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Public Health and Wellbeing Amendment Bill 2022

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Samantha Ratnam
Leader of the Victorian Greens
7 April 2022

I rise to speak to the Public Health and Wellbeing Amendment Bill 2022. This bill is making a number of uncontroversial amendments to our public health legislation, and the Greens are happy to support these. We have been spending a lot of time talking about public health and wellbeing in recent years, so it is also a good time to remember that public health and the act are not just concerned with dealing with pandemics or infectious diseases. They also include all the policies that aim to prolong life and health, whether this involves identifying food toxins, promoting sport and exercise, restricting junk food advertising, addressing problem gambling and homelessness or preparing for the extreme heat caused by climate change.

One of the aims of public health policy is also to minimise the harm from legal and illegal drug use. Since the mid-1970s, for political reasons, public health drugs policy has almost entirely deferred to law enforcement drugs policy. Suffice to say this politicised law and order approach to drug use has not improved public health. In fact it has had the opposite effect, particularly in our most disadvantaged communities. Yet despite much of the world, including the leading international law enforcement agencies, finally recognising that drug use is a public health issue requiring a public health first response, we in Victoria still operate under the legacy of law enforcement opinion having disproportionate influence and the final say over this public health issue. So we need to clarify today exactly what is Victoria’s harm minimisation strategy to drug use, and as this is a public health issue, this bill and this act are the appropriate way of doing this, through the amendments that I will now circulate.

Greens amendments circulated by Dr RATNAM pursuant to standing orders.

Dr RATNAM: The Public Health and Wellbeing Act 2008 (PHW) sets out a framework for what are known as notifiable conditions. These are prescribed diseases or microorganisms and include things like Ross River fever, measles, salmonella and of course now COVID-19. When a notifiable condition is encountered by a medical professional, the act requires them to notify the Department of Health within a prescribed amount of time, and this allows the department to implement whatever public health response is needed to control or limit the spread of the disease—for example, alerting public health that Japanese encephalitis has been detected in mosquitoes in Victoria.

The bill today makes some changes that seek to improve the way intelligence is shared and gathered. Obviously the Department of Health receiving timely, relevant intelligence on specific threats to public health is the key to an effective response to counter these threats, so we support the proposed changes in the bill. But early warning alert systems for specific batches of drugs circulating save lives in exactly the same way as health alerts for notifiable conditions do. This is not just public health theory; these are the findings of the Victorian coroner and a Victorian parliamentary committee in 2018, and it is the accepted practice of health agencies all over the world, including the Centers for Disease Control and Prevention in the United States.

Since March 2020 it has also been the policy of the Department of Health, who have been issuing drug alerts to the public when toxic substances have been identified in specific batches of illegal drugs. These drug alerts take an identical form to and are located online in the same place as health alerts for notifiable conditions. However, there is no established mechanism or rule for reporting toxic substances found in drugs to the Department of Health under the PHW act. The drug alerts are also only based on intelligence received from the state’s hospitals under an informal, ad hoc arrangement. This means drug alerts are only issued when the specific toxins found in drugs have already caused enough harm to send a person to hospital and the health worker has had the foresight to think that maybe it would be a good idea to share this information at a higher level at some stage.

Timely, accurate intelligence meets public health damage can be minimised, but where our intelligence is either missing, untimely or ignored, trying to contain the fallout is a lot more painful. So I am introducing amendments today to create a consistent approach and codify the informal information sharing that currently takes place between hospitals and the department in terms of when specific substances found in drugs should be notifiable in exactly the same way that currently occurs with notifiable conditions. But the amendments also go further, because waiting for someone to wind up in hospital before we act is far too late.

Victoria Police’s drug strategy is to intercept illegal drugs to limit their supply in the community. This means they frequently come across batches of drugs before or at a very early stage of their distribution and use. They also already frequently have these drugs analysed by a laboratory to determine their composition. However, Victoria Police currently do not share this potentially life-saving drug analysis information with the Department of Health. In fact they refuse to share this information, even when they know that the analysis indicates that the drugs contain substances that would lead to an urgent public health alert being issued if they were uncovered in a hospital. I will speak more about the reasons for this in the committee stage.

To be clear, my amendments do not propose to introduce an early warning drug alert system run by the Department of Health, because this is already in place. My amendments simply clarify exactly what substances in drugs should be notifiable to the Department of Health, the same way that notifiable conditions are, and require Victoria Police, like hospitals, to feed this drug intelligence to the Department of Health in all cases. This bill is about making our existing public health systems work better to save lives. The amendments are entirely consistent with this aim, and they should be supported.

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Samantha Ratnam
Leader of the Victorian Greens
7 April 2022
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