Thursday, 17 October 2024

Bills

Health Legislation Amendment (Regulatory Reform) Bill 2024

Second reading

Debate resumed on motion of Enver Erdogan:

That the bill be now read a second time.

Georgie CROZIER (Southern Metropolitan) (10:19): I rise to speak to the Health Legislation Amendment (Regulatory Reform) Bill 2024, and I want to just put on record my thanks to the department and the minister’s office for providing information to me about various aspects that needed clarification. I was very thankful for that input that I received. I want to also thank those members of the community that have reached out to me in relation to this very important issue. They have shared their stories and provided their insights, some of which have been widely reported in the media and others that have not. I want to thank them for providing me with the information and their concerns that they have shared regarding various aspects of this bill.

This bill proposes amendments designed to enhance and strengthen compliance and enforcement tools across a number of health regulation schemes, and these will be consolidated under the health regulator. Importantly, where most of the feedback has come from, as I have just mentioned, has been around part 2 of the bill, and what the bill does is it abolishes the Victorian Assisted Reproductive Treatment Authority, or VARTA, and transfers its regulatory functions to the Secretary of the Department of Health. This aspect of the bill has been quite contentious in some areas, and again I want to put on record that Victoria has led the way in reproductive health and that there have been many good things that have come out of VARTA and what it has achieved over many, many years. But as we have moved on, obviously there have been various concerns, and I will go to those concerns throughout my contribution and why the government is moving towards this piece of legislation.

The bill also makes minor and miscellaneous amendments to a number of acts, and whilst, as I said, there are concerns that have been raised – and I will be wanting to raise some of those points in the committee stage – the Liberals and Nationals will not be opposing the government’s bill. But we do have concerns around certain elements of the transfer of VARTA’s powers to the Department of Health. As many know, I do not like a big, centralised bureaucracy and the department overseeing all things in terms of taking control. Obviously they have a role to play in terms of safety and administering our health system, but I do have concern, and that is why I am proposing an amendment for a three-year review for this piece of legislation to ensure that what is proposed in the legislation is actually being enforced. I am happy for those amendments to be circulated now so members can see them. It is a very simple amendment to the bill, and I thank the government also for the discussions around my proposed amendments.

Amendments circulated pursuant to standing orders.

Georgie CROZIER: The transition of VARTA into the department requires proper management to ensure effective oversight remains and the risk of harm to vulnerable individuals is minimised, and I think that is incredibly important. I note that there are many people who have understood that and that a lot of the information that has come out of the proposed legislation is a result of the Gorton review. Some of those concerns I raised have been around the educational component of VARTA and the publication of data. Many people, as I said, have spoken to me about that.

This bill seeks to improves compliance and enforcement tools. The bill makes amendments to regulatory frameworks in a number of acts. They include cooling towers under the Public Health and Wellbeing Act 2008 – clause 104 deals with that. It includes drinking water under the Safe Drinking Water Act 2003 – clause 110 goes into some detail in relation to that component – and first aid services under the Non-Emergency Patient Transport and First Aid Services Act 2003. I know that there is a review around non-emergency patient transport. I have been calling on the release of that review by the government. That has not been done, and I say again that that has been some time in the making and it needs to be released. Non-emergency patient transport under the Non-Emergency Patient Transport and First Aid Services Act 2003 – as I said, clause 101 deals with that. It includes pest control operators under the Public Health and Wellbeing Act 2008 and private hospitals, day procedure centres and mobile services under the Health Services Act 1988.

In relation to private hospitals, I note that the health complaints commissioner report was tabled this week, and that shows an increase in complaints from 2016–17, when the last health complaints commissioner was in place. Not that that has got any relevance whatsoever, but there has been this significant increase in complaints – 29.4 per cent of complaints in the public system – whereas in the private system there has actually been a decrease of 3.1 per cent in complaints to the health complaints commissioner. I think that is just an interesting note to take on board around what is happening in our public health system as well as overseeing and making sure that our private health system is operating to the best effect for the Victorian community. But those health complaints within the public health system I think are very concerning – for them to increase as much as they have.

Also, just a couple of other things the bill deals with are the medicines and poisons under the Drugs, Poisons and Controlled Substances Act 1981 and radiation sources under the Radiation Act 2005. The regulation will be centralised in the health regulator with the aim of strengthening compliance and enforcement powers, with graduated steps for appropriate intervention when required, including mid-range remedies and penalties, from low-level guidance and support right through to prosecution. I think that was one of the issues through that consultation, looking at the number of prosecution penalties that were not being totally complied with. That is partly the reason why this bill is in the house today, because the bill gives the health regulator the powers to issue improvement or prohibition notices, accept enforceable undertakings, issue infringement notices and require the production of documents. These new powers have generally been well received by stakeholders as necessary improvements.

The department put out a consultation paper, and it was very detailed. It referred in its consultation paper to one example that demonstrates what these reforms will actually do, or are intended to do, and that is to address the inadequacy of compliance with the current SafeScript system. That was something that was brought in a number of years ago. SafeScript is a clinical tool that allows doctors, nurse practitioners and pharmacists real-time access to patients’ prescription records to prevent harm, including death from overdose of high-risk prescription medications. It has more than 36,000 registered users and records around 46,000 prescribing or supply events per day. It is a very significant piece of monitoring that goes on with the numbers of people that are requiring prescriptions.

But earlier this year the Coroners Court held an inquest into the death of a 16-year-old boy who obtained 64 prescriptions from 31 doctors in a year, feigning illness to get opioids and benzodiazepines. That is what is commonly known as doctor shopping, and SafeScript is designed to prevent that from occurring. I think that is a very good example of what SafeScript is trying to prevent – another incident like that sad case. Despite a mandatory requirement for health professionals to check SafeScript, the coroner highlighted a compliance rate of 70 per cent, which showed that the legislation was clearly not operating as intended to prevent doctor shopping by people addicted to dangerous drugs and other medications.

The coroner noted particularly concerning evidence of the extremely low number of clinicians being referred to regulators, described by the coroner as a drop in the ocean considering the number of breaches. Since the obligation for compulsory checks began in 2020, no medical practitioners have been penalised under the legislation, which a Department of Health representative confirmed to the coroner was due to a drafting error. I think that it is incredibly important that that be corrected. It goes on to say that the Department of Health representative told a coronial inquest into the overdose of the boy that I mentioned that:

At the moment we currently have not ever administered that penalty…

That was the acting director of Medicines and Poisons Regulation when the boy was known to have died. And:

My understanding is due to the way the legislation has been drafted we are not actually able to implement that penalty.

Hopefully this will go a long way in fixing those errors to enable that to be corrected. The coroner recommended the department improve monitoring and compliance strategies for SafeScript as a priority, including additional enforcement options, which are included in this bill and are long overdue, coming four and a half years since that mandatory check-in began.

The main part is part 2 of the bill, and that is about the regulation of assisted reproductive treatment (ART). As I said at the outset of my contribution, there have been a number of areas of concern. There is a need for specialist expertise, and stakeholders have expressed concern that the regulator will not have the requisite knowledge, expertise and resources to continue providing the level of support needed in this complex space. I think everybody acknowledges that it is a complex and very sensitive area, and that came through in terms of the government’s consultation paper but also the feedback from various stakeholders.

Removing mandatory counselling before accessing information from donor registers is one particular area. The issue has generated a great deal of concern from individuals, providers and organisations, including the Australian and New Zealand Infertility Counsellors Association, Australian Solo Mothers by Choice and Monash IVF; they are just some that I am aware of. Some believe replacing mandatory counselling with explanatory material could have devastating consequences for vulnerable individuals confronted with life-changing information. There is scant detail in the bill about what this material will contain and how it will ensure that people make fully informed decisions about whether to undertake counselling. But I do think that those concerns have been taken on board by the government, and I am hoping they will address that.

It is important to acknowledge that people seeking information or contact with a donor parent or child are exposed to a potential minefield of issues, such as finding out the parent or child has died, has serious criminal convictions or has extensive mental health issues. Anyone who has worked in this space will understand exactly those very confronting elements for these individuals that may be either a parent or a donor-conceived child. The feedback includes concerns that, in situations which have such life-changing ramifications, specialised psychosocial counselling is essential as a safeguard against the risk of psychological harm to individuals in this very complex area. I would really reiterate that, understanding that it can cause some very significant issues. Throughout the consultation on this I have spoken to people who have highlighted these issues and their own personal experiences.

Since changes to donor conception laws in 2017 all Victorians conceived through donor treatment procedures can access identifying information about their donors on the central register. This removed anonymity from all donors, including those who donated before 1998 and believed they would remain anonymous. This world-first legislation followed recommendations of the Parliament’s Law Reform Committee in 2012. That was under the Baillieu government at the time. I want to commend my former colleague Clem Newton-Brown, the former member for Prahran, who did a lot of work in this area. I remember having meetings with donor-conceived children who were really pushing for these reforms and talking about their individual experiences around medical conditions that they were not aware of. There were some very sad cases throughout that entire debate, so I was very pleased that it was the Baillieu government and the Premier himself who intervened in the case of a 30-year-old woman who was dying of bowel cancer and desperately searching for her donor father. It was an incredibly sad story.

The department’s consultation summary states:

… there was generally support for people being able to choose whether or not they undertake counselling.

I think that is an important element of what this bill is seeking to do – to give choice to people around counselling, because not everybody did think it was necessary. I received feedback and I spoke to a constituent who was a donor in the 1980s and has worked closely with donors and donor-conceived children for over a decade, and he told me that some donor-conceived people and some donors have found the provisions in the act for mandatory counselling to be onerous and unnecessary. He in fact supported the intention to move from mandated to voluntary counselling yet was concerned that the government’s ongoing commitments to providing counselling and donor-linking services, in his words, were ‘very weak’. Again, I think the government are aware of these concerns, and I would hope that they would be taking them under consideration. It is partly why I have moved for a three-year review to ensure that these aspects that have been raised with me – I have fed back to the government and I know others have as well – will be reviewed and that what is intended to be working around this very important counselling component will be achieved. I do note also that counselling will remain mandatory before consenting to receiving treatment using donated material or consenting to be a donor – I think that is an important distinction here. Requirements for a counsellor to confirm the maturity of a child involved in accessing information will also be retained.

The removal of donor-linking services and the move to replace face-to-face donor-linking services with an online portal have also been questioned, as they may pose risks for donor-conceived people and donors who wish to exchange information. The department and the donor conception registrar will need to ensure that these people are still adequately supported during this process. That may involve sharing health information and other sensitive matters – another area that really needs to be closely monitored.

Can I just go back to the issue around the educational resources. VARTA’s educational resources developed over years are highly regarded as the leading source of reliable, current, evidence-based information about infertility and donor conception. I note again the minister’s commitment, in her second-reading speech:

… to continuing to make those available through non-legislated arrangements.

This is another point that needs further clarification to address the risk that research and educational features will cease without funding or a legislated requirement. Certainly we will be exploring that in a little bit more detail in the committee stage.

Currently it is an offence under the ART act to move donor gametes and embryos created from them into or out of Victoria without the written approval of VARTA. This bill replaces the preapproval with a certification requirement in line with recommendation 56 of the Gorton review. This is designed to reduce unnecessary regulatory burden as a barrier to accessing gametes and embryos from outside of Victoria, balanced with appropriate oversight, including new compliance measures. Whilst removing barriers helps to reduce delays and onerous requirements, concerns remain around making guidelines to ensure adherence to the 10-family unit. I note the feedback from the department’s consultation that being required to make best efforts to comply with family limits is not rigorous enough. Whilst I was speaking with various stakeholders around this issue, they were also raising with me that in the ACT and New South Wales there is a five-family limit. We have a 10-family limit, and we have got these cross-border issues. That is why the Fertility Society of Australia and New Zealand did make this very point to me as well – or their report, I should say, made this point. Speaking to stakeholders, they were also concerned about it. FSANZ said:

Differences in donor laws in different states and the lack of a national register means that there is an increasing risk of children of serial or prolific donors unknowingly meeting and potentially partnering and having children of their own as adults.

That is a huge concern, and that is what I want to come back to in a bit more detail. But if I can just go to the issue around data security, a recent report by the ABC revealed a serious risk of donor data being lost or hacked. A KPMG review found the integrity of data held by VARTA was at extreme risk of being compromised with a lack of cybersecurity awareness and security measures in place. Another report from the health department in 2021 refers to major concerns over ongoing data corruption. I know that that story that I referred to from the ABC and other stakeholders that have contacted me about it and also constituents and a donor-conceived child actually raised it with me – Steph is quoted in that report, and she raised the issue that when she found out she was donor conceived it was quite confronting for her.

I think it is very important to understand the emotion that is around when children have parents who have undertaken IVF and ART and they are absolutely aware of their circumstances. As she said when she was sitting there with her parents and finding out that she was donor conceived, she said it was terrifying to know the information on the database could be lost, and she already thought some of the information she had received may be incorrect. She was questioning various aspects of her own personal make-up. She talked about that storage of data, which is the point I am raising, and she went on to say in this report:

Admittedly this was 30 years ago but some of that information may have been lost or changed. Knowing that something that’s so fundamentally private about me … could be accessed by anyone, or that a computer malfunction could be the reason that I don’t get answers is insane.

So that data security issue I think is very, very relevant, and Steph’s story is one where she expresses it so well, and she talks about how important the security of health data is. The FSANZ review also raised these concerns as a consideration in the need to implement a centralised system to store, track and access genetic information.

Regarding the consultation process in relation to the bill before us, a number of stakeholders have expressed to me that that consultation lacked a degree of transparency, which was disappointing, and the short timeframe that they had to make submissions was just five weeks. When it comes to consultation I have to say that this government has demonstrated time and time again it does not engage in full, transparent processes, and I think that we need to understand how important that is, whether it is this issue or whether it is other issues around health, the government’s proposed plans to amalgamate health services and what they are going to do. They have left local communities in the dark, and you do not want people to feel that they have not understood the full implications of the legislation.

Just returning to the FSANZ review, the Fertility Society of Australia and New Zealand, their comprehensive review of governance and standards in ART and the IVF sector that was undertaken, the draft findings and recommendations were released on 15 September, just a few weeks ago. In this they were talking about governments, and they talked about a 10-year review, a 10-year national fertility road map based on four key pillars, those being governance, safety and efficacy, access, and research and technology. In the governance aspects they went into great detail because they said:

The primary issue raised in interviews and submissions is that the difference in laws and standards across over 30 pieces of legislation in 9 jurisdictions within Australia significantly impacts children, parents, donors, and the cost of ART in general, and, IVF in particular.

They went on to talk about, as I said and have mentioned before:

… the lack of a national register means that there is an increasing risk of children of serial or prolific donors unknowingly meeting and potentially partnering and having children of their own as adults … There should be a single national health standard for egg and sperm donation to ensure consistency and safe futures for children conceived by ART in general, and, IVF in particular.

There should also be a single national standard on the rights of children to seek information regarding their genetic parentage.

I really think that is an important aspect of that review, which I have got concerns about. They have a vision to work with state, territory and federal governments towards the establishment of a national regulatory framework, as I said, to ensure that these aspects that they raised that can have wide implications and very serious ones are addressed. I have been reassured by the minister’s office that nothing in the bill will preclude further cooperation with other jurisdictions and that consideration of a national fertility plan will go ahead. I would urge the government to really push ahead with that. Take it to the health ministers COAG and really work towards that, given the implications and given that tremendous body of work that was done, highlighting these issues and looking at those recommendations. As I said, those four key pillars that they highlighted can be worked on and should be worked on at a national level.

In conclusion, my amendment, as I mentioned, requires the minister to instigate a formal review of part 2 of the legislation to commence after three years of operation and be tabled in the Parliament within four years of the commencement of the act. The legislated review seeks to ensure that the department has undertaken proper management in the implementation of its new functions to ensure that appropriate support as well as information continue to be provided to people requiring the services formally provided by VARTA.

As I said, whilst we do not oppose the bill, the Liberals and Nationals are asking for this amendment to be supported so that there is a legislated mechanism to hold the government accountable for these reforms and what is intended in the bill is actually undertaken. I would urge the government to work on that national fertility plan so that we can have those issues resolved at a national level and prevent the potential for very distressing and concerning implications given what I have described in the course of this debate. I look forward to a speedy passage of this bill.

Sarah MANSFIELD (Western Victoria) (10:46): There are two parts to this bill, as Ms Crozier has already outlined. The first part, which supports the centralised health regulator and provides the regulator with some mid-range enforcement tools, is relatively uncontroversial; it makes a lot of sense and is something that we would support. Ms Crozier has already touched on some of those functions that would be centralised. I am not going to go into those any further. As I said, those particular changes we support. It is the second part of this bill that we have concerns with, and that is the part that makes changes to the Victorian Assisted Reproductive Treatment Authority (VARTA).

We have serious concerns about the proposed dissolution of VARTA, particularly given the feedback we received from a really wide range of stakeholders. I spoke with many people representing really diverse interests, sometimes opposing interests, and not a single one of them was supportive of dismantling VARTA, nor were any confident that absorbing VARTA’s functions into the Department of Health was the way to go. While there were different views about alternative approaches, it was clear that the one being proposed by the government here with this bill is not the one that they believe should occur. VARTA is actually a gold standard when it comes to assisted reproductive regulation, particularly with respect to regulation of donor conception. Now, it is not often we get to say we have the gold standard model in something. The whole world looks to us when it comes to our model for regulation of assisted reproductive technology and treatment. That does beg the question: why are we looking to change something that is held up as such a gold standard?

VARTA currently have a broad range of functions. They include responsive research into emerging technologies and trends, undertaking public education and producing educational resources, which as Ms Crozier has identified, are extremely well regarded. These are very specialised resources and VARTA plays an important role in bringing that specialised expertise to producing those. One example is a program that I believe may no longer be running but was called Time to Tell, which supports the parents of donor-conceived children with the process of letting children know early that they are donor conceived – a very complex area. VARTA was well placed to provide education and support in this space. They also had the role of maintaining the donor register, which is again highly sensitive work and quite different to other registers that may be maintained by the health department. They also played a role in counselling and donor linkage support, which is really valued, as we heard from stakeholders, because it is independent from assisted reproductive treatment providers. That independence is something that is really valued, as well as the expertise and high level of qualification of the counsellors that were provided by VARTA.

Some stakeholders remarked that, if anything, VARTA needed to be strengthened and given more teeth for it to effectively regulate the predatory behaviours of some assisted reproductive treatment providers. Mid-range enforcement tools are one thing, but sometimes tough measures are necessary to ward off sinister and inappropriate behaviour. Most other states and territories do not actually have a specialised regulator. It is not a reason to get rid of ours. In fact many, as I said, in Australia and overseas look towards VARTA as a leader in the field and are considering developing their own version of VARTA. There was recently a national review of ART, which Ms Crozier has already referenced, and that made a range of recommendations, including potentially establishing a national donor register and streamlining relevant legislation. Across the country there are dozens of different pieces of ART legislation. It is an incredibly confusing and sometimes conflicting space when it comes to regulation and legislation, and there is substantial scope to streamline this to develop some consistency between jurisdictions. Obviously that is a piece of work that needs to take place at the federal level, in partnership with states and territories. The federal government has yet to respond to this report that has recently been provided, but it seems that it is particularly premature to start up a whole new system in Victoria when it is quite possible that there will be wholesale changes to ART at a national level.

The reasons that we have been provided by the government and by the department for abolishing VARTA have been unconvincing. We still have not received a really solid reason for why this needs to occur. Centralising regulation is one thing – we can understand why, for many of the other areas that this bill deals with, that makes sense – but getting rid of a specialised authority that is so well regarded and absorbing its functions across the Department of Health is quite another thing. Specialist services have value, even when what they oversee is an increasingly normalised part of our society. Rainbow families, single mothers by choice, donor-conceived people, people with chronic diseases or certain genetic markers – the impact of this Parliament’s decision today will be most keenly felt by those groups. I have heard from many constituents who found out they were donor conceived later in life, a revelation that had a profound impact on their sense of identity and raised many questions for them about their family, their romantic relationships and, importantly, their own medical history. While for many this experience was incredibly traumatic, many also told me that without VARTA the days and months after learning about the nature of their conception would have been so much more difficult. For these individuals who have contacted me and so generously shared your deeply personal stories, I thank you.

There has been a growing acceptance and use of ART, which has enabled so many to have children who otherwise might not have been able to. While we have made great strides in this space, particularly when it comes to destigmatising the use of donor gametes for those who are seeking to conceive, it is clear that for those who are donor conceived there is much more work to do. The Gorton review of assisted reproductive treatment was tabled in 2019. That was a review of the Victorian ART legislation, and it recognised much of the complexity that exists in the ART space and identified many areas that require reform. To this day many of the recommendations remain to be implemented, and given that the ART legislation is before us now it would have been an opportune time to fulfil some of those recommendations.

It is curious to note that the government has cherrypicked some components of the Gorton review for implementation. In some instances, though, with this legislation before us they are implementing changes that either were not recommended by Gorton or actually go against the recommendations in the Gorton review. This legislation only removes mandatory counselling for people who are seeking information via the donor register, something Gorton did not actually address because it was outside the scope of that review. Gorton instead recommended the removal of the requirement for mandatory counselling for all ART, something this legislation does not address and that the government has repeatedly failed to deal with. The requirement for mandatory counselling for all ART is absolutely outdated, and the government has failed to explain why it refuses to change this. With respect to where the functions of VARTA should lie, there is an explicit statement in the Gorton review that says it:

… does not consider that it would be desirable or appropriate for the Department of Health and Human Services to take on all of the functions currently performed by VARTA.

That is on page 166 of the Gorton review.

A key recommendation was that whichever entity undertook the regulatory and other functions of VARTA, it would need to be able to command the confidence of the sector and the public. I think that is really what is really critical here: it needs to be able to command the confidence of the sector and the public. From the significant amount of feedback we have received from a broad variety of stakeholders, including from the sector and the public, it is clear that they do not have confidence in the Department of Health to hold these functions when it comes to regulation and the other functions undertaken by VARTA. Perhaps that confidence could be gained over time with further consultation and engagement, but that work has clearly not been done, from the feedback that we have received.

From all those working in the field the resounding feedback was that the government have already made up their mind to abolish VARTA, and there was little that they could do or say that would change the government’s course of action here. Yet how these functions are going to be effectively transferred to the department and then executed has been surprisingly vague. We have very little information other than, ‘Look, the department is able to do this. We run other programs. We run education. We’ll take on education. We’ll outsource the counselling. We’ll find some counsellors. We’ll set up a donor registrar. We’ll have a regulator. We’ll let the regulator manage this.’ Very little assurance has been provided on a whole host of issues related to this space in order to gain the confidence of all of those who have an interest in seeing this work well.

We believe that it is so important to get these changes right that we feel that the bill cannot proceed as it is without further engagement with experts in this field. That is why we will be moving a reasoned amendment. I move:

That all the words and expressions after ‘That’ be omitted and replaced with ‘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.’

This amendment is a simple one. We believe that this further round of genuine consultation to look at what model would work best could result in, I think at the very least, some assurances to key stakeholders and members of the public around any new arrangements, and it may provide scope for some other model where perhaps some of the current functions of VARTA are retained. This is something the government I am aware was not keen to do. We believe that at the very least VARTA could have been maintained and allowed to continue with their education, information and counselling roles. However, as I said, the government was not willing to consider this as an option. We think further consultation with relevant experts would be really valuable before proceeding with such a significant decision. We will have some further questions in the committee stage, but I may leave my contributions for the moment at that.

Jacinta ERMACORA (Western Victoria) (10:59): I am pleased to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. The bill amends the Assisted Reproductive Treatment Act 2008 to abolish the Victorian Assisted Reproductive Treatment Authority (VARTA), which will provide for employment of a donor conception registrar. The Assisted Reproductive Treatment Act 2008, or ART act, is an exceptionally important piece of legislation when it comes to assisting and protecting those seeking, receiving or involved in donation in the reproductive health sector. Victoria has led the way in Australia when it comes to assisted reproductive treatments. Victoria was the first state in the country to provide legislative safeguards for people undertaking assisted reproductive treatment through the Infertility (Medical Procedures) Act 1984. Victoria was the first Australian state to give people born via donor treatment access to information about their genetic history. It is an amazing thing and one to be very proud of that Victoria has led the way in so many medical and health-related fields, whether it be assisted reproduction treatment, euthanasia, medicinal cannabis and so on. With the amendments in this bill, the Allan Labor government continues to lead the way and modernise and ensure a fit-for-purpose regulator that will utilise their skills and expertise to protect and support Victorians involved in assisted reproductive treatments.

As a result of recommendations made by the Gorton review, functions that are currently being performed by VARTA in the regulation of assisted reproductive treatment will be transferred to the Secretary of the Department of Health. In this regard there is an element of normalisation, as this is becoming a familiar and regular part of the health system in Victoria. There are always medical advancements, as there are across all fields of health, and this is just simply another field of health in Victoria.

New compliance and enforcement powers are introduced through legislation, as well as new offences. The amendments in this bill ensure that the legislation aligns with other health regulatory schemes and addresses issues specific to the sector. This bill sees the introduction of the donor conception registrar, which will be located within the Department of Health, and this will be administratively separate from the regulatory functions. That makes sense. Presently, counselling before information is accessed from registers or contact preferences are lodged is mandatory. The amendments in this bill will change this to voluntary, and this is about respecting the rights of individuals to make informed choices about their own needs. Counselling before consenting to treatment or to being a donor will remain mandatory.

The act will continue to ensure that people are given all relevant information via the donor conception registers. Access to essential resources is still available to ensure that people can make properly informed choices. As part of the amendments within this bill, a requirement is added that will ensure that the donor conception registrar provides a person with information where that person is making an application to registers for information or is a person whose information may be released from registers. This is done so that should any issues arise, a person may navigate them in an easier manner.

In this set of amendments there are funding plans to have an appropriate organisation who has counsellors who are qualified within this area to deliver culturally safe counselling to anyone who may be accessing the registers and wants to access counselling while doing so.

During its years of operation VARTA has been instrumental in providing high-quality education and in promotion of research and consulting. Most of these functions are currently legislated. The bill will remove these functions from the legislation. However, the Allan Labor government recognises the great importance of these functions and the resources developed by VARTA over time and will ensure that these resources are delivered through non-legislated arrangements.

The Allan Labor government will continue to ensure that the welfare and best interests of those born as a result of assisted reproductive treatments, those seeking or receiving ART and those involved in donor conception are upheld as intended by the act when it was first legislated. We have seen over the years significant advancements in medical treatments and technology, as well as changing social attitudes towards fertility treatments. It is becoming quite normalised. This bill reflects those advancements and changes in societal thinking. We also acknowledge that due to the very specialised field that assisted reproductive treatment fits into, there are and will be issues that are uniquely only found within this particular medical field. Some of these issues may require legal protections. Through these reforms there is recognition that a regulatory agency is the most appropriate support option for anyone impacted by issues arising that are not necessarily required to be legislated functions of the act. This gives greater flexibility to the regulatory agency responding to these issues.

Many women have experienced heartbreak through miscarriage and stillbirth. That is why we want to make the act as clear of red tape as possible, to remove confusion and stress where it need not be, particularly where there is already likely a significant amount of stress. As part of the Gorton review a recommendation was laid out that there be a reduction of unnecessary red tape, particularly when it comes to donor gametes or embryos and their movement in and out of Victoria. The bill makes amendments to remove the requirement to have preapproval to move donor gametes or embryos – and I do know a particular family who are having embryos sent to the UK for testing, and I am sure this will be a positive thing even though they have already been through the process. The bill retains the safeguards and existing requirements already set out under the act. These simple amendments will alleviate stress, provide greater clarity and reduce any delays in the movement of gametes and embryos, with those requirements being counselling, consent and provision of information to registers.

The Allan Labor government is serious about ensuring all Victorians have a health system that works for them. This bill is one that will see the Assistive Reproductive Treatment Act modernised and brought up to today’s social expectations for fertility treatment. It ensures that those seeking treatment, receiving treatment or going through the donor process can do so with clarity, safety and less red tape. It means that those who are seeking treatment or receiving treatment during what is likely to be a very stressful time can do so without added burdens and roadblocks impeding their dream of having a baby. This bill is just another step in the right direction to making Victoria’s healthcare system in all its forms one of the best in Australia, and I commend this bill.

Wendy LOVELL (Northern Victoria) (11:07): I rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024. This bill will amend the Assisted Reproductive Treatment Act 2008 to abolish the Victorian Assisted Reproductive Treatment Authority, VARTA. It will also provide for the employment of a donor conception registrar, transfer certain functions and powers from VARTA to the secretary and the donor conception register, further provide for donor gametes or embryos produced from donor gametes to be brought into and out of Victoria, remove mandatory counselling requirements for accessing information on the donor conception register and further provide for regulatory and enforcement matters and the service of documents.

It will also amend the Drugs, Poisons and Controlled Substances Act 1981 to further provide for the amendment of the poisons code, regulatory and enforcement matters and the service of documents, and it amends several other acts to provide for regulatory and enforcement matters and to make minor miscellaneous amendments. Some of the other amendments it will make are to the regulatory frameworks in the following acts: the Public Health and Wellbeing Act 2008, where it will make amendments to regulations for cooling towers; the Safe Drinking Water Act 2003, where it will make amendments to the regulation of drinking water; the Non-Emergency Patient Transport and First Aid Services Act 2003 to amend regulation for first aid services; the Non-Emergency Patient Transport and First Aid Services Act 2003, again, to make amendments to non-emergency patient transport regulations; the Public Health and Wellbeing Act 2008 to make amendments for regulations regarding pest control operators; and also the Health Services Act 1988 to make amendments regarding private hospitals, day procedure centres and mobile services.

I particularly just want to talk a little bit about non-emergency patient transport because that has been a big issue in my electorate over the past few weeks. Patients who require dialysis have been notified of changes to their transfers to and from the hospital for dialysis. Previously these transport services were provided by Ambulance Victoria. Ambulance Victoria would organise a taxi to make sure that dialysis patients could be at the service to receive their dialysis, which they need to do around three times a week. This is not a service that they can opt to put off or to go to less regularly. It is a life-saving treatment that they must access when it is needed, and that is up to three times a week.

Previously the patient would arrange these transfers through Ambulance Victoria – Ambulance Victoria organised the taxis and paid for the taxis. But at the end of last month, patients in rural and regional Victoria were advised that they would no longer get that transfer and they would have to make their own way to and from dialysis, whether that be by driving themselves, asking friends or family to drive them or arranging their own taxis. This has proved to be very difficult for many, many patients because family and friends work and may not be available to do these transfers on a regular basis. We know that patients who do go for dialysis often report being dizzy and confused after treatment and it would be dangerous for them to be on the road driving themselves. It is also dangerous in rural Victoria that patients are driving themselves long distances on very unsafe roads, because this government has not maintained the roads. They certainly do not want to be driving on pothole-ridden, unsafe roads at 100 kilometres an hour after treatment if they are not feeling particularly well, and it does take a lot out of patients when they undergo dialysis.

The other option is to organise a taxi. Well, taxis may cost patients hundreds of dollars a week. If we look at dialysis that is provided in Shepparton, people come from as far away as Cobram and Euroa to access those services. To have a taxi to and from Euroa or Cobram three times a week on a regular basis would be hundreds of dollars. Publicly subsidised taxi services are limited. They are limited to up to $60 for each fare, and it is only half of that cost – 50 per cent of up to $60. This would never cover the cost of their taxis, and it certainly will not provide for those who have to travel vast distances. The taxi services could be more than their income for the week, or more than their pension for the week, to travel to Shepparton from Cobram or Euroa or other areas within regional Victoria just to access their life-saving treatment.

This is very short-sighted of the government. We know that Ambulance Victoria have been forced to make this change because their budget was cut by $20 million in this year’s state budget. We know that there have been cuts to health services right throughout country Victoria and health services are desperately trying to make ends meet to provide their basic services. This government cannot manage money, and because it has got the state finances in the state that they are now, it is clawing back funding from health services, from vital services and life-saving services like dialysis for those who need that service.

The patients that require these services deserve more respect from the government than what they have been given – just a letter to say, ‘This service would end. You’re on your own. Get to the hospital. Use your family, your friends. Use a taxi, whatever.’ It is not a solution. The government must come up with a far better solution than this. What we have seen, too, is that those who actually require medical assistance do still qualify for transfer by Ambulance Victoria, but these services are now being provided by ambulances, which is taking an ambulance and the paramedic crew that man that ambulance off the road. They are not available to attend an emergency patient while they are transferring someone to and from the hospital for dialysis. Often they will wait. It is very difficult to know when a person who is on dialysis is going to finish their appointment and be ready to go home, so we have ambulances now ramped outside the dialysis clinic waiting for people to finish their dialysis to drive them home. It is going to compound the problem we have with ambulance services in country Victoria as well, because there will be less ambulances available to assist those who need the urgent provision of an ambulance because they are now acting as transport services for some dialysis patients – very few dialysis patients. These services used to be provided by taxis and could still be provided by taxis if the government could only get its act together.

The government must order Ambulance Victoria to restore the full suite of services to dialysis patients that they were being offered up until the end of September. People say it is not a cut, that it is just applying the criteria more strictly or applying the criteria and working to the letter of the criteria maybe and there has been no change, but there has been a change, because people who got a service last month are no longer getting a service this month. That is a cut to their service, and this government must realise that they are cutting vital health services to regional Victorians by applying a stricter criteria to who can be transported to and from dialysis services. It is particularly impacting country Victorians who have to travel vast distances, so if the government would like to provide more dialysis services that are closer to people’s homes, that would be fantastic. But if they cannot do that, they must provide the patients with transfer to and from their dialysis.

Sheena WATT (Northern Metropolitan) (11:18): Acting President, thank you for the opportunity to rise today to contribute to the Health Legislation Amendment (Regulatory Reform) Bill 2024. This bill before us is designed to improve and modernise health regulation in Victoria, ensuring that the health system remains robust, consistent and adaptable to contemporary challenges. This bill will deliver comprehensive reforms across various health sectors. It aims to enhance the overall safety and wellbeing of all Victorians, particularly those accessing services such as assisted reproductive treatment (ART). The Victorian government, under the leadership of the Allan Labor government, is dedicated to improving health regulation to address evolving risks, advancements in technology and shifting community expectations. Through this legislation before us in the chamber, the government intends to ensure that all Victorians can enjoy the highest attainable standards of health and wellbeing at every stage of life.

I know that it has come up a number of times about reproductive technology and of course changing expectations and technological advancement in this place. I have had the opportunity then to talk on my contributions to women’s health and women’s reproductive health in particular through the Women’s Health Victoria board and all the associated organisations. So can I just take a moment to acknowledge and thank Women’s Health in the North, as well as all the women’s health organisations right across state. I know that they play such a critical role in myth busting and providing information and connection and referrals to what are really essential services in our community. So thank you to those organisations and thank you to the leadership of Women’s Health Victoria. I had the good fortune of spending that time surrounded by some of the very best in women’s health in our state. I did take some time throughout that appointment to learn a lot about changing expectations and changing access to reproductive technology in our state, and I learned lots about the LGBTI community and their hopes and dreams and aspirations for starting a family, but also lots about single folks that just want to have a family and cannot. Thank you to each and every one of those people that reached out to me throughout my time on that board and shared with me some of their aspirations and hopes for beginning families.

Also, can I just take a moment to acknowledge some new mums in my world that are now enjoying the absolute delights and pleasures and sleepless nights of parenthood thanks to assisted reproductive technologies. I am so delighted. So much of that technology that is now celebrated right across the world began right here in our state, and that is something that is not lost on us. It also means that we as a state are on the very forefront when it comes to moving with the technology of the times, and that is what this bill before us does.

The bill establishes a new health regulator which has some responsibilities for overseeing our health regulatory framework. These frameworks cover areas including medicines, poisons, private hospitals, day procedure centres, first aid services and safe drinking water. I will say that it importantly introduces a consistent set of compliance and enforcement tools for the health regulator, enabling a really graduated and health-based and proportionate approach to health regulations. Some of the new powers conferred to the health regulator include improvement notices which require regulatory entities to rectify noncompliance, prohibition notices which can stop certain activities that may pose a health or safety risk, information or document production notices which allow the regulator to request information for compliance monitoring and infringement notices which impose fines for specific noncompliance in forcible undertakings where entities agree to take corrective action. These tools are designed to equip the health regulator to respond effectively to breaches of the law, both reactively and proactively, and align with best practice in health regulation. We have come so far in just a few years in ensuring that the system can prevent and minimise risks to public health and safety.

I will take a moment to acknowledge the introduction and incredible work of Safer Care Victoria. They are certainly a really important part of the Victorian health landscape now, and anything that helps to prevent and minimise risks to public health and safety is of course welcome. That is why I think having this new health regulator on board will further strengthen our health system here in the state.

Importantly, I will also say that we have important reforms to the regulation of assisted reproductive treatments following recommendations from the Gorton review. Responsibilities for regulating assisted reproductive treatment will be transferred from the Victorian Assisted Reproductive Treatment Authority (VARTA) to the health regulator, and this transfer aims to improve compliance and enforcement of ART providers and simplify access to donor conception registers. I have had the good fortune to enjoy the trust of a great number of people who have shared what they view to be their challenges with the donor conception registers and how they are used and the information is managed. So I am pleased to see that we have looked to implement some improvements.

I have got to tell you it is an incredibly challenging time for families and for folks that are wanting to start a family and needing to access assisted reproductive treatment. I am reminded, in fact, of someone who is a good friend to those of us on this side of the chamber, and that is the member for Dandenong, who has so bravely and boldly shared her story of her hopes to bring a child into the world. Now we have got the good fortune of having met her son, but it took a little while to get there. I just want to acknowledge and thank Gabrielle Williams for sharing that in the hope that we all understand a little bit more about the enormous challenges of assisted reproductive technologies and treatments. For me, I learned a lot from Gab during that time about just how challenging it can be, and I am eternally grateful to her for sharing that and know that she inspired a great number of women to be much bolder in telling their stories about their challenges. That is why I was so pleased to see that we have got legislation before us that I hope makes life a little bit easier for those going through what can be a very, very challenging time. Hopefully they all experience at the end of it the enormous joy of parenthood, but I know that that is not always the case.

I am getting a little bit emotional thinking about the folks in my world that have had the good fortune and sometimes not good fortune of assisted reproductive treatment. I know that after that come some questions for families about donors and donor conception registers and what that looks like for the future of their families. So I was happy to see that in this bill the management of these donor conception registers will now fall under the responsibility of a new donor conception registrar, which will be located under the Department of Health, and this move aims to ensure that information on donor-conceived individuals and in fact donors themselves is handled securely and effectively.

The requirement for mandatory counselling before accessing information on donor conception registers will be made voluntary, which I think is extraordinarily good. This provides more flexibility for individuals seeking information while still ensuring that support remains available through government-funded counselling services.

Ms Ermacora spoke a little while ago about some barriers to obtaining donor gametes from interstate or overseas, and they will be reduced by replacing VARTA’s preapproval process with a certification process aimed to reduce delays for those seeking to start or grow their families while maintaining safeguards.

I do have more to say, but I have taken up some time talking a little bit more about the very real and lived experiences of folks in my world and across Victoria of accessing assisted reproductive treatments. If it is okay with the chamber, I might leave my remarks there and take a moment to end by thanking the Minister for Health for this important work and lending to it my wholehearted support. I commend this bill to the house.

Renee HEATH (Eastern Victoria) (11:29): I rise to speak on the Health Legislation Amendment (Regulatory Reform) Bill 2024, a bill that was created and is situated within the Department of Health. This body consolidates oversight across a range of critical issues and is now responsible for regulating medicines and poisons, ensuring drinking water is safe, controlling tobacco and e-cigarettes and overseeing food safety, child safety, radiation safety, pest control and other risks.

The primary purpose is to update and strengthen our health regulation systems, and it is argued that current frameworks are outdated and lack appropriate mid-range penalties, which limits our ability to address noncompliance issues effectively. This bill addresses the issues by introducing enhanced compliance and enforcement tools. There are a couple of key changes. The first one is health regulation compliance. The bill amends regulatory frameworks across several sectors, including cooling towers, drinking water, first aid services, non-emergency patient transport, pest control, private hospitals and medicines. It creates more extensive graduated compliance enforcement powers to ensure penalties are proportionate – for example, the ability to issue improvement or prohibition notices, enforce undertakings, issue infringement notices and require the production of documents.

Then there is a second area which we have heard a lot of concern about, which I share, which is the changes to the assisted reproductive treatment, or ART. These changes I believe are problematic, and they do present potentially devastating issues. The bill proposes to abolish the Victorian Assisted Reproductive Treatment Authority, or VARTA, and transfer its responsibilities to the Secretary of the Department of Health. This includes the regulations of ART services and the management of donor registers. While the move is intended to streamline the process, and I acknowledge that, it also eliminates mandatory counselling before accessing donor information and removes some legislative requirements for public education and research, something that I think is of vital importance. The transfer of VARTA’s regulation to a new donor conception registrar within the department and replacing mandatory pre-approval requirements with a certification process for moving donor gametes and embryos is removing the legislative mandate for public education and research, which was previously undertaken by VARTA. So there are some serious concerns around this change, which we have heard from both my Liberal colleagues and also Dr Mansfield. The decision to dismantle VARTA or centralise ART regulation under a government department raises significant issues that need urgent attention, and I think there are some questions that the government most certainly needs to answer.

The push to centralise all IVF-related matters within government departments contradicts the recommendations that were made from the Gorton review. This review explicitly advocated for maintaining an independent regulation body to ensure rigorous oversight and best practices in the IVF and fertility industries. The Gorton review stated that this final report sets out a renovation plan; it does not propose a radical overhaul or a complete rebuild. So to me this raises a critical question: why is the government pursuing a complete overhaul that the review warned against? While the government denies that this action is related to cost cutting, it has not allowed any stakeholder oversight into the reasons or made available public submissions in relation to this bill. If it is not budgetary purposes, then what is the reason, and what other reasons would cause this government to wind up a world-class, world-first and well-performing statutory body? Stakeholders say that this move would drive industry standards backwards by decades, creating the same problems that VARTA was established to solve.

VARTA has a critical role and history. It was established in 2009 under the Victorian Assisted Reproductive Treatment Act 2008 to provide an independent not-for-profit statutory authority for ART regulation. VARTA provides independent information and support for individuals, couples and health professionals regarding fertility, infertility and ART, and it works in the best interests of children born. Its role has been pivotal in ensuring that ART services adhere to the highest standards of care and ethical practices. VARTA’s independence has allowed it to be effective in mediating between IVF clinics and the government and has ensured accountability and transparency. VARTA’s success has been recognised internationally, and this demonstrates its effectiveness. It has been a global model for ART regulation in both the US and the UK. The removal of this independent body jeopardises the quality of care and critical supports that are needed for everybody involved in ART.

Stakeholders do not understand why this bill was introduced at a time when other states are seeking to strengthen IVF regulations. Victoria is winding back the standards, and nobody understands why. Within the IVF industry, Queensland has been referred to as the wild west. It is known for its lack of strong regulation, and Victorians often bypass this state’s strict requirements by heading over the border. But Queensland’s low regulatory standards have raised concerns of incest among donor children, as sperm donors have donated hundreds of times.

In 2007 there was a paper published called Revisiting Old Ground in Light of New Dilemmas: The Need for Queensland to Reconsider the Regulation of Assisted Reproductive Technologies, which highlights the need for a statutory authority – the Queensland Bioethics Advisory Committee, or QBAC – similar to what was formed in Victoria. The functions of QBAC would have included an advisory role in relation to bioethical issues to both government and medical organisations and institutions, a responsibility to monitor advanced ART as well as acting as an educational resource for the community. This is exactly the model that was created in Victoria through VARTA, which the government is now seeking to dissolve, and I think that raises many questions.

There is a risk of decreasing IVF clinics’ regulatory accountability in donor selection. One of the significant concerns about centralising ART regulation is the involvement of IVF clinics in the regulatory process. IVF clinics driven by profit motives may prioritise financial gains over ethical considerations. Under the oversight of VARTA, donor providers do not receive monetary compensation. These ethical implications were highlighted as far back as 1984 in the Demack review, which says:

… the range and complexity of the issues of an ethical character which have been or are likely to be thrown up by changes in medical technology, and the public policy implications of these issues, are such that it would be insufficient to entrust their resolution to the ethics committees of particular organisations or institutions.

The real increased risks of having no independent body could lead to compromised screening or regulations of donors, and the vested interests of IVF clinics could result in leniency in adhering to critical standards, increasing the risk of exploitation or ethical breaches. VARTA advocates for the interests of all those involved in the process. IVF clinics ultimately only have one obligation to donors and to surrogates.

Post treatment of surrogates: in places with weak regulatory frameworks, surrogate mothers often face exploitation and poor treatment, especially in Third World countries. They may be coerced into surrogacy agreements under unfavourable conditions or lack adequate medical care or emotional support. These issues underscore the need for rigorous oversight and ethical standards. This is something that Victoria has really led the way in, and I think it is very sad that it is something that we seem to be turning our back on.

ART is a complex and rapidly evolving field with significant scientific, medical and social implications. VARTA’s specialised expertise ensures that donors, surrogates and recipients receive the highest standard of care and support. Concerns about whether the Department of Health can maintain specialist knowledge, I believe, are valid given the complexity and the rapidly evolving science in ART. I think that it is a huge concern that there is going to be the removal of mandatory counselling for donor-conceived children. I think that is something that is really unfair. Donor conception involves sensitive issues that require specialist psychological report. Without VARTA’s oversight, there is a risk of diminishing that support, potentially leading to significant emotional and psychological distress for those that are involved. VARTA has been the leader of public education and research in the area of fertility and donor conception. Its annual reports have provided valuable insights and oversight that could be lost under this new framework. The proposed changes lack legislative requirements such as reporting, raising concerns about the future availability of critical information and transparency. Currently VARTA publishes this information annually, but this bill does not require it to publish any reports.

Victoria is one of just two jurisdictions in the world – the other is South Australia – that allows donors to reach out to their biological children, which can result in an adult finding out for the first time ever that they were donor conceived via a letter or a phone call from the regulator. This can shatter somebody’s sense of identity, and some people that I have spoken to who have had it happen to them said it was like the rug was ripped out from underneath their feet. It can be a very confronting experience, and I am worried that this places people at risk.

Just in the interest of time, in conclusion, I do not agree with the removal of VARTA. I think that centralising ART regulation into the department poses serious risk, including potential conflicts of interest, exploitation of donors and surrogates and the erosion of essential support. I urge the government to consider these issues, and I agree with my colleague’s amendment to make sure that we review this in three years time.

Rachel PAYNE (South-Eastern Metropolitan) (11:42): I rise to make a contribution on the Health Legislation Amendment (Regulatory Reform) Bill 2024 on behalf of Legalise Cannabis Victoria. As members of Parliament, we are often required to vote on and contribute to pieces of legislation that are related to our own personal experiences. How much of our own stories we share is a personal choice, but I think it is important that those we represent can also understand that we too are impacted by the laws made in this place. As someone who was donor conceived, it has been difficult for me to review this legislation. It has been something I have found challenging to reconcile – an experience that many donor-conceived people will share.

In fact in consultation with numerous stakeholders who have reached out in objection to parts of this legislation, I have found that there are many other shared experiences. The common theme coming out of conversations with donor-conceived people, donors, families and advocates has been that the Victorian Assisted Reproductive Treatment Authority has been a life-changing support service offering specialist advice and provisions. Many of these people have taken the brave step to share their personal stories publicly and to tell us how VARTA has supported them. For Michelle Galea, VARTA was essential to enabling her to get in touch with her donor-conceived child Charlie’s half-siblings. Charlie was able to get in contact with his sister Amber, who was dying of a terminal illness and sadly later passed away. VARTA again played an invaluable role, offering a free counselling service that helped both Michelle and Charlie work through their grief.

If a service provider like VARTA had been available to me and my family, I believe my experience would have been very different. Their specialist advice and support provide families with the tools to navigate the difficult conversations and complex emotions that come along with donor conception. That is why I was so disheartened to see that this bill proposes to dissolve VARTA. But I was also perplexed. This is a world-leading service, so why was the first option to dissolve it? If there are issues, extra funding and minor legislative changes could have gone a long way. VARTA have been awarded Best Fertility Service for outstanding patient service in reproductive health by the European Fertility Society. It has also been the subject of study by researchers from Britain and Canada wanting to establish their own service. We have heard from many about how VARTA’s community outreach network, group workshops and education seminars have been invaluable. VARTA also developed the Time to Tell series, which helped parents and potential parents to feel more confident about their story. This helped undo the hurt of decades of advice to families to just not tell donor-conceived children about their status.

Victoria has always been a world leader when it comes to assisted reproductive technology. We were the first jurisdiction in the world to introduce comprehensive laws regulating ART through the Infertility (Medical Procedures) Act 1984. We should be proud of this history as a world leader and build upon it rather than dismantle it. The Fertility Society of Australia and New Zealand last month published their draft findings, recommendations and framework for a 10-year national fertility road map. In this road map not only did they show that the use of assisted reproductive technology will grow significantly over the coming decade, but they also put forward a number of recommendations to ensure that we are prepared to deal with the future surge in demand.

The first recommendation of this road map was that:

… Australian States and Territories work with the Commonwealth, patients, clinicians and the sector to develop a Uniform National Fertility Law for IVF which would be passed by a lead jurisdiction and adopted by others.

This is what makes the timing of these reforms so perplexing. The department and the minister have taken a piecemeal approach to these reforms and implementing the recommendations of the Gorton review.

My other concern coming out of this bill and the road map is the overlap when it comes to a single national register and other similar measures. If these are implemented federally, there would likely be a requirement for another raft of changes to legislation here in Victoria. This means we are putting in place changes that potentially will just be undone, which in my mind is simply a waste of time and resources. We are assured that through non-legislative measures the many incredible educational resources that VARTA has available will be preserved. These resources not only help donor-conceived people and their families in Victoria but are available to those in other states and countries who may have nowhere else to access information from. We do hope this preservation of materials extends to the creation of new educational materials as needed, but unfortunately we cannot say that we have received that assurance from this government. It is concerning that there is no legislation binding this commitment to protect independence and excellence in ART research and education.

The Gorton review into assisted reproductive treatment in Victoria did not recommend a major overhaul of the system, which is what we see this bill to be. In fact it suggested this government could consider additional funding for VARTA to support their work. Whether they did or not will be a question for the committee stage, but I suspect the existence of this bill gives me that answer.

We have concerns that dissolving VARTA is a Trojan Horse for cost cutting. We can think of little other explanation when it comes to things like the change from mandatory to optional counselling in some instances and the decision to remove functions from the legislation relating to education, community consultation and research proposals. Employees from the counselling arm of VARTA are set to be stuck in limbo, being transferred to the Department of Health but with the commitment that the counselling services will eventually be set up in an external private body. They do not know what that private body will be, whether they have guaranteed employment with them and when all these changes will happen.

I will be raising a number of questions in the committee-of-the-whole stage on these matters and other matters that I believe have remained unresolved. I look forward to putting these questions to the government and offering donor-conceived people and their families some kind of reassurance and clarity. In this same vein we will be supporting the amendment to be moved by the Greens that an expert panel comprising representatives from the legal sector, specialist counsellors, people with lived experience of donor conception and assisted reproductive technology and people with other relevant expertise examine the implications of the dissolution of the Victorian Assisted Reproductive Treatment Authority or VARTA. We have heard from stakeholders that there is a genuine appetite to reopen consultation and a belief that the initial process was inadequate. Until this government can evidence the need to dissolve the world-leading service that is VARTA, Legalise Cannabis Victoria will not be supporting this bill.

Gaelle BROAD (Northern Victoria) (11:50): I rise to speak about the Health Legislation Amendment (Regulatory Reform) Bill 2024. This bill seeks to address the recommendations of the Gorton review into the assisted reproductive treatment framework in Victoria. There are several purposes behind this bill. It makes changes to improve health regulation compliance and enforcement tools, makes changes to assisted reproductive treatment regulation with the transfer of ART regulation to the Secretary of the Department of Health and abolishes the Victorian Assisted Reproductive Treatment Authority. It also makes other minor and miscellaneous amendments to a number of acts.

I want to thank my colleague Georgie Crozier, the Shadow Minister for Health, for addressing the proposed changes in this bill that will affect the operations of VARTA, the Victorian Assisted Reproductive Treatment Authority. I have also spoken with constituents directly on this issue, and I highlight that with reproductive treatments, education and counselling are very important parts of the process. Following community consultation and with key stakeholders I note that counselling will still be mandatory before consenting to treatment or consenting to be a donor. Like Ms Crozier, I heard directly from people who hold the information and resources provided by VARTA in high regard. I think it is valuable for the public to have access to independent sources of reliable, evidence-based information about infertility and donor conception to help them make informed decisions about fertility treatment, and removing the education function of VARTA is disappointing without a clear plan to ensure continuity of this important role to provide reliable, independent information.

This bill makes amendments to the regulatory frameworks in the following areas: to non-emergency patient transport under the Non-Emergency Patient Transport and First Aid Services Act 2003; to private hospitals, day procedure centres and mobile services under the Health Services Act 1988; and also to medicines and poisons under the Drugs, Poisons and Controlled Substances Act 1981.

I think when we look at the report card on health in Victoria, it is very concerning. Certainly when we look at ambulance services, the Allan Labor government is still failing when it comes to ambulance response times, with only 64.2 per cent of code 1 ambulances arriving within 15 minutes, well short of its own target. And the average code 2 response time is now 46 minutes and 43 seconds. Ambulance ramping is still a problem, with almost 39 per cent of patients arriving by ambulance waiting more than 40 minutes to be admitted to an emergency department. I know that ramping continues to be an issue right across the state, especially in Northern Victoria. I have seen ambulances ramped outside Bendigo Hospital up to 10 at a time, with patients desperately waiting to get the help that they need. The same is happening in Shepparton and also in Wodonga. I have spoken to many people who are very concerned about that.

It is important to note that the ambulance inquiry submissions are now open – and to share your stories, because I have heard many. I have heard of a lady who was in severe pain who called for an ambulance and was advised that a taxi would be made available to her. There was another case where the constituent lived literally 200 metres from the hospital and had to wait several hours to be transported by ambulance. And I had another that was suffering anaphylaxis and had the fire service turn up instead.

This bill also mentions surgery. Looking at surgeries in Victoria, more than 58,000 Victorians continue to be in pain as they are waiting on that elective surgery waitlist, and category 2 elective surgery patients continue to wait excessively, with around a third waiting longer than clinically recommended. Category 3 elective surgery patients are also waiting too long, with more than 15 per cent not being seen within the clinically recommended time of one year. The Allan Labor government’s decision to cut the number of patients being admitted by 40,000 a year will only worsen the elective surgery backlog. I really do commend the St John of God hospital in Bendigo for their work doing a whole lot of fundraising to support the purchase of a surgical robot. They have spoken at length about the benefits of these surgical robots, which can really improve the recovery time for patients and help to get through a lot more surgeries quicker. I have certainly raised that in this house, and I really do commend Agnico Eagle Mines, because they donated a significant amount of money to support the contribution towards that da Vinci robot for the residents of Bendigo and also the wider Northern Victoria Region, because it certainly services a very large area.

This bill refers to hospitals, and in regional areas there are significant concerns about Labor’s plan to reduce the number of health networks and introduce Hospitals Victoria. I am not sure that adding another layer of bureaucracy will result in better outcomes for patients. There have been rallies in regional areas. I know in Yea there were hundreds of people gathered to protest – and also in Mansfield. We have also had petitions with thousands of people signing them because in rural and regional areas health services are the heart of their communities, and Labor’s plan certainly will lead to job losses and a diminishment of community input into local health service delivery. It is disappointing. I know Bendigo Hospital has been directly impacted. They have had budget cuts of about $120 million, which is huge. It is having an impact on the clinical support nurse educators, who actually support young nursing students that are coming into the hospital. It is also going to have an impact on the IT department, the finance department and the HR department, so I am very concerned. Management has sent an email to all staff talking about redeployments and redundancies. Instead of wasting over $200 billion on the Suburban Rail Loop, Labor should focus on keeping local health services up and running.

This bill also refers to medicines and makes amendments to medicines and poisons under the Drugs, Poisons and Controlled Substances Act 1981. Pharmacies are a very important part of that chain; they play an important role dispensing medicines and relieving the pressure on our hospitals. I have visited a number of pharmacies around the region, and I have been contacted just recently by a constituent who is very concerned about the closure of the supercare pharmacies and the complete removal, from September, by the state government of that nursing service, which really took a lot of pressure off those emergency appearances at hospital by enabling people to be cared for by the local pharmacy. I know that media reports today say the federal government is contributing to Bendigo’s health services because it is clear that the state government are running out of funds and have really dropped the ball on health care in Bendigo. I know Bendigo Health have had code yellow this year for consecutive days, and that is because they have been overwhelmed by the pressure that they have been under with the demand for health services in the region.

In closing, I will make a comment on the public consultation process for this bill. It was far too short – just five weeks – and it allowed written submissions only and did not make these submissions publicly available. It is a recurring theme we see under this government – a lack of transparency around community engagement and very short timeframes given for feedback. I have heard that many times, being involved in parliamentary committee inquiries. People talk about this government’s approach – being consultold rather than consulted.

The timing of this bill is not ideal given the changes being considered at the national level, and it is important that state and Commonwealth governments work together, particularly when it comes to reproductive treatments, to avoid duplication and people falling through the cracks. I ask members of this chamber to support the proposed amendment for a three-year review.

Business interrupted pursuant to standing orders.