Thursday, 28 November 2024

Bills

Drugs, Poisons and Controlled Substances Amendment (Paramedic Practitioners) Bill 2024

Second reading

Debate resumed on motion of Natalie Suleyman:

That this bill be now read a second time.

James Newbury interjected.

The SPEAKER: The member for Brighton can leave the chamber for half an hour.

Member for Brighton withdrew from chamber.

Jackson TAYLOR (Bayswater) (16:38): Can I first say I am a little bit hurt by the mass exodus prior to my speech.

A member interjected.

Jackson TAYLOR: I will take it personally. I am hurt. I am deeply impacted. Alas, the show must go on, and I am absolutely proud today to stand and provide a contribution on the Drugs, Poisons and Controlled Substances Amendment (Paramedic Practitioners) Bill 2024. Can I first say a huge thankyou to the Minister for Health and Leader of the House and of course all of her staff for their important work in bringing this piece of critical legislation to help acquit a really important election commitment that this government made in 2022. Now we are not just seeing that through but getting it done and doing what we said we would.

I just want to acknowledge a few contributions by some members in this place today. The Minister for Environment I think gave a fantastic contribution. He spoke about the record that Labor governments have when it comes to supporting health care and supporting our healthcare workers right across this state – metro, regional, in every single corner of this great state. He talked about the record investments of not just Labor governments but now the Allan Labor government and of course the Andrews Labor government in making sure we have got a world-class healthcare system here in Victoria and in my electorate of Bayswater. We also know we had that contribution from the Minister for Environment.

We have heard contributions from the other side talking down our healthcare system, talking down our hospitals, and the reality is that we do have a world-class healthcare system here in Victoria, one we should be proud of, one we should continue to work towards improving and making better each and every single day. Nobody is denying that. That is important. That is the work of any good and decent government, and that is what we are doing; that is the work that this government is doing.

The reality is that those on the opposite side talk about all these different things they have raised in this place, but the reality is that people in Victoria simply do not trust Liberal–National governments when it comes to health care. People love to prognosticate and talk about polls and all this, that and the other, but the reality is the only poll that counts is the one that is on election day, and the people of Victoria have voted for Labor governments in this state, and I am very grateful to be here because people voted for Labor governments, and we have not let them down. Whether it was through the pandemic, whether it is business as usual, this government backs in health care each and every single day.

We heard also from the member for Melton, a former secretary of the Victorian Ambulance Union, about his experiences not just in the union but in this place and his passion for health care not just in Victoria but in his electorate as well. I know there was a member who spoke about the healthcare system in perhaps less glowing terms, but it is important to note that the latest data seen in Warrnambool in terms of ambulance response times is 83.8 per cent for code 1 cases within 15 ‍minutes, which is a 3 per cent improvement on the last quarter. So well done to our hardworking paramedics, the people at Ambulance Victoria, who are doing the hard work each and every single day. That is also the best result in terms of LGAs in the state.

We also heard that some think that these are the only 30 practitioners who will go through this course, but the reality is this is just the first tranche. There are more to come. The commitment was to deliver 100 over four years, and that is exactly what this government will do. Of course we will keep our promises and we will continue to support our hardworking paramedics, because that is what we do. We respect our paramedics. We support them. We have heard this phrase in this place, and it is absolutely true and something we should remind the Victorian people of: that we support paramedics and we do not go to war with them. We support them. We thank them for their work, and we back them in with funding and the resources each and every single day through the instruments of this government.

Thank you to our paramedics across this state and also the hardworking paramedics who I have had the great pleasure of sitting down with on many occasions with multiple ministers we have had over the course of my journey in this place. Most recently at the branch in Ferntree Gully we sat down, listened to paramedics, their experiences, how we can continue to improve the system, how we can continue to make our healthcare system even better and the way in which paramedics interact with it ‍– wonderful, wonderful people, the best of us, in my view. I think that of all healthcare workers. I have often said in this place it is a very hard job, and honestly I do not think I could do it. I really do not think I could do it. They are incredible people, and I am very grateful for work they do.

Of course this government is not just backing in our paramedics, we are also doing the important work of building the infrastructure this state needs, whether it is Frankston Hospital, Footscray Hospital, Melton Hospital or the upgrade that we will deliver with the Maroondah Hospital. The Angliss Hospital construction is underway as well. I was there the other day with the board chair and the CEO of Eastern Health – both great people doing great work in their communities and across the Eastern Health sites, of which there are many. The Angliss Hospital essentially is a new wing. There will be more beds. There will be more elective surgery suites and a new central sterilisation services department – I have got the ordering of that sentence correct; the first few iterations needed a bit of practice. And there will also be some more parking – not lots of extra parking but some more parking ‍– which will make locals very, very happy and will keep the ticket inspectors at Knox council less busy, I sincerely hope. That is underway, and that construction will be complete in 2026. We saw the new Wantirna aged care also delivered – a wonderful public aged care facility. It is a remarkable feat – four storeys, 120 beds – and really lets people age in place and age with dignity. We know that we have also put in place nurse-to-patient ratios and provided the funding needed.

This bill is to support the introduction of a paramedic practitioner role in Victoria through amendments to the Drugs, Poisons and Controlled Substances Act 1981 to authorise paramedic practitioners to autonomously obtain, possess, use, supply, administer and prescribe scheduled medicines. It will insert a definition of ‘paramedic practitioner’ in the act. A paramedic practitioner will be defined as a registered paramedic who has completed a prescribed postgraduate qualification and who satisfies the prescribed experience requirements. It will permit paramedic practitioners to practise autonomously by providing authorisations under the act equivalent to a nurse practitioner, including the ability to obtain, possess, use, supply, administer or prescribe scheduled medicines. It will also allow paramedic practitioners to access, use and disclose information on the monitored poisons database SafeScript and will require that paramedic practitioners check SafeScript before supplying or prescribing a monitored poison, similar to a registered medical practitioner or nurse practitioner.

I spoke a little bit about the last election, when we committed to establishing this position in Victoria. Twenty-five on the road will be in rural and regional Victoria by the end of 2026, and these of course will be specialised paramedics able to independently deliver urgent care in the field without needing to transport patients to an emergency department. This is really, really huge. It is forward thinking, the first of its kind in the country. It will take people out of EDs, along with that important reform we also made around priority primary care centres, which are doing a great job. It is a fantastic bill.

I would just like to say, with 1 minute and 18 seconds left and with the indulgence of the house, that it is the season to be jolly – fa la la la la la la la la. I want to say merry Christmas to you, Acting Speaker, and to everyone in this place of all political ilk. I hope everyone has a great Christmas. I want to thank the team at Hansard, who do a great job. The bow ties today were on point; they were great. I enjoyed the photo; I saw it pop up on Parliament services. Great work, team. Have a great Christmas. Thank you. If the camera could just do a nod at this point, that would be great. A big thankyou to everyone else at the Department of Parliamentary Services, to all in the catering team and to everyone who makes my life so easy in this place. For all of us they do a wonderful job. To all of my staff at the Bayswater electorate office, thank you so much. They say you need smarter people around you, and I have no doubt that that is the case with me at the Bayswater EO. They are great people. I love having them around. They are not just staff, they are friends as well. I appreciate them each and every single day.

This is a great piece of legislation, a fantastic piece of legislation, that acquits an election commitment and gets on and delivers for the good people of Victoria. What a way to end 2024.

Cindy McLEISH (Eildon) (16:48): I am pleased to finally have the opportunity, which I thought had passed me by, to speak on the bill before us. Whilst the concept of a paramedic practitioner might be new to us, the concept of a nurse practitioner is well known. This concept is closely modelled on that of a nurse practitioner, whereby those who already have the paramedic qualification are able to undergo particular training as prescribed postgraduate courses at Monash University to obtain a master of paramedic practitioner. What that will allow them to do is expand on the roles that they already do. In theory that is going to have great outcomes and make a big difference to the health services and the ambulance service, but when you look at the number that are going to be going through the course, it is not going to make much of a dent in this already at crisis and underfunded system in Victoria.

The purpose of the bill is fairly simple. It is to establish the paramedic practitioners as a class of registered paramedics, and then there are authorisations around what they can do around obtaining, possessing, using and selling and supplying certain substances. We are all very familiar with the concept of what a paramedic does and where they go, whether it is visiting somebody’s home or whether they have to go to an accident in various different types of places. We are familiar with that, but sometimes there are limitations on what a paramedic can do, and increasing the scope of services that they are able to undertake will make some of their treatments a little bit quicker and perhaps help them get back onto the road fairly quickly. This training will help them assess, diagnose and administer medication, which is a little bit different, treating patients onsite, and they can make medical and clinical decisions which will prevent the transfer of a patient to hospital. That may be for a short term, because depending on the nature of the illness and what happens, they may need to go to hospital a bit later on.

I have mentioned nurse practitioners, and I have been familiar with the nurse practitioner concept for quite some time. When I was the member for Seymour we had one at the Seymour hospital. It was different, and there was a little bit of pushback from people about this concept being different and nurses being able to do additional tasks. I think that that calmed down after a while and it has worked quite well, because within that nursing system they have the clinical leadership for some of that direct clinical care and they can intervene more in clinical practice. This has been successful, and expanding this to paramedics is fine and should make life a little bit easier, but as I said, they are being rolled out only to a limited extent.

Paramedics in my electorate have a fairly challenging environment. Sometimes it is hard to meet the times that are set to get to a location because physically you cannot do it – you cannot get there in that amount of time. If you are in Mansfield and you have to go to Woods Point and drive an hour and a half, you are not going to get there in the prescribed time period, and often what happens is people in Woods Point have to drive towards Jamieson and meet an ambulance. We can have ambulance community officers, ACOs, as well who can help with this. It is difficult when ambulances come from out of area, because they do not know rural roads. They do not know that you actually cannot get through what sometimes on a map it looks like you can get through. We have had instances in the Mansfield shire when an ambulance has turned up on one side of a river thinking that they could get across and they could not, and they needed to have gone locally, and that certainly impacts on response times.

It is very different being a paramedic in country areas to the city. We see also that they get called out a lot, and when ours get called out they go to so many different areas. If you are in Mansfield, you are likely to end up in Wangaratta, where ramping still does happen. If you are in Alexandra, you would probably head over the Spur, hope to goodness there are no trees down over the Spur and you can get to Maroondah or maybe even Box Hill. If you are in Yea, that one is a little bit more difficult, because sometimes you might go to Maroondah and other times you might go to the Northern. This has challenges, because with the amalgamations by stealth that the government are undertaking at the moment the hospitals now have to choose which network they want to belong to. If they have got somebody from in or around Yea, depending on what side of Yea you go to, the ambulance will choose to go the Ringwood–Box Hill path or to go the Northern path; very infrequently they will go to Shepparton, even though the psychiatric link is supposedly at Goulburn Valley Health. That makes it really difficult because people do not go to visit because that is not the normal connector of where things happen.

We know too that there are a lot of crises in the health and ambulance sector at the moment and indeed even 000. It was not that long ago – I think it was in August – that the Parliament supported a motion to establish an inquiry into the performance, workplace culture and procurement practices of Ambulance Victoria by the Legal and Social Issues Committee, because we know that under Labor ambulance response times have missed their targets and there has been extensive ramping outside hospital emergency departments. We all see the photos: ambulance officers, paramedics – they send them to us. We know what happens; they post them. Morale is shot – I do not think anyone can disagree with that – and they are exhausted. They have been having to battle for so long, and the service continues to be under-resourced. For too long the government has refused to provide an explanation around the performance and take real action to address the issues.

I know that there are issues at that leadership level. We have had the new CEO resign after 18 months. The CFO I believe has gone as well. There have been issues at board level. With this sort of disruption and change at the top, it filters down, and it does impact on morale when people are not sure what is going on, who their leader is and how it is going to work out. I understand that they had a bit of an issue recently where Ambulance Victoria failed to publish the rosters with the required 28 days notice, and that roster period went right up until Christmas. There will be people who want to have time off, and to change your roster needs approval. There are these sorts of things that happen too often. I am not even sure that they did not have to borrow, Ambulance Victoria, to top up the books before the end of the financial year.

Today we had the tabling of the Triple Zero Victoria annual report, which was probably due I would say a month or so ago, but we saw it tabled today. That says that Triple Zero Victoria recorded an $81.2 million deficit, down from a $338,000 surplus in 2023, so that is a turnaround of almost $82 million. Government funding for call taking and dispatch was cut by over $38 million. Triple Zero are particularly relevant to Ambulance Victoria because they have their performance and their benchmarks. The AV code 1 annual target is 90 per cent, and it was 80.4 per cent. It has varied; it has gone down by 10.7 per cent. There are problems at every level of the health service.

This initiative that is being put forward today of the paramedic practitioner will help in instances where they are called to somebody’s house. If they can deal with it quickly and they do not need to go to hospital and experience ramping times, they may be able to turn that around fairly quickly, and I think that is certainly positive. The limited number that are going to be going through and deploying into regional Victoria by I think 2026 – I wish that that was at least doubled to make a real difference, but it is a start.

Daniela DE MARTINO (Monbulk) (16:57): I am pleased to rise to make a contribution, albeit a very, very brief one as we approach the guillotine, on the Drugs, Poisons and Controlled Substances Amendment (Paramedic Practitioners) Bill 2024. This is a wonderful first for our nation, and once again it is Victoria leading the charge. What a fabulous thing we are doing here. It is really pleasing that this will be going through unopposed. It is an exceptionally important piece of legislation which is going to make a real impact for everyone in Victoria. For anyone who needs an ambulance or believes they need to get to hospital, we are going to have dedicated paramedic practitioners out there who are going to be able to make sure that those who do not actually need to get to the emergency department can get the assistance that they require without a trip to our hospitals, without putting pressure on our system, especially as the population ages and we require a little bit more medical attention. It means people can be treated in their home. They can be given the care that they require, and that may be in a nursing home as well. It is absolutely groundbreaking for us here, this legislation.

Instead of going into great detail on it, I do want to take the opportunity, with 50 seconds on the clock, to thank our amazing paramedics across the state of Victoria. They will be working around the clock while we may be out there enjoying Christmas celebrations, new year’s celebrations or whatever celebrations our faith or otherwise takes us to – barbecues. Whatever celebration anyone may be enjoying, our paramedics will be standing ready to assist us. While we all have a wonderful festive time, I would like us all to spare a thought for our fabulous healthcare workers, who will be there waiting for us in our time of need should it arise. They are absolutely superhuman people. Unfortunately, I have had far too many interactions with paramedics, between my family members. I commend the bill to the house.

The ACTING SPEAKER (Nathan Lambert): The time set down for consideration of the remaining items on the government business program has arrived, and I am required to interrupt business.

Motion agreed to.

Read second time.

Third reading

Motion agreed to.

Read third time.

The ACTING SPEAKER (Nathan Lambert): The bill will now be sent to the Legislative Council and their agreement requested.