I rise to speak in support of the Access to Medicinal Cannabis Bill 2015.
In doing so, I do have concerns about the bill, but I have been able to put most of them to rest because of the nature of the bill and the fact that it has been formatted in a way that provides for staged clinical trials and for staged production and cultivation.
It was looked at very closely over a period of time before its introduction.
The legislation follows on from the Victorian Law Reform Commission’s (VLRC) report on medicinal cannabis that was tabled in this Parliament on 6 October 2015. The Victorian government asked the law reform commission to review options to enable medicinal cannabis to become available to patients in exceptional circumstances. The VLRC made some 42 recommendations and many of those have been adopted in the legislation. It is important to remember that the reference to the law reform commission from the government was that the commission was to look at how to implement the framework to enable this legislation to be put in place. It was not asked whether it should occur.
The legislation before the house is very detailed and provides for a highly regulated and careful scheme for implementation. Part 4 of the bill contains provisions detailing how cannabis will be cultivated and manufactured. The bill does not sanction any form of unregulated home-grown scheme — that does exist in some other jurisdictions — but instead it provides for a high level of control. It provides for the Department of Economic Development Jobs, Transport and Resources to oversee the cultivation trials and to license growers to cultivate the cannabis.
Parts 5 and 6 of the bill set out the scheme for the cultivation and manufacture of cannabis, and there are detailed licensing and contractual provisions relating to how that is to occur. Parts 7 and 8 of the bill detail contractual issues between cultivators and manufacturers and contain provisions regarding the health secretary’s functions in relation to obtaining, purchasing, registering, selling and otherwise supplying medicinal cannabis. Parts 9 and 10 of the bill set out the circumstances for authorising practitioners to issue a patient with medicinal cannabis authorisations. The scheme is a detailed one, and the bill provides for a careful procedure for it to be implemented.
The government has decided that it will start the release of medicinal cannabis to young people who are suffering from epilepsy, and that will occur in 2017. And while there is provision for further eligibility as time goes on, it is quite clear that there is very general community support for this legislation. The Victorian Law Reform Commission refers to the fact that just generally among the community there is a high level of support.
For many years the release of medicines into the community has been based on evidence-based practice, and that has really been a cornerstone of modern medical practice. I note that the Australian Medical Association (AMA) in its submission to the VLRC expressed concern about departing from the principles of evidence-based medicine even in exceptional circumstances. The AMA advocated further clinical trials be undertaken before medicinal cannabis is made available for use.
The government has determined to legalise the medicinal use of cannabis contemporaneously with the conduct of these trials, so it is a departure from the norm in this sense. I guess one of the risks is that this could be used as a precedent in the future. We need to be concerned about influential and powerful international drug companies that are working on drugs that they would like to see go to market very quickly, without having to go through the normal trials and requirements that exist. That is a challenge for the future. But again the fact that we have a fairly slow phasing-in process and that we have clinical trials operating at the same time does give me some comfort in this case.
It is clear that many of the submissions made to the VLRC were from people like the Australian Nursing and Midwifery Federation. These are people at the coalface. These are people who nurse people who are dying in palliative care institutions, in hospitals and in homes. There is a lot of anecdotal evidence to suggest that the use of medicinal cannabis in situations such as that has great benefit.
We have heard many accounts from parents who truly believe that their children have had relief from epilepsy and fitting by using it. We know of families whose children suffer hundreds of fits in a day, and life is simply unbearable in those circumstances. Many parents have had to access medicinal cannabis over time from an illegal market, and when they do this they cannot be in any way confident that the composition of the substance they are using is fit for their children. This must create enormous stress for parents who are trying to find effective solutions for their children’s condition.
In an article in the Age of 3 February this year we learnt the Austin Hospital in Melbourne is recruiting 60 children with intractable epilepsy to participate in a trial of a cannabidiol, known as CBD, which is a product of an American company. Professor Ingrid Scheffer, who is the hospital’s director of paediatrics and an internationally renowned paediatrician and specialist in epilepsy, will be conducting the clinical trial. It is regarded as a very high standard form of clinical trial in that it is going to be the first double-blind randomised controlled trial. It is the most reliable design that there can possibly be to establish whether the drug works. It means that neither the patients nor the researchers will know who received the real drug versus the placebo.
Professor Scheffer confirmed what many members of this house will have heard from desperate parents of children with severe epilepsy — that is, that sourcing cannabis from the black market can be unknown, it can be dangerous and it is a cause of great stress and anxiety. She welcomes the opportunity to conduct this trial. She is concerned that there are no checks and balances in the black market and that this will provide that opportunity.
This research is very encouraging. The high-quality research methods being used in this process I think will give all of us here comfort. It is the current poor state of research that was referred to in the Victorian Law Reform Commission’s report that I think raises many concerns for many of us here. In speaking to a range of illnesses and conditions that the report referred to, the general view was that the use of medicinal marijuana was regarded as of moderate quality. Despite the anecdotal evidence out there that suggests that medicinal cannabis is effective in a range of conditions, we are now moving into a stage where we all have the trials and where there will be evidence-based assessments done to determine whether it will be useful and whether it will be safe.
I have been contacted by a number of constituents in my electorate who have expressed their very strong desire for medicinal cannabis to be made available to them for the treatment of chronic pain. I do not doubt that many members of the house have also been contacted over the years too. Many of the people who have spoken to me have been watching this process very closely. They have accessed the Victorian Law Reform Commission’s report. They have seen the legislation, and they are very keen for this drug to be made available to them as soon as possible. Naturally, coming from Shepparton, a number of my constituents in more remote parts of Victoria are very concerned about whether they will be able to get access to this drug when it is finally in a process of being released to them and they have become authorised patients to use it. Just the fact that two medical specialists may be required may create issues in some areas where there are very few medical specialists available. I ask the government to give consideration to some of those issues in the future when this medication is becoming more widely available.
I take heart from the fact that the bill before the house provides for that detailed and highly regulated scheme, unlike what has emerged in a number of other jurisdictions.