Ms ROSOL (Bass) – Deputy Speaker, I rise to speak on the Poisons Amendment (Interstate Prescriptions) Bill 2025. The Greens will be supporting this bill. We have already heard from both the previous speakers about the need for these amendments to the Poisons Act because we have heard the stories of people who experience significant difficulty obtaining medications and sometimes missing out on what they need. This bill will go towards resolving those issues. The bill provides a framework for interstate prescriptions to be dispensed in Tasmania, as well as covering gaps in our legislation regarding the legality of possessing controlled substances lawfully dispensed in other jurisdictions.
I note that the bill has generally been positively received by a wide range of stakeholders. However, the Greens have circulated amendments to the bill we intend to move. Many concerns were raised during consultation, both concerns directly to do with the bill and tangentially related to it.
A recurrent theme throughout the submissions to the draft was that these amendments are necessary in part because access to GPs and specialists in Tasmania is so challenging. For that reason, Tasmanians are increasingly needing to turn to interstate medical professionals. We are increasingly seeing reforms around pharmacy dispensing to address the difficulty in accessing specialists and GPs. While this reform is welcome regardless of this issue, far more work and investment to address the core issue needs to occur. A doctor at Ochre Healthcare recently stated that about 30 per cent of the patients they see at their Urgent Care Clinic do not have a Tasmanian-based GP at all.
One of the common issues raised through the consultation was the need to mitigate risks of misuse of prescription drugs, particularly opioids, benzodiazepines and psychostimulants, and the potential heightened risk of this misuse that the framework introduces. The Australian Medical Association (AMA) made a range of recommendations to mitigate these risks and I’m curious to hear the government’s response to these recommendations. One of the AMA recommendations was a requirement that pharmacists dispensing high-risk medications on interstate prescriptions notify a patient’s nominated GP that a script has been dispensed, but as far as we can determine, this recommendation has not been adopted.
The AMA further recommended that there be a two-year monitoring period post-implementation in which the government collects and publicly reports on data regarding rates of dispensing of interstate prescriptions, incidents of diversion or misuse, and impacts on ED presentations and urgent care services. I’m wondering if this is something the government is intending to do.
A further matter canvassed by the AMA and many other submitters was the matter of a national database. Many raised the need for a national database to be developed, both for safety reasons as well as administrative ease. I note that in the minister’s second reading speech, she talked about the fact that we don’t yet have a truly nationally monitored medicine database but that some progress is being made on it. I would just like to clarify that if the Tasmania government’s position is that there should be, is it something you’re advocating and can you outline how you’re advocating that and working towards it?
The proposed safety framework relies on the use of various monitoring databases. However, the Royal Australian College of General Practitioners (RACGP) raised concerns about relying solely on these systems as they currently stand. I will quote from their submission:
Whilst the proposed amendment to s38G of the act requires interstate prescribers to check the monitored medicines database prior to issuing a prescription for a monitored medicine, Tasmanian physicians report concerns about how this will be monitored and enforced. The messaging in TasScript to dispensing pharmacists is regarded by some as not definitive enough, e.g. it allows discretion outside of the top in the instance of opioid pharmacotherapy.
If these amendments to the act are made, we urge additional resourcing and a clear framework for proactively monitoring and enforcing the act and the regulations and more definitive instructions in TasScript that align with endorsed policy and legislation.
Minister, is the government planning for more resourcing and is there any plan to consult with stakeholders about appropriate changes to the instructions and messaging in the TasScript system?
The RACGP also noted the need to have effective referral and follow-up systems in place to support telehealth-facilitated consultations. Does the government intend to undertake any reforms in this space?
The Rural Doctors Association of Tasmania emphasised the need to have monitoring systems in place to differentiate between one-off dispensing of high-risk medications from interstate prescriptions as opposed to regular prescriptions requiring authority to prescribe. They specifically asked how the government intends to enforce compliance of section 59E of the act on interstate prescribers. I think that builds on the question asked by Ms Dow around what monitoring would happen. My question would be how would that be enforced for prescribers who are outside of our state? How are we able to enforce them following an act that’s within our state?
For my final question, I note that the draft bill was accompanied by draft regulations. I know the minister mentioned in her second reading speech some of the plans around draft regulations, but in your summation can you outline any changes that have been made to the draft regulations since the consultation?
As I indicated at the outset, the Greens have amendments to this bill. As part of these reforms, a range of amendments are included to provide the same protections for interstate prescriptions that they would have for Tasmanian-based prescriptions. For example, the bill provides that a person does not commit a possession or importation offence for a substance lawfully prescribed and dispensed to the person in another state or a territory. Furthermore, the consultation materials state the bill will broaden the circumstances in which people in Tasmania can lawfully drive if using prescribed medicinal cannabis as long as they are not impaired. This broadening is, however, limited and does not include prescriptions that are both prescribed and dispensed in another state or territory.
Currently, section 6A of the Road Safety, Alcohol and Drugs Act 1970 provides that a person does not commit a driving with prescribed illicit drug in blood offence if the prescribed illicit drug was obtained and administered in accordance with the Poisons Act 1971. The bill as it stands extends this provision to cover circumstances where a prescription is issued interstate but the drug is dispensed in Tasmania. Our amendment extends this to also cover circumstances where the drug is both prescribed and dispensed interstate.
The absence of this amendment within the bill does not make sense to us. It is existing law that having a prescription is a valid defence to the driving with prescribed illicit drug in blood offence. It is the clear policy intent of this bill to extend existing defences for Tasmanian prescribed and dispensed medications to also apply to interstate prescribed and dispensed medications, and the absence of this provision is therefore inconsistent with these positions. During the briefing, the rationale provided for this not being included was that there was a desire not to step on Tasmania Police’s toes, but the Greens think this is a poor argument.
The bill already extends defences for possession and importation and section 6A of the Road Safety, Alcohol and Drugs Act 1970 already defers to the Poisons Act 1971. We do not think it is reasonable to allow a loophole that allows a person to be charged with an offence to remain when there is a clear intent for it not to be an offence, solely to avoid stepping on another department’s toes. We also think this is important in light of the fact that the department’s own consultation page admits to partially addressing this loophole already. This loophole has been evident for some time and the excuses to avoid addressing it are growing tired.
I am pleased to support this bill on behalf of the Greens and hope members will support our amendments when we go into Committee.
DEPUTY SPEAKER – Is it your intention to put forward those amendments to the House during Committee?
Ms Rosol – Yes.
