be.
-
If
you
have
a
regulated
product,
you
know
what
you
are
getting,
and
you get prescribed the product that is fit for your condition.
Of
course,
it
will
be
different
if
you
have
it
to
treat
intractable
epilepsy
than
it
would
be
for treating nausea and vomiting and suppressed appetite, for example.
It
makes
no
sense
to
actually
force
people
into
a
situation
where
they
are
growing
their
own,
with
no
quality
control,
rather
than
having
a
regulated
product
with
limited
access
-
and
that
is
what
we
are
asking
for
here.
We
are
not
asking
for
a
free-for-all.
We
are
asking
for
limited access.
The
other
contradiction,
Mr
President,
is
at
the
time
of
the
committee,
I
know
we
were
not
actually
growing
any
medicinal
cannabis
in
the
state,
and
there
is
a
very
strict
regulatory
framework
for
facilitating
that.
You
have
to
get
Commonwealth
licences
and
state
licences,
and it was a fairly convoluted process.
But
now
we
have
people
growing
medicinal
cannabis
in
this
state.
No
Tasmanian
can
use
it,
but
it
is
being
grown
in
the
state,
and
we
are
supplying
-
so
where
is
the
sense
in that?
-
Well,
there
is
some
just
out
near
Bagdad,
or
Brighton,
or
wherever
it
is out on the road there, and there are others as well.
There
are
so
many
contradictions
in
this.
It
just
beggars
belief
we
have
not
been
able
to
progress
-
even
with
the
research
and
the
pilot
stages
that
have
been
done
-
to
a
sensible
approach. It is purely a policy setting of this Government.
It
is
like
access
to
termination
of
pregnancy.
We
have
the
right
law,
but
we
have
the
wrong
policy
setting.
It
is
a
policy
setting
of
this
Government.
This
Government
can
change
it.
I
know
the
member
for
Windermere
was
not
able
to
give
me
the
names
of
the
TMAAC
members
at
that
point
-
the
Leader
may
have
them
-
but
I
am
interested
in
whether
the
minister -
-
All
right.
Whether
the
minister
has
any
power
over
TMAAC
-
I
will
just read - and I appreciate the member for Windermere providing this -
The
Tasmanian
Medicines
Access
and
Advisory
Committee
(TMAAC)
is
a
multidisciplinary
committee
consisting
of
statewide
representation
of
medical,
nursing,
pharmacy,
consumer
and
Department
of
representatives.
Medical
representation
is
in
the
form
of
a
variety
of
medical
and
surgical
specialties,
and
TMAAC
will
also
nominate
additional
specialists
who
may
be consulted and/or co-opted when relevant.
It
does
not
actually
name
the
members,
but
that
is
okay.
From
that
description
there
is
a
wide range of expertise on this committee. So, what is the problem?
Can
the
minister
influence
this
-
and
I
want
the
Leader
to
see
if
she
can
respond
to
that
-
and
if
so,
what
influence
does
the
minister
have
in
this?
Or
is
it
purely
that
we
have
such
ridiculous
policy
settings
in
this
area
that
it
just
becomes
a
moot
point,
and
this
committee
cannot
-
I
mean,
they
have
other
roles
besides
medicinal
cannabis,
obviously.
They
have
a
range of roles in assessment of other medication, and things like that.
It also says here -
TMAAC
has
delegated
authority
from
the
secretary
for
for
review
of
applications
made
under
the
Controlled
Access
Scheme
for
unregistered
cannabinoid
medicines.
These
applications
are
assessed
in
line
with
established
TMAAC
processes
for
assessing
applications
for
unregistered
medicines.
Who
sets
those
processes?
Does
the
committee
set
them,
or
does
the
minister,
or
does
the department under the oversight of the minister set them?
Something
does
not
seem
to
be
making
sense
here
to
me
if
you
are
going
to
apply
a
consistent
approach
federally,
as
the
federal
government
in
a
Senate
inquiry
has
called
for,
and other states appear to be adopting.
There are a lot of unanswered questions, and I just wondered where this influence is.
It goes on to say -
Unlike
other
medicines,
these
applications
are
concurrently
assessed
by
a
delegate
of
the
secretary
for
under
the
Poisons
Act
1971
to
streamline
both
of
the
necessary
application
processes
required
for
cannabis
We
have
access
in
to
some
cannabis
products,
and
the
name
of
the
medication
escapes
me.
Anyway,
it
is
in
the
Poisons
Act
-
the
cannabinoid
medications
are
listed
there.
They are very limited; there is also a synthetic form, as I understand it generally.
It
is
not
like
this
is
a
completely
foreign
concept.
What
we
are
talking
about
here
is
providing
controlled
access
to
a
regulated
product
that
is
consistent
in
its
dosage
and
its
purity,
to
provide
to
-
what
I
understand
the
request
is,
and
has
always
been
-
a
small
number
of patients with specific conditions that do not respond to other conventional medicines.
The
requirement
is
that
Jeremy
Cleaver
has
to
try
every
medication
that
is
available
before
he
can
use
this,
when
they
have
tried
so
many
others.
They
know
medicinal
cannabis
does work.
I
visited
the
family
and
met
Jeremy.
I
think
it
is
really
sad.
If
he
were
your
child,
what
would you do?
When
Lara
Giddings
was
trying
to
get
some
progress
in
this
area,
she
was
advocating
on
behalf
of
families
with
young
children
with
severe
intractable
epilepsy,
a
similar
sort
of
thing.
Those
families
were
also
using
medicinal
cannabis
because
it
was
the
thing
that
worked.
It
is
not
like
we
are
creating
a
whole
generation
of
drug
abusers.
I
do
not
know
why
we
get stuck in this mentality.
Anyway,
it
is
good
to
see
an
old
former
copper
supporting
this
sort
of
approach.
As
I
said,
by
interjection,
it
is
nonsense
to
think
that
you
have
a
law
that
the
police
will
ignore
most of the time, if not all of the time, because it is a silly law.
You
deal
with
that.
You
change
the
law.
That
was
the
case
back
in
2014
when
we
debated this committee report. Why keep a law that is being ignored in a category?
We
are
not
asking
for
a
free-for-all
there,
either.
We
are
asking
for
limited
access
-
people
are
already
using
it
-
to
give
them
the
comfort
of
not
having
the
police
drive
up
the
driveway
and
arresting
them
because
it
is
illegal.
We
know
that.
If
it
was
your
child,
what
would you do?
Mr
President,
I
support
the
motion.
I
hope
that
we
will
get
to
see
some
action
on
this
-
not
just
for
Jeremy
Cleaver
and
his
family
but
for
all
others
who
currently
use
and
need
it
and
those
who
may
in
the
future
-
and
to
take
a
more
strategic
and
consistent
approach
across
the
country.
Sure,
you
could
continue
the
research
and
looking
at
the
long-term
effects,
but
you
cannot
assess
long-term
effects
unless
you
actually
use
it
long
term.
This
whole
argument
about
potheads
and
things
like
that
-
we
are
not
talking
about
drug
abuse.
We
are
talking
about medicinal use. That is what we need to focus on.
I
thank
the
member
for
bringing
this
motion
on
and
I
look
forward
to
other
members'
contributions.
[4.05 p.m.]
Ms
ARMITAGE
(Launceston)
-
Mr
President,
I
also
thank
the
member
for
Windermere
for
bringing
this
motion
forward.
It
has
been
an
ongoing
issue
and
we
have
all
had
representations
from
many
constituents
over
a
long
period
of
time.
There
is
no
predetermined
list
of
conditions
for
which
a
cannabis
medicine
can
be
prescribed.
However,
the
Commonwealth
department
of
indicates
numerous
health
conditions
potentially
can
be
treated
by
the
use
of
such
medicine,
including
epilepsy
in
children
and
adults,
multiple
sclerosis,
chronic
non-cancer
pain,
chemotherapy,
induced
nausea
and
vomiting
in
cancer
and
palliative
care.
Quite
a
significant
range
of
conditions
and
associated
symptoms
could
potentially be treated and alleviated by allowing sufferers access to cannabis medicine.
The
Therapeutic
Goods
Administration,
which
currently
oversees
the
administration
of
access
to
cannabis
medicine,
specifically
refers
to
such
treatment
as
not
being
a
cure-all,
but
one
which
is
evidence-based
and
considers
the
patient's
individual
circumstances.
The
TGA
says
evidence
suggests
that
when
used
in
conjunction
with
other
treatments,
medicinal
cannabis
may
benefit
some
patients
with
specific
conditions.
Moreover,
the
TGA
stipulates
the
provision
of
cannabinoid
-
CBD
-
is
on
a
last-resort
basis
and
only
to
be
approved
when
other treatments options have been tried and failed.
At
present
in
other
Australian
jurisdictions,
CBD
is
available
by
prescription
only,
made
by
a
registered
medical
professional.
A
doctor
makes
his
professional
judgment
by
assessing
the
patient's
symptoms,
family
history,
and
other
treatments
that
have
not
had
the
desired
effect
on
their
symptoms.
To
me,
these
are
reasonable
and
fair
conditions
to
apply
to
access
to
an
apparently
very
potent
medicine,
which
is
also
still
very
much
in
the
experimental
stages of research.
We
cannot,
however,
ignore
the
direction
the
current
levels
of
evidence
point
us.
Cannabis
medicine
can
have
manifestly
positive
benefits
on
a
variety
of
conditions,
something
which
is
supported
by
both
quantitative
and
current
scientific
evidence.
This
is
not
helped,
however,
by
the
fact
there
is
no
authoritative
high-quality
evidence
on
the
safety,
effectiveness
of
unregistered
cannabinoid
products
for
any
medical
condition.
As
a
result,
in
the
medical
cannabis
Controlled
Access
Scheme
requires
relevant
medical
specialists
on
referral
from
a
patient's
general
practitioner
to
apply
for
an
authorisation
for
each
patient
they
wish
to
trial
the
product.
This
is
clearly
a
quite
significant
undertaking
which
takes
a
lot
of
time
and
resources.
I
understand
little
research
has
been
done
into
examining
the
long-term
effects
of
medicinal
cannabis
on
a
person's
health
considering
all
the
variables
at
play,
including
the
long-term
effects
of
a
significant
illness
on
a
person's
long-term prognosis.
It
is
understandable
that
reliable
evidence,
one
way
or
another,
will
take
a
long
time
to
come
through;
however,
this
is
exactly
what
sufferers
of
these
illnesses
lack
-
time
and
care
for
the
long
term.
These
people
are
sick
and
in
need
of
relief
now.
It
is
important
to
emphasise
just
what
a
significantly
positive
effect
cannabis
medicine
has
for
some
people.
A
constituent
some
time
ago
sent
me
pages
and
pages
they
had
kept
on
their
child's
neurological
condition.
Over
time,
this
person
suffered
dozens
-
perhaps
hundreds
-
of
grand
mal
seizures,
incontinence,
dribbling,
difficulty
in
speaking
and
slow
movement.
On
one
day
alone,
this
person
suffered
14
grand
mal
seizures.
This
does
not
even
begin
to
consider
the
mental
and
emotional
toll
these
physical
symptoms
had
on
this
person's
life
and
that
of
their
family
and
carers.
At
the
time
these
constituents
came
to
see
me,
their
GP
had
advised
them
that
while
the
prescription
of
CBD
would
likely
have
extremely
positive
effects
on
this
person's
condition,
the
process,
under
the
Controlled
Access
Scheme,
was
just
beyond
them.
Of
course,
this
person
was
on
a
cocktail
of
other
medications
in
an
attempt
to
treat
their
primary
and
secondary
symptoms.
These
included
valium,
a
relaxant;
prednisolone,
a
steroid;
phenobarb,
a
barbiturate;
and
an
assortment
of
others,
each
with
their
own
side
effects.
It
is
difficult
to
comprehend
why
the
process
to
acquire
one
medicine
to
go
off
these
others,
which
were
not
working
anyway,
was
so
difficult,
and
why
we
could
abide
letting
this
person
continue
to
suffer this low quality of life.
Early
in
2020,
the
Senate
Community
Affairs
References
Committee
handed
down
a
report
into
the
current
barriers
to
patient
access
to
medicinal
cannabis
in
Of
the
20
recommendations of this committee, I will refer to just numbers 10 and 11.
Recommendation
10
was
that
the
Council
of
Australian
Governments
Council
develop
a
national
framework
for
medicinal
cannabis
access,
to
set
out
goals
for
further
harmonisation
of
related
federal,
state
and
territory
laws.
Recommendation
11
was
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.
The
same
Senate
inquiry
estimated
that
of
the
unknown
number
of
people
who
have
tried
to
legally
acquire
medicinal
cannabis
through
the
Tasmanian
Controlled
Access
Scheme,
only
17
patients
have
been
granted
access
to
the
medicine.
This
follows
a
very
detailed
process.
First,
a
person
seeking
medicinal
cannabis
must
be
referred
by
the
GP
to
a
specialist,
who
must
then
make
application
to
the
Tasmanian
Department
of
for
assessment
by
a
multidisciplinary
expert
panel
of
clinicians.
If
the
prescription
is
authorised,
the
medicinal
cannabis product must then be dispensed through a Tasmanian hospital pharmacy.
As
an
aside,
I
note
that
this
scheme
is
fully
funded
and
patients
who
receive
access
pay
only
the
Pharmaceutical
Benefits
Scheme
co-payment
amount.
However,
despite
this,
the
Senate inquiry report states -
It
was
a
widely
held
view
that
not
allowing
Tasmanian
patients
to
access
medicinal
cannabis
outside
of
the
CAS
is
putting
them
at
a
significant
disadvantage to the rest of the country.
Many
patients,
their
families
and
carers
simply
and
understandably
do
not
have
the
wherewithal to go through the entire CAS process, only to be rejected at the end.
As
a
result,
many
Tasmanians
feel
compelled
to
obtain
cannabis
unlawfully.
We
should
not
allow
the
state
of
Tasmanian
law
to
criminalise
people
who
are
seeking
help.
That
is
neither
productive
nor
just.
A
further
benefit
of
lowering
the
barriers
to
access
medicinal
cannabis
is
also
the
particular
scientific
type.
As
I
understand
it,
cannabis
bought
from
drug
dealers,
for
example
-
that
is,
marijuana
grown
hydroponically
or
outside,
then
smoked
or
ingested
-
contains
higher
levels
of
THC,
the
part
of
the
drug
with
psychoactive
properties.
Medicinal
cannabis
in
the
form
of
oil
or
pills,
I
believe
contains
lower
THC,
but
higher
amounts
of
CBD.
This
has
the
twofold
benefit
of
delivering
the
symptom-alleviating
properties
that
the
cannabis
possesses
without
inducing
the
psychoactive
high
that
a
person
gets when they smoke regular cannabis.
We
should
remember
that
people
who
are
seeking
medicinal
cannabis
are
not
doing
so
in
order
to
get
a
high.
They
are
doing
it
to
access
the
symptom-relieving
effects
it
has
on
conditions
which
significantly
impair
their
quality
of
life.
It
makes
complete
sense
to
reduce
barriers
to
access
medicinal
cannabis
if
we
have
appropriately
robust
legislation
and
guidelines
overseeing
that
access.
I
do
not
understand
what
value
is
added
by
the
Tasmanian
CAS
requiring
a
specialist
to
assess
a
patient's
suitability
for
medicinal
cannabis
when
a
person's
general
practitioner
knows
them
and
their
conditions
better,
and
has
done
for
a
longer period of time.
Reducing
these
barriers
also
makes
financial
sense,
not
just
for
people
who
are
legitimately
trying
to
access
this
medicine,
but
also
for
the
state,
which
subsidises
access
for
many
people
to
access
these
specialists.
What
are
we
also
saying
about
our
GPs
if
we
do
not
trust
them
enough
to
exercise
the
appropriate
level
of
professional
judgment
in
assessing
a
patient's suitability for medicinal cannabis? It all seems very inconsistent to me.
What
I
am
saying
is
that
for
the
limited
use
of
that
CBD
that
is
being
proposed
here,
the
evidence
we
have
now
is
probably
enough.
For
the
purposes
of
making
laws
that
will
benefit
the
class
of
people
it
is
supposed
to,
bringing
Tasmanian
legislation
in
line
with
other
jurisdictions
-
that
is
to
say
that
GPs
are
trusted
as
the
medical
professionals
they
are
to
prescribe cannabis medicine - and it will have the benefits that are intended.
We
are
in
the
unique
position
to
learn
from
the
approaches
taken
in
the
other
jurisdictions
and
to
implement
quickly,
efficiently
and
appropriately
a
CBD
prescription
scheme
in
that
will
have
the
added
benefit
of
freeing
up
resources
being
expended
on the current processes under the Tasmanian Controlled Access Scheme.
This
is
not
to
say
that
prescription
of
cannabis
medicine
should
be
taken
lightly,
nor
should
a
very
liberal
approach
be
taken
to
implementing
a
prescription
scheme
in
Many
factors
need
to
be
considered;
however,
I
definitely
support
an
approach
that
takes
a
cautious,
reasoned
approach
which
relies
on
current
best
evidence
that
could
bring
life-changing relief to some people in the shorter term.
I certainly support the motion before us.
[4.16 p.m.]
Mrs
HISCUTT
-
Leader
of
the
Government
in
the
Legislative
Council)
-
Mr
President,
today's
motion
is
concerned
with
medicinal
cannabis.
It
asks
the
Government
to
further
consider
the
legislative
framework
regulating
the
access
and
use
of
medicinal
As
members
are
aware,
medicinal
cannabis
has
been
able
to
be
prescribed
in
since
2017
in
accordance
with
a
Controlled
Access
Scheme
-
CAS.
The
scheme
allows
patients
to
access
medical
cannabis
lawfully
for
treatment
under
well-established
processes
for all unproven and unregistered medical products.
Under
the
framework
established
by
the
Tasmanian
Poisons
Act
1971,
medicinal
cannabis
in
the
form
of
cannabinoid
is
regulated
as
a
restricted
substance.
Medicinal
cannabis
in
other
forms
is
regulated
as
a
narcotic
substance.
In
each
case,
approval
by
the
This
process
supports
the
safe
and
responsible
use
of
medical
cannabis
products
through
the
rigorous
assessment
of
applications
informed
by
evidence
and
expert
clinical
advice.
This
process
is
required
because
unlike
other
medicines,
most
medicinal
cannabis
products
have
not
been
assessed
by
the
Therapeutic
Good
Administration
as
safe,
efficacious
or of sufficient quality to permit inclusion in the Australian Register of Therapeutic Goods.
Therapeutic
goods
can
be
lawfully
supplied
in
through
two
main
pathways.
Medical
cannabis
products
entered
to
the
Australian
Register
of
Therapeutic
Goods
may
be
accessed in accordance with the framework established by the Poisons Act and regulations.
The
Therapeutic
Goods
Act
provides
the
standard
for
the
uniform
scheduling
of
medicines and poisons, also known as uniform standards.
The
uniform
standards
reflects
decisions
made
by
the
secretary
of
the
Australian
Government
Department
of
about
the
classification
of
medicines
and
poisons
into
schedules.
The
schedule
and
classification
sets
the
level
of
control
on
the
availability
of
Tasmania's
poisons
legislation
adapts
the
uniform
standard
and
reflects
this
classification.
Medicinal
cannabis
products
that
are
not
entered
to
the
register
may
be
accessed
by
the
the
Therapeutic
Goods
Administration
Special
Access
Scheme,
Authorised
Prescriber Scheme or in clinical trials.
In
approval
through
CAS
is
required
and
that
complements
the
Therapeutic
Goods
Administration
Special
Access
Scheme.
The
Controlled
Access
Scheme
is
a
well-established
mechanism
to
support
the
safe
and
responsible
use
of
unregistered
medicinal
cannabis
products
in
It
allows
Tasmanians
with
a
serious
illness
which
has
not
responded
to
conventional
therapies
access
to
unregistered
medical
cannabis
products
when
prescribed by a suitably qualified relevant medical specialist.
The
CAS
is
specifically
designed
to
support
the
safe
and
appropriate
use
of
unproven
medical
cannabis
products
through
the
rigorous
assessment
of
applications
informed
by
evidence and expert clinical advice.
This
is
the
same
process
applied
to
all
other
unproven
medicines
access
through
the
public
health
system
in
It
is
important
because
the
Therapeutic
Goods
Administration
does
not
vouch
for
the
quality,
safety
or
effectiveness
of
unapproved
products
assessed through the Special Access Scheme.
To
protect
patient
safety,
Tasmania's
scheme
requires
standard
evidence-based
treatments to be exhausted before unregistered medicinal cannabis products are trialled.
The
CAS
is
not
condition-specific
and
any
relevant
medical
specialists
present
and
practicing
in
may
make
application
to
access
these
unproven
medical
products
for
their
patients
in
accordance
with
the
scheme
requirements.
The
CAS
is
supported
by
robust
processes
applied
to
unregistered
medicinal
cannabis
in
the
same
way
they
are
applied
to
other
costly
medicines
with
limited
evidence.
Importantly,
the
Tasmanian
Government
is
the
only
government
in
to
subsidise
the
cost
of
highly
expensive
unregistered
medicinal
cannabis
products
and
to
make
their
potential
benefits
accessible
to
all
Tasmanians,
not
just
those who can afford to pay.
The
most
any
approved
Tasmanian
patient
will
pay
for
an
unproven
medical
cannabis
product
under
the
controlled
access
scheme
is
the
applicable
Commonwealth
PBS
patient
co-payment
each
time
the
product
is
dispensed,
which
is
$41
or
$6.60
for
concessional
healthcare
patients.
As
identified
in
the
Senate
inquiry,
one
of
the
major
impediments
for
patients
accessing
unproved
medicinal
cannabis
products
experienced
in
other
jurisdictions
is
the cost, which has been reported to be thousands of dollars for some products.
Public
health
advice
has
consistently
been
that
the
safest
and
most
responsible
way
these
products
can
presently
be
prescribed
is
through
a
specialist
referral
model.
This
ensures
the
management
of
a
patient's
condition
is
optimised
with
existing
proven
therapies,
before
resorting
to
unapproved
medical
cannabis
products.
This
is
not
uncommon
for
highly
specialised
products,
such
as
some
cancer
medications.
The
implementation
of
the
Controlled
Access
Scheme
does
not
change
the
status
of
cannabis
as
an
illegal
drug
in
when
grown
without
a
licence
or
possessed
without
having
been
prescribed
by
an
authorised
specialist medical practitioner.
As
members
may
know,
it
is
an
offence
under
the
Tasmanian
Misuse
of
Drugs
Act
2001
for
a
person
to
cultivate,
possess,
use,
supply
or
sell
cannabis.
The
Australian
Government's
Criminal
Code
Act
1995
also
makes
certain
dealings
in
relation
to
cannabis
unlawful.
Of
course,
any
decision
regarding
offences
and
prosecutions
is
a
matter
for
Tasmanian
police
and
the
Director
of
Public
Prosecutions.
Since
the
Controlled
Access
Scheme
was
implemented
in
2017,
approval
to
access
the
medicinal
cannabis
products
in
a
clinically
sound
way
has
been
granted
to
Tasmanian
patients
demonstrating
the
scheme
is
working
as
it
was
intended,
striking
the
right
balance
between
access
and
safe
prescription
of
unproven
and
unregistered
products for vulnerable Tasmanians.
The
Government
is
committed
to
ensuring
Tasmanians
have
access
to
medicinal
cannabis
in
a
sensible,
responsible
and
evidence-based
way.
We
have
cleared
the
path
on
this
issue
and
the
Tasmanian
approach
has
received
strong
support
from
stakeholders
during
the
development
of
the
scheme,
including
the
Australian
Medical
Association,
the
Royal
Australian
College
of
General
Practitioners
and
Epilepsy
amongst
others.
The
Tasmanian
Government
will
continue
to
support
the
judgments
of
our
specialist
clinicians
and
always
take
advice
from
public
health
experts
on
how
we
allow
access
to
unproven
and
unregistered
medical
products.
We
will
also
continue
to
work
collaboratively
with
the
Government,
other
states
and
territories
to
ensure
access
to
these
unproven
products
is safe and consistent with high-quality evidence-based clinical guidelines.
A
question
was
asked
about
the
numbers;
since
November
2017,
39
applications
under
the
CAS
have
been
submitted
by
relevant
medical
specialists
for
27
patients,
resulting
in
17
approvals
for
16
patients.
One
patient
was
approved
following
re-application
when
the
original approval had lapsed.
The
other
question
was
related
to
the
TGA
and
the
TMAAC
approvals
processes.
To
be
clear,
the
Therapeutical
Goods
Administration
and
the
Tasmanian
Medical
Access
and
Advisory
Committee
serve
different
purposes
and
approval
processes,
but
operate
concurrently.
The
TGA
is
responsible
for
scheduling
assessment
and
registration
of
medicines
in
including
approval
to
import
unregistered
products
through
the
Special
Access
Scheme.
Individual
assessments
of
patients
are
not
conducted
by
the
TGA
when
assessing
applications.
TMAAC
is
responsible
for
ensuring
the
quality
and
cost-effective
use
of
medicines
in
through
the
Tasmanian
hospital
system.
An
individual
risk
or
benefit
assessment
of
applications
occurs
to
ensure
experimental
use
of
unregistered
medicines
is
safe
and
appropriate
in
the
clinical
setting
and
allows
for
subsidised
treatment.
This
assessment
informs
the
secretary
of
the
Department
of
Health's
approval.
I
thank
the
member
for
bringing
on
his
motion.
I
am
sympathetic
to
the
reasoning
behind
the
member
putting
the
motion
forward
and
recognise
the
many
challenges
faced
by
Tasmanians
suffering
debilitating
medical
conditions.
However,
the
Government
does
not
support
the
motion, but rest assured it has been noted.
[4.26 p.m.]
Ms
(McIntyre)
-
Madam
Deputy
President,
I
rise
to
place
on
the
record
my
support
for
the
member's
motion
and
particularly
thank
him
for
bringing
this
forward
today.
This
is
something
that
obviously
has,
as
the
member
for
Launceston
indicated,
been
raised
with many members of parliament over many years.
When
I
saw
this
motion,
my
mind
went
back
to
a
constituent
of
mine.
We
all
received
a
letter
back
in
2014
from
Beverley
Rubenach
and
her
family
-
Beverley
and
Peter
-
for
their
son
Tim,
who
lived
at
St
Marys.
They
shared
their
story
about
Tim's
condition
and
his
challenges
living
with
having
epileptic
seizures
as
a
result
of
a
brain
injury.
He
was
about
28
years of age and had been prescribed a range of anticonvulsant medications.
Sadly,
Tim
passed
away
on
22
May
2018.
He
had
to
access
his
medicinal
cannabis
through
friends
who
provided
that
substance
to
him,
and
that
supported
his
family
to
be
able
to
cope
with
Tim
to
stay
at
home.
Tim
stayed
at
home
and
his
family
cared
for
him
right
through
until
May
2018.
The
Rubenach
family
has
been
very
proactive
in
their
support
for
medicinal
cannabis
to
be
made
available
to
people
who
need
it
under
circumstances
that
have
been spoken of quite eloquently around this Chamber so far on this notice of motion.
They
also
made
representation
through
end-of-life
choices
and
they
attended
the
St
Helens
seminar.
The
member
for
will
remember
Mr
and
Mrs
Rubenach
being
there,
sharing and indicating their support at that time, given what Tim had experienced in his life.
I
pulled
out
the
letter
and
will
not
go
over
it
in
any
fullness,
just
to
again
thank
the
Rubenach
family
for
continuing
to
support
others
in
the
community
and
share
their
story
of
Tim's
challenges
in
not
being
able
to
access
legally
medicinal
cannabis
in
his
time
of
need.
That
was
the
momentum
for
me
to
support
at
that
time,
but
also
to
continue
to
support
this
approach today.
Members
will
note
that
in
question
time
I
received
some
answers,
because
I
had
recently
had
representation
from
a
constituent
of
mine
who
is
accessing
medicinal
cannabis
through
a
doctor
in
and
the
medication
is
dispensed
through
a
pharmacy
in
This
is
not
the
approach
we
need.
Again,
by
interjection,
when
the
member
for
Windermere
was
presenting
his
contribution
to
his
notice
of
motion,
I
said
we
need
a
consistent
and
controlled
approach
here.
That
is
what
we
need.
The
member
for
Murchison
talked
about
the
fact
that
you
do
not
know
what
level
of
THC
you
have
when
you
are
buying
it or sourcing it from wherever.
I,
by
interjection
again,
said
it
might
depend
on
how
much
watering
a
crop
has
had,
or
the conditions of the season, all of those things.
We
should
be
able
to
source
that
medication
in
a
consistent
way.
You
should
not
have
to be finding your source, and as the Rubenachs said -
…
due
to
the
generosity
of
friends
and
acquaintances,
we
were
able
to
acquire
a
sample
of
cold
processed
(THC
has
not
been
activated)
medical
cannabis oil [for Tim] to try.
The Rubenachs should not have had to do that for their son, Tim.
My
constituent
should
not
have
to
get
it
through
somebody
in
then
have
the
That
should
not
be
happening
for
our
constituents.
There
should
be
that
consistent
approach.
Again,
I
support
everything
said
by
the
previous
speakers
-
with
some
exceptions
to
the
Leader, who did not support the motion on behalf of her Government. That is its right.
Ms
-
That
is
right,
because
it
is
the
policy.
I
note
in
the
response
to
my
questions
and
the
answers
provided
-
and
some
of
what
the
honourable
Leader
has
just
read
out
was
in
the
contents
of
the
answers.
I
thank
the
honourable
Leader
for
providing
me
quickly with a copy of that. You cannot take it all in when you are listening.
It
said
that
it
is
important
to
note
that
the
Tasmanian
Government
is
the
only
government
in
to
subsidise
the
cost
of
highly
expensive
unregistered
medical
cannabis
products
and
make
their
potential
benefits
accessible
to
all
Tasmanians,
not
just
those who can afford to pay.
We
just
note
with
the
numbers
that
there
are
only
17
people
accessing
it
-
39
applications
and
only
17
accessing.
What
are
those
other
22
people
doing,
plus
all
the
other
people
in
our
communities
who
are
doing
exactly
like
the
Cleavers
and
finding
it,
using
friends and acquaintances if need be, or growing it themselves?
Mrs
Hiscutt
-
Through
you,
Mr
President,
the
reason
there
was
a
remainder
was
that
they
had
not
exhausted
all
conventional
-
whatever
it
is
-
medicines
for
their
condition
at
that
stage.
Ms
-
I
acknowledge
that
is
the
Government's
position,
but
I
recall
the
member
for
Murchison
talking
about
the
fact
that
some
of
those
traditional
medications
are
actually
worse
than
what
the
person
is
dealing
with.
They
have
more
negative
side
effects
to
what
they
are
dealing
with.
Nobody
is
going
to
go
through
the
CAS
process
if
they
have
not
at least gone through the process with their GP.
In
the
last
few
weeks
we
have
put
so
much
faith
in
the
medical
fraternity,
in
our
doctors,
when
we
discussed
the
End-of-Life
Choices
(Voluntary
Assisted
Dying)
Bill,
and
the
role that doctors play in the lives of their patients. We have talked about that.
Why
would
they
not
know
and
have
that
understanding
of
whether
their
patient
is
going
to
receive
the
relief
they
need
from
traditional
medicine,
or
in
this
case
from
accessing
medicinal
cannabis?
They
would
know
that,
because
we
trust
those
doctors
who
look
after
their patients to know that, to have that level of understanding.
I
believe
that
if
we
are
going
to
trust
them
in
that
way,
we
should
at
least
be
in
line.
I
know
I
am
not
always
a
supporter
of
a
nationally
consistent
approach,
but
in
this
case
I
would
have
to
say
that
when
you
hear
-
and
I
thank
the
member
for
Windermere
for
going
through
the
different
states,
and
outlining
which
ones
have
the
right
process
in
place
-
that
New
South
South
Western
Australian
Capital
Territory
and
Northern
Territory
are
doing
things
a
little
differently,
and
here
is
lagging at the bottom of the pack.
My
particular
constituent
-
because
the
questions
I
asked
were
around
PTSD,
certainly
not
the
epilepsy
path
-
but
still,
this
particular
person
is
able
to
have
a
more
normal
and
functioning life because of the access to medicinal cannabis.
Again,
as
I
said,
a
doctor
in
a
pharmacist
in
That
was
the
basis
of
my
questions.
I
do
not
believe
I
have
enough
answers
to
go
back
to
my
constituent
at
this
point,
but
I
believe
that,
as
a
House
of
parliament
representing
our
community,
this
is
a
really
useful
process and vehicle to continue to push the Government to look at their policy.
I
know
the
Leader
will
make
sure
that
the
minister
and
her
Government
take
on
board
the
contributions
made
by
members,
because
we
are
representing
our
communities.
I
absolutely
do
not
support
the
use
of
drugs
in
any
way,
shape
or
form,
other
than
for
medicinal
purposes. That is what we are asking for here.
We are asking for access for medicinal purposes.
The
reason
the
Government
has
been
so
generous
in
subsiding
-
the
only
government
in
to
subsidise
-
the
cost
of
highly
expensive
unregistered
medicinal
cannabis
products,
and
make
their
potential
benefits
accessible
to
all
Tasmanians,
not
just
those
who
can afford to pay, is because we hardly have any, I suggest.
I
believe
that
if
a
contribution
were
needed,
a
lot
of
people
in
the
community
would
not
be
at
their
properties
hoping
they
do
not
see
a
police
officer
coming
up
their
driveway,
and
feeling
very
anxious.
They
would
much
rather
pay
some
level
of
money,
whether
it
be
subsidised
to
the
level
that
the
Government
has
been
so
generous
thus
far,
or
whether
it
be
at
perhaps
a
higher
level.
I
expect
there
would
be
family
who
would
be
willing
to
support
their
family
member
in
these
circumstances,
rather
than
have
their
loved
ones
feeling
anxious
every
time
they
see
a
police
officer
in
and
around
their
neighbourhood,
wondering
if
somebody
has
dobbed
them
in,
or
somebody
has
suggested
that
their
particular
loved
one
may be using, illegally using, cannabis for medicinal purposes.
I
do
not
think
I
need
to
make
too
many
more
points
about
this.
From
what
I
am
hearing,
it
is
very
obvious
that
there
is
support
in
our
communities,
very
much
so,
for
the
access
to
and
the
use
of
medicinal
cannabis
where
a
GP
has
made
a
decision
that
their
patient
meets the criteria.
It
should
not
need
a
referral
to
an
appropriate
specialist.
We
talked
about
the
value
of
a
GP,
your
own
local
doctor
or
your
doctor,
whether
they
be
local
or
whether
they
be
a
locum,
or
whatever
they
be.
If
they
are
your
GP
and
they
know
you,
and
you
meet
the
requirements,
and
you
have
done
what
you
can
through
traditional
medication,
and
it
is
not
working
for
you,
you should be able to access medicinal cannabis, in my view.
Again,
I
congratulate
the
compassionate
former
copper
on
his
devotion
to
this,
and
certainly
representing
the
Cleaver
family,
in
this
regard.
I
again
thank
the
Rubenach
family
which
has
continued
to
advocate
for
those
in
our
community
so
that
they
do
not
have
to
live
through what the Rubenachs had to while their son, Tim, was on this earth.
In
respect
for
the
Rubenach
family,
I
need
to
support
this,
and
I
will
continue
to
support
this particular avenue that the member is asking the Government to support.
We will not give up on this.
[4.42 p.m.]
Ms
PALMER
(Rosevears)
-
Mr
President,
when
I
was
doorknocking
during
my
election
campaign,
in
the
beautiful
part
of
Rosevears,
Grindelwald,
quite
a
quaint
and
peaceful
part
of
the
electorate,
I
knocked
on
the
door
of
Scott
and
Katinka
Hudman.
At
the
time
our
conversation
was
totally
based
around
voluntary
assisted
dying.
Katinka
shared
with
me about her mother's journey in that space.
Since
then
we
have
exchanged
a
number
of
emails
and
the
issue
of
medicinal
cannabis
has
come
up.
Now
it
has
not
come
up
just
out
of
interest
on
the
matter,
but
out
of
desperation
for
Katinka
who
has
multiple
sclerosis,
to
stop
the
constant
spasms
that
occur
throughout
the
day and that keep her awake at night.
I
can
certainly
relate
to
this,
Mr
President,
having
watched
my
own
dad
suffer
from
very
painful
spasms,
also
as
a
result
of
MS.
It
was
a
daily
task,
where
he
would
yell
out
from
his
chair
or
his
bed
for
my
brother
and
me
to
run
to
him
to
push
his
foot
against
the
spasms
to
try to stop the pain.
So,
I
contacted
Katinka,
and
I
asked
her
if
I
could
share
a
little
bit
about
her
story
in
this
place today. She agreed to that.
In
1992,
at
the
age
of
42,
Katinka,
a
registered
nurse
of
over
20
years'
experience
working
in
rehabilitation,
was
diagnosed
with
relapsing-remitting
multiple
sclerosis.
Like
many
MS
patients,
her
disease
progressed
to
secondary
progressive
MS.
That
means
Katinka
is steadily and slowly deteriorating without any possibility of recovery.
We
move
forward
now,
some
two
decades,
and
this
is
a
snippet
of
her
daily
life,
her
daily challenges in her own words -
I
have
learnt
to
live
with
continuous
pain,
spasms,
fatigue,
incontinence
and
severely
reduced
mobility.
I
have
learned
to
cope
with
my
ever-changing
limitations
with
the
use
of
scooters,
splints,
incontinence
aids,
and
many
adaptations
to
daily
living
arrangements
requiring
walking
frames
and
learning to accept help.
Katinka
has
been
very
clear
in
what
she
has
sent
to
me.
She
is
not
looking
for
pity.
She
does
not
want
or
need
pity.
What
she
says
she
needs
is
help
to
reduce
the
intractable
nerve
pains
and
spasms,
especially
in
her
legs
and
feet,
because
she
just
cannot
sleep.
Her
nights
are continuously broken by pain.
The
only
time
in
Katinka's
life
where
she
has
found
relief
was
a
period
of
time
when
she
lived
in
Europe.
Here,
she
was
able
to
access
medicinal
cannabis
through
the
MS
society.
Unfortunately,
after
she
moved,
this
was
no
longer
available
to
her
and
she
recommenced taking numerous drugs to try to maintain some quality of life.
The
list
of
drugs
is
quite
long
and
to
be
honest
I
actually
cannot
pronounce
half
of
them.
The
only
drug
that
actually
stood
out
to
me
was
Baclofen,
which
was
a
drug
I
remember
hearing as a child that my father had used.
I
understand
this
is
a
muscle
relaxant,
an
antispasmodic
agent
and
the
side
effects
can
include
daytime
drowsiness,
nausea
and
issues
with
bladder
control.
After
Katinka
shared
her
story
with
me,
I
contacted
our
minister,
Sarah
Courtney,
to
ask
where
the
Government
The
minister
responded
to
our
request
for
help
in
this
area,
setting
out
the
pathway
for
Tasmanians
to
access
treatment
with
these
unregistered
products.
The
member
for
Windermere
has
already
touched
on
this
process
but
I
would
like
to
refer
to
the
response
I
received from the minister.
It
begins
with
a
general
practitioner
consultation,
then
a
referral
to
a
specialist
medical
practitioner
in
a
relevant
field
of
practice.
Public
advice
has
consistently
been
that
the
safest
and
most
responsible
way
these
products
can
presently
be
prescribed
is
through
a
specialist
referral
model.
This
ensures
the
management
of
their
condition
is
optimised
with
existing
proven
therapies
before
resorting
to
unapproved
medical
products,
and
the
member
for Windermere touched on this.
This
is
the
established
clinical
practice
pathway
for
assessment
of
any
treatment
of
a
refractory
medical
condition,
not
just
unapproved
medical
cannabis
products.
Once
the
specialist
medical
practitioner
considers
an
unregistered
medical
cannabis
product
is
safe
and
appropriate
for
the
patient,
they
then
seek
legal
authority
from
the
secretary
of
the
Department
of
to
prescribe
and
it
is
reviewed
by
the
Tasmanian
Medicines
Access
and
Advisory Committee.
Unfortunately,
Katinka
hit
a
hurdle
at
the
very
first
jump.
Katinka
told
me
her
GP
was
unable
to
help
her
in
this
space
so
her
journey
continues
and
tonight,
again,
she
will
have
a
night with broken sleep.
All
medicines
can
be
used
for
good
or
for
bad.
Endone
is
a
highly
addictive
pain
killer.
Yet
at
times
it
is
the
only
way
my
mum
can
actually
control
the
extreme
pain
in
her
leg
following
her
hip
replacement
surgery.
Pseudoephedrine
used
in
amphetamines,
great
as
a
nasal or sinus decongestant, is also found in numerous filthy party drugs.
There
can
be
great
goodness
and
certainly
relief
found
in
medicinal
cannabis
products.
I
am
pleased
the
Tasmanian
Government
is
continuing
to
diligently
and
carefully
move
in
this
space.
In
2016
the
Tasmanian
Government
commenced
the
Controlled
Access
Scheme,
which
the
Leader
spoke
about,
allowing
relevant
medical
specialists
the
option
of
considering
unregistered
medicinal
cannabis
products.
The
CAS
is
not
condition-specific.
Any
relevant
medical
specialist
practising
in
may
make
application
if
the
illness
or
condition
has
not
responded
to
conventional
therapies,
and
it
is
considered
by
the
specialist
that
the
use
of
an unregistered medical cannabis product is safe and appropriate for the patient.
The
CAS
continues
to
support
the
safe
and
responsible
use
of
unregistered
medical
cannabis products informed by evidence and expert clinical advice.
Of
course,
I
deeply
sympathise
with
Tasmanians
suffering
chronic
and
challenging
medical
conditions
and
I
acknowledge
the
struggle
that
they
face
on
a
daily
basis.
While
the
Government
does
not
support
the
motion,
it
has
been
noted
and
the
minister
for
and
the
Government
will
continue
to
work
to
improve
health
services
and
to
do
all
they
can
to
support
our
fellow
Tasmanians.
I
will
be
watching
closely
and
supporting
the
Government's
movements in this space because I believe Tasmanians are counting on it.
Before
I
sit
down,
I
have
one
more
answer
on
behalf
of
the
Leader.
This
is
for
the
member
for
Murchison.
The
question
was
in
regard
to
ministerial
influence
on
TMAAC
and
the
list
of
memberships.
TMAAC
members
provide
clinical
advice
based
on
their
relevant
expertise.
The
committee
membership
is
based
on
the
specialities
required
for
the
application
and
may
change
depending
on
the
expertise
required.
The
committee
membership
is
made
up
of
representatives
from
infectious
disease,
oncology,
haematology,
psychiatry,
gastroenterology,
rheumatology
and
paediatrics
as
well
as
specialist
pharmacists
and
consumer
representatives,
which
reflects
the
scope
of
applications
routinely
assessed
by
the
committee.
[4.51 p.m.]
Mr
GAFFNEY
-
Mr
President,
I
rise
to
speak
with
a
feeling
of
great
sympathy
for
the
predicament
Jeremy
Cleaver
and
his
family
faces
on
a
daily
basis.
I
thank
the
member
for
Windermere
for
raising
this
issue
in
the
place
so
we
may
offer
our
thoughts.
It
is
interesting
listening
to
all
the
previous
speakers
-
and
I
thank
them
for
their
contributions
-
but
I
thought,
well,
I
should
take
that
out
and
take
that
out
and
if
I
take
all
those
parts
out,
it
will not make sense in my speech.
So,
I
apologise
if
I
repeat
things,
but,
hopefully,
I
will
be
able
to
provide
some
more
information.
Like
a
number
of
members,
I
was
part
of
the
inquiry
committee
that
investigated
the
use
of
natural
botanical
medicinal
cannabis
flower
and
extracted
cannabinoids
for
medical
purposes.
As
members
may
recall,
this
inquiry
was
brought
to
a
close
in
light
of
developments
at
a
national
level
in
consideration
of
the
use
of
cannabis
in
a
medical
context
-
namely,
the
introduction
of
the
Regulator
of
Medicinal
Cannabis
Bill
2014
as
a
joint
private
members'
bill
with
cross-party
support
and
the
subsequent
referral
of
this
bill
in
2015
to
the
Legal
and
Constitutional
Affairs
Legislation
Committee
for
inquiry
and
report.
Additionally,
the
New
South
Government
established
a
planned
series
of
clinical
trials
to
explore
the
nature
of
cannabis
for
medicine
purposes.
Trials
are
ongoing
and
I
can
only
imagine
the
impact
of
the
current
COVID-19
pandemic
on
the
management
and
conduct
of
this
essential
research.
Looking
into
the
broad
terms
of
these
trials,
we
see
stated
on
its
official
website
that
the
New
South
Government
has
provided
over
$9
million
towards
clinical trials in three areas to evaluate the safety and effectiveness of cannabis medicine to -
(1)
reduce
seizures
in
children
with
severe
treatment-resistant
epilepsy
through
a partnership with the Sydney Childrens Hospital Network;
(2)
improve
appetite
and
appetite-related
symptoms
in
adult
palliative
care
patients with advanced cancer;
(3)
prevent
chemotherapy-induced
nausea
and
vomiting
in
adult
patients
where
standard treatments have proven ineffective; and,
(4)
improve
the
control
of
symptoms
including
pain,
nausea,
and
lack
of
appetite in advanced cancer patients.
They
state
that
sufficient
evidence
collected
from
these
high-quality
clinical
trials
could
help
lead
to
registration
of
a
cannabis
medicine
by
the
TGA,
listing
on
the
Pharmaceutical
Benefits
Scheme
and,
potentially,
patient
access
at
a
subsidised
price.
Thus,
there
is
hope
that
robust clinical data will emerge from these trials that can inform future policy and regulation.
In
the
meantime,
we
face
the
problem
of
how
to
allow
safe
access
to
what
some
see
as
a
life-changing
naturally
occurring
remedy
that
can
improve
the
management
of
their
condition
against
what
many
consider
to
be
a
gateway
drug
into
potential
dependency
and
criminality.
Maybe
the
impact
of
medical
opiate
dependency
is
an
additional
and
intangible
factor
in
official reticence to open up access to cannabinoid remedies.
I
am
mindful
that
since
our
inquiry,
the
Tasmanian
Government
has
developed
the
medicinal
cannabis
Controlled
Access
Scheme
to
allow
defined
medical
specialists
the
opportunity
to
prescribe
medicinal
cannabis
in
the
form
of
unregistered
cannabinoid
products
where
conventional
treatments
may
have
failed
to
give
relief.
Although
only
in
limited
circumstances
-
and,
as
the
member
for
Windermere
describes
for
his
constituent
-
only
when
all conventional treatments have been tried and failed.
The
Government
appears
to
be
unique
in
in
that
it
has,
in
its
own
words,
heavily
subsidised
the
cost
of
the
commercially
produced
cannabis
medicine
product.
Interestingly,
a
quick
search
finds
such
a
medical
specialist
in
advertising
an
initial
consultation
fee
of
$199
with
the
special
offer
of
the
conditional
promise
of
guaranteed
approval or your money back on your first consultation.
Maybe
this
is
not
necessarily
the
nature
of
a
heavily
subsidised
service
the
Government
or
potential
patients
and
their
families
envisage.
What
we
also
see
are
reportedly
very
low
numbers
of
people
actually
accessing
these
services,
with
a
recent
media
report
suggesting
only
16
applicants
to
the
CAS
scheme
have
been
approved.
This
is
from
a
total
of
35
applications in just over three years the scheme has been operating.
In
essence,
have
we
created
another
set
of
barriers
whereby
legal
access
requires
a
bureaucratic
and
regulatory
framework
that
could
be
said
to
focus
on
the
needs
of
regulators
over
that
of
patients?
One
of
the
recommendations
from
the
inquiry
reports
was
to
decriminalise
possession
and
administration
of
cannabis
products
on
compassionate
grounds
for
people
using
them
for
medical
purposes.
This
was
a
recommendation
the
Government
declined
to
support
on
the
grounds
there
is
the
absence
of
a
regulated
framework
to
support
this,
as
it
is
an
illicit
drug
in
law.
Any
police
officer
is
compelled
to
investigate
and
report
and/or seize any material thus discovered.
However,
it
was
pleasing
to
note
that
Police
has
stated
it
will
not
actively
pursue
people
who
make
claims
to
be
using
cannabis
products
for
medical
purposes.
It
does,
however,
place
such
normally
law-abiding
people
in
the
legally
conflicted
limbo
the
member
for
Windermere
described.
If
we
look
to
New
South
Wales
as
a
host
state
of
the
clinical
trials,
we
see
it
does
have
in
place
a
medicinal
cannabis
compassionate
use
scheme
that
perhaps
offers
a
model
that
could
be
adapted
and
enhanced
for
Tasmania.
To
quote
from
its
website -
…the
Medicinal
Cannabis
Compassionate
Use
Scheme
provides
guidelines
for
NSW
Police
officers
about
using
their
discretion
not
to
charge
adults
with
a
terminal
illness
for
possession
of
cannabis
not
lawfully
prescribed
if
they are registered with the Scheme, as well as up to three registered carers.
With
this
comes
a
series
of
helpful
resources
and
registration
forms
for
both
medical
practitioners
and
potential
applicants
available
from
April
this
year.
It
allows
a
GP
to
authorise
the
patient
and
carers
to
retain
and
administer
cannabis-based
products
by
confirming
the
patient's
terminal
diagnosis,
whilst
not
being
required
to
endorse
the
use
of
the
cannabis
as
a
treatment
option,
thus
neatly
sidestepping
the
conscientious
objection
issue
that
can
cause
barriers
to
equity
of
access.
The
provisions
in
both
New
South
Wales
and
Tasmania
in
no
way
allow
an
individual
to
cultivate
cannabis
for
such
use,
a
route
that
would
allow
a
possibly
lower
cost
option
for
both
patient
and
government,
although
it
comes
with
the perception the cultivation of high-THC cannabis could lead to inappropriate use by others.
However,
as
we
are
only
talking
about
just
over
11
applications
to
the
CAS
scheme
in
a
year,
half
of
which
were
unsuccessful,
it
does
not
seem
to
be
a
huge
issue
for
the
Government
to
find
a
way
to
accommodate
the
expectations
and
hope
of
those
in
genuine
need.
In
these
cases,
hope
may
well
be
a
powerful
restorative
to
someone
in
need
of
relief.
There
are
many
anecdotal
reports
of
patients
accessing
CBD
products
via
unconventional
routes,
some
of
which
do
put
people
at
risk
of
prosecution.
However,
it
is
gratifying
to
see
a
recent
media
article
pointed
to
a
recent
interim
decision
from
the
TGA
proposing
low-dose
CBD
products
be classified to be available to Australian patients in consultation with their pharmacist.
I
genuinely
hope
this
option
is
one
that
can
be
adopted
by
the
Government,
as
it
does
relate
to
CBD
as
a
cannabinoid
derivative
that
has
no
psychotropic
effect
on
a
person.
Additionally,
I
have
heard
anecdotal
reports
CBD
products
are
often
sought
out
by
people
in
pain
as
another
option
to
try
as
a
potentially
low
or
no-risk
plant-based
remedy.
Some
of
which
suggests
for
a
person
with
an
eight
out
of
10
pain,
a
CBD
product
may
reduce
it
to
a
six
out
of
10.
This
is
not
to
say
there
is
a
suggestion
it
is
a
consistent
effect
or
one
based
on
clinical
trial
findings
-
it
may
offer
potential
relief
for
some
and
nothing
at
all
for
others
-
on
an experimental 'try it and see' basis.
Within
all
this,
we
face
another
current
conundrum
whereby
legal
access
requires
a
bureaucratic
and
regulatory
framework
that
can
be
said
to
be
system-centric
rather
than
patient-centric.
I
can
understand
the
concern
of
medical
and
research
professionals
that
these
products
need
to
be
properly
regulated
with
consistent
treatment
and
dosage
protocols
in
place,
together
with
an
understanding
of
any
possible
side
effects.
It
could
also
be
argued
that
black
market
CBD
material
is
apparently
a
loose
and
unregulated
product
that
possibly
borders
on
the
anecdotal
nature
of
the
efficacy
or
not
of
homeopathic
remedies.
What
we
have
is
a
complex
issue
where
there
seems
to
be
no
absolute
right
or
wrong
answers,
just
suggestions that we need to ask further questions to establish what is appropriate.
I
fully
support
the
Government's
approach
in
terms
of
working
collaboratively
with
the
New
South
Wales
clinical
trials,
but
at
the
same
time
I
wonder
if
there
is
the
opportunity
to
revisit its opinion of the findings of our inquiry into legalised medicinal cannabis.
There
was
a
suggestion
in
the
final
report
that
we
might
keep
a
watching
brief
on
the
developments
of
this
subject,
both
at
the
federal
level
and
in
other
jurisdictions.
Five
years
have
now
elapsed
since
our
inquiry
reported
its
findings
and
made
a
number
of
recommendations, some of which have been accepted and enacted while others have not.
We
have
an
opportunity
to
revisit
what
is
appropriate
in
a
modern-day
world
that
is
coming
to
terms
with
the
implications
of
the
long-term
impact
of
the
COVID-19
pandemic.
Additionally,
if
we
sought
to
do
this
on
a
formal
basis,
we
would
need
some
fresh
terms
of
reference,
and
perhaps
a
new
committee
of
inquiry.
Maybe
now,
or
in
the
very
near
future,
is
a
time
for
this.
Its
terms
of
reference
could
also
be
broadened
to
include
a
holistic
review
of
pain
management
and
support
service
options
within
Tasmania,
especially
those
within
our
outlying regions.
If
a
new
inquiry
as
an
extension
of
the
learnings
from
our
last
one
is
not
deemed
to
be
the
appropriate
next
step,
the
very
least
our
current
Government
may
need
to
revisit
is
how
Tasmania's
legislation
may
be
more
symbiotically
aligned
with
that
of
the
Australian
Government and our fellow state and territory jurisdictions.
Perhaps
this
needs
to
be
actioned
as
a
matter
of
urgency,
as
we
all
have
constituents
who
need
our
support
in
helping
them
to
improve
their
wellbeing
and
enjoyment
of
life,
especially
those
who
are
struggling
to
cope
with
seemingly
irresolvable
medical
conditions
that
come
with
a
range
of
difficult-to-manage
chronic
medical
issues,
including
persistent
pain and other forms of suffering that inhibit their daily lives.
I
thank
the
member
for
Windermere
for
bringing
on
this
motion,
and
I
am
pleased
to
add my support.
[5.02 p.m.]
Dr
SEIDEL
(Huon)
-
Mr
President,
I
did
not
prepare
a
formal
speech,
but
please
allow
me
to
make
a
couple
of
comments,
because
it
really
is
an
interesting
area
we
are
dealing
with.
When
we
talk
about
health
legislation
and
regulation,
I
think
we
should
focus
on
one
thing
and
one
thing
only
-
and
that
is
the
patient.
We
have
to
be
committed
to
ensure
that
the
legislation and regulation are meeting the needs of patients. That is all - it is not that hard.
It
is
clear,
listening
to
members,
that
the
scheme
we
currently
have
in
Tasmania
certainly
does
not
meet
the
needs
of
vulnerable
patients
who
have
tried
everything
else
in
the
medical
textbooks
and
do
not
find
answers
there,
and
therefore
are
looking
for
alternatives
and find relief in medicinal cannabis products that currently are unapproved and unregulated.
It
is
fair
to
say,
and
I
have
mentioned
this
before,
that
prescribing,
regulating
and
accessing
medicinal
cannabis
in
Australia
is
pretty
much
a
basket
case.
It
is
what
it
is.
For
years,
I
have
been
asking
for
a
nationally
consistent
regulatory
framework
for
access
and
prescribing medicinal cannabis. It should not be that hard.
Realistically,
when
I
was
national
president
of
the
college
of
GPs,
we
had
positive
meetings
on
a
federal
level
with
the
federal
Minister
for
Health,
the
honourable
Greg
Hunt.
He
was
committed
to
introducing
a
nationally
consistent
regulatory
framework.
To
do
that,
you
would
need
to
get
the
states
on
board,
so
my
role
was
to
speak
to
respective
state
health
ministers on that.
I
did
not
have
much
luck
with
the
Tasmanian
Health
minister
at
the
time,
Michael
Ferguson.
It
did
not
make
any
sense
to
me
at
the
time
why
you
would
consider
unnecessary
barriers
and
create
unnecessary
burdens,
considering
that
we
could
focus
on
the
national
body
-
and
TGA
was
proposed
as
the
one-stop
shop
for
approving
medicinal
cannabis
products.
It
did not make any sense, so we progressed it in January 2018.
Other
states,
like
New
South
Wales,
committed
to
a
framework,
and
reduced
their
barriers.
In
March,
New
South
Wales
decided
just
to
have
the
TGA
as
the
one-stop
approval
point,
and
it
was
meant
to
be
discussed
at
a
Council
of
Australian
Governments
health
ministers'
meeting
in
April
2018.
I
know
they
did
discuss
it,
but
unfortunately
Tasmania
stood quite firm and said, 'No, we are not going to be involved; we do what we do.'.
And
here
we
are
in
2020
when
it
does
not
seem
to
work
and
it
is
completely
unnecessary.
I
am
getting
a
bit
upset
when
I
am
hearing,
'Well,
but
we
have
a
special
access
scheme
and
compassionate
access
scheme,
and
we
are
the
only
state
in
the
Commonwealth
that
subsidises medicinal cannabis when approved.'.
That
is
fair
enough,
but
it
is
almost
like
a
spin
doctor
talking
rather
than
a
real
doctor
talking,
because
you
could
do
this
so
much
easier.
You
just
commit
to
subsidise
each
and
every
medicinal
cannabis
product
that
is
also
approved
by
the
TGA.
End
of
story.
The
secretary
of
the
Department
of
Health
could
do
that,
or
her
delegate
could
just
stamp
'Approved'.
There
is
no
need
for
an
extra
committee.
There
is
just
no
need,
because
the
product
is
already
approved.
The
application
has
been
made
to
the
TGA;
the
TGA
has
appraised
the
application;
and
if
the
TGA
approves
it,
because
it
feels
it
is
appropriate
for
this
patient
to
have
access
to
medicinal
cannabis,
why
would
you
need
to
have
another
body
approving
what
is
approved?
That
body
in
Tasmania
could
just
say,
'Yes,
if
it
is
approved
by
the
TGA,
we subsidise it.'. That is it.
If
we
want
to
reduce
red
tape,
we
can
do
this
now.
We
do
not
have
to
wait
for
anything.
Trust
the
TGA
to
do
the
right
thing
-
and
it
is
doing
this
nationally
in
each
and
every
state
anyway.
To
be
frank,
cannabis
is
not
that
special.
It
is
just
medication,
you
know.
It
is
not
that
special. It is not that different to other medicines, really.
Dr
SEIDEL
-
I
will
come
to
that
in
a
minute.
If
we
look
at
things
that
are
readily
available
-
like
opioids,
for
example
-
that
seems
to
be
straightforward.
Anybody
can
prescribe it. Junior doctors can prescribe it.
Dr
SEIDEL
-
Much
more
harmful,
but
I
remember
when
I
went
to
medical
school,
we
were
told
nobody
should
be
in
pain,
and
the
solution
for
pain
is
to
prescribe
opioids.
When
I
was a GP, we got called out because GPs were not prescribing enough opioids.
Dr
SEIDEL
-
And
we
were
told
it
is
safe,
and
we
should
be
prescribing
more,
and
how
dare
we
GPs
-
we
are
not
educated
enough
because
we
do
not
prescribe
opioids?
That
was
the
big
industry
push,
and
pain
specialists
were
trained
and
pushed
us
GPs
to
prescribe,
and
see
what
happened.
We
were
told
the
evidence
was
great.
All
the
guidelines
said
the
evidence
is
really
strong
-
and
20
years
down
the
line,
we
have
another
problem.
A
huge
issue, and it is getting worse.
Now
we
know
opioids
do
not
work
for
chronic
pain,
but
we
prescribe
it
regardless,
and
we approve it regardless, and the PBS subsidises it regardless.
It
does
not
make
any
sense,
but
for
medicinal
cannabis,
which
is
not
a
panacea
for
all,
but
might
well
be
the
appropriate
medication
and
treatment
of
last
resort
for
a
small
number
of
people
-
a
last
resort
for
a
small
number
of
people
-
we
just
create
these
unnecessary
artificial barriers. It does not make any sense.
It
does
not
make
any
sense
from
a
scientific
point
of
view.
It
does
not
make
any
sense
from a medical point of view. It does not make any sense from a commonsense point of view.
We
are
failing
our
patients,
and
we
have
heard
the
stories
over
and
over
again,
and
it
is
sad.
Honourable
Leader,
when
the
Tasmanian
scheme
was
introduced,
I
certainly
referred
a
patient
of
mine
with
chronic
pain.
We
had
tried
everything
-
absolutely
everything.
All
the
standard
medicines.
We
did
acupuncture,
we
did
psychology,
we
did
exercise
physiology
-
you name it, he has done it.
I
referred
him
for
an
assessment
to
consider
medicinal
cannabis,
and
I
had
a
handwritten letter back, 'We do not offer that service', and then the patient stays where he is.
He
said,
'Well,
I
will
just
have
to
grow
my
own
then',
because
he
was
not
going
to
use
any of the other stuff I have tried. I have tried the lot.
So
again,
it
is
not
many,
but
there
are
patients
out
there
that
the
current
scheme
as
we
have
it
now
is
failing.
We
continually
say
we
are
the
only
state
that
financially
subsidises
medicinal cannabis, but I am not sure that is going to fly.
I
will
talk
a
bit
about
what
we
are
looking
for
with
evidence.
I
heard
what
the
member
for
Mersey
said
with
regard
to
more
trials,
more
science.
Yes,
scientists
and
medical
researchers
always
ask
for
more
trials
and
so
forth
and
that
is
great.
But
I
want
to
put
on
record
there
is
conclusive
evidence
that
cannabis
or
cannabinoids
are
effective
in
outcomes
for
the
treatment
of
chronic
pain
in
adults,
as
an
antiemetic
in
the
treatment
of
chemotherapy
to
reduce
nausea
and
vomiting,
and
for
improving
patient-reported
multiple
sclerosis
spasticity symptoms - conclusive evidence.
Mr
President,
that
is
not
my
opinion
-
right,
it
is
not
my
opinion
-
it
is
the
opinion
and
the
conclusion
of
the
National
Academy
of
Sciences
in
the
United
States
of
America,
which
published
its
seminal
work
on
the
health
effect
of
cannabinoids
in
2017.
Now,
remember,
that
was
not
a
quick
review;
it
was
not
a
hush
job,
because
since
1999,
when
the
initial
institute's
report
was
released,
an
additional
24
000
articles
were
published
and
reviewed
by
the
National
Academy
of
Sciences.
They
reviewed
and
appraised
each
and
every
one
of
them,
and
so
they
should.
There
is
really
nothing
the
academy
can
do
better
tha
n
appraising
evidence
-
that
is
what
it
does.
It
is
a
great
institution,
founded
in
1863,
funded
through
a
$500
million
endowment.
It
consists
of
2000
members
and
1000
staff,
and
190
of
the
members
have
received
a
Nobel
prize.
If
there
is
anything
it
can
do,
it
can
establish
scientific
facts. We certainly have the highest level of evidence, which is from 2017.
Yes,
you
know
there
have
been
more
reviews
and
more
science
and
more
research
papers
since
then;
of
course.
There
have
been.
Science
is
always
going
to
evolve,
and
it
should,
but
I
want
to
be
quite
clear
we
have
just
one
area
where
there
is
absence
of
evidence,
which
does
not
mean
there
is
actually
absence
of
evidence
either.
We
have
to
be
really
quite
mindful
of
that.
It
is
a
difference
between
absence
of
evidence
and
the
evidence
of
absence.
Realistically,
we
in
health
are
doing
off-label
prescribing
already;
it
is
a
common
practice.
Routinely,
we
are
doing
off-label
prescribing.
We
are
doing
this
in
particular
for
people
at
risk,
and
children.
Most
of
the
medicines
we
use
for
children
have
not
been
through
rigorous
randomised control trials; they just have not.
We
are
prescribing
based
on
the
safety
profile
of
the
medication.
We
are
prescribing
based
on
surrounding
science.
That
is
why
the
member
for
Murchison
is
right,
cannabidiol
is
one
of
over
100
chemicals
in
the
marijuana
plant;
it
is
actually
very
safe.
It
is
impossible
to
overdose
-
you
would
need
half
a
ton
of
cannabidiol;
it
is
not
going
to
work.
You
would
be
crushed
rather
than
poisoned
by
it
-
that
is
how
much
cannabidiol
you
actually
need.
With
regard
to
THC,
it
is
a
bit
of
a
different
story
-
there
are
potentially
psychotic
effects,
mental
health effects; we know that.
But
again,
we
can
distinguish
that
it
is
entirely
reasonable.
Cannabidiol
has
been
well
studied
and
we
know
it
is
safe.
So,
if
you
know
it
is
safe
and
we
know
it
is
indicated,
why
are
we
not
allowed
to
prescribe
it?
It
really
should
not
be
that
hard.
We
can
do
this
now.
Again,
we
could
go
on
and
on.
How
do
we
monitor
for
long-term
effects
and
long-term
trials?
That
has
all
been
discussed
extensively.
We
can
do
n-of-1
trials;
we
can
do
a
central
register
-
it
is
all
possible,
the
models
already
exist,
it
can
be
done
tomorrow,
it
is
not
that
hard.
I
welcome
the
availability
now
of
low-dose
cannabidiol
products
as
scheduled
for
pharmacy-only
medications.
It
is
a
good
starting
point.
It
also
indicates
to
the
wider
public
that those medicines actually are safe.
But
again,
what
I
also
do
not
want
is
that
patients
are
now
going
from
one
pharmacy
to
another
pharmacy
to
another
pharmacy
just
to
get
more
and
more
of
those
low-concentration
drugs.
Let
us
have
a
commonsense
approach
here
-
regulate
appropriately
and
remove
unnecessary
barriers.
The
scheme
we
currently
have
in
Tasmania
is
a
barrier;
there
is
no
benefit
for
it.
If
you
want
to
subsidise
medicinal
cannabis,
great
-
subsidise
each
and
every
drug
that
has
been
approved
by
the
TGA.
The
TGA
now
has
a
turnaround
time
online
of
less
than
four
days.
GPs
could
directly
refer
to
the
TGA
for
an
approval
process.
That
is
how
it
should work, it is not that hard.
I certainly commend the member for Windermere for his motion and I fully support it.
[5.15 p.m.]
Mr
VALENTINE
(Hobart)
-
Mr
President,
I
found
it
quite
fascinating
doing
a
little
of
reading and research about this topic.
I
thank
the
member
for
Windermere,
who
is
not
in
the
Chamber
at
the
moment,
for
bringing on this motion.
It
has
been
interesting
to
listen
to
the
different
opinions,
especially
those
of
the
member
for Huon.
It
seems
to
me
there
would
be
a
lot
of
sense
in
having
a
national
approach
to
this,
because
people
do
not
stand
still.
They
move
from
one
state
to
another.
They
take
their
condition
with
them,
and
I
think
it
is
important,
using
that
patient-centric
approach,
that
it
ought to be a decision that covers the nation as opposed to just individual states.
In
reading
some
of
the
information,
I
know
the
member
for
Windermere
went
through
and
talked
about
the
situation
in
each
state.
The
research
done
for
me
looked
at
professional,
private
and
other
aspects
that
exist
around
the
way
medicinal
cannabis,
or
cannabis
actually,
is dealt with by the different states.
I want to highlight those differences by reading out some of them out.
In
Victoria,
privately
medicinal
cannabis
can
only
be
legally
accessed
through
your
doctor.
Growing
your
own
cannabis,
or
smoking
illicit
cannabis,
for
medicinal
purposes
remains illegal.
In
New
South
Wales,
individual
patients
cannot
apply
to
obtain
approval
to
import
and
access unapproved cannabis medicines.
In
Queensland,
you
cannot
legally
produce
your
own
cannabis
for
medicinal
use.
Queensland does not have an amnesty scheme.
In
South
Australia,
it
is
not
legal
to
grow
or
use
cannabis
for
non-medical
purposes,
nor
do they legalise the cultivation of cannabis or its use outside of regulated medicinal purposes.
Some
extras
in
South
Australia.
Exemptions
apply
in
South
Australia
for
patients
aged
over
70
years
of
age
and
terminally
ill
patients,
whose
doctors
have
notified
the
Drugs
of
Dependence Unit (Notified Palliative Care Patients).
In
Western
Australia,
you
cannot
grow
your
own
medicinal
cannabis.
Smoking
cannabis is still a highly regulated drug, and it is still illegal to use recreational cannabis.
We
know
about
Tasmania,
but
the
information
that
came
to
me
through
this
research
is
that
the
scheme
does
not
affect
the
status
of
cannabis
as
an
illegal
drug
that
causes
significant
harm
in
the
community.
All
Tasmanian
offences
for
cannabis
cultivation,
possession
and
use
still apply.
In
the
Australian
Capital
Territory,
people
cannot
legally
cultivate
their
own
cannabis
for
medicinal
use.
Possession
and
supply
of
all
other
non-approved
cannabis,
whether
for
medicinal or recreational use, remains illegal in the ACT.
In
the
Northern
Territory,
the
growing
and
use
of
the
cannabis
plant,
and
all
parts
of
the
cannabis
plant,
is
illegal
under
the
Northern
Territory
Misuse
of
Drugs
Act
1990,
which
is
the
responsibility of the Northern Territory Department of Attorney-General and Justice.
An
extra
there
in
the
Northern
Territory
-
cannabidiol
CBD
products
are
Schedule
4
and
prescription
only,
the
same
as
medicines
used
for
medical
conditions
such
as
high
blood
pressure,
diabetes,
epilepsy
et
cetera.
The
prescriber
does
not
need
a
Northern
Territory
authorisation or to notify that they have prescribed an S4 CBD medicine.
You
can
see
there
is
nothing,
you
would
say,
that
is
wholly
consistent.
In
doing
the
research,
I
was
provided
with
something
from
a
page
of
the
Alcohol
and
Drug
Foundation.
I
do
not
always
agree
with
the
Alcohol
and
Drug
Foundation
and
its
stance
on
different
things,
but I thought it dealt with this in a significant way.
I will preface it by saying that the note on its page says -
The
information
given
on
this
page
is
not
medical
advice
and
should
not
be
relied
on
in
this
way.
Individuals
wanting
medical
advice
on
this
issue
should consult a health professional.
I
have
not
had
a
chance
to
verify
what
I
am
reading
and
it
is
information
that
is
being
provided for the record. They go into 'What is medicinal cannabis?' -
Broadly
speaking,
medicinal
cannabis
is
cannabis
prescribed
to
relieve
the
symptoms
of
a
medical
condition,
such
as
epilepsy.
It
is
important
to
make
the
distinction
between
medicinal
cannabis
and
recreational
cannabis.
Recreational
cannabis
is
the
form
of
cannabis
people
use
to
get
'high'.
For
some
people
suffering
from
chronic
or
terminal
illnesses,
conventional
medicines
do
not
work
or
do
not
work
as
effectively
as
medicinal
cannabis.
Also,
for
some
patients,
conventional
medicines
may
work
but
cause
debilitating side effects that cannabis can help to relieve.
The member for Huon pointed that out very carefully for us -
What
are
cannabinoids?
The
main
psychoactive
ingredient
of
cannabis
is
tetrahydrocannabinol
(THC),
which
acts
on
specific
receptors
in
the
brain
known
as
cannabinoid
or
CB1
receptors.
Research
has
found
that
the
cannabis
plant
produces
between
80
and
100
cannabinoids
and
about
300
non-cannabinoid
chemicals.
The
two
main
cannabinoids
that
have
been
found
to
have
therapeutic
benefits
are
delta-9-tetrahydrocannabinol
(THC)
and cannabidiol (CBD).
Which other members have talked about -
There
have
been
claims
that
a
number
of
other
cannabinoids
have
therapeutic
properties
but
these
have
not
yet
been
proven.
The
main
difference
between
the
two
cannabinoids
is
that
THC
has
strong
psychoactive
effects,
meaning
it
makes
a
person
'high',
whereas
CBD
is
thought
to
have
an
anti-psychoactive
effect
that
controls
or
moderates
the
'high'
caused
by
the
THC.
CBD
is
also
thought
to
reduce
some
of
the
other
negative effects that people can experience from THC, such as anxiety.
The
psychoactive
effects
of
THC,
such
as
euphoria
and
feeling
relaxed
or
sleepy,
are
well
known,
but
THC
has
also
been
found
to
have
analgesic,
anti-inflammatory
and
antioxidant
properties,
as
well
as
being
able
to
prevent and reduce vomiting.
Research
is
being
conducted
into
CBD
for
its
potential
to
treat
epilepsy,
schizophrenia
and
other
psychotic
disorders,
type
2
diabetes,
inflammatory
bowel disease, some tumours and drug dependency.
…
The
endocannabinoid
system
is
a
unique
communications
system
found
in
the
brain
and
body
that
affects
many
important
functions.
It
is
made
up
of
natural
molecules
known
as
cannabinoids
and
the
pathways
they
interact
with.
Together,
these
parts
work
to
regulate
a
number
of
activities,
including
mood,
memory,
sleep
and
appetite.
It
is
thought
that
medicinal
cannabis
can
treat
various
illnesses
by
acting
on
the
endocannabinoid
system.
Types
and
forms
of
medicinal
cannabis.
There
are
three
main
forms
of
cannabis
that
can
be
used
medicinally:
pharmaceutical
cannabis
products
that
are
approved
by
an
organisation
such
as
the
Therapeutic
Goods
Administration,
including
nabiximols,
[marketed
as]
Sativex,
and
synthetic
cannabinoids
such
as
Dronabinol.
Sativex,
which
comes
as
a
nasal
or
oral
spray,
has
been
approved
in
over
24
countries
for
treating
spasticity
due
to
multiple
sclerosis;
controlled
and
standardised
herbal
cannabis
(plant
products)
such
as
the
products
produced
in
the
Netherlands;
unregulated
and
illegal
herbal
cannabis
(plant
products)
which
contains
unknown
concentrations
of
cannabinoids
and
potentially
harmful
impurities,
such
as
bacteria and mould (USA only).
It
is
quite
clear
to
me
when
I
read
through
those
sorts
of
things
how
important
it
is
to
make
sure
that
whatever
patients
are
taking
is
properly
regulated.
We
would
all
agree
with
that.
It
is
so
important
they
know
that
the
medicines
they
are
taking
are
not
harmful.
Who
knows
in
an
environment
where
people
are
making
money
out
of
a
product,
be
it
medicinal
cannabis
or
otherwise,
what
that
product
has
in
it?
Whether
it
has
additives
to
bulk
it
out.
Who
knows
what
happens
in
that
circumstance?
So
it
is
important,
really
important,
that
these sorts of products are properly regulated.
One
of
the
links
provided
to
me
was
to
the
notice
of
interim
decisions
on
proposed
amendments
to
the
Poisons
Standard,
the
ACMS
and
joint
ACMS-ACCS
meetings
of
June
2020.
This
was
included
because
it
is
basically
the
Therapeutic
Goods
Administration
making
an
interim
decision
in
relation
to
cannabidiol
(private
application)
and
cannabidiol
(delegate-initiated)
and
this
is
what
they
have
come
down
with
in
terms
of
an
interim
decision
-
In
relation
to
the
proposed
amendment
in
the
private
scheduling
application
it
made
an
interim
decision
not
to
amend
the
current
Poisons
Standard
to
exclude cannabidiol from scheduling and allow its general sale.
So, in the interim, it is not allowed to be sold generally, basically. Secondly -
In
relation
to
the
proposed
delegate-initiated
amendment,
it
made
an
interim
decision
to
amend
the
current
Poisons
Standard
to
down
schedule
cannabidiol
to
allow
greater
access
through
a
new
Schedule
3
entry
in
accordance
with
specified
requirements
and
with
additional
supply
requirements
specified
in
appendix
M
to
allow
it
to
be
provided
by
a
pharmacist.
This
decision
has
basically
been
made
and
it
was
in
June
2020,
so
just
recently.
The
proposed Poisons Standard entry in relation to CBD is as follows, the amended entry -
Cannabidiol
in
and
preparations
for
therapeutic
use
where
CBD
comprises
98
per
cent
or
more
of
the
total
cannabinoid
content
of
the
preparation;
and
any
cannabinoids
other
than
CBD
must
be
only
those
naturally
found
in
cannabis
and
comprise
2
per
cent
or
less
of
the
total
CBD
content
of
the
preparation.
Mr
VALENTINE
-
Well,
cannabidiol
is
CBD
and
cannabinol
is
the
THC
one,
according
to
the
information.
When
I
say
CBD,
I
am
talking
about
cannabidiol,
to
be
clear
for
the
record.
Quite
clearly,
this
is
something
moving
along
and,
indeed,
as
it
turns
out,
it
looks
like
it
may
-
and
I
say
'may'
because
we
have
to
wait
and
see
-
become,
rather
than
an
interim decision, an actual decision in June 2021.
Things
are
happening
in
this
area.
The
important
thing
about
the
member's
motion
is
that
Tasmania
is
on
board
with
it,
and
to
make
sure
we
are
taking
part
in
the
national
conversation,
to
make
sure
that
people
who
live
in
this
state,
albeit
not
many
of
them,
who
access
or
need
to
access
this
-
hence
the
reason
the
Government
is
happy
to
help
fund
them
because it is not going to cost them an arm and a leg, whereas it might in some other states.
It
is
important
we
try
to
have
a
national
approach.
I
thank
the
member
for
bringing
this
motion
forward.
I
appreciate
the
need
-
you
can
only
try
to
imagine
what
it
is
like
for
anyone,
a
parent
especially,
who
may
need
these
products.
Particularly
for
children
who
are
suffering
-
and
imagine
what
it
would
be
like
for
a
parent
knowing
this
particular
product
can
assist
and
make
such
a
difference,
but
they
simply
cannot
get
it
or
it
is
not
allowed
to
be
sold
or
prescribed to them. I support the motion.
[5.30 p.m.]
Mr DEAN
(Windermere) - Mr President, I will move -
———————————————————
Answer to Question
Mrs
HISCUTT
(Montgomery)
-
Mr
President,
by
way
of
clarification,
before
the
member
starts:
the
member
for
Murchison
earlier
asked
a
question
about
ministerial
influence over TMAAC.
The
Chief
Medical
Officer
was
in
a
meeting
so
we
could
not
get
the
answer
then,
but
we
have
it
now.
He
says
the
minister
has
no
influence
on
the
committee's
decision-making
ability which is evidenced and clinically based.
———————————————————
Mr DEAN
- I thank the Leader for that.
I
thank
all
members
for
their
contributions
on
this
motion.
In
my
view,
they
were
some
of
the
most
powerful
contributions
I
have
heard
for
a
long
time
on
a
motion
on
a
specific
point.
We
get
great
contributions
in
this
place,
which
is
one
of
the
benefits
and
advantages
of
this House - we all come from different walks of life, which is shown in this place.
There
were
very
strong
contributions
by
everybody.
If
a
government
were
listening
to
them,
and
if
it
could
still
say,
after
all
that,
that
it
is
doing
enough
in
this
area,
it
is
just
taking
no
notice
and
shutting
itself
off
from
what
is
happening
here.
That
is
how
strong
this
debate
has
been.
It
really
has
been
strong,
and
I
invite
the
Government
to
look
at
what
has
been
said,
Leader,
and
what
has
been
pointed
out
by
all
members
who
have
made
a
contribution.
I
think
it would probably support this in any event. I would be very surprised if it does not.
I
cannot
say
enough
about
that
and
whatever
I
say
now
is
not
going
to
come
anyway
near that standard of contribution, and I say that genuinely.
I
want
to
make
one
or
two
comments
briefly.
Our
doctors
are
pivotal
in
this
whole
issue,
as
they
were
in
the
previous
matter
we
were
dealing
with
over
a
long
time.
Doctors
are
on
the
very
top
rung
of
that
status
ladder
I
keep
referring
to.
The
public
has
the
absolute
utmost
faith
in
our
doctors.
This
motion
is
not
about
wanting
access
to
this
product
without
a
proper
process
in
place
and
without
the
medical
fraternity
having
a
major
part
in
this
whole
thing.
We
come
back
to
doctors
and,
as
I
said,
we
admire
them
and
have
the
greatest
amount
of faith in them.
I
thank
members
for
raising
this
issue.
We
should
not
take
any
course
that
pushes
people
towards
illegal
access
to
this
product,
and
that
unfortunately
and
sadly
is
what
we
are
doing.
I
have
a
problem
when
they
say
every
product,
every
medicine,
on
the
shelf
should
be
trialled
in
the
first
place
before
TMAAC
will
sign
off
on
providing
access
to
medicinal
cannabis.
That
worries
me
from
a
number
of
perspectives,
and
I
have
raised
one
of
those
issues
already.
It
has
also
been
raised
here
by
a
number
of
members
that
some
of
these
medicines have severe side effects.
I
was
recently
on
one
medication
that
had
tremendous
side
effects
and
I
had
to
give
it
away
and
put
up
with
the
problem
I
had.
The
problem
I
had
was
much
better
than
the
medicine I was taking to try to control it.
Ms
Rattray
-
That
is
exactly
the
point
that
needs
to
be
made.
The
side
effect
is
often
worse than the ailment.
Mr
DEAN
-
That
is
right
and
a
lot
of
these
medicines
-
the
three
outstanding
medicines
-
are
still
yet
to
be
trialled
and
have
severe
warnings
on
them
of
side
effects,
and
one
has
a
sign it could cause blindness.
If
you
trialled
heaps
of
medications
-
which
is
what
has
happened
in
the
Cleaver
case
-
and
you
come
up
with
a
medication
that
gives
you
relief,
why
would
you
then
keep
trialling
other
medications
with
side
effects?
Why
would
you
force
people
down
that
path?
That
is
my
point
-
we
should
not
do
it.
To
me
it
is
irresponsible;
it
is
wrong,
and
we
should
never
go
near it. In my view, it is just not right for us to do that.
Ms
Rattray
-
It
would
be
interesting
to
know
how
many
different
types
of
products
there are that supposedly have the same effect that you have to try as well.
Mr
DEAN
-
One
thing
I
have
not
asked
the
Cleavers
is
just
how
many
medications
they
have
trialled,
other
than
to
know
that
they
have
trialled
many.
I
do
not
know
the
number,
and I am not going to have a guess at that, but that really concerns me.
The
Rubenach
story
is
a
very
strong
one.
I
remember
when
the
member
for
McIntyre
started
referring
it
to
us.
We
know
exactly
what
happened
there,
and
the
impact
on
that
family
was
just
enormous.
You
know
why
they
went
in
the
direction
they
did,
and
good
on
them for doing that.
What
we
are
doing
-
and
I
have
said
this
before,
and
other
members
have
said
it
-
is
making
criminals
of
people.
That
is
what
we
are
doing.
We
are
making
criminals
of
people.
Whether
they
are
caught
or
not,
that
is
what
they
are.
They
are
criminals,
because
they
are
acting contrary to the law - growing, cultivating, manufacturing. Really, that is what they are.
You
know
what
should
happen
here?
I
urge
the
police
to
start
taking
action
against
these
people,
because
once
that
happens,
there
will
be
an
absolute
outcry.
There
will
be
protests
and
everything
else
will
be
occurring,
because
you
are
taking
a
medicine
away
from
a person who needs it, one which is giving them control and is helping them and so on.
I
think
if
that
happened,
we
would
have
action
taken
very
quickly.
People
would
not
put
up
with
it.
I
am
not
sure
that
would
not
be
something
that
should
happen.
I
would
feel
sorry
for
those
people
involved,
but
that
might
be
a
way
we
would
get
the
stronger
action
we
want today.
I
was
trying
to
get
the
point
where
the
Leader
of
the
Government
said
it
needed
to
be
evidence-based.
Something
about
the
Government
supports
the
use,
but
it
has
to
be
sensible
and evidence-based to support it - words to that effect were said.
Well,
this
is
evidence-based,
Mr
President.
How
much
more
evidence
do
you
want?
It
is
there
and
it
is
sensible.
I
just
want
to
raise
that
point.
It
is
there.
We
do
not
need
any
more
evidence. We really do not.
How
many
levels
of
approval
do
you
want?
I
think
the
member
for
Hobart
and
the
member
for
Huon
mentioned
this.
How
many
levels
of
approval
do
you
need?
You
have
the
Therapeutic
Goods
Administration.
I
would
have
thought
that
organisation,
with
its
background
and
what
it
does,
would
have
been
sufficient,
but,
no,
we
have
TMAAC
on
top
of
that. I am surprised we do not have somebody else on top of TMAAC.
Where
do
you
go?
I
just
question
at
times
some
of
the
things
we
do,
and
why
we
do
them.
We
cannot
legally
cultivate
cannabis
here.
We
cannot
legally
do
that.
You
have
to
have
a licence and permits and so on for that to happen.
I
think
somebody
mentioned
medicinal
versus
recreational.
That
is
not
what
this
is
about.
This
is
about
medicinal
cannabis.
We
are
not
talking
about
recreational
cannabis
at
all.
That
does
not
come
into
this.
In
no
way
should
that
come
in
here,
to
have
some
impact
on what this motion is calling for and asking for.
The
member
for
Hobart
was
certainly
right
when
he
said
it
needs
to
be
regulated,
and
that
is
what
we
are
all
saying.
It
needs
to
be
clearly
regulated
and
controlled,
and
that
is
clearly not the position at this present time.
Mr
President,
having
said
those
words,
I
urge
all
members
to
support
this
motion,
and
I
ask
that
the
Government
-
yes,
it
is
paying
lip-service
to
it,
it
is
noting
it,
but
cannot
support
it.
I
really
have
concern
about
that.
If
the
Government
were
to
go
back
and
look
at
all
the
information
that
has
come
through
here
this
afternoon
in
relation
to
this
matter
and
still
take
that
course
of
action,
in
my
view
it
is
missing
the
point,
and
missing
the
point
miserably.
It
really ought to take a good look at where it is and what it is doing here.
Please,
Government,
please
help
people.
Have
a
look
at
this
and
start
an
action
that
will
help
these
people
move
forward
in
the
right
way.
I
thank
members
for
their
contributions
and
I commend the motion to the House.
Motion agreed to.
ELECTRICITY, WATER AND SEWERAGE PRICING (MISCELLANEOUS
AMENDMENTS) BILL 2020 (No. 40)
First Reading
Bill received from the Assembly and read the first time.
ADJOURNMENT
[5.42 p.m.]
Mrs
HISCUTT
(Montgomery
-
Leader
of
the
Government
in
the
Legislative
Council)
-
Mr President, I move -
That
the
Council,
at
its
rising,
adjourns
until
12
noon
Wednesday
11
November 2020.
This
will
enable
members
to
attend
the
Remembrance
service
at
the
front
of
the
building.
A
notice
was
sent
around
by
the
Clerk.
The
service
has
been
moved
to
the
lawns
and
will
happen
at
11
o'clock
for
members
who
wish
to
attend
that
service,
and
then
the
Legislative
Council
will
sit
at
12
noon.
I
also
remind
members
that
briefings
will
start
at
9
a.m.
in
Committee Room 2, and we will roll through those if everything aligns.
Motion agreed to.
The Council adjourned at 5.42 p.m.