Thursday, 29 August 2024

Health Legislation Amendment (Regulatory Reform) Bill 2024

Second reading

Debate resumed on motion of Mary-Anne Thomas:

That this bill be now read a second time.

And Tim Read’s amendment:

That all the words after ‘That’ be omitted and replaced with the words ‘this house refuses to read this bill a second time until an expert panel comprised of representatives from the legal sector, specialist counsellors, people with lived experience of donor conception and assisted reproductive technology, and people with other relevant expertise has examined the implications of the dissolution of the Victorian Assisted Reproductive Treatment Authority and that the findings of this panel are tabled in both houses.’

Kim O’KEEFFE (Shepparton) (15:12): Today I rise to make a contribution on the Health Legislation Amendment (Regulatory Reform) Bill 2024. Firstly, it was so wonderful to hear the member for Warrandyte’s announcement that she is expecting a baby boy. There is quite a baby boom happening in the chamber at the moment. We are very much looking forward to news from the member for Euroa and the member for Kew. Obviously births are coming along very soon.

I will get back onto the bill. I would like to thank the member for Warrandyte for sharing her personal experiences. We will get to some of the IVF and other difficult conception stories along the way, but sharing her story not only with us here in this place but also more broadly helps others that are going through conception challenges. I thank all the speakers on the bill that have shared their own experiences, including some of the men in the chamber. It is really great to have the men included and hear a diverse range of experiences.

The bill will make amendments to regulatory frameworks in seven acts to modernise and streamline compliance and enforcement powers to support a graduated, proportionate and risk-based approach to regulation by the Department of Health to prevent or minimise harm to the health or safety of Victorians. In addition, the bill also seeks to amend the Assisted Reproductive Treatment Act 2008 to abolish the Victorian Assisted Reproductive Treatment Authority and improve the regulation of assisted reproductive treatment by transferring the regulatory function to the Secretary of the Department of Health and strengthening compliance and enforcement powers. Further, the bill also seeks to transfer the management of the donor conception registers to a new donor conception registrar employed by the Department of Health.

The Department of Health has a diverse range of regulatory responsibilities, including child safety, communicable disease, medicines and poisons, legionella risk management, pest control, radiation safety, food safety, private hospitals, day procedures, non-emergency patient transport and first aid providers, tobacco, e-cigarettes and safe drinking water. Some health regulation schemes have not kept pace with modern best practice regulation design and do not include common midrange compliance and enforcement powers, limiting the ability of the regulator to take graduated, risk-based and proportionate regulatory action to prevent harm. The bill improves compliance and enforcement powers across a number of regulatory schemes. The bill includes powers for the regulator to issue improvement and prohibition notices and will enable the health regulator to choose the right tool at the right time, respond to noncompliance proactively as well as reactively and prevent or minimise the risk of harm to health and safety.

One of the main purposes of the bill is to amend the Assisted Reproductive Treatment Act 2008 in relation to abolishing the Victorian Assisted Reproductive Treatment Authority, VARTA, by providing for the employment of a donor conception registrar and transferring certain functions and powers from VARTA to the Secretary of the Department of Health and the donor conception registrar. VARTA, since its establishment, has been providing independent information and support to Victorians and health professionals regarding fertility, infertility, assisted reproductive treatment and the best interests of children born. In addition VARTA regulates the provision of fertility treatment in Victoria to help people understand what they can do to improve their chances of conceiving and support those involved in donor conception to get the information they need and achieve their preferences. It can be a very complex process, as we know, and over time, with increasing demand for this way of conception, we are sure people will need more support as the need continues to grow.

Working in my business for many years, my clients were predominantly women, and I saw firsthand the struggles and tribulations that many women go through trying to conceive. I can also remember when I conceived my first child. One of my clients was struggling at the time to conceive. She and her husband were having tests and trying to find out why they could not conceive. It was hard to share my joy when I knew what they were going through. Going through IVF can have an enormous effect on a couple and their families, their life, their relationship, their finances and their careers.

I also saw firsthand the process of IVF when a friend’s daughter had turned to IVF to help her conceive. The lead-up to this decision can be such a stressful time, with the couple wanting to start a family but having issues trying to conceive. Most couples tend to think that when they want to start a family it will automatically happen, and it can be such a shock when it does not happen or does not in the timeframe they were hoping for. It can cause a range of emotions. Correct support and medical advice do play a significant role, and in some cases counselling is needed. The couple I knew did end up turning to IVF, but it was not successful the first time. It can be heartbreaking for all of the family; her mother is a very close friend of mine. It was also very costly. Fortunately on their second try they did conceive, and now they have a beautiful daughter, who recently turned six. We need to ensure that everyone has access to IVF, should they require it, and that it is affordable.

The first Australian IVF baby was born in Victoria in 1980 – Candice Reed, only the third IVF baby born in the world at the time. Assisted reproductive treatment has become an increasingly common way for Victorians to grow their families, so it is important that we as a state have specific regulations for this sector, in particular for donor conception treatment, and especially that we have in place safeguards for children who may be born as a result of treatment as well as for donors, surrogates and those undertaking treatment.

As VARTA currently regulates assisted reproductive treatment in Victoria, to address certain recommendations in the Gorton review the amendments that the bill makes include changes to the functions currently performed by VARTA under the Assisted Reproductive Treatment Act. Further, the management of the donor conception registers will be transferred to a new donor conception registrar under the bill. This will be located within the Department of Health and will be administered separately from the regulatory functions. Counselling before information is accessed from the registers or a contact preference is lodged will transition from mandatory to voluntary, ensuring the rights of individuals to make an informed choice about their needs are respected. Counselling will continue to remain mandatory before consenting to treatment or consenting to be a donor. The Assisted Reproductive Treatment Act will also continue to require that people are provided with the information that they are entitled to from the donor conception registers in a supportive way and that they also have access to resources to help them make informed decisions.

Referring back to the Gorton review, the amendments listed in the bill will seek to reduce the unnecessary regulatory barriers to the movement of donor gametes or embryos that are formed from them into or out of Victoria, while maintaining safeguards and existing requirements. As such, a requirement to have pre-approval from the regulator before moving donor eggs or sperm into or out of Victoria will be replaced with the requirement to certify that specific criteria are met, providing additional clarity and reducing delays. A donor conception advisory group will be established, which will include experts and people with lived experience, to assist with the implementation of these changes by providing ongoing advice and expertise in relation to donor conception. More details need to be provided about this new advisory group in terms of what the membership will look like, the amount of people sitting on the group and other determined details.

Donor conception is an increasingly common method of family formation, and it can present with unique challenges and complexities for those involved. The proposed reforms include plans to deliver funding for an appropriate organisation with suitably qualified and experienced counsellors to deliver quality, culturally safe counselling for those involved in accessing the registers and those who wish to access counselling. The welfare and interests of persons born or to be born as a result of treatment procedures are paramount. It is acknowledged that assisted reproductive treatment raises issues that are not common to other health services for those accessing treatment, for people conceived through donor treatment procedures and for donor surrogates and that these issues may require specific legal protections.

In addition, the bill makes minor or miscellaneous amendments to a number of acts. The bill seeks to amend the Drugs, Poisons and Controlled Substances Act 1981 to allow for the minister to amend the Victorian Poisons Code to remove, substitute or incorporate amended provisions from the poisons standard relating to the supply or possession of certain scheduled medicines. The bill also corrects an error in the general immunity provision in the Public Health and Wellbeing Act 2008.

It is critical that health is a priority, and we need to ensure that every Victorian has access to health. On that final note, I really need to stop and remind the chamber that we need to provide perfect health services for all communities. GV Health in my electorate is still waiting for funding for stage 2. Stage ‍1 was funded. Stage 2 includes an integrated cancer centre, and we know that when people are going through cancer they need to have access close to home. We also have a helipad as part of stage 2. As you can imagine, in the growing region in which I live we do not have a helipad. Having a helipad means that people can have immediate support. Also, at the moment we do not have enough car parking around our hospital, and that includes for our medical staff.

This government needs to stop and ensure that all Victorians – all people within all communities – are supported. This government is not supporting all of our communities when it comes to health, and I urge the government to stop and think about what that means to all Victorians.

Nina TAYLOR (Albert Park) (15:21): I am very pleased to rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. It is certainly, I have to say, a very emotional subject matter to speak to. It was very moving to hear from those who have, certainly in the chamber, shared quite candidly about having endured some fairly difficult and heart-wrenching processes to be able to get to the point of pregnancy and to deliver babies, which they probably had dreamed for many years of being able to do. I am really grateful to those who have been able to share in the chamber. I certainly think it adds to the experience of Victorians who may be watching or may read the debate afterwards or may simply hear of the legislation to know that we can connect with that particular vulnerability.

I have to say, on a lighter note, it is lovely to have a number of pregnancies in the chamber. It is innately positive, and it also shows changing times. We are in a different era. Once upon a time, once you got pregnant that was it: you stopped your job and it was the end. I have to say it is also a real positive in that sense for all the right reasons. Enough of that topic, but I just wanted to say it only enhances the workplace that we are in.

Coming back to the core premise of the bill, really it is about strengthening health regulation to better protect Victorians – at the end of the day that is what this is doing – including those who are accessing or born through assisted reproductive treatment. It also made me reflect. I remember a friend in senior school who had gone through cancer. She was confronted with potentially never being able to have children, a very difficult decision at any stage of life where you are able to have children, but for someone in her senior years of high school it was particularly difficult. But thanks to scientists, thanks to their magnificent ability to develop this technology, she was able to have her eggs harvested and put aside, and that meant that she had hope for the future. I am very grateful and thank scientists for their continuing work in supporting this amazing technology that is already delivering so many – I am going to say magical – outcomes, because obviously every birth is a miracle. It is a wonderful thing.

A couple of things I did want to pick up on are that there have been no cuts to public IVF, and we are getting on with delivering our commitment to establish public fertility services in Victoria. Why is this important? Because it is easing the financial pressure on families during what is already a difficult experience. The 2021–22 Victorian budget delivered $70 million in funding to create an Australian-first public IVF system as well as an egg and sperm bank. The 2023–24 budget invested a further $49.9 million to expand and extend the public fertility program, and the 2024–25 Victoria budget builds on this investment with an additional nearly $2 million in funding for a public egg and sperm bank. When fully established, this over $120 million program, funded and delivered over five years, will have the capacity to support up to 5000 Victorians every year to access these services, helping them save up to $10,000, which is significant. It is certainly inspiring to see that so many Victorians will be able to access this very important technology.

A couple of other matters that I do want to speak to are the SafeScript elements. I am just going to divert here and then come back to some other elements of the bill, but they are actually part of the bill. We are looking at strengthening the regulations, not the least, I should say, by enabling the health regulator to ensure that clinicians are complying with the mandatory requirement to check the SafeScript clinical decision-making support tool, helping to protect Victorians from accidental prescription drug overdoses; better monitoring and rectification of noncompliance, with safe storage requirements for schedule 4 and schedule 8 medicines; and prohibiting the use of unsuitable vehicles for non-emergency patient transport until safety issues have been rectified. There were some concerns, naturally, about persons who might go to a number of doctors, unfortunately nurturing a very unhealthy intake of medication. Overmedication is essentially life-threatening, and it can potentially have devastating consequences, hence the imperative for these regulations to better strengthen the power of the regulator to monitor and protect Victorians in that regard.

With regard to the counselling elements, which of course are very, very important – I am coming back to the issue of assisted reproductive technology – we are supporting choice and informed decision-making by making counselling requirements for disclosure of information on the register voluntary instead of mandatory. But I would very much like to emphasise that what this legislation is doing is still making sure that people can access the counselling. The actual counselling services are not being withdrawn as such, and I think that is a very important point. It is important to note that counselling remains a fundamental and important safeguard of the act. All other counselling requirements in the act will continue as mandatory. For example, donors and recipients will still be required to undertake counselling before they consent to the use of donated material in a treatment procedure.

We know that whilst donor conception is an increasingly common method of family formation, it can present unique challenges and complexities for those involved. I think that goes without saying, and it has been well articulated in the chamber to date. This might include donor-conceived people who find out they are donor-conceived later in life or donors who donated under the previous conditions of anonymity. You can see inherently the complexity and the emotional turmoil that could be connected with these aspects of being a donor or a child who is born through donated gametes. Many stakeholders, particularly donor-conceived people, have told us how valuable counselling was for them personally, so we absolutely are backing in the counselling.

To ensure these important supports remain available to Victorians, we will deliver funding to an appropriate organisation with suitably qualified and experienced counsellors, focusing obviously on high-quality counselling, to deliver quality, culturally safe counselling, because that has also been emphasised as being understandably very important for those who wish to access it. In addition, the new donor conception registrar will be required to provide explanatory material to anyone who applies for information from the registers or who can lodge a contact preference under the act. I should say, very importantly, that this material will be developed with specialist input from experts and deal with matters currently covered during mandatory counselling, such as rights and duties of the parties, the potential implications of disclosure and where to access support. We can see how this is also providing better protection for Victorians.

Another point: I did think it was a little unusual before that there were some comments made about mental health and our backing in of mental health. I do remember once upon a time the opposition being rather reluctant to back in financial aspects of mental health reform. It is vivid in my memory.

Members interjecting.

The ACTING SPEAKER (Daniela De Martino): Order! Member for Lowan, you are not in your seat.

Nina TAYLOR: I am just saying I did think that that was a little unusual in the context of what we are discussing here.

However, coming back to the bill, noting that counselling is an important aspect of the bill, I certainly commend the minister and all the hard work of all the stakeholders who have had input and continue thanking, as I was saying from the outset, the scientists who continue to deliver this amazing technology that is helping to deliver beautiful babies for Victorians and of course internationally as well where such technology is supported. I trust that better regulation will ensure that Victorians have better protection into the future in this very vulnerable and very delicate but very important space when it comes to delivering children for our great state of Victoria.

Jade BENHAM (Mildura) (15:31): I am more than happy to rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024 today. I am more than happy to speak on anything that helps to assist with positive health outcomes in this state, and there is a fair bit in this bill. I know that there have been many members in this place today sharing their personal stories, which I appreciate because it does add humanity to things like this, to regulatory reform. Obviously the member for Euroa has –

Kim O’Keeffe interjected.

Jade BENHAM: Yes, she has had to leave the building because of her delicate situation and some occurrences during the week, so we wish her all the best. I will put on the record that I am predicting that that baby is coming sooner rather than later, and it will be a boy.

A member interjected.

Jade BENHAM: No, it is not going to be a wombat. But also of course the member for Kew – being pregnant is obviously one of the miracles of life. I have said to both of them over the last week to take it easy – ‘You’re growing elbows and shoulder joints and brain matter, and those things are complicated.’ I will come back to that later, because I have a little story of mine to share as well.

When going through this bill, there is a fair bit to it. I am always full of stories, and I did think of a few while I was going through this. One of them was the Safe Drinking Water Act 2003 that this bill makes amendments to. I am very, very lucky in that where we live we live off rainwater – we are not connected to town water at all. In tropical north Victoria, out where we live in a farm zone, we live on rainwater. But as a child growing up in the 1980s we were encouraged to take fluoride tablets. You might remember this, Acting Speaker De Martino. They were little coloured tablets. Apparently they paid off. I was at the dentist last week and she said ‘You must be a fluoride tablet baby’ because of my still perfect teeth. It may have something to do with my Mediterranean background; I do not know. But safe drinking water obviously is very important. I was talking to a couple of Rotary clubs over the last couple of months that are doing projects to help provide safe drinking water overseas, which is one of the great things that Rotary clubs right around the world do. That got me thinking about that.

The amendments to the Non-Emergency Patient Transport and First Aid Services Act 2003 allow me to give a shout-out to the wonderful work of the Royal Flying Doctor Service, who are very active in our community both with their GP service that they have acquired over the last few years and now with their community transport. Robinvale is an hour away from Mildura Base Public Hospital and that health precinct there. It is very important that people can get from Robinvale to Mildura. They have come together in the Northern Mallee Integrated Partnership, which I talk about often.

The Royal Flying Doctor Service does a great job between those two and also Mallee Track Health and Community Service. There are three of them: Mallee Track Health and Community Service, which is a multipurpose service; Robinvale District Health Services, which is also a multipurpose services; and the subregional hospital, which is Mildura Base Public Hospital. They have all come together in what is known formally as the Northern Mallee Integrated Partnership, which allows them to share resources. There is a huge amount of work that has gone into this, with such positive outcomes for service delivery, particularly in those smaller towns serviced by RDHS and Mallee Track, with them being able to offer virtual acute care again, being able to offer some radiology services potentially and expanding that care that we hear is so important to deliver close to home.

Noting how well the Northern Mallee integrated partnership is working and has worked whilst maintaining individual governance for each health service and individual administration, of course being able to share some of those back-of-house resources allows a more cohesive service right throughout the region, which is geographically huge. It has worked so, so well. I was reading the health services plan over the last week or so, noting that the Mallee network, which is now an option on the table, is essentially a more formal agreement between these three health services, really formalising that partnership between the three health services. That in my mind, again, allows us to maintain the local governance, the individual boards and the individual administration but to share resources both clinical and back of house. That in my mind is a no-brainer. That is where this should go to avoid being sucked up into a much, much larger network that is hours and hours away and geographically so hard to get to for people in our region. The Mallee health network is a no-brainer rather than being absorbed into Loddon Mallee, which I think would end up – I mean, who is to say? If we use Grampians Health as example, and that is the direction, it would be a disaster. The Mallee health network, given that it is essentially, from my understanding, a rebranding of the Northern Mallee integrated partnership, which again has worked so well up to this point, I think again is a no-brainer.

The member for Shepparton mentioned before the need for GV Health to have a cancer centre. Mildura has a cancer centre, Icon Cancer Centre. They launched 18 months ago, I think. It has completely changed the landscape of cancer treatment in regional Victoria. It really has. We have a radiation bunker there now. We have the ability for people to have radiation treatment onsite, close to home – but, again, geographically huge. Mildura Health Foundation at the moment are of course building accommodation, a suite of self-contained apartments, so people that are travelling from Robinvale, Underbool, Walpeup and Murrayville over near the South Australian border can actually stay quite comfortably while they are having their radiation and cancer treatment. In fact I am doing a fundraiser. I will be running again the Melbourne half marathon in a bid to add hopefully a significant amount of money to that project. The slab is down and the frames are up, so it is happening. But I am running the half marathon, doing the kays so patients do not have to. If anyone wants to donate, then head to my socials.

Coming back to the assisted reproductive treatments that a lot of people have spoken about, with the 2 minutes I have left, it is wonderful to see lots of pregnancies around this place at the moment. It stirs something in you, I think, as a female. I love babies, but my journey to motherhood was not so smooth. IVF certainly was not an option like it could be now. The Mildura Base Public Hospital was the first to offer public IVF in the state.

My eldest, who is nine years old, was in fact my sixth pregnancy, so he is my rainbow baby. It was at the tender age of 35, so it was not easy. I did not love pregnancy; I loved the outcome of the pregnancies. After six goes at it and finally getting one through to the keeper, I could not have been happier. Then after that, it set something off, and another one came along unplanned a few years later. It is a wonderful, wonderful thing to see so many babies due to arrive soon in this place. The clucks are getting very loud, I can tell you. But at the tender age of 44, it is off the cards, and I have stopped. The member for Warrandyte said earlier that I had commented on her Instagram that I have stopped drinking the water in this place. This is true – just in case. I know that it is safe drinking water, and it will only get safer, but just in case.

Again, I am more than happy to speak on any reform that improves positive health outcomes for Victorians, and positive health outcomes allow those that have had a difficult journey to parenthood a much easier journey. That has got to be a good thing.

Dylan WIGHT (Tarneit) (15:41): It gives me great pleasure this afternoon to rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. Just before I do I would like to echo the sentiments of the member for Mildura and acknowledge some of the fantastic contributions that have come before me today, particularly the contribution from my friend the member for Point Cook. I think contributions like we have heard today do bring a human element to this place, which at different times, particularly between 2 pm and 3 pm in the afternoon, is significantly lacking.

The Allan Labor government is committed to better health outcomes for all Victorians. That is why we are taking decisive action through this legislation to strengthen health regulation in Victoria and in doing so are ensuring better protection for all Victorians. There are several different ways that we do that. There are several different ways that we strive for those better outcomes for all Victorians. I understand that this piece of legislation amends seven different acts.

What I would like to do and what I think is incredibly important to do, given the tone of the debate this afternoon, is recognise the incredible work done by several hospitals and the nurses and medical staff providing IVF services around the state. They are services that are so incredibly important to so many Victorian families and so incredibly important to so many people trying to conceive, like my brother Jarrod and his wife Kylie, who now have two absolutely gorgeous children thanks to IVF services in this state. If you will indulge me just for a second, my brother’s first child Ines was conceived through IVF. My brother had a fantastic idea for a name and that was to call Ines ‘Ivy Frances,’ which he thought was hilarious, so she would have the initials ‘IVF’. Initially, his wife loved the name – until she figured out what was going on. They ultimately settled on Ines. But it is thanks to IVF services and the fantastic work done by health professionals in Victoria that I have two absolutely gorgeous nieces. I would like to give a particular shout-out to those workers at Western Health and at the Sunshine Hospital that deliver some of those services.

On that topic – and we have heard it from even those opposite – we are getting on with delivering on our commitment to establishing public fertility services in Victoria, which eases the financial pressure on families that are trying to conceive and going through that difficult experience. IVF until now, until public IVF services, was something that was incredibly expensive, without any guarantee that you would get the desired outcome from the investment that you had made in those services. Public IVF is not just fantastic for all of the reasons that we understand it is, but it is fantastic so that all Victorians, irrespective of how much money they have in their bank account, get fair and equal access to those incredibly important services.

In the 2021–22 Victorian budget we delivered $70 million in funding to create an Australian-first public IVF system as well as an egg and sperm bank. The 2023–24 budget invested a further $49.9 million to expand and extend that public fertility program, and then we built on that investment with an additional nearly $2 million in funding for the public egg and sperm bank as well. When fully established this program, which is now worth over $120 million, will be funded and delivered over five years and will have the capacity to support up to 5000 Victorians each and every year to access these services, which helps to save them $10,000 – which was the cost before these services were available.

As I said, it is a priority for this government to deliver better health outcomes for each and every Victorian. There are several ways that we are doing exactly that. If you were to come out to my part of the world, out to the western suburbs of Melbourne, you would see the significant investment that this government is making in public health. You could come out just next to my electorate – I think it is actually in the Treasurer’s electorate, but it certainly borders my electorate – and look at the very beginning of construction on the expansion of the Werribee Mercy Hospital and its emergency department. This expansion will double the hospital’s emergency department’s current capacity and allow for an extra 25,000 presentations each and every year. The upgrade will also feature four new resuscitation bays, 16 short-stay beds and 36 emergency care cubicles. I cannot overstate how incredibly important that piece of infrastructure and the redevelopment of that emergency department are to my community. Wyndham is one of the fastest growing areas in all of Australia, and making sure that we have the health infrastructure to support that growing community is absolutely paramount, particularly when you have such a diverse community, a community that perhaps does not have the knowledge of Australia’s health system or Victoria’s health system as would someone who was born and raised here from childhood. Making sure that we have that extra capacity and that we have those improved health outcomes for that community is so incredibly important.

The Werribee Mercy upgrade builds on an earlier upgrade in 2018, which also delivered new inpatient beds and new critical care beds. The state government has an incredibly important and fantastic partnership with Mercy Health, and delivering those outcomes to my community is something that I know the member for Point Cook, the member for Werribee, the member for Laverton and I are so incredibly proud of. I could not believe this when I first became the member for Tarneit, but there are 110 babies born in Wyndham each and every week. That gives you a little bit of an idea why we are one of the fastest growing areas, not just in Victoria but in all of Australia, and as we continue to grow we are going to have to continue to invest in those primary health facilities.

We also have the Joan Kirner and Sunshine hospitals just up the road. I was lucky enough in recent months to go out to the hospital for a visit and go through the facilities that they have. That is not just a good piece of health infrastructure. The Joan Kirner hospital is a world-class health facility built exclusively for people in the west. To be able to go through and talk with the health professionals – to be able to talk with nurses and with doctors – and meet with the committee or the board and talk about the fantastic work that they are doing there, including, as I said, delivering those outcomes with IVF treatment, was an absolutely amazing experience for me. I do note that some in my community use that hospital as well, just because of how absolutely amazing it is.

As I said at the beginning of my contribution, the Allan Labor government is committed to delivering better health outcomes for all Victorians, whether that be Victorians looking to conceive their first child or whether that be Victorians presenting to emergency. We are committed to that and always will be.

Richard RIORDAN (Polwarth) (15:51): I will take the opportunity this afternoon to make some comments on the Health Legislation Amendment (Regulatory Reform) Bill 2024, which is an omnibus bill. It has ticked off lots of various acts along the way that it is making slight amendments to, and I will just mention a couple of them because they are relevant in the contribution I wish to make today. They are the Health Services Act 1988, the Non-Emergency Patient Transport and First Aid Services Act 2003, the Public Health and Wellbeing Act 2008, the Safe Drinking Water Act 2003, the Assisted Reproductive Treatment Act 2008 and quite a few other health-related acts.

I guess I will start my contribution today with this: it is not often I reference the member for Tarneit’s contributions, because his part of the world bears very little resemblance to mine; however, he brought out an interesting fact about 110 births a week in Werribee. That western suburb of Melbourne is well known for its rapidly growing population and the health pressures that no doubt that part of town feels. However, it actually leads into one of the contributions I want to make today, and that is about the enormous pressure the health services have on them all the way further west of Werribee. It concerns me greatly what occurred on six occasions this year – can you believe that, on six occasions – when people having a baby anywhere up to 200 kilometres west of Werribee ended up having to be on bypass and were transferred to Werribee. If Werribee is already a very busy and stressed health service, at 110 births, it does not make sense that women and families and children are not able to access proper health services in Camperdown, in Colac and in Geelong – and Geelong did have, until this government failed to assist them last year, three world-class hospitals they could have had maternity services in; but we have seen one lost, so we are down to only two in Geelong. But on six occasions every single one of those health services was on bypass, sending unsuspecting families all the way through to Werribee.

I support the member for Tarneit in his quest to have better support for Werribee, but not only do we need better support for Werribee, we have actually got to put the basic, fundamental support into the health services in all those major health services further west than Werribee, because it does not make sense to families at this point in their lives. We very rarely get the privilege of knowing when that little bub is going to turn up, and if you are all the way down in the bush to the south of a place like Cobden or out in the bush in Gellibrand or Lavers Hill – quite remote places at the best of times – it is a very, very long way to go for what is essentially one of humanity’s most basic services, and that is a world-class, safe maternity service.

About three weeks ago this government’s continual lack of commitment to providing sustainable funding for health services in regional Victoria came to light when another one of my hospitals announced, without having liaised with any of its GP obstetricians or GP anaesthetists, that it had cancelled maternity services. This was Camperdown Hospital. For nearly a week this government was unrepentant and not prepared to step in and say, ‘No, a hospital like Camperdown that has successfully delivered babies for 100-odd years absolutely must be supported to keep that service.’ It had a GP workforce, a maternity workforce and the facilities there to continue that service. It took a public outcry and the threat of petitions to get the government to walk back from that.

People in country Victoria understand that you cannot offer maternity services unless you have got the key staff and services there. Bypasses of maternity services are a risk that country communities live with but are prepared to live with because it is in their best interests. However, it is not sustainable, and it is not good management of those scarce resources when Camperdown, Colac, St John of God, Barwon Health and University Hospital in Geelong are all bypassing through to Werribee. Unfortunately this bill is not designed to solve that issue, but it is one of the most critical outstanding health issues in regional Victoria in the seat of Polwarth.

I would also like to draw attention in dealing with this part of the bill and this act to the non-emergency patient transport. That is a really critical service in providing good quality health care in regional Victoria. For a long time I was part of a hospital board and in recent times I have been heavily involved in a health foundation in my community. We call it the Long Road Appeal. The Long Road Appeal is about shortening the long travel times that country people face. Any services that can over time be provided as close to home as possible absolutely aid in quick recovery and better health outcomes for families.

Many people revealed stories today, and I will reveal probably one of the most heartbreaking health stories that I dealt with in the last week, and that is around eating disorders. Eating disorders are silent health conditions, mental health conditions that affect families for years and years. Unfortunately our system does not treat mental health and eating disorders as one illness; they treat them as two. When they treat them as two and you live in a country town, the effect is catastrophic for families. The group of mums I met with last week, three mums, have given up their careers and given up their lives and have been full-time carers for their late adolescent and young adult children. There are no other options for them because there are not the mental health services and there are not the eating disorder health services.

What was particularly disturbing in dealing with this is that one of regional Victoria’s most pre-eminent eating disorder specialists comes once a week to my community, Colac, not wearing their eating disorder hat but a mental health hat. In wearing the mental health hat instead of the eating disorder hat that practitioner is not allowed to deal with those families. In this day and age that defies logic and does not make sense. Once again this bill is not designed to solve that problem, but it is a crucial part of getting a system that is fair and equitable and provides the services that people need closer to home, which is absolutely a theme for any good government in managing its health services and making the tweaks and reforms that are required to provide better outcomes for the community.

When we talk about non-emergency patient transport, anything that provides a service closer to home is going to be better, particularly in my electorate. It is a relatively older electorate. It has a lot of people having to seek care services for conditions later in life. Whether it is hips, hearts, legs, arms, cancers, old age or whatever the condition may be, you often have to get to the big smoke. You have to get to Melbourne, you have to get to Geelong for the primary interventions that can later be served at home.

It disturbed me also recently to learn from constituents about the system for non-emergency patient transport. That is often done by the Red Cross, but many communities have their own volunteer organisations that help also. There have been some changes there, too, which have not made people’s lives easier; they have made them more difficult. One of the great anomalies in it is that the system has not been designed to be the lowest-cost, easiest-to-operate service. Someone sitting in a call centre in Melbourne does not necessarily understand where someone lives or how to get to them quickly, efficiently and at the best times when they are out on a farm or down a country road and they need to be transported to and from there, but those things can be easily organised at a local level. Patients are telling me that under the old system they could liaise directly with the driver and organise pick-up times and drop-off times because often people might want to be taken back to a son or daughter that lives in another part of the community and not back to the same address. These sorts of nuances should be taken into account if we are truly providing patient-focused, patient-centred care services. I worry that the cuts to resources and cuts to funding in the health sector, particularly in regional Victoria, will continue to dilute and make these services not the services that they could be. We are not talking about spending extra money or a lot of extra money. We are talking about listening to the needs of patients, listening to the needs of the community and making sure that those really key services are focused on that and providing the services that are needed to make sure we keep as many people in country Victoria as safe as possible.

Anthony CIANFLONE (Pascoe Vale) (16:01): I too rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. I would like to begin by acknowledging, like others have, the vast array of contributions and experiences that have been shared in the chamber today throughout this debate, particularly those from the member for Bellarine, the member for Laverton and the member for Point Cook, who is in the chamber as well – those deep personal stories and experiences that I think we can all acknowledge and sympathise with. At the other end of the debate spectrum, we have seen the member for Warrandyte give a gender reveal. I think that is a first for the chamber. That builds on, let the record show, the member for Preston’s marriage proposal at the start of this parliamentary term. So we have had a marriage proposal and we have had a gender reveal. I do not know where this is leading, but there have been a couple of feats in this Parliament that we have experienced.

I would also like to commend the Minister for Health and her team, her department and the relevant stakeholders for bringing this bill to the house. I would also like to commend, of course, as we are here speaking, all the health workers that are proudly keeping our health sector running. Many of them are represented by the Australian Nursing and Midwifery Federation, the ANMF, and the Health and Community Services Union, who are in the building as we speak – HACSU. I would like to acknowledge all the health workers across my community. There are almost 13,000 residents across Merri-bek in my community, including Pascoe Vale, Coburg and Brunswick West, that work in the health sector, social sector or community sector. Almost 14 per cent of local residents work in health or community services. It is the largest employment sector in my community, and they do an absolutely incredible job, particularly those at Merri community health, which I would like to touch on as part of this contribution.

I would like to say as well that I am proud to be part of a Labor government and indeed a labour movement that has always fought and stood up for universal access to health care and the health and wellbeing of every Victorian. Regardless of postcode, bank balance or circumstances, Labor has always been a strident defender of the community’s right to access public health care, medicines, treatments and supports. Whether it be through the creation of Medibank under the Whitlam government, the creation of Medicare under the Hawke government, the establishment of the NDIS under the Rudd–Gillard government or laying the foundations for today’s modern pharmaceutical benefits scheme under the Curtin Labor government back in 1944, access to health care is really ingrained in the DNA of the labour movement.

It is also at a state level that Labor has continued to work, including through this bill, which I will turn to in a moment, to invest in and support the public’s access to health care, treatment and support via our public health system. Since 2014 we have invested almost $60 billion to deliver world-class health care, better facilities and the latest equipment across our entire health system and invested a record $20 billion in Victoria’s hospitals. This year alone it makes up more than 25 per cent of the state budget. Recently, as well, we announced an additional $1.5 billion towards supporting our hospital system. That is on top of upgrades for the Northern Hospital and the Austin Hospital – $813 million for construction of a new emergency department at the Northern and $275 million to expand the capacity of the Austin Hospital with a new expanded emergency department and paediatrics unit as well.

Our public surgery waiting lists are now the lowest they have been since the pandemic, with almost 210,000 planned surgeries performed this financial year, driving the waitlist down by 33 per cent since 2022. Since coming to office we have also grown our health workforce by 40 per cent – that is 60 per cent more doctors and 36 per cent more nurses and midwives in our hospitals. We made it free for 10,000 students to study nursing and midwifery, and we are implementing a stronger nurse-to-patient ratio across the public system. We have established priority care clinics, now known as urgent care clinics, to relieve pressure on hospital emergency departments, which are averaging 7000 patient visits a month through the urgent care clinics. That is 500,000 patients they have seen and treated since their inception. Of course we have also reformed Triple Zero Victoria, we have sustained the Nurse-on-Call hotline and we have established the Victorian Virtual Emergency Department as well. Many of them are being trained out of La Trobe University. We have supported community pharmacies and rolled out the pharmacy pilot, and all of this is helping to relieve pressure on GPs, hospital emergency departments and of course our hardworking emergency services.

This bill before us today will help us continue to build on this work to build a better and fairer health and wellbeing system for all Victorians. This bill, as we have heard, contains a number of provisions. It is an omnibus bill. It will essentially enable the health regulator to more effectively minimise risks to the health and safety of Victorians via a number of things, including amending the Drugs, Poisons and Controlled Substances Act 1981, the Public Health and Wellbeing Act 2008, the Epworth Foundation Act 1980 and the Safe Drinking Water Act 2003. We heard the members for Mildura and Yan Yean, I believe, speak substantively with respect to that, so I will refer members to those contributions to hear and learn more about those changes. There are also quite a number of other technical and minor amendments to reflect machinery-of-government changes.

Perhaps the most substantive and meaningful reforms contained in this bill, which will impact many Victorians today and in years to come, relate to the changes to the Assisted Reproductive Treatment Act 2008, which will improve the regulation of assisted reproductive treatment to better protect Victorians, simplify access to information from the donor conception registers and reduce unnecessary barriers relating to accessing donor gametes, including sperm, eggs and embryos. Victoria has long been a leader, as we have heard, in the provision and regulation of assisted reproductive treatment. The first Australian IVF baby was born here in Victoria back in 1980. Just recently, in 2020, four years ago, the Royal Women’s Hospital celebrated the 40-year anniversary of the first IVF baby, Candice Reed – a major milestone in science and fertility for this country. The pioneering team at the Women’s hospital – where I was born as well, mind you – led by the late Dr Ian Johnston, who ran the hospital’s infertility clinic, was able to achieve Australia’s first IVF pregnancy in 1979, which led to Candice’s birth on 23 June 1980.

I have done a little bit of research here, but these are the figures I can bring together here with the time I have. I understand that well over 200,000 children across Australia have been conceived or born via IVF, with a previous University of New South Wales report finding that around one in 20 babies across Australia are born via IVF. That is around one child in every classroom. The stats also show that the overall live birth rate per embryo transfer is just over 27 per cent, and that has increased from 24 per cent on previous years. So that illustrates that for every successful IVF birth there are still roughly around three or four unsuccessful IVF cycles that families and parents do sadly experience. Like I said, I acknowledge and commend families who have gone through and continue to go through the IVF process to conceive and start a family, and I acknowledge all those contributions from those respective members who have done so.

Victoria was also the first jurisdiction in the country to provide legislative safeguards for individuals undertaking assisted reproductive treatment through the Infertility (Medical Procedures) Act 1984. It was also the first Australian jurisdiction to recognise the need for people conceived through donor treatment procedures to have access to information about their genetic gametes – again, with respect to sperm, eggs and embryos. Building on these previous landmark reforms, the Michael Gorton review, which began in 2018 and was completed in 2019, 10 years after the passage of the landmark Assisted Reproductive Treatment Act 2008, basically formed the basis for a lot of these changes here today. That legislation was quite landmark. It gave legal access to treatment in Victoria for single women and same-sex couples to enable altruistic surrogacy, and the legacy of these law reforms is clear, with thousands and thousands of Victorians since being helped to start families. But the 2008 act itself had a long and difficult story. It began in 2000 when leading fertility specialist Professor John McBain challenged restrictions to Victorian legislation that limited IVF to married women, and ultimately in 2002 the High Court agreed that the act was discriminatory.

In response, the Victorian government asked the Victorian Law Reform Commission to review these laws, and from 2004 to 2007 it provided the foundations for the 2008 bill, which was presented to the Victorian Parliament in mid-2008 by then Attorney-General Rob Hulls. The bill was passed by one vote in the upper house on 4 December 2008. The reforms contained in this bill will also build of course on our commitment to deliver public IVF through a $70 million commitment and our work through the women’s pain inquiry as well.

In the time I have I would like to commend of course our community health workers at Merri community health. On 6 August I had the pleasure to catch up with CEO Tassia Michaleas and chief operating officer Amy Jackman to get an update on their fantastic work to keep our community healthy, resilient and safe. It is one of the longest running community health organisations in Victoria, established over 45 years ago, and is operating across a number of sites across Merri-bek, employing 400-plus health and community workers. Merri Health and their team do an amazing job in looking after our local wellbeing. They provided over 266,000 service instances in the last financial year, supported over 17,000 carers across Victoria, provided dental care for children – over 1000 children ‍– provided mental health and wellbeing support to older residents and launched a new School Ties program for young people impacted by COVID. I have previously had the Minister for Health actually come along and visit to have a look at their work to support and assist with chronic pain. I have also welcomed the former Minister for Mental Health and the Parliamentary Secretary for Mental Health and Suicide Prevention, Minister Williams and Tim Richardson, previously to look at their work in mental health. It is in that spirit that I truly commend this bill to the house on behalf of our local workers.

Martin CAMERON (Morwell) (16:11): I too rise today to talk on the Health Legislation Amendment (Regulatory Reform) Bill 2024. From everyone that I have heard speak in the chamber when I have been in here or while listening to it down in my office, there have been a lot of fantastic contributions, and it is amazing the stories that you do hear about people’s travels into parenthood. Some people have it nice and easy, so to speak, and have children unassisted, but some other people have a lot of trouble conceiving. I think to be able to make changes with this bill to help those people that do struggle to conceive and those that are wanting to start a family is great.

I am very lucky to have three healthy children – well, adults now – but at the start of my former wife’s and my journey to parenthood we did go through three miscarriages along the way. When you actually go through that, there is a lot that does play on your mind as to why. We were very, very lucky that after those three miscarriages we were able to have three healthy children. We went to a doctor – because obviously after a miscarriage your wife or partner needs to be checked out – and they are virtually the only people you talk to about that. It did have a little bit of a – not a stigma, but it was something that was not spoken about very much back in the day. Once you – if you ever did – raised it with other people, it was amazing how many people had been on that journey also with either having miscarriages or having a great amount of trouble to be able to conceive to start their family. As I said, we stand in this chamber I think united, all of us, that we can actually have a pathway forward for all Victorians who are wanting to start a family to be able to do that.

I have two close friends, being part of the Traralgon Football Netball Club, Kate and Beth, two girls that got married and went on their journey to start a family. Luckily for them, it happened virtually straight away, so both Kate and Beth have now had two little boys who are healthy, and they are a loving family. But I did not realise how expensive it was to actually go through the process if you decide to go down the track of IVF – not that they would ever complain at all. When I did speak to them about it, I was actually shocked at the amount of money that they had to pay to be able to go on the journey of being able to start a family. As they relayed to me, they are the lucky ones that were actually pregnant – both of them – the first time, virtually, where others go on a longer journey over many, many years, as we have heard, of being able to conceive.

I think when we are younger and we are growing up we take for granted that we are going to be able to start a family and raise that family through to adulthood, like I have done. But along the way there are not roadblocks but little mishaps here and there, so nothing is ever straightforward. We see this bill ‍– there are a few other bits and pieces to the bill, which I will touch on later – actually making the journey a lot easier. It is lucky that we can stand in this chamber and make those changes and differences to people’s lives and their family lives.

It is great to see all the expectant mums in the chamber also. We are going to have a busy 2025 in the chamber, which is great, because when you stand and you want to become an MP you do it for the young families and young kids that are being born, to give them a better life moving forward. It was one of the reasons I stood to be an MP, to be able to make people’s lives better. I think it will keep everybody in the chamber on their toes once 2025 rolls around, and we wish everybody a safe journey through that pregnancy. My love for young kids – when they are bawling their eyes out I have a knack of being able to stop them crying, so, member for Kew, keep that in mind when your child is in here and crying and you need to stand up. I will be able to stand up, take charge and make sure that everything is fine. That is wonderful.

Being part of a sporting fraternity that does have both football and netball, very regularly when you are growing up inside the football club there are no children there, then all of a sudden you get an influx of 10 to 15 children running around. It really is enlightening being able to sit down with everybody and talk about their journey of how they got there, about how some families conceive easily, as I said before, but also the trials and tribulations of others that really have to take a journey to be able to become pregnant – those who need to use sperm donors, for argument’s sake – and go through that IVF treatment to end up with their family. As we said at the start, this is a great bill where we can actually work together collaboratively to make sure that it does happen.

There is some stuff there we spoke on before – health regulation compliance. The bill amends the regulatory frameworks in a couple of other matters, one being cooling towers under the Public Health and Wellbeing Act 2008. Although I love talking about families and children, I also love talking about plumbing stuff and cooling towers. Through my journey as a former plumber, I have had a fair bit to do with cooling towers. You would think a cooling tower is a straightforward structure that sits on top of the roof of a building, and you never have to worry about it ever again. Well, it is one of the hardest things to get right. One of the things that you need to make sure, with these regulatory changes that they are bringing in, is that there is a checklist to make sure that everyone stays healthy inside that building. It is great to see that they are doing some work on the cooling towers. Our local water firm down in the Latrobe Valley, Gippsland Water, who have a wide reach right across greater Gippsland and into Melbourne too – they reach into the peninsula and stuff like that – are making sure that our water is safe and drinkable. We are very, very lucky that we do have such fantastic drinking water in Australia and particularly here in Victoria. I have just come back from being in Kokoda, where their water is, well, let us say it is questionable to be suitable to drink. They do not have a lot of running water out in the villages. They derive all their water out of the river, and in that river they also bathe, and they use it for sanitary purposes. We are very, very lucky here in Australia that our drinking water is first class.

Non-emergency patient transport under the Non-Emergency Patient Transport and First Aid Services Act 2003 – this bill also cleans up a few bits and pieces there. Pest control operators under the Public Health and Wellbeing Act 2008; private hospitals, day care procedure centres and mobile services under the Health Services Act 1988; medicines and poisons under the Drugs, Poisons and Controlled Substances Act 1981; radiation sources under the Radiation Act 2005 – we can see there are a lot of bits and pieces that we are making sure are right in this bill so that moving forward we can have a better outcome for everybody in the state of Victoria. I started by talking about being able to have our children born safely and being lucky enough to have them healthy, and I am glad we are not opposing this. I commend the bill to the house.

Pauline RICHARDS (Cranbourne) (16:21): Acting Speaker Lambert, I am very pleased to be able to contribute to debate on this, and I am pleased to see you in the chair, always ably and conscientiously fulfilling the tasks that need to be undertaken in this place.

Before the member for Morwell leaves I do need to reflect that on hearing about that offer of being able to get babies to sleep I think there might be a little bit of work coming his way. We have got obviously the member for Kew, the member for Ripon and many, many other members who will be looking to the member for Morwell to check availability. I know that there might be a roster. I am not sure how we going to manage priorities – I do wish everyone the best – but we will need to have a roster for the work undertaken by the member for Morwell in the task of keeping babies asleep or putting babies to sleep.

I am very grateful to the Minister for Health for the important reform work that is being undertaken. This is an area of great passion for the minister and a reform that speaks to the heart of the need to make sure that, from the cradle to the grave, this week the Allan Labor government is really working on ensuring Victorians have their decent and hardworking members of Parliament contributing to debates that do make changes to the Victorian community. Of course, health is our bread and butter. I often reflect that I wake to the sound of children in the streets. Cranbourne has a great deal of growth and many, many children. I know that for many people the journey to parenthood is not exactly the way they had anticipated or expected, and I do want to say how honoured I am to actually be in this chamber to hear the many contributions that have been extraordinarily heartfelt. In particular I want to thank the member for Point Cook for the generosity that the member showed in sharing stories and also cautioning people who are tuning in to Parliament that there are topics and discussions that are had here that can be difficult and complex. I think that we saw the best of our chamber here this afternoon. I do say again how grateful I am to the member for Point Cook for that extraordinary generosity.

This bill amends health regulatory frameworks across seven acts of Parliament. As we have heard this afternoon, it affects the health portfolio across governing medicines – we know SafeScript has been a really key reform of this government – making sure that we are getting ahead of any changes that need to be made. Poisons, private hospitals, day procedure centres, first-aid services, safe drinking water and assisted reproductive treatment – I think it is terrific that so many members in the government and those opposite, many of whom have faced life-changing medical challenges themselves, are advocating and campaigning every day to make sure we invest in the right places and make the necessary changes that will ensure Victorians have a higher standard of medical care. We have heard that this bill is designed to modernise and enhance the regulatory framework governing our health sector. Reform is essential. The health sector is dynamic place, and we are making sure that all new and emerging healthcare standards are met in a way that is appropriate.

I am going to take the opportunity as well, with a bit of indulgence, to reflect on the member for Mulgrave, and to consider the remarkable support that we have seen in evidence again across the chamber for the member for Mulgrave. At the recent morning tea that was held at Killester College many, many members of Parliament came to support the member for Mulgrave. The member for Mordialloc was a terrific MC, and of course the Minister for Government Services in her capacity as the member for Dandenong and as a good friend made a decision to shave her hair off as a way of raising funds. The member for Point Cook travelled across to Killester to support the member for Mulgrave in those endeavours. We had an extraordinary number of other important friends and relatives there, including the member for Narre Warren North, the member for Pakenham and so many others – Mr Tarlamis in the other place and Mr Galea. It was just extraordinary.

I am conscious of the thoughtful contributions that have been put forward, but I am also conscious that the genesis of this legislation was an independent review of assisted reproductive treatment undertaken by Michael Gorton AM. This bill makes amendments to reduce barriers to accessing donor gametes while maintaining safeguards and simplifying access to information. I was reflecting again on the genesis of the bill and the work that was undertaken by my previous boss the then member for Altona in her capacity as the Minister for Health, when she undertook to organise a review of assisted reproduction. I went back to have a look at what was said at the time:

The Andrews Labor Government will review Victoria’s assisted reproductive services for the first time in a decade, and strengthen current laws to provide more safeguards and support to women accessing these services.

Tick. This is something that was committed to in 2018. It has been an iterative process, and this legislation before us today is part of that process. Again, quoting:

The review of the Assisted Reproductive Treatment Act will ensure women and families using assisted reproduction are supported through their entire treatment … make sure they are receiving realistic information when it comes to their reproductive journey.

Assisted reproductive treatment is often an extremely vulnerable and trying process …

I was also interested to look back and reflect on the words that were spoken at the time, which were: ‘Everyone knows somebody who has a story of assisted reproduction.’ There are stories of joy, but there are many experiences that end in heartbreak. I think we have heard that today in the contributions this afternoon. I do want to thank Michael Gorton for the work that was done and the leadership that was undertaken by somebody with Mr Gorton’s eminence to ensure that where we are today is again stepping in the right direction.

Just to take a slight step change, I was reflecting on this legislation while watching some of the speeches at the Democratic National Convention, and I am sure, Acting Speaker, you might have been similarly tuned to Coach Walz. If Coach Walz is watching, I would say that it was an extraordinary speech. I did notice the way that the new vice-presidential nominee spoke about his journey and the way that his family was formed. He did speak about the pain of those calls they received as they attempted to form a family. I did think that I would not use this example, because the tone of this debate has been very important, but at some time I might reflect on how occasionally the conversation can turn weird as people go to places where I think governments should not be. But that is not the conversation that I think is appropriate today.

I did want to put on the record, though, that there have been some claims made by those opposite that there have been cuts to public IVF funding. I think it is important to record that there have been no cuts to public IVF. We are getting on with delivering our commitment to establish public fertility services in Victoria and we are easing the financial pressure on families when they are enduring what is a difficult experience. The 2021–22 budget delivered $70 million in funding to create an Australian-first public IVF system as well as an egg and sperm donor bank. The 2023–24 budget invested a further $49.9 million to expand and extend the public fertility program and the 2024–25 budget built on that investment with an additional nearly $2 million in funding for the public egg and sperm donor bank. I think it is really important to make sure that we record that, that we know that there is absolutely a commitment from this government to those services.

This idea that there are long waiting lists also needs to be challenged. We have established a brand new, nation-leading service. Quality, patient-centred care has been a priority for this government. This includes establishing new public labs, partner sites and the egg and sperm bank. There is so much going on in this really important area of reform. The contributions have been extraordinary from across the chamber, but there is no doubt that it takes a Labor government to undertake the sorts of reform that we are seeing. I commend this bill, and I am really grateful to everyone for the contributions they have made.

Jess WILSON (Kew) (16:31): I too rise for probably what will be a brief contribution, because my lung capacity seems to be limited by the day at the moment, on the Health Legislation Amendment (Regulatory Reform) Bill 2024. I echo the comments of the member for Cranbourne about the powerful speeches that have been made today on this piece of legislation. It can be a very difficult discussion and difficult process when talking about what can be very personal fertility journeys, and I think having a number of members share their own only helps others who are going through that difficult journey to understand that there are others out there going through that experience and there is support available.

This legislation before us today will make a number of amendments to the regulatory frameworks to essentially modernise, streamline and look at the compliance enforcement powers around health regulation in the state, particularly by the Department of Health’s regulator, and look at making sure that our regulation that supports our health system and the Department of Health is minimising risk and promoting health and safety for all Victorians. It does come off the back of the Gorton review, which looked into assisted reproductive treatment, and it proposes changes to enhance compliance enforcement tools across a number of pieces of health regulation and a number of schemes, including, as the member for –

A member: Morwell.

Jess WILSON: The wonderful member for Morwell, who is going to do a lot of babysitting. I should not forget that as we pass the babies around the chamber.

The member for Morwell went into great detail and provided a good understanding for all of us around cooling towers under the Public Health and Wellbeing Act 2008; drinking water under the Safe Drinking Water Act 2003; first-aid services under the Non-Emergency Patient Transport and First Aid Services Act 2003; non-emergency patient transport under the Non-Emergency Patient Transport and First Aid Services Act; pest control operations under the Public Health and Wellbeing Act 2008; private hospitals, day procedure centres and mobile services under the Health Services Act 1988; medicines and poisons under the Drugs, Poisons and Controlled Substances Act 1981; and radiation sources under the Radiation Act 2005. All of those consequential amendments under this piece of legislation will look at strengthening the regulation of our health system, ensuring that we are minimising risk for Victorians.

But as has been spoken about at length today, the bill does see the abolition of the Victorian Assisted Reproductive Treatment Authority and the transfer of its responsibilities for regulation of assisted reproductive treatment. We know the current functions of VARTA include the registration of assisted reproductive treatment providers and monitoring compliance; management of the registers that hold donor conception information in Victoria – essentially the central register – including providing counselling to people who seek to access and store information on those registers; consideration of applications to bring donated embryos from them into and out of Victoria; and importantly – and something that I know that a number of stakeholders have pointed to in the drafting of this bill and making sure that this continues post the introduction of this legislation – public education and promoting research about fertility and reproductive services here in Victoria.

On this side of the house, while we will not be opposing the bill before us today, we do note a number of concerns with the drafting and just want to ensure that we are putting forward legislation that does at all points in time minimise risk and promote the health and safety of all Victorians and particularly the need for specialist expertise and whether the health department will maintain the level of knowledge and expertise in this complex area that has been previously provided by VARTA and I know has been extremely valued over the course of the existence of VARTA. There are also concerns around removing mandatory counselling for donor register access. People accessing donor information are very vulnerable and may face unexpected and confronting information such as discovering the parent or child has passed away, has criminal convictions or has mental health issues, and there is a need for adequate support in that space. I know that stakeholders have stressed the need for specialised counselling to safeguard individuals’ wellbeing in this space and that counselling remain mandatory for treatment of donor consent.

In particular we have heard in our own work – and can I commend the member in the other place the Shadow Minister for Health for her immense work with stakeholders in consulting on this bill – when speaking to Monash IVF, they certainly shared their concerns around mandatory counselling for donor registers, particularly around opposing the removal of that mandatory counselling, highlighting the importance of counselling in managing the identity and, importantly, the expectations and the relationships of those accessing donor registers. They are on the record pointing to the potential psychological harm and trauma without that proper support. We do want to see as part of the work that the Shadow Minister for Health has done her proposal around a review when it comes to looking at this legislation in a few years time, ensuring that that counselling does remain available and that it does form part of the new role that the Department of Health will have when it comes to administering the reproductive and IVF services here in Victoria to make sure that we are putting forward the support for those accessing donor information in particular.

The other concern that we have spoken about and that we on this side of the house have is the removal of the legislative requirement for research and education in this bill. Previously there were requirements as part of the legislation that there would be access to reliable, independent information on current research about infertility and donor conception, and the change with this piece of legislation is that is no longer a legislative requirement under the bill. The government have said that they are committed to providing that ongoing service. It has been acknowledged the role that VARTA has had previously in providing that service to ensure that particularly that independent information is available when trying to make important decisions in this very specialised area of care, and we want to make sure that those educational resources do not cease without that legislative framework sitting around them. That is something where once again Monash IVF have expressed their concerns and just expressed their disappointment that that ongoing educational role of VARTA’s will not be replicated in this piece of legislation before us today, calling on the government to commit more broadly to not only providing the education and ensuring that it is available and accessible into the future but outlining their clear plan to do so, continuing to provide that reliable and independent fertility information that so many Victorians have relied on in the past and should be able to rely on into the future.

The opposition has a range of other concerns with the piece of legislation before us, including the lack of clarity on the future of the data being published by VARTA in its annual report and just the process by which the public consultation took place. It was indeed a very short time, limited to written submissions only, and those submissions were not made publicly available to ensure that stakeholders who work every day in this space, who are experts in this space, were actually able to put their feedback on the record and that the bill before us today is fit for purpose and is meeting the expectations not only of the Victorian community but of those stakeholders who work in the space every single day.

As I said, the opposition will not be opposing this bill. It does seek to put in place a number of regulatory changes and streamline a number of regulatory changes in the health system, and I am thankful for the opportunity to speak on it today.

Bronwyn HALFPENNY (Thomastown) (16:41): I also rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. The bill that we are debating today and the legislative changes it proposes really came about as a consequence of the Minister for Health’s announcement back last year that there would be strengthening and reform of health regulation and that that would include the establishment of a health regulator, and some of the legislation that is to be amended within this bill is around including the health regulator as the body to oversee and regulate various aspects of the health practices and system.

In terms of the Assisted Reproductive Treatment Act 2008 changes that we are also looking at today, which include certain aspects of it coming under the health regulator, that was also subject to considerable consultation. The views of those with the lived experience and those in the industry were of course all taken into account. But the purpose of this bill today is actually to strengthen the rights of the participants or those that will be accessing these health services. We want to make sure that the rights of those people are foremost and, most importantly, protected. We know, though, that the IVF program, for example, prior to the Allan government introducing public IVF treatments, was mostly in the private domain. We always need to ensure when there is profit involved that we have strong regulation to preserve the rights of donors and those using the services to ensure that everybody is protected.

I will just quickly go through some of the changes. I think there are seven pieces of legislation that will be amended, including those to do with the health regulator and strengthening powers. We are looking at things like the power to issue improvement notices, where the regulated entity will have to take specific action to remedy noncompliance. These are very practical steps to ensure that there is compliance, to ensure that quick action is taken and to determine the type of action that is required in order to be compliant; to issue prohibition notices, which prohibit a regulated entity from engaging in a particular activity that may pose a risk of harm to health and safety; and to issue information or document production notices. Of course it is so important when it comes to compliance and regulation that access to information is very clearly stated, and this again is what is being proposed in this bill.

There is the issuing of infringement notices. There is no point having requirements and regulations to comply if there is not some sort of penalty that is issued in the event that there is not compliance. There is the imposition of fines for noncompliance in appropriate circumstances. Also, there are enforceable undertakings. Binding, formal and legally enforceable agreements are to ensure that health services or bodies can reach agreement. There might be a little bit more flexibility in those sorts of legal undertakings, but they are just as important and just as strong as compliance notices or offences. Those agreements are enforceable by law, and penalties apply if they are not followed.

This, again, is about protecting Victorians and making sure that services are provided. We all know that with services in the area of health in particular, often people are using these services because they are life-changing or they are life-saving. In the case of IVF treatments, there is so much at stake. We have heard today from many previous speakers with experiences of issues around fertility, around family and around children. In those situations you are not always focusing on how it is that you are going to have that service delivered or what is expected of the provider, so it is so important that there is regulation to support and strengthen and carry people through the journey that they are about to go on so it can be as good as it possibly can be as an experience rather than a difficult experience because of the way the provider is treating you or acting, or even due to differences of opinion or whatever it might be later on down the track.

The opposition were making some claims about cuts to funding and waiting lists. I know that at the Northern Hospital there is a great partnership with the Royal Women’s Hospital, and there is a public fertility clinic there. I have not spoken to everybody that has been using that service, but the few people I have spoken to have really given me great feedback – that it is a great place with lots of support. Also, I think it was only a couple of months ago, when I was last speaking to representatives at the hospital, that there were actually some vacancies, so people could still go to receive the treatment. So I do not know where this idea or this fallacy about waiting lists has come from, but it certainly is not accurate when it comes to the northern suburbs of Melbourne and the programs and the fertility clinic that is in operation there.

The other thing in terms of the details of this proposal and the health regulator is that we are trying to accommodate all circumstances and also provide flexibility. I have been here for some years now. Whenever legislation is put up and changes are made, there are always those that try to get around them. There might be changes to technology or there might be changes to the way we operate, and therefore legislation continues to need updating. The amendments that we are talking about today are about doing that updating as well as providing additional strengths and imposing additional penalties for offences. Again, this really fits in with the Allan Labor government and our absolute commitment to and support for the health of Victorians in the state of Victoria.

The Northern Hospital has gone from strength to strength. It was the hospital that developed the virtual emergency department. The feedback you get from people, including my family who have used that service, really demonstrates its great commitment and how innovative it is and how it can actually change the way people seek emergency medical treatment and advice.

I know there has been incredibly good feedback around the paediatric services within that virtual emergency department, and just this morning I co-hosted with a member in the other place Gaelle Broad the Parliamentary Friends of People Affected by Diabetes, and we were celebrating the virtual emergency department that has now established a diabetes clinic within that service. Anybody that has the misfortune of having type 1 or 2 diabetes will have heard of really difficult experiences of going into the public hospital system through the normal emergency and there not being the staff there that really understand the illness. Another thing of course was the announcement, which I did earlier this year with the Minister for Health and other members from the area, such as the member for Yan Yean, who is in the chamber, and the member for Mill Park, of another $235 million to support and expand the virtual emergency department. It services the whole state. It is not just for those that live in the north, but of course it does operate through Northern Health. They really do a fantastic job. This legislation is important, vitally needed and hopefully will give more peace of mind to those using health services.

Katie HALL (Footscray) (16:51): I am delighted to make a contribution – the last contribution – in today’s debate of the Health Legislation Amendment (Regulatory Reform) Bill 2024. I do so with some personal experience that I have spoken about in this place before, in that my beautiful now eight-year-old girl Matilda McCrone is a child who came to me through IVF. It is really not an easy journey, and I would like to acknowledge the contributions from across the chamber today. We have had some really beautiful and thoughtful and very personal contributions from people. I would like to acknowledge in particular the member for Point Cook and the member for Laverton, who are in here. The member for Laverton is always really generous with her sharing of her experience, and also the member for Point Cook. There have been really deeply moving contributions from a range of people today, and I think that is the Parliament at its best.

There is one thing that I find really compelling about this bill. Something that I remember very well is that I was required to go to counselling before I embarked on the IVF journey. I remember thinking at the time – and I know that the counselling is a really important opportunity for people, because every journey is different – that for me at that point in my life it was the last thing I wanted to do. I did not want to go to counselling and explain why I wanted to have a baby or the circumstances where I was going to have a baby, so if I had been offered the choice, I would have really liked to have opted out of that. I was sick of explaining to people at that point in time why I did not have a baby yet, and I just wanted to get on with it. I went through that process. It was not for me; that does not mean it is not for other people. I think giving patients choice is a really, really important thing, especially in the very challenging experience of IVF, so I am pleased that we are introducing these reforms.

The bill gives effect to reforms announced last December that will strengthen and reform health regulation in Victoria and provide greater consistency to regulation across the health system through the newly established health regulator. Of course that is a really important role in contributing to the public health and wellbeing vision where Victoria is free of the burden of diseases and injuries so that all Victorians can enjoy the highest attainable standards of health, wellbeing and participation at every age.

Many of the contributions today have focused on assisted reproductive treatment, and I know for a lot of people in my community the Allan Labor government’s reforms to introduce public IVF have been absolutely life changing. I have friends who have spent a house deposit on trying to fulfil their dreams of having a child. I am very pleased that high-quality public health care that includes access to public IVF services is available for women and their partners at Sunshine Hospital, close to my electorate of Footscray.

We are embarking on a very substantial period of reform in health infrastructure and health service delivery in Footscray. It is something that will transform the access for many people in the western suburbs through the delivery of the $1.5 billion new Footscray Hospital. It has an additional 200 beds, and it will see an extra 20,000 emergency department admissions each year. We are building the infrastructure we need across the state, the high-quality public infrastructure. I noted before the member for Mildura’s contribution where she spoke about public IVF at a public hospital. Well, we are also very proud to have brought that hospital back into public hands, because equity of access is something we believe in. IVF should not depend on how much money you have.

I know that this announcement – I believe it is $120 million now, as a commitment to public IVF – is really changing the lives of Victorians who perhaps otherwise would not be able to afford what is a very expensive treatment. I know for my cycle it was around $10,000, which at the time we could ill afford, but it was something that we had to do, and at that time public IVF was not available to us. So these reforms are really important – and the regulatory reforms that go with them. I think making sure there is accountability and transparency in the system and making sure that choice is centred for patient care are really important things.

I would just like to acknowledge, with the time I have remaining, the work of the late Sarah Carter in our community. IVF and access to IVF and our public IVF reforms were something that she really championed. She was very open about her struggles with trying to conceive a child, and I know that she would be very proud of these reforms, because they deliver on a safer, fairer and more accessible ART system for Victorians, including people seeking and receiving donors and surrogates.

The bill amends health regulatory frameworks in seven acts across a whole range of sectors. Obviously the focus today has been predominantly on ART, but there are a range of different reforms that will improve the regulatory environment and framework for Victorians. I am very pleased to have been able to make a contribution to this bill, and I am very proud to be part of a government that is delivering improved equity of access for all Victorians, whether it be through beautiful new infrastructure, like the new Footscray Hospital, or through public IVF.

The SPEAKER: The time set down for consideration of items on the government business program has arrived, and I am required to interrupt business. The house is considering the Health Legislation Amendment (Regulatory Reform) Bill 2024. The minister has moved that the bill be now read a second time. The member for Brunswick has moved a reasoned amendment to the motion. He has proposed to omit all of the words after ‘That’ and replace them with the words which have been circulated. The question is:

That the words proposed to be omitted stand part of the question.

Those supporting the reasoned amendment moved by the member for Brunswick should vote no.

Assembly divided on question:

Ayes (72): Juliana Addison, Brad Battin, Jade Benham, Roma Britnell, Colin Brooks, Josh Bull, Tim Bull, Martin Cameron, Anthony Carbines, Ben Carroll, Anthony Cianflone, Sarah Connolly, Chris Couzens, Chris Crewther, Jordan Crugnale, Lily D’Ambrosio, Daniela De Martino, Steve Dimopoulos, Paul Edbrooke, Matt Fregon, Ella George, Luba Grigorovitch, Sam Groth, Bronwyn Halfpenny, Katie Hall, Paul Hamer, Martha Haylett, Mathew Hilakari, David Hodgett, Melissa Horne, Lauren Kathage, Emma Kealy, Sonya Kilkenny, Nathan Lambert, Gary Maas, Alison Marchant, Kathleen Matthews-Ward, Tim McCurdy, Steve McGhie, Cindy McLeish, Paul Mercurio, John Mullahy, James Newbury, Michael O’Brien, Kim O’Keeffe, Tim Pallas, Danny Pearson, John Pesutto, Pauline Richards, Tim Richardson, Richard Riordan, Michaela Settle, David Southwick, Ros Spence, Nick Staikos, Natalie Suleyman, Meng Heang Tak, Jackson Taylor, Nina Taylor, Kat Theophanous, Mary-Anne Thomas, Bill Tilley, Bridget Vallence, Peter Walsh, Iwan Walters, Vicki Ward, Kim Wells, Nicole Werner, Dylan Wight, Gabrielle Williams, Belinda Wilson, Jess Wilson

Noes (4): Gabrielle de Vietri, Sam Hibbins, Tim Read, Ellen Sandell

Question agreed to.

Motion agreed to.

Read second time.

Third reading

Motion agreed to.

Read third time.

The SPEAKER: The bill will now be sent to the Legislative Council and their agreement requested.