Second Reading Debate: Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017

Extracted from Hansard
19 September 2017

Second Reading Debate: Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017

I rise to speak on this bill, which will establish a database that contains the records of the supply of high-risk medications that will allow prescribers and pharmacists to access records and require them to review the patient’s dispensing history before writing or dispensing a prescription for certain addictive drugs. I note that the coalition will be supporting this bill.

Addiction to prescription drugs is somewhat misunderstood in the community. Whilst most people are quick to condemn the use of illicit drugs, the reality is that prescription drugs are causing more deaths by overdose. That receives very little coverage; it is almost a hidden crisis. The figures are staggering. In 2016, 372 people overdosed on prescription drugs compared to 257 people who were lost to illicit drug use overdoses.

I have noticed a significant change in the way pain has been managed over the last 30 years that I have worked in the health system. Doctors need a system like this — real-time prescribing — so that they can see what prescriptions have been written and dispensed and understand historically and holistically a patient’s pain management treatment and address potential addiction issues. Without this system, that has been almost impossible for them to do. A doctor was not empowered to refuse a patient because the patient would simply go elsewhere for the drug. The current system does not support a doctor in being the caring physician that he or she trained to be and desires to be. It supports a business approach which encourages clients to doctor shop. I have worked with many, many doctors, and in my experience I can honestly say that doctors become doctors because they want to help people. They were not money driven, but this current system has failed them.

I am also pleased to note that there is a bipartisan view on this issue. It was, I note with pride, the former Napthine-Baillieu governments that took the lead in this area. In 2013 the Victorian government-led National Pharmaceutical Drug Misuse Framework for Action was released. It identified the lack of real-time information as making it difficult for prescribers and pharmacists to make properly informed decisions regarding patient medications. Ahead of the 2014 election the coalition government made a commitment to deliver a real-time prescription monitoring program for certain addictive drugs. It was not an election commitment made by the now Labor government, but following the election the Premier was non-committal about the issue, saying the Minister for Health was seeking advice and believed that the issue required a nationally coordinated approach before deciding to go at it alone in April last year.

If we are to get serious about this problem, the states cannot go at it alone. We need a national solution that prevents people from doctor shopping across jurisdictions. This is particularly important for my electorate, which has a shared boundary with South Australia. It is not difficult for people to make a quick trip to Mount Gambier to get the prescription they are after. That is why I am pleased to see that the federal government has committed to rolling out a national prescription monitoring program. It is absolutely what is needed. As such it will be absolutely vital that the Victorian scheme is interoperable with the national scheme to ensure patients are not able to doctor shop across jurisdictions. This really must be a bipartisan, national system for it to work properly.

I note that in his comments on this issue the federal health minister Greg Hunt noted that while this is an important step to tackling this growing concern, it is not the only response that is required. With all addictions there needs to be a focus on education and training to continually improve our approach to treating addiction. We need to be supporting doctors to be able to intervene early and give them the resources to be able to stop the problem escalating. Preventing doctor shopping by implementing real-time prescription monitoring does just that. It empowers the doctor to offer support and help their client.

As they say, prevention is better than the cure — better for the patient, better for the taxpayer and better for the health system. But of course we cannot stop there. We need to ensure there are appropriate resources in our police force and legal system to be dealing with drug-related crime. There is a balance to be struck between support and accountability. Drugs often lead to criminal activity, and drug addiction is an illness. Health and law and order can work together to assist each other.

Addiction is a major issue in my electorate, one that was highlighted during the time I was seeking election into this place. It is an area I have specifically worked in for many years. When working in community health I worked with many clients who had families begging for assistance from people working in the field I was in. It included people like John and Margaret Millington, who are here today. I clearly remember one client’s mother begging for more to be done to help her son. She talked about health professionals protecting the clients or patients’ rights, but asked, ‘What about my rights to save my son?’. Unfortunately he is also dead today.

Our area is exceptional in South West Healthcare. We are incredibly lucky to have a range of specialist services based locally, including detox facilities, outpatient services, wellness programs, counselling, early intervention services and pharmacotherapy and strong associations between mental health services and education providers. I believe we in South-West Coast are on the cusp of perfecting the best services this state has seen. It is probably unique that in one region you have so many committed and expert services with specialist clinicians like we have. We are incredibly lucky to have the likes of Geoff Soma, who heads up the Western Region Alcohol and Drug Centre (WRAD) and has more than 20 years experience in Warrnambool alone and many years prior to that. There is also Dr Rodger Brough, a leading expert in withdrawal. They are both passionate advocates for increasing training for GPs to be able to intervene effectively and early in the addiction cycle. I have known Rodger for many years, and we have had long and frank discussions, many times about real-time prescribing.

It is always good people that make something work well, and these people are complemented by others in the community. We recently had Karyn Cook appointed to South West Healthcare as the director of mental health. Karyn also brings more than 20 years experience of working in mental health, drug, alcohol and gambling treatments. Her experience in this area is vital because there is a strong association between addiction and mental health. And she is already forging strong links with Geoff and Rodger. I am sure this renewed focus on the integration will further strengthen the wraparound approach to additional services that we have in South-West Coast and build on the excellent work that has already been done locally.

Whilst we have a fantastic service in general, there are gaps. The withdrawal unit based in Warrnambool is a facility that has to close down on weekends and school holidays. From my experience in nursing and in Aboriginal community health, I can assure you that withdrawal cannot be treated between 9 and 5, and it does not take weekends and holidays. The other major gap is no residential rehabilitation, a gap that my community has identified as needing to be filled. It is now coming together to make sure this area is addressed.

In 2015–16 only two of 421 admissions to Odyssey House Victoria came from my area, and there were no admissions to Windana from the Great South Coast region. As we know, people are less likely to seek treatment away from home, so the WRAD Lookout project will not only put residential beds online but will also increase the uptake of rehabilitation services closer to home, saving the taxpayer thousands of dollars, because a stay in rehab is cheaper than a stay in prison or hospital.

My local community has said, ‘This is our problem, and it’s up to us to find a solution’. A power of work has been done, and the community fundraising campaign is well underway. A facility has been found, and WRAD is now looking for government support to help make this centre a reality. I have spoken to the Minister for Housing, Disability and Ageing about this directly. A residential rehab centre would truly complement the other services on offer and complete the picture. It would be a stand-out service and could be implemented elsewhere. This holistic approach being taken would really address the drug addiction issue. As we know, people from South-West Coast do not take no for an answer. We got our brilliant cancer centre because of that dogged determination, and we will do the same this time with residential rehab.

While this bill will go a long way to providing support to doctors and pharmacists and will make it harder for people to doctor shop, we cannot sit by and do nothing. We need to ensure that there are no gaps in treatment services, that we have strong mental health supports and that there is access to services right across the state, not just in a few centralised locations. I urge the state government to support the WRAD Lookout project. I am pleased to support this bill. It is something I have talked about for a very long time, so I am pleased we are starting here.