Tuesday, 26 August 2025

Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025

Second reading

Debate resumed on motion of Mary-Anne Thomas:

That this bill be now read a second time.

Tim BULL (Gippsland East) (16:02): I rise to make a contribution on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. That is a bit of a mouthful. This bill seeks to amend the Drugs, Poisons and Controlled Substances Act 1981 to strengthen medication safety in aged care settings. The claim is that clinical responsibility for administering these very specific medicines rests with qualified health professionals, and I do not think anybody in the chamber would argue with that. It updates the legislative framework governing medication administration in residential aged care facilities, and what it means is that only registered and enrolled nurses, other than health professionals such as maybe your doctors or your pharmacists, may administer prescribed drugs of dependence and schedule 4, 8 and 9 medications. However, as I will explain, this bill does not guarantee that outcome, because until we address workforce shortages around areas of the state where they exist, the intent of this bill cannot be implemented and it cannot play out on the ground. We understand on this side of the chamber and we certainly respect that this aligns Victorian legislation with the national aged care standards and the Commonwealth reforms, and that is why we are not opposing this bill. But it does raise concerns in that area around staffing, which I will elaborate on shortly.

The bill claims to bring aged care settings into line with the standards in hospitals and other health services, and we know that it outlines specifically those scheduled medicines 4, 8 and 9 and their administration to aged care residents. But because of the workforce shortages that exist around the state, there will be exemptions put in place, meaning that in a lot of circumstances and instances this simply cannot occur, and it will create grey areas. There are certainly exemptions we need, and we have got some rural members in the chamber here now who would well know that in a lot of our aged care residences and facilities around the state, we simply do not have the nurses on staff to be able to implement what this bill seeks that we do. Prescription medications referred to in these schedules are serious medications. They include antibiotics, local anaesthetics, opioid analgesics like pethidine and morphine, and even clinical trial medications, so we are talking about serious medications here.

The reform’s intent is good in that it seeks to address the risk of harm from the current practice that allows personal care workers to administer these what you might deem or call high-risk medicines without the education and regulation that apply to enrolled and registered nurses.

However, I want to now elaborate on the staff shortages matter. There are a number of locations around the state, and they are particularly and predominantly in rural and regional areas of Victoria – it exists in my electorate of East Gippsland; I was talking to the member for Shepparton before, and it certainly exists in her area as well – where we just do not have the nurses in the community, not only in aged care but in the hospital and health system, to meet the need of our communities. This reform will shine an even brighter light on the fact that we have that discrepancy between our aged care homes when metropolitan areas are compared to rural areas. If a facility does not have the appropriately qualified staff, what happens under this rigid framework that has been outlined? I put to you: is it that rigid? The section of the bill that refers to this element says:

A registered provider who delivers funded aged care services in a residential aged care home must ensure that a person specified in subsection (2) administers any drug of dependence, Schedule 9 poison, Schedule 8 poison or Schedule 4 poison …

The punishment is 600 penalty units, and I think that is a fairly significant penalty. That is about $120,000 or a little bit more. But the key phrase in that element of the bill is that it must ensure a qualified person administers those medications in question – must ensure. Given this, it puts great difficulty on the aged care providers who cannot access those staff in their communities to be able to do this. What happens when the staff simply do not exist to allow this bill’s intent to be implemented? The bill says ‘must ensure’. When we raised this point in the bill briefing, we were advised that in these circumstances the act would not necessarily apply and the penalties and enforcement would not necessarily apply. The advice that we received was that in these circumstances that element of the bill would be treated as – the term used was – ‘educational’. It is then questionable what difference this bill makes on the ground in comparison with what happens now in our nursing homes, because where we have nurses in these aged care facilities within our community, they presently do administer these medications. They do it now.

I do note that almost a quarter of the complaints in relation to aged care that are made by family members, made by loved ones, relate to medications not being received on time. It can relate to doses being missed altogether, and it can relate to delayed treatments in some instances. When this occurs, that can result in a lack of attention to issues like pain management, and we want to make sure all of our loved ones in aged care facilities are not burdened with that. I acknowledge the second-reading speech refers to unforeseen circumstances impacting nursing availability to administer medication on time. That second-reading speech says that this bill will allow for another person to administer prescribed medication if there is a risk to the resident from delayed or missed medication. I put to the chamber that that is all good and that safeguards to allow our aged care facilities to operate certainly need to be in place. But there is a question mark that has been raised by some stakeholders as to how that will play out on the ground.

We certainly do not want staff holding off on medications to be administered in the hope that a nurse becomes available and with the threat of a $120,000 fine hanging over their head. It also says in the second-reading speech that this clause to allow for another person to administer the medications is not intended to cover rosters with insufficient nurses. It says it will only cover unplanned situations. So if it does not cover rosters with insufficient nurses, what happens in that case? That is where that comment in the second-reading speech has been found to be quite ambiguous, not only by me or the minister in the other place but also by stakeholders out in the field. If rosters cannot be filled with nurses due to thin markets, that ambiguous comment indicates that those scenarios and situations indeed may not be covered. As some stakeholders have pointed out, this is ambiguous, and this is something that needs clarification. It also requires clarification on whether enforcement will be applied in those particular areas.

In relation to administration I will clarify who we are referring to here: the only authorised administrators of these medications in this bill are a registered nurse, an enrolled nurse with an approved qualification or another authorised registered health practitioner. The bill is pretty rigid around who can administer and what they can administer; it is ambiguous around what occurs when staffing levels cannot be met by those qualified people. We are told that in locations where qualified staff cannot be accessed it will not be enforced; it will be educational. But there is certainly more explanation needed around the detailed scenarios that sit within that and how that will play out on the ground. In the scenario I mentioned before, where you might have a resident of an aged care home in pain and requiring medication and there is a registered nurse on but they are tending to another client or clients, does that staff member hold off or do they risk incurring a fine? We must remember that nurses do not only administer medication; in fact it is a very small part of their job. They have got many, many other very important responsibilities to carry out. They are constantly triaging clients at those locations. They undertake an extraordinary amount of palliative care work in our aged care facilities and the complex wound management that we often see, and they generally support residents within those facilities with very, very high care needs.

So that element of how this plays out on the ground does need clarification, and there is plenty of time for this, because this legislation does not get enacted for another 10 months. I would certainly hope that engagement takes place with stakeholders in the field, because the feedback that we got from them in seeking their thoughts and comments on the bill was: ‘Yes, we’d have no issue with this. We’re generally supportive. We’re not sure if it changes much, because we do that now unless they have enrolled nurses in, but we need some clarity around those details and those elements of the bill that aren’t fully explained.’ We have 10 months to do that, so I would hope that the engagement with our aged care stakeholders occurs to a level that satisfies their concerns and queries going forward.

But in that time we also need some real action from this government to address the workforce shortages, because, as I started off my speech saying, the intent of this bill is good, but it cannot be implemented when you have not got the staff to do it. It is as simple as that. Unless we address the workforce shortages that we are facing in this state, not only in aged care facilities but in our health system more generally, it will be impossible to implement the intent of this bill within that sector.

We are going to have exemptions being incurred all over the place, and nothing will really change as to what happens now. Without addressing this we are going to see probably the status quo to a large degree remain, and according to this bill non-qualified persons will continue to administer the medicines. As we know, the administration of these medicines is predominantly managed by registered nurses and then administered by enrolled nurses and in some cases care workers. I know the intent of the bill is to remove care workers from doing this, and it is acknowledged that care workers are not trained and qualified to recognise and respond to the issues that may arise. One of the major complaints that are made is that the care workers do not have knowledge of adverse reactions when medications are mixed. We have a number of our residents in aged care facilities – I have spent a lot of time in those in the last decade with my dear mother – and we do know that the needs of residents within aged care can be extremely complex, and they can require large amounts of different medication to keep the various ailments under control. I think my dear mother was taking nine different types of medication in her latter stages of life, so there is a high level of complexity there, and we do understand and recognise that. Thirty-six per cent of Victorian aged care residents have been prescribed nine or more medications – there you go – and 19 per cent take antipsychotics. It can get very complex, and it can get very complicated.

The Royal Commission into Aged Care Quality and Safety actually went into some level of depth in relation to this and in relation to the administering of medications. Its final report came out in 2021. I would not have thought it was that long ago – time flies. But what that report indicated was that they heard about:

… incorrect administration of medicines, and of poor prescribing and dispensing practices. These included overuse of medication in lieu of more suitable treatments, and the prescription of medications that have negative interactions …

with other medications, which I just touched on previously, because that was in the feedback that we had in liaising on this bill. The commission heard that there were:

… numerous instances of inappropriate management of medication regimens.

It heard that aged care staff members failed to administer medicines correctly in many cases or administered medicines without then ensuring that the aged care patient had actually swallowed that medication. We heard of failures to administer medicines at the correct time or in the correct doses and of residents being administered incorrect medicines. That was in that commission report in 2021.

In liaison with their stakeholders, Dementia Australia noted that 54 per cent of people living in aged care have dementia. That is a very high number. It is sad, but it is a very high number, and pain management is certainly challenging when those patients’ ability to communicate directly and communicate with great detail is compromised. In the feedback that was provided to me, Dementia Australia acknowledged that pain needs to be regularly and effectively assessed by appropriately trained nursing staff with the use of appropriate pain assessment tools that mitigate inaccurate judgements. In a 2020 report in support of that, the Pharmaceutical Society of Australia estimated that 20 per cent of unplanned hospital admissions from aged care facilities – 20 per cent is a high number – were simply the result of inappropriate use of medicines. So I go back: that is why we are not opposed to the intent of this bill. The intent of this bill is good. The concerns we have are whether the outcomes that it is aiming to achieve can be achieved on the ground, because without the persons with the qualifications, nothing will change.

I mentioned that 54 per cent of aged care residents have dementia, but it is also important to make the point in this debate that there are a number of residents in our aged care facilities that are able to administer medicines by themselves, and the ability for them to do that does not change. They are still certainly able to do that, and the ability for them to do that is covered by Commonwealth guiding principles, which include regular clinical assessments to determine people’s capacity to self-administer. So for those that are able to do that, that is well and good and they can keep to their medication regime. This bill predominantly applies to those who need assistance and cannot do that.

There will be a five-year review of this legislation to check whether the stated objectives are being met. Personally I would like to see that reduced. I think if we do have an issue with this legislation where it is maybe not going 100 per cent according to plan, we should not be waiting five years before we act on it. I would like to think that there is maybe a full review in five years but we are monitoring the outcomes on the ground as we are going, and one of those outcomes we could perhaps monitor is what has actually changed in relation to this.

We are also told that anonymous six-monthly voluntary surveys will be used to collect information from the sector to inform progress and be fed into the review process. I think getting the surveys done is good. Making them anonymous nearly avoids the opportunity to follow up on concerns raised or have the dialogue maybe needed to improve the system. So the surveys are a good idea, but I would question whether making them anonymous is required, because most of the people – from all of our experiences – working in aged care have the best interests of their clients at heart, want the best systems in place and want the best outcomes for those that they grow close to. Surely we can have feedback provided here that does not necessarily have to be anonymous. Having that option might be a good idea, but it certainly should not be mandatory.

Before I do finish up, I just want to make a few comments about the sector and the workforce more generally. I mentioned my own mother before. Mum passed away a couple of months ago, which was after a great life of almost 99 years. For the last 10 of those years, she spent that time in an aged care facility. In fact I think at that particular aged care facility she was one of if not the longest-term residents in there on her passing. She went in at 88 and passed away at 98, nearly 99. That resulted in me spending a hell of a lot of time in that particular nursing home. As part of our job – and I am sure I am speaking for the majority of members in the chamber – we visit nursing homes on a reasonably regular basis. As I travel around, I visit a lot of our World War II and Korean War veterans in our nursing homes as the Shadow Minister for Veterans’ Affairs, and I have a chat to them. But we do spend a bit of time in those facilities, and it is a very challenging environment to work in at times. As I said, we are often dealing with patients with dementia, and those staff members are dealing with a lot of the clients who are nearing end of life, and they create relationships and friendships with those people towards the end of their lives. It takes, I think, a special type of person to work in that system and do what they do to make that period of the residents’ lives the best it can possibly be.

My mum went through periods in the early days of going on outings with groups. This slowed down, progressing to games within the facility to, towards the end, fairly much being confined to her own room apart from mealtimes. But every time I went over there it was clear that she was being cared for by staff who cared. We have seen royal commissions and we have seen inquiries that have at times exposed the worst practices and the worst behaviours of those who work in that sector.

I think it is important to put on the record that this is a minority and that the vast amount of people who work in our aged care sector are people who are in there for the right reasons and doing an absolutely fantastic job, so we thank the staff in our aged care sector in this state for all that they do to look after our loved ones in those latter years of their lives.

In finishing up, I just put on the record that this bill is not coming into effect until 1 July 2026. We are not opposing it, but we have some concerns, with the lack of nursing staff in the state, that its intent will be able to be put into effect, because without the qualified staff it simply cannot be done. I repeat: we are primarily talking about areas of rural and regional Victoria. So before this bill passes, assuming it passes the other place, there is a lot of consultation to do with the aged care sector to sort out those areas that they have found a bit ambiguous or that need more detail clarified to them around implementation. We certainly need this government to embark on a program of ensuring that we have the appropriate staff within our aged care facilities to ensure the intent of this bill can be implemented within our community.

Chris COUZENS (Geelong) (16:26): I am pleased to rise to contribute on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. I want to start by acknowledging and thanking all our aged care nurses and staff and workers out there, who are doing a fantastic job. It is important that we recall what happened during COVID and the pressure that was put on those aged care workers in particular and acknowledge the great work that they have done.

When we are looking after older people in aged care, it is absolutely critical that we have these safety mechanisms in place, and we have a great public system that protects older Victorians. That was a shining light during COVID, and we know that for a fact. With people living longer, we know we have to have a safer system. I will say that if you are providing aged care, you have a responsibility to provide safe and quality care for all those people living in your residential facility. It is not just the workers – in fact I would say, looking at the history and looking through the Royal Commission into Aged Care Quality and Safety, that it is not just a small minority of workers; it is the actual owners of these facilities, because back in I think 1997 the Howard government changed the system and allowed the private sector into aged care. That is when we started to see the demise of our aged care system and why we had to have a royal commission into aged care. Having followed that closely, because my parents both went into aged care – firstly, my mother, during COVID, followed a couple of years later by my father – one of my concerns was all the information that I had heard about aged care and that we were failing older Victorians, who required that quality care and were not getting it. Luckily, my parents were in good facilities, and their experiences were what you would expect in a good-quality aged care facility and the staff were amazing, but that is not always the case, and we know that. The private sector is about making profit. It is not about providing the best quality care, it is about making profit, and we know that it was exposed that many of those did not even have an enrolled nurse or a registered nurse in their facilities, and if they did it was minimal.

We need to start dealing with some of these issues, and obviously the Albanese government have started doing that by implementing these reforms. This is an important one too, because we know the royal commission highlighted that administration of medicines was one of the key factors that needed change – that there were too many incidents of medications being administered that were putting people into the hospital system, for example. Yes, some people can administer their own medication, but because we are living longer and have far more complex needs as we get older, we need to have a good-quality system whereby only experts are administering that medication, which will help take pressure off our hospital system, which has been full of people who have been transferred to public hospitals because of what is happening in aged care. So this is a really important piece of legislation.

The royal commission also found the aged care system failed to meet the needs of older people in the delivery of safe and quality care. As I said, this is about us as a state doing what we can to make sure that these facilities are at their best. There were a lot of recommendations within the royal commission, which I have mentioned, but medication management and safety was one of the key reforms that was required. Older people are increasingly entering aged care later in life with more complex health conditions that cannot be safely managed in their own home. These more complex care needs often require people to take multiple medications, including the risk of medicine-related problems. The royal commission identified that and that medicine management and safety in residential aged care was essential for improvement. The royal commission’s report highlighted incidents of inappropriate management of medications, including medications not being administered correctly or residents being given tablets without oversight to ensure they swallowed them.

While medication harm can occur at different points in the process of using medications, including prescribing, dispensing and administration, the Victorian government is responsible for who can administer the medication in residential aged care. Currently medication is mostly administered by registered nurses and, under the indirect supervision of an RN, enrolled nurses and personal care workers. While personal care workers play a vital role in residential aged care, particularly in relation to personal care, mobility and daily living, this is an unregulated workforce without qualifications and skills to understand therapeutic benefits of medication and recognise and respond to potential adverse reactions. We know through the royal commission and what was unveiled through COVID that there were careworkers who were not qualified to administer medication and other areas who were forced into a position where they were administering medication – or not. That was the other issue. So to put the blame on those careworkers I think is unfair. They were directed by their employer to do that. There were some pretty extreme situations that we saw during COVID. I know in my community of Geelong there were some pretty horrific incidents that came about because unqualified staff were asked to do or expected to do things that nurses and registered nurses, who just were not onsite, do.

This is a really important bill to make sure that those aged care facilities are complying. I know our public system is one of the best in the country, and we have quite a large number of public services in the Geelong community who I know my community are very appreciative of. Barwon Health run quite a large service and do the right thing by those patients. I think the important thing too is that there has been quite a range of consultation on this, so everybody has had the opportunity to have input, which is great.

This bill will place an obligation on Victorian residential aged care providers to ensure that only registered and enrolled nurses administer, prescribe and dispense drugs of dependence and schedule 4, 8 and 9 medicines; provide that regulations may prescribe circumstances where the obligation does not apply and how these circumstances should be managed; and modernise language and terminology, including to align with the Commonwealth government’s new Aged Care Act 2024.

I think also our previous speaker mentioned a shortage in the workforce. This government has had that as a high priority – to make sure that we get the nurses on board – and that will make a difference in providing safe, quality care. We are addressing the staff shortages through providing the free TAFE initiatives for a diploma in nursing. It is available under the Victorian government’s free TAFE initiative, which will increase the pipeline for additional enrolled nurses for government and non-government health and care sectors. I know that in my electorate of Geelong the Gordon TAFE are delivering this course. There are many people enrolled in the course. It has been amazing for my community to have those opportunities to have free TAFE and for us to be able to educate and skill up these workers, because we know how important it is for them to be going into managing the medical needs of people in aged care – initiatives making it free to study nursing and aiming to increase the public sector nursing workforce, including public sector residential aged care services. I commend the bill to the house.

David HODGETT (Croydon) (16:36): It is a pleasure to rise and make a contribution this afternoon on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. In the time I have available I might just outline the purpose of the bill and talk a little bit about the background, which gives us a picture of how we have arrived with this bill here today. Then, if time permits, I do want to talk a little bit about workforce capacity, which the lead speaker, the member for Gippsland East, touched on in his contribution.

Firstly, just to turn my attention to the purpose of the bill, the bill seeks to amend the Drugs, Poisons and Controlled Substances Act 1981 to strengthen medication safety in aged care settings by ensuring clinical responsibility for administering specific medicines rests with qualified health professionals. The bill updates the legislative framework governing medication administration in residential aged care facilities. Only registered and enrolled nurses or other health professionals such as doctors and pharmacists may administer prescribed drugs of dependence and schedule 4, 8 and 9 medications. This aligns Victorian legislation with national aged care standards and Commonwealth reforms. The bill supports clinical governance frameworks that ensure safe and accountable medication practices to bring aged care settings into line with the standards in hospital and other health services. Personal care workers will no longer be able to administer drugs of dependence and schedule 4, 8 and 9 medications to aged care residents. These prescription medications include antibiotics, local anaesthetics, opioid analgesics like pethidine, morphine and oxycodone –

Members interjecting.

David HODGETT: Can I assure Hansard I will hand my notes in to ensure the correct spelling of these medications, which is not my expertise, but to give the last one a go – benzodiazepines. Medications are not my field of expertise, in administering or taking, so I will try and help Hansard out with some notes here to get those. All those are clinical trial medications. The reform will address the risk of harm from the current practice which allows personal care workers to administer high-risk medications without the education and regulation that applies to enrolled and registered nurses. And finally, the changes will reduce demand on the acute health system. Hospitalisations due to medication issues are more likely to occur without the clinical expertise and oversight that only qualified nurses and other health professionals can provide.

I put on record my appreciation of all the work that our nurses and health professionals do. I dare say everyone in this place has had experiences with our health system, and my family and I – and indeed my extended family – very much value and appreciate all of the work that our health professionals do. We really do value and appreciate that.

By way of background, currently the administration of controlled medications is predominantly managed by registered nurses and then actually administered by enrolled nurses and careworkers, but careworkers are not trained or qualified in recognising and responding to issues that may arise, such as adverse reactions to medications. Aged care residents increasingly have more complex care needs and require more medications: 36 per cent of Victorian aged care residents have been prescribed nine or more medications, and 19 per cent take antipsychotics. The reform responds to sector feedback and addresses significant concerns identified by the Royal Commission into Aged Care Quality and Safety about inappropriate and unsafe use of medications, including chemical restraints. Just to note some of the contents of its final report in 2021, the commission heard about incorrect administration of medicines and of poor prescribing and dispensing practices. These included overuse of medication in lieu of more suitable treatments and the prescription of medications that have negative interactions with each other. We heard of numerous instances of inappropriate management of medication regimes. We heard about aged care staff members failing to administer medicines correctly or administering medicines but failing to ensure residents swallowed them. We heard of failures to administer medicines at the correct time or in the correct dose and of residents being administered incorrect medicines.

According to Dementia Australia 54 per cent of people living in aged care have dementia, and pain management is challenging when they are unable to communicate pain levels effectively. In feedback provided to our shadow minister for ageing, Dementia Australia observed that pain needs to be regularly and effectively assessed by appropriately trained RNs and ENs with the use of appropriate pain assessment tools that mitigate inaccurate judgements. In a 2020 report the Pharmaceutical Society of Australia estimated that 20 per cent of unplanned hospital admissions from aged care facilities are a result of inappropriate use of medicines. Those points that I have just spent a little bit of time going through give us a thorough background to this bill, why it is here and why we are not opposing it.

I do not intend to go through the main provisions of the bill – I think the lead speaker outlined those, and I am sure others in their contributions will go through the main provisions – except to note the following exceptions that apply. The bill does not affect the operation of the voluntary assisted dying scheme – new section 36EA(4). Residents may also continue to self-administer medications where appropriate and safe. An individual’s ability is governed by Commonwealth government guiding principles, which include regular clinical assessment to determine capacity to self-administer, and exemptions can apply in exceptional circumstances such as an emergency or unexpected staff shortage, where no appropriate qualified staff are available and delaying medication would place a resident at risk. This is not intended to apply to rosters with insufficient numbers of nurses but unplanned temporary shortages. The above exemptions also apply in other situations that are to be prescribed by regulations under the act. In terms of the commencement of the bill, the changes will commence on 1 July 2026, with a 90-day grace period until 29 September 2026.

I want to speak a little bit about, in the time remaining, just workforce capacity, because I note that this reform will require additional nurses. It was reported by the Herald Sun on 31 July 2025 that the Victorian government expects the sector will need to hire about 650 new nurses. Given there are shortages of nurses across the state, especially in regional and rural areas, there are concerns that compliance could be challenging here. As I said at the outset, we are not opposing this bill. I do acknowledge and restate that one of the main purposes of the bill is that the administration of these specific medications rest with qualified health professionals, and I support that. But given workplace capacity challenges facing the sector I do wonder what role AI might play in supporting our aged and health care systems in the future.

Indeed there is much discussion, debate and research on the pros and cons surrounding AI. This may be something that the Parliament explores further, perhaps through the joint committees, with appropriate inquiry references to examine these matters in a bipartisan and constructive way. In looking at workforce capacity, I learned in some of my recent reading some figures on the global population and the ratio of workers to retirees shifting, with the labour force dwindling. For example, countries including Japan, Germany, Italy, Russia and South Korea are even now approaching a crisis of working age population. If you look further at the total fertility rate of China and their neighbours in South Korea and Taiwan, you will see the challenges they face in working-age population, workforce capacity and expertise, so they are looking to technological improvements and new technologies.

The point I make is that we too are facing workforce capacity challenges, and the Parliament will do well to advance their thinking around the use of new technologies to support various sectors, including the health and aged care sectors, to address workforce capacity issues and to maintain living standards. We are not a not opposing the bill, and it has been a pleasure to make a contribution towards the bill today.

Mathew HILAKARI (Point Cook) (16:46): I follow on from the member for Croydon and the member for Geelong, and I appreciate the member for Croydon has indicated that they will not be opposing the bill. It is a pleasure to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025, and of course I support it.

The member for Geelong talked about public sector residential aged care in the community that she represents, and I think that is an outcome that all Victorians, certainly this Victorian government, should be very proud of, our engagement in public sector residential aged care, because we have stuck with it. Almost all around the country governments have largely exited the market. We have a public sector residential aged care rate of about 11 per cent of beds across the state or thereabouts, and they are a really big deal, particularly in lots of regional and rural communities. Our public sector residential aged care facilities ensure that people can be within their community and age within their community. I know there is a really strong propensity for people to want to age in place in their own homes – rightly so; I understand that. But when the circumstances arise that you are no longer able to be in your own home, having those facilities across all of Victoria I think is a really wonderful thing, and I celebrate that we do have public sector aged care facilities at such a rate in Victoria.

I just want to do a bit of a shout-out to the Boollam Boollam Aged Care Centre in Monash Health’s Kingston Centre in Heatherton, which has just been completed. It is the largest public aged care facility in Victoria – 150 single modern rooms and private ensuites for people who are residents. That does not exist in every aged care facility, and I am really grateful that this is becoming par for the course across our public sector aged care. But they do an amazing job, all of the nurses, the staff and the personal care assistants, and I want to give a shout-out to all those people who work diligently in the department. For my sins, I was previously an aged care adviser for former minister Martin Foley, and that was –

Members interjecting.

Mathew HILAKARI: Exactly. A big shout-our and round of applause for Martin Foley – I would like to just put that on note. But the time that I spent in that office and some of the lessons that I think we took from it and some of the advances that we were making as a government at that point have really stuck with me and are some of the proudest things that I have been involved in. Introducing the nurse-to-resident ratios in aged care was I think, by some of those opposite, a bit pooh-poohed at the time. They thought that this was a bit of an overreach; they were not happy with it. There were some in the sector who did not like it. But what it provided was that really important skill set that is really required for people who we know are entering the aged care sector older and more vulnerable.

Then, as we did that and as we saw those wonderful nurses in place in what are people’s homes, COVID hit.

COVID hit the sector, including the aged care sector, in a really devastating way – an absolutely shocking way – and so many people’s lives were finished as a result of it. So many people were poorly affected because of it, but not so in public aged care. They did not bear the brunt of it, because they had the nurses who had the skills and the expertise to understand infection control and to put that in place in the facilities that they were working in. The personal care assistants were doing wonderful work as well, and not to deny the fact of their care and their efforts, but they just did not have the skills. They did not have those amazing skills that our nurses have in understanding infection control. It was just so important to residents in those places where vulnerable people live and to their families as well, who were often not able to go into those facilities during COVID – rightly so because of infection control. I just want to give a shout-out to all those nurses but also the personal care assistants and everyone particularly working in the public sector residential aged care facilities at that time. That was a really tough time, and they worked and did their job brilliantly in keeping people who were vulnerable safe. So thank you to them and thank you to everyone in the department who did that work during that time, because they were working to keep people safe – one of the jobs that we should be doing within government all the time

I note the member for Croydon appropriately and with candour admitted that he should not be giving out medicines – and I am very glad to hear that – and was candid around his challenges with some of the medicines themselves. He did rightly point out that this does not go on to affect our voluntary assisted dying. It does not affect people who self-administer appropriately or where there are exceptional staff shortages. I am not talking about deliberate rostering but genuine staff shortages, which only happen from time to time. I thank him for putting those sentiments on the record, because it is important that people who are in aged care who can take their own medicine be able to continue to do so, and there is nothing in this bill that should prevent them from doing so.

The member for Croydon also talked a little bit about the challenges of the workforce sector and some potential responses to it. This government is not waiting for potential responses to it in the future. We are putting in place those measures that will drive more people into nursing, into a wonderful career, and that includes a landmark 28.4 per cent wage increase to nurses and midwives across their 2024–28 enterprise agreement. Pay does mean something. Pay does affect sometimes the willingness of people to work in a sector when they have got choices. Nurses have choices to do a whole series of jobs because of the high skill that they have, and I am glad to see when they do come into the aged care sector particularly that we can ensure they have wages which are more commensurate with their skills. We have also made it free to study nursing in a series of different circumstances, and that is another way that we are driving people into the aged care sector and supporting the workforce there.

At the moment in the aged care sector, and this is from a 2024 survey, nurses administered medication 91.2 per cent of the time in public sector aged care facilities and 81.2 per cent of the time in non-government aged care facilities. That is just purely a reflection of the requirements that the government has put in place – that 10 per cent gap that exists – because we have made mandatory nurse-to-resident ratios. That is why the gap exists. But it is also reflective of nurses working hard across the whole of the aged care sector to make sure people are safe at a vulnerable point in time. I think we have discussed it already, but I would reiterate that 36 per cent of people living in Victorian residential aged care facilities are prescribed nine or more medicines. That is a huge amount of information that people have to be able to absorb and understand and make sure is delivered appropriately to those people who require that number of medicines. Nine is a huge amount. It is a massive amount, and it is complex, the interaction of medicines, one with another. So I am really thankful that, particularly in our public sector residential aged care facilities, we are meeting 90 per cent plus. We hope that this drives it even higher, and we hope that it drives it higher particularly in the non-government sector. Particularly where medicines are not managed appropriately, they can have devastating effects.

We know those devastating effects exist because 20 per cent of unplanned hospital admissions from residential aged care result from inappropriate medication use. If you do not think that has an impact on you and your family, then you are wrong, because this goes to access to hospitals and access to health care. These will be circumstances where it is most likely an emergency when we see people there – an unnecessary emergency, an emergency that should not exist. So this bill seeks to fix and assist with that. It will not fix it all the time, but if we can get it to a higher level and a higher quality all the time, we will be certainly a much happier community.

Just in the 20 seconds that I have left, I want to thank the minister. I want to thank also the advisers. I know how hard they work in making sure that the most vulnerable in our community are looked after, and they are always looking for the next thing that we can be doing in this really well needed sector.

Cindy McLEISH (Eildon) (16:56): I rise to make a contribution on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. I think the longer we live, the more experience we have of the aged care system. We want it to be good and it has not always been great, but I do know that the experiences that my family and I have had in the aged care system have been particularly positive. That was at Vasey RSL Care in East Brighton and also in Yea. I know my mother-in-law was 97 before she decided she might be suitable for aged care, and she lived out her last three-and-a-bit years there. But we had positive experiences, and I know that that is not always the case. Because of the royal commission in 2021 there have been a number of changes that needed to be introduced, and this bill deals with those.

In particular, the bill updates the legislative framework governing medication administration in residential aged care facilities. This is something that is particularly important because so many residents in aged care require medication. I have one constituent who is in her mid 90s, and her husband I think is 99; she often tells me how wonderful it is because he still does not require any medication. But we know that so many people as they age, for a variety of reasons, require medication. Around this framework, only registered or enrolled nurses, other than health professionals such as doctors and pharmacists, may administer drugs of dependence and schedule 4, 8 and 9 medications. Making this change will bring Victoria in line with the national Aged Care Quality Standards and the Commonwealth reforms. I think that is important, and we would like to see that consistency around the country.

The bill supports the clinical governance frameworks that ensure safe and accountable medication practices to bring aged care settings into line with the standards in hospitals and other health services. The intent here is very good. I am very worried, like a number of other speakers, about how this will play out, because whilst the intent is good, there are a number of issues that are going to impact here. The safety and clinical guidance is particularly important. What this bill means is that personal care workers will no longer be able to administer drugs of dependence – schedule 4, 8 and 9 medications – to these aged care residents. With the current system there is a risk of harm with the current practices because personal careworkers can deliver high-risk medications and they actually have not had the education that applies if you are a registered nurse or an enrolled nurse – the training that lets them understand how to and sets you up to be able to administer particular medications. If you have not had that, you are not skilled to be able to adequately do these things, and we do need to have things going as best we can.

Now, these changes will reduce the demand on the acute health system; hospitalisations due to medication issues are more likely to occur without the clinical expertise and oversight that only qualified nurses and other health professionals can provide.

At the moment in aged care medication is predominantly managed by registered nurses and then administered by enrolled nurses and careworkers, and these careworkers, as I have mentioned, do not have the appropriate skills and training. Aged care residents are increasingly complex in their care needs and are requiring more medications. A staggering 36 per cent of Victorian aged care residents have been prescribed nine or more medications, and 19 per cent take antipsychotics. If we have a think about the types of health conditions that people may have in aged care as they get older, there are often a lot of respiratory conditions and heart disease – people maybe having had heart attacks. They might have strokes or diabetes. Dementia is there. A lot of people actually have falls, and with those falls they might need some pain medication as well. So the range of drugs that are required can be actually quite complex. We had the royal commission, as I mentioned earlier, in 2021, and they heard about:

… incorrect administration of medicines, and of poor prescribing and dispensing practices. These included overuse of medication in lieu of more suitable treatments, and the prescription of medications that have negative interactions with each other.

Whether sometimes this is sloppiness or rushing, I think it is really important that we take heed of this. We had a situation at home with a family member who was self-administering some strong painkillers, Endone, with some anti-inflammatories and antibiotics, and the impacts were quite severe. I realised fairly quickly that they had mixed up the drugs that they were taking when I found in the bin an empty packet of Endone which should not have been empty for another week. I saw the consequences of that and how easily somebody who was completely with it – not living in aged care – just made a mistake with the medication and mixed up the packets. We know that can happen sometimes, and it should not happen. If we are in an aged care setting, in that formalised setting, we really want to make sure that all risks are minimised. This bill certainly will go some way to doing that.

Dementia Australia, who provided some feedback to us on this bill – they had no problems with it – said 54 per cent of people living in aged care have dementia and pain management is challenging when they are unable to communicate more or less effectively. Sometimes they might be quite insistent that they have actually taken the medication but they have not taken it, and perhaps they might even strike out. It can be very difficult, so it is important that we have the right skills and training here for that administration.

One of the concerns that we have is about the workforce capacity, and this hits rural and regional areas much more because given the ratios and what this reform will need – every time they make changes, they require more registered nurses – in the country there are not always more registered nurses to be found. What we also find is that so many registered nurses have actually decided to leave full-time employment and go and work for agencies because they get a little bit more money. Now, this costs the same; people end up doing the same work, but they are getting paid through the agency rather than directly employed by the health service or the aged care service. So what happens in that instance? It is putting more and more pressure on the aged care facility or the health service because of the funding that is required. This is a real issue, and it is there in conjunction with the lack of workforce.

I know that this bill is not going to take effect until 1 July next year, some nine months away, and there is that 90-day grace period, but I am very worried that there will be a lot of areas where this will be very difficult to administer or implement. I mentioned early on the intent here is very good, but we need to see how problematic it is going to be once it actually gets into practice and what enforcement there will be. Sometimes the enforcement may be lacking because no-one knows that there is a problem. They think it is going okay; they might check once every couple of weeks rather than as frequently as is required.

So I am quite concerned about the workforce capacity, because it exists now, that lack of experienced people in the country. You go to many different hospitals or aged care services, and they cannot find the people to employ now, so if they are going to have to increase the number of registered nurses that they have on their books, it is most definitely going to be problematic. I think it is so important with drugs of dependence, and we know what those drugs of dependence are – certainly the opiates we would all be very aware of, for pain and anxiety, for sleep, pethidine and morphine. We know what drugs are there, and we know how dangerous they are and why there are such strict protocols, even with ambulance officers and hospitals administering them and storing them so they cannot be taken or tampered with. These are such important drugs. We do need to make sure that they are administered properly, but I am concerned about the workforce issues.

John LISTER (Werribee) (17:06): I am proud to speak about this crucial reform, which is part of a whole package of reforms that we have made in the aged care sector. This Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025 is particularly important for older Victorians to make sure that we have the right people with the right qualifications administering what are some pretty hectic substances, which I will go to in just a moment. This bill requires that from 1 July 2026 only qualified nurses and other registered health practitioners, including GPs and pharmacists of course, will be authorised to administer certain medications to aged care residents.

I have to reflect that I have not spent a lot of time in aged care homes, although one of my first roles was doing work experience at a local aged care home. One of the things that I reflect on in my engagement as an MP and throughout my time is that part of being in one of these residential aged care facilities is that you are giving over that little bit of autonomy to people that you need to trust are qualified and have that understanding of your physiology and your needs in order to be able to meet those needs. It is quite a vulnerable space to be in, and I appreciate that. So this bill looks at how we can make sure that we have the right people with the right qualifications administering these drugs.

Drugs of dependence and medicines classified under schedules 4, 8 and 9 – I was just having a quick look at the schedules before I spoke and, like many other people contributing to this bill, probably cannot pronounce a lot of them. But some of the more common culprits in the schedules are things like anaesthetics, antibiotics and stronger medications like morphine and drugs in that particular family. These changes reflect the government’s firm commitment to reducing risks associated with medication errors, which in the past have occurred without that clinical judgement or, worse, have resulted in residents missing critical doses altogether. These reforms are long overdue, and it is something that we are here to address today.

The bill directly addresses serious safety concerns highlighted by the Royal Commission into Aged Care Quality and Safety, where it was revealed that medications were too often administered unsafely and without proper professional oversight. I know some of my colleagues have referred to this, but it is pretty shocking that in some data from the Commonwealth 36 per cent of people living in Victorian residential aged care homes are prescribed nine or more medications. I cannot even remember one or two medications off the top of my head. The professionals who we are designating will be the only ones who can deliver these medications have done years of training to be able to determine how these different medications interact with the body at different times and make sure that it is done safely and with regard to that particular person’s needs.

Nineteen per cent in residential aged care are receiving antipsychotics. This is a particularly nasty family of drugs when it comes to how they can play with other different drugs that might be in your system, so it is particularly important to have people who understand that interplay in someone’s body. They were left vulnerable because medication administration was being done by unregulated staff in a lot of cases, who are not bound by those standards required of nurses by the Nursing and Midwifery Board of Australia. At this point I would like to just give a shout-out to the Australian Nursing and Midwifery Federation (ANMF) for their advocacy in this, and I know a lot of this comes out of that work that they have done with their members. They are very much a union that is focused on listening to their members and the experiences that they have out in the field, so this was a commitment that we had made at the 2022 state election to make sure that this was brought in.

The other thing that I want to say is that ensuring that only qualified health practitioners handle what are quite often quite powerful medicines and, in the case of some people with a lot of health needs, at quite high doses will reduce clinical risks, improve health outcomes and prevent unnecessary hospitalisations caused by medication errors. I want to just reflect a little bit on the hospitalisation that we are seeing from these sorts of errors. Quite often when an older person is admitted into hospital it is not a good experience and can be quite a lengthy stay, so we need to do whatever we can to avoid hospitalisation whenever we can. Twenty per cent of unplanned hospital admissions from residential aged care are because of inappropriate medicine use. We are dealing with people who have quite vulnerable bodies because of their age and a lot of the other conditions that they may have going on in them at the same time, so it is quite important to have people who understand those interactions, as I reflected on before.

There are some other things I want to reflect on in particular. Some of those drugs of dependence in schedules 4, 8 and 9 are ones that quite often do not interact well with each other unless they are managed. We acknowledge that there are some in those lower schedules that are over-the-counter medications which can still be administered by other people who are authorised in those particular centres to do so, but it is important to make sure that these drugs that do have quite difficult interactions within the body are managed properly.

There have been some concerns raised by people throughout the house – and I appreciate that those opposite are supporting this bill with the care that is needed for this topic – around nursing supply across Victoria, not just in the regions but in our growing suburbs as well. It gives me a lot of pride to see so many of those young people that I worked with in schools wanting to go into a career in nursing, and quite often we would have trouble getting work experience at the Werribee hospital because of various COVID arrangements and things like that. So one of the first contacts that a lot of these young people who want to go into the healthcare profession have with health care is through the aged care system, because often aged care homes are quite happy to take on a work experience student. Because of that we have seen a growth in the number of young people, particularly in my electorate, looking to go into nursing, and that has been helped in part by initiatives by this Labor government to support that growth of nursing supply. Under our free TAFE initiative a diploma of nursing is available. I know that particularly free TAFE is really important to make sure that there are as few barriers to entering into the profession as possible. The making it free to study nursing initiative will also help increase that supply.

We have also seen over the last four years a 28.4 per cent increase in the pay that nurses and midwives are getting under their EBA, and we have invested, in the 2025–26 state budget, $95.1 million over four years to support the health workforce, including initiatives around registered undergraduate students of nursing, transitional support programs and capacity development for rural nurses. I know yesterday I was contacted actually by someone who is studying nursing, looking to access that support to go and work in rural areas, and as someone who did a rural replacement in their profession, I would always recommend it as an entry into the industry.

The reform that we are seeing has not happened in isolation; it is part of an extensive consultation with stakeholders. I have already given a shout-out to the ANMF, but it is always important to give them credit for the work that they do, as well as those other peak bodies and the wide range of providers that we have from charities, religious groups and multicultural backgrounds. We understand that this change takes time, and that is why there is a 12-month transition period, which we have spoken about, built into this, giving aged care providers the opportunity to adjust their staffing models and fully comply with these new requirements. We understand that a lot are already doing this in practice, but we want to make sure that wherever you are and whatever aged care setting you are in, you get that same level of care. We have spoken a little bit about how public aged care has led the way when it comes to these standards not only during the pandemic and the way that infection control was managed but also around those nurse-to-patient ratios as well.

I would also like to give a shout-out to the staff in particular at my local aged care homes, at Glendale; Estia Health on Russell Street; Mercy Place, which is one of the places where I did my work experience; Wyndham Lodge; Manor Court, which is a great little one – some of my former teachers are actually at Manor Court and it is always good to see them when we have to go there with the fire brigade for a fire alarm, which is always because someone has burnt the toast; St Vincent’s on Hoppers Lane; and Uniting in Manor Lakes. This bill empowers our nurses and health professionals at all those places around Victoria, and I commend it to the house.

Emma KEALY (Lowan) (17:16): I rise today to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. At the outset I would like to thank everybody who works in aged care. It is of course our fabulous nurses and it is also our personal care attendants, as well as many, many other supporters of keeping people in their later years, delivering a fabulous life for them in their sunset days. It is certainly an important role. Having had family members who have spent their last years in aged care and also of course from my time at Edenhope and District Memorial Hospital, where we supported two aged care facilities, I know firsthand the amazing work that people who work in that sector deliver.

It is such a confronting period to deal with, the reality of people as they age. It is a reminder for us all that we are not here forever. It is, I think, particularly confronting when people’s minds and their bodies deteriorate at different paces. I think it is harrowing to see someone who is physically still very fit and able but with the impacts of whether it is dementia or other ways that the mind deteriorates over time. A neurological deterioration over time can be very, very difficult for everyone to deal with – the individual as well as the family members and the carers around them. But equally when the mind is agile and the body is frail it is an extraordinarily challenging time. However, we are very fortunate if we are able to make that stage of our life. Again I just want to acknowledge the fabulous work of people in that area. It is difficult, and people are not paid very well. It is very difficult and confronting, as I have said, but also you get to share some of the most special moments in people’s lives, particularly in their final weeks, days and hours. We are incredibly fortunate there are so many people who are willing to put their hand up and hold the hand of people when they are not in the prime of their life.

This legislation will make a number of amendments which will align Victoria’s legislation with what aged care facilities have to work within anyway through the national aged care standards and of course the Commonwealth reforms. The key shift is really around personal care workers no longer being able to administer drugs of dependence, including schedule 4, 8 and 9 medications to aged care residents.

As was eloquently outlined in the lead speech by my friend and colleague the member for Gippsland East, there are certainly some challenges when it comes to delivering the aspirations of this legislation. We of course want to make sure that there is a minimal number of incidents related to medication being inappropriately prescribed, inappropriately given to a patient or given to the wrong patient.

Medication errors of course are far too prevalent. However, we do need to make sure that we acknowledge that anybody can do that. It is not just within the aged care sector; it is not just personal care attendants. Unfortunately, we see far too many people accidentally take too much medication, accidentally overdose, and that can have serious outcomes, not just fatalities. You can see the impacts of toxication from high doses of certain drugs where people lose their kidney function, and that can be just as debilitating on an individual as can other aspects. So certainly the consequences of medication errors and medication mismanagement are something that we all want to work to minimise.

It is something that the healthcare sector does a lot of work on to have better systems that can identify where there is an extra check that is appropriate. There will be medication reviews. There are of course contraindications for some drugs. We see often a system established where a pharmacist will do a medication review and try to deal with polypharmacy, the prescribing and interaction of multiple drugs, which of course is something that happens quite frequently as we get older. We have different issues that need to have their own sets of medication to deal with those specific issues, and the older you get, the more of those issues that tend to arise. Rather than reviewing all of the different drugs that you are being prescribed or that you are taking, there tends to just be a layering upon layering: ‘This is your problem, so we need to add this medication. This is your problem; we need to add this medication.’ That in and of itself can have significant consequences physiologically. I have seen aged care residents have a polypharmacy review, and we had residents who were going from taking over 20 tablets a day to less than five. There are certainly opportunities to do that, but it is very difficult within the healthcare system, which has particularly been starved of funds. It is a centralised process at the moment. This is one of the things that actually makes a huge difference: allocating time so people have the opportunity to review the whole suite of medication that someone, whether it is a patient or whether it is a resident, is receiving and making sure that we put in place something that is safe and something that is right. So there are multiple aspects to making sure we get medication right.

Absolutely it is around adhering to the quality management systems, which are the standards that every aged care facility has to meet, whether it is public or it is private. There are legislative responsibilities that have to be met as well, as is included in the legislation that we are debating today. But we must acknowledge that it is not your role, it is not your job, that determines whether you make an error or not, and so I would support additional support being given to nursing staff, who will take on a greater proportion of the administration of drugs in aged care facilities, because equally nurses can make those errors. We want to make sure that we are supporting them, and we want to make sure that they have additional training that supports this move to focus more on administration of medications, because there will be a lot more pressure on our nursing team to be able to deliver that.

This was something that was raised by my colleague the member for Gippsland East. We already have a critical shortage of nurses right across the state. It is particularly prevalent in rural and regional Victoria, and I know that the merger of many of our hospitals under the Grampians Health banner has had a critical impact on staff satisfaction. The people matters survey for Grampians Health certainly has reflected the deteriorating sense of importance and sense of how much people appreciate our health staff, because they cannot make local decisions; some are being made hundreds of kilometres away. I would like to reiterate to everybody who works in hospitals, our aged care facilities, our medical clinics and our allied health clinics as well: I do not mind what you do. I do not care what your qualifications are, what your experience is, whether you have been in for six weeks or whether you have been working for 60 years; I greatly appreciate all that you do to support our community. I think it is very important that everyone who works within health understands that they are valued.

Certainly the Nationals and the Liberals will do all we can to make sure that we have a health system that supports its staff but also delivers for every single Victorian, no matter where they live. We need to make sure that we have a health system that is responsive, that provides that care and support and that is an employer of preference, because we know that people will go where they are treated the best. It may be interstate, and we are certainly seeing that in my part of the state, given I abut South Australia. We have seen health staff who are now working in South Australia rather than working under a centralised model in Victoria.

I think that more needs to be done around supporting older people; I do not think enough focus is given within this place or within the general community.

If I can send one message out to the people of Victoria: do not be afraid of visiting somebody in aged care. It is perhaps one of the most inspiring places that you can go to hear stories of what people have achieved over their lifetime, what is important to them and what they are most proud of. It is something we can all reflect upon, it is something we can all learn from and it is something that we can take in our own life and our own journey to make sure that we can make the most out of our time on this earth.

There are of course issues around this legislation; I have gone through those. But again, thank you very much to everybody who works in aged care. Thank you to our researchers, who are doing an incredible amount of work supporting better medications to make sure that the impacts of chronic disease in particular are held off for longer, that we have better health outcomes and that it is not just about quantity of life, it is also about quality of life. That is what aged care can deliver in the best possible way.

Michaela SETTLE (Eureka) (17:26): I am very pleased to rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. I am very pleased to support this bill. I think, as many before me have said, aged care is something that is so incredibly important to all of us and to our community. We have an ageing population, and the calls on the service for aged care are only going to become greater as we see that population come through. As someone with ageing parents, it is something that I am pretty alive to. You want the best for your family in their later years, and you want to make sure that the facilities and organisations are at the very best standard.

I would say that this government has done quite a bit in this space, and this bill is another example of our awareness of this sector and the importance of this sector. In addition to this bill, we certainly did some huge investments in the 2025–26 budget to bolster public sector residential aged care services, and I think that is so important. If we think back to COVID, the real difference that we saw in aged care services was that the public health services really stood out in that there was no loss of life. In many ways I think that can be attributed to the really important work that this government did around nurse–patient ratios, which also covered off aged care workers. It was such an important piece of legislation to make sure that people that were in those services knew that they had enough staff on hand to care for them.

In addition to that of course we had the ageing well action plan 2022–2026. That was introduced under this government and really sought to look at reducing ageism, fostering intergenerational ties and ensuring that accessibility to services. So it is clear to see that this government has a really strong commitment to supporting this sector and has done so in many ways. I know in my own electorate that Grant Lodge in Bacchus Marsh have been there for many, many years and provide a really, really important service to our community.

I think something I would say in addition, as a regional MP, is that those services locally are incredibly important because you want to be able to continue to see your loved ones and to go and visit them when they are in there. I guess if you live in metropolitan Melbourne, there are many options, and you can hop on a tram to go and visit your family. But for us in the regions it is so important to have those services close to home so that we can really keep that connection with them.

Grant Lodge in Bacchus Marsh has been there for many, many years, and I was so pleased that in 2021 they received $5.5 million under the Regional Health Infrastructure Fund to develop it. I was even happier when a year later, in 2022, the then minister, Minister Carbines, invested a further $3.75 million. Those investments, which obviously round up to nearly $10 million, meant that we could really have a high-quality facility in Bacchus Marsh that was dementia friendly but also served the staff and the wonderful nurses that work there. It gave them better spaces in which they could work. I think on this side of the house probably one of our most motivating drives is to care for the most vulnerable in our communities. We do that in many ways across many different policies, but certainly the investment that we have made into aged care is a continuation of that really deep value that those on this side of the house hold.

To go to this particular bill, again I would say it is really about protecting our most vulnerable, our older Victorians in residential care. There are many more people entering aged care, but they are also entering later in life. While that is a wonderful thing that people can stay at home a lot longer, it does mean that they are presenting to aged care with much more complex medical needs. I think we have heard this statistic before, but one in three residents are on nine or more medications. I understand that it is one of the highest rates of polypharmacy in the country. So while I am delighted that we have these medicines available, it is a complex space, so it is important that the people that are administering them are really aware of contraindications and all of those sorts of things.

My own mother has been diagnosed with lung cancer, and she is on a range of different medications. Recently, quite weirdly, she got a Buruli ulcer. Apparently they used to be called Bairnsdale ulcers. It was quite a scary ulcer, but what was really scary going through that process was that the medication she needed to treat the Buruli ulcer had a detrimental effect on the drugs that she was taking to manage her cancer. She is 86, and you get to that age when those contraindications can be fatal. You know, your body is a little bit less robust. So it is so important that we have people that really know what they are doing administering those drugs. This bill ensures that only qualified registered and enrolled nurses and other authorised health practitioners can administer schedule 4, 8 and 9 medications. This is going to reduce the risk of medication errors and inappropriate use, which is really about protecting the older people in our community. It is commencing in July 2026, with a 90-day grace period to support implementation. It is important also to note that there is flexibility for unforeseen emergencies like sudden staff shortages. We are making sure that we offer the best care we possibly can.

Like others before me, I would like to acknowledge the Australian Nursing and Midwifery Federation and all of the work that they do in supporting our wonderful nurses. They are a fabulous union who have worked really closely with government to ensure the best outcomes for their members. All of their members want the best outcomes for their patients, so when they have come to us in the past seeking support, it has always been with an eye to the outcomes for the community. I think the nurse–patient ratio is an extraordinary example of that.

It was not about just getting jobs for nurses, it was about making sure that people in our health system were getting absolutely the best care that we could offer. So I certainly want to take a moment to really thank them for all of the work that they have done in this space.

As I say, this bill recognises the skills of our nurses and strengthens their role in aged care. Of course, again, this government has gone in with real support with things like the free TAFE nursing courses to grow our pipeline and of course the pay rise that the ANMF negotiated in their recent enterprise agreement. Whilst these things might seem outside the bill, they all go towards creating a health system and particularly an aged care system that will offer the very, very best to people in our community as they enter their sunset years. It will happen to all of us, and so I think all of us are beholden to make sure that we have the very best care in our community for the people that have given so much to our community.

Wayne FARNHAM (Narracan) (17:36): I am pleased to rise today on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. I do not think we could make that title any longer; I think that is about as long as we get. Right from the start I will say we do not oppose this bill. As previous speakers have said – and I will just touch on what the member for Eureka said as well, because I agree with her 100 per cent on this issue – it is incumbent on this government to look after the most vulnerable in our community. I think everyone in this chamber agrees on that and that is an absolute no-brainer.

The bill seeks to amend the Drugs, Poisons and Controlled Substances Act 1981 to strengthen medication safety in aged care settings by ensuring clinical responsibility for administering specific medicines rests with qualified health professionals. The bill updates the legislative framework governing medication administration in residential aged care facilities. Only registered and enrolled nurses or other health professionals, such as doctors and pharmacists, may administer prescribed drugs of dependence in schedules 4, 8 and 9 medications. Ultimately this amends and aligns the bill with the national aged care standard and a number of critical Commonwealth government reforms.

Before I actually get right into this, I will shout out to our aged care workers, who are phenomenal. When our parents get to that age and we put them into these care providers, we want the best care for them, and especially our aged care nurses do a fantastic job – they do. When you put your parents in there, you know you can go home at night and have a decent night’s sleep because you know they are getting looked after properly.

I have listened to a bit of the debate today, and it has been interesting. We talked about administering medication now only being done by qualified people. It has been pointed out a few times – and I did not know this statistic – that 36 per cent of aged care residents have nine pills or more. I will tell you a nickname we had for my dad was Tic Tac, because he used to take that many pills that he used to rattle when he walked. He took a lot of pills, poor old George. I was actually glad that someone was there to help administer his medication, because he was taking a lot of pills. He would take pills to make him do all sorts of things towards the end of it there, and the nurses, again, were absolutely fantastic.

There are a couple of things here I just want to touch on. The last data I can get – and this has probably been updated, but I have got data from June 2022 – says there are about 178,000 permanent residents in aged care and about 7400 respite residents. That is a lot of patients, and it has probably increased a little bit, I imagine, since 2022. But that is a lot of permanent residents.

When we talk about medication, it is very important that it is administered properly. We do not want mistakes to be made and people to suffer. But one thing, especially in regional Victoria, and the member for Eureka touched on this as well, is the nurse-to-patient ratio. We do not always get that in regional Victoria. Even with this bill going through – and I understand the intent of the bill and what the bill is there to do – (a) we are not always going to have those nurse-to-patient ratios, but (b) we may not always have the qualified people to do the medications. That is very problematic in regional Victoria. There are a couple of things around regional Victoria: We already have a shortage of beds. That is problem 1. Problem 2 is getting people to go to regional Victoria and retaining those people in these regional areas, whether it be Warragul or Warrnambool for that matter.

It is very hard to keep highly skilled people in these regional areas, which leads me to the next point. I believe that in the bill briefing the question was asked, basically: if a qualified nurse or a doctor or whatever is not there, what are the legal implications of this? What are the legal implications if someone is not qualified to administer the medication? This may not be anyone’s fault other than a lack of staff or a lack of resources in these areas. I do not think that question was answered appropriately. I do not think there was an answer for it. I think the government needs to think about this and maybe have some sort of backup plan, because I do not think you are always going to have the staff there to do the job, and the patient will still need their medication. Maybe we have to look at training more nurses or more people to be better qualified to do this. But there was no real answer to the question, when it was raised, of what the legal implications would be if the problem arises in administration of specific medication. I think the government needs to have a look at that.

It is okay to bring the bill in, and we support the bill; there is not a problem there. But sometimes there are unintended consequences with bills as well, and these things hopefully get ironed out as these problems occur. Not even government has a crystal ball, to be fair, and when problems occur, then then we need to have a solution to those problems. I think the government needs to look at that carefully, especially when we talk about shortages in the aged care sector. The aged care sector is one of our largest sectors in Australia, and it is only getting bigger. It is not getting smaller, because like you, Acting Speaker Mercurio, we are all getting older, and unfortunately one day we will probably end up in aged care as well. By the time you and I get there, hopefully we have got it right, but I think the government needs to bear those comments in mind. When we talk about aged care and how big the sector is, it is no more important than in regional Victoria, and I know we have shortages in my electorate. Even with the new West Gippsland Hospital, whenever that decides to get up and going, there is aged care in that facility within that area.

The problem we have got now at the moment I will put forward in a meeting with the Minister for Health Infrastructure in the next sitting week, which I am very appreciative of. When I am talking about the West Gippsland Hospital, aged care and also training, there are two components of this hospital that are a federal responsibility, which are aged care and training, in the funding model. Unfortunately, we know the government is under financial pressure. We get that. We hear it all the time. What I do not understand is why the government has not gone to the federal government to contribute to this hospital, to stump up the money that they are responsible for. In the case of West Gippsland it is about $200 million. It is a significant amount of money. I would actually urge the government, if they are struggling to get the project started because of financial constraints, to go to the federal government, go to the Albanese government. We hear often ‘They’re our friends in Canberra.’ Well, make your friends stump up the $200 million, their share of the hospital. Take the pressure off the state. Make the feds contribute what they are meant to contribute. I need this aged care facility within this electorate, but it is no good to me if no-one can start the project because of a lack of funds.

So do not be a martyr with the system. Go to the federal government and get the money that they are required to actually put in, and then we can get this hospital started and I can have quality aged care in my electorate and have more people trained, more nurses trained, because training is part of it. This is part of the problem – that we do have a lack of trained nurses. So why doesn’t the state government go to the feds and ask them to stump up their responsibility for the West Gippsland hospital, take the pressure off the state and get these things started?

As I said at the start, we do not oppose this bill. I know everyone in this chamber believes we do have to look after the most vulnerable in our community, and I can appreciate that is what the government is doing with this bill. There are a couple of issues around shortages, and I probably think the government is aware of that. As I said, the only point is if it is administered, how you are going to deal with that.

Bronwyn HALFPENNY (Thomastown) (17:46): I would also like to rise and speak in the debate on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. This bill that we are debating has what was in fact an election commitment by the Labor government in 2022. It is also to address a problem that was highlighted in the Royal Commission into Aged Care Quality and Safety a number of years ago – I think it was just during or around the time of the pandemic. It also supports the work of nurses and increases the training and the skills within the aged care setting, because aged care is something that is growing in Australia as the population ages. People do not go to aged care unless there is a requirement to and it is due to some medical condition or a situation where perhaps it is no longer possible to be cared for or for them to care for themselves in their own home. But that does not mean that they should be going into anything substandard. It ought to be good quality care.

I know that there are a number of aged care facilities in the electorate of Thomastown that really do care. They are very professional, and they provide a lot of support for those that are living in those facilities. I hear a lot of stories from families who are also very happy with the care that their ageing relatives are getting. But as with anything in these areas, you also get providers or operators that really do not always have the best interest of those in their care and are really just using their operation as a money-making exercise to take as much as they can rather than to have any sort of pride or commitment to caring for older Victorians. We need to continue to be vigilant and ensure that we have good, strong legislation making sure that these places have good quality care as well as supporting residents and getting rid of those that are not so good.

It just comes to mind the Epping Gardens aged care facility and the terrible things that were going on there during the pandemic and the way people were treated in there. It was just something that none of us even want to think about or go back to. We saw a lot of deaths in that facility. It was all over the media because of the lack of care that was being received. In fact it was the Northern Hospital and nurses from the Northern Hospital that actually had to go in and run that facility and care for the residents. Many of them were absolutely devastated by what they saw and also had a lot of issues afterwards. But anyway, that facility now is up and running and much better than it was.

I think when we look at the regulations and how aged care places need to run, this bill is another step in a very good, right direction because it is all about making sure that residents are safe. At the moment, prior to this legislation being implemented, careworkers, nurses or whoever is there is able to give medications. Of course some of these medications are very addictive, they are strong and they ought not to be taken with other medications, and you need a lot of skill and knowledge in order to make sure that when you are giving such medication you know that you are doing it in a safe way. In some of the statistics that other speakers have mentioned, I think it is something like 20 per cent of hospital admissions from aged care are due to medications being given in a wrong way – either there is something wrong with the way the medication is being delivered or there is an adverse reaction from the resident. If we provide skilled workers, such as enrolled nurses, to give this medication – they have had many years of training in administering medication as well as caring for patients in health settings.

There are particular drugs, and they are drugs of dependence and schedule 4, 8 and 9 medications, that when this bill is implemented will have to be administered by nurses. But that does not mean that some of the over-the-counter drugs will not continue to be administered in the way they are now, and this legislation will not have much effect. While we are talking about nursing staff administering medications, there was not that long ago federal legislation to ensure that there should be nurses actually employed in aged care facilities, because in the past we did not even have that standard. It is really important to make sure that residents in aged care are not just being cared for in terms of their daily needs. They are there because of, in most cases, complex health issues, and so there needs to be the proper attention paid to those matters as well. You really need trained health professionals in order to do that.

[NAME AWAITING VERIFICATION]

That is not to take away from other staff that are not nurses. Many of them do such an incredible job. They really care. They are very caring, gentle and patient and of course they love what they do. For example, there is a young woman in the Thomastown electorate, Shakira, who has just successfully completed her My Aged Care support worker training, and she is just about to start her career working in aged care. Good luck to her, and I know anybody that she will be caring for is a very, very lucky person because she certainly has the empathy and the concern. Also she would be a lot of fun and hopefully will get on well with everybody that she meets.

When I look at some of what this legislation is doing, this is just one area of many. We are trying to make sure that the aged care area is one that works well and is in the best interests of residents. It also builds on things like what we are doing in terms of building up the nursing workforce, ensuring that there is proper pay and equal pay within the nursing professions and also greater emphasis on nurse practitioners. All of these things help us to address some of the challenges we have in the health areas where there is a lack of GPs and other professionals. We are taking action to ensure that we do build up the workforce and that we have the staff to do the work that is required. I know that there were some concerns, for example, about whether there will be enough nurses in order to do this work. Just on that, as I said, we are building up the workforce. Similar things were said when the federal government introduced legislation requiring nurses in aged care places. Requirements under this piece of legislation will not come into effect until 1 July 2026, and there is also quite a bit of lead-up time where there will not be any enforcement action taken, to ensure that aged care facilities can actually implement and have the time to put in place what they need to put in place. If there are issues, they need to raise those issues so they can be addressed.

This legislation will also be reviewed five years from the date of implementation just to make sure that it is working as it should and if there are any other issues that will need to be addressed. Of course the Allan Labor government is always up for doing that. We always want to do things the best way we can, so it is always important to have reviews in order to ensure that the legislation is doing what we want it to do and that there are no unintended consequences and no other ways that it could be done better.

This is one further step in protecting elderly Victorians in terms of making sure that their medication is administered by properly qualified and trained people, and by doing that of course we are trying to prevent adverse events. I know many have had to go to hospital for something like this when we already have very full emergency departments, so of course this is another step in the many actions that we are taking in order to address those problems too.

Roma BRITNELL (South-West Coast) (17:56): I speak today on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. This is a bill that will seek to amend the 1981 act to ensure that only registered nurses, enrolled nurses or other authorised health professionals such as doctors and pharmacists can administer drugs of dependence and schedules 4, 8 and 9 medications in aged care settings. On the surface this sounds like a step towards improving medication safety, and of course we all want that. We want our elderly to be safe; we want medications to be managed properly.

Personal care attendants will no longer be allowed to administer these medications, and this includes antibiotics. Some of these personal care attendants, who are often the locals in rural residential scenes, like where I live in South-West Coast, know their patients by name, they understand their routines and they understand their needs and their personalities, and they really are the backbone of our aged care settings. So I want to take a minute to actually acknowledge the great work they do. I was around during the time when we transitioned to personal care attendants in aged care facilities, because we recognise that it is a home environment; it is not a hospital setting.

As has already been said, as we age, the complexities of our health actually can result in medications of many, many tablets, but I want to just take a minute to acknowledge that it does not seem the best use of registered nurses’ and enrolled nurses’ time to be administering Webster packs. For those that do not understand what a Webster pack is, you go to the chemist, and the chemist, under the instruction of the doctor who is prescribing the medication, puts in the pills and the day and the time of the day so that they can just be administered by popping out the medication. In an aged care facility you often have people who do not remember where they are, like dementia patients, so you cannot leave medications laying around. So often the personal care attendant will just assist the patient – or the client, or the resident – to pop the pills out. That is something I do not think we should lose. Obviously we are talking about antibiotics, and they can be put in these Webster packs by pharmacists and prescribed by doctors very adequately, and also things like Palexia, which is a schedule 8 but can be given bd, twice a day. I think with some of these changes, whilst I understand the royal commission’s findings and the intent, we do not want to be tying up staff when it is not as necessary as it is when a patient is going through a change and needs something like an endone administered for pain or morphine when it is in a pump in a palliative care setting, for example. Those are the things we do want the registered nurses freed up to be able to do. So I want to take a minute to just acknowledge the great work that the aged care facilities do in providing a home environment – and let us not forget the human cost.

In Terang, a town of 2000 people, there is actually a real deficit of aged care beds, and there is actually no respite available. This is as a result of the May Noonan facility being sold and losing the aged care beds from Terang.

The nearest option is 25 kilometres away, and the government, when I spoke to them about the need in Terang last time, said, ‘Look, it’s all sorted. We’ve been doing a great job. We’ve got beds in Cobden and Camperdown,’ which is quite a distance, and it is not recognising the realities that the families and the spouses do not do any business in those towns. That is not where the community of interest is; the community of interest is in Terang. So often family members are saving the government millions of dollars by caring for their loved ones at home, but they need looking after as well. They deserve support, and they deserve access to respite. The government can assist this by giving Terang hospital funding to provide respite beds and help the people in Terang.

Just last week one of my own family members in Terang had to move into aged care down in Cobden, and it is terribly traumatic for the family. The family members that I am talking about have been married for over 50 years. Visiting involves a treacherous journey on a poorly maintained road full of potholes. For an elderly person, as in the case of my family member, this seems cruel and actually almost irresponsible. But why shouldn’t they have the right to be in the relationship they have been in and support each other in their older years? I spoke to Eve, a community member from Terang, last week, who begged me to tell the government that the effect this is having on her community is very significant, and she actually rightfully said it is a form of elder abuse to break up these homes and force people into these situations and not understand the country environment.

Health services in the south-west really do need funding, just like other parts of Victoria. For example, we have a Lookout facility proposed for drug and alcohol rehabilitation, and the committee who sit with the Warrnambool regional alcohol and drug centre have been working with the government, doing everything they believe that the government have asked them to do and jumping through every hoop over the last eight years to be eligible to get funding. Yet last week the Minister for Mental Health Ingrid Stitt visited and said she was proud of the collective push of the community for this proposed service. I felt it was really patronising. She actually said:

We’re proud to support WRAD and the work they’re doing with their community and Traditional Owners to plan for the region’s first residential rehabilitation service.

As I said, this rehabilitation centre was shovel-ready 2½, three years ago, and the government kept putting more obstacles in front or changing goalposts. It is really insulting, and then to give them $100,000 – it is like me giving my child $5 as a reward at 30 years of age. It was just such a minuscule amount of money, which was supposed to go towards a feasibility study. Well, the reality is we do not need a feasibility study. It is quite clear, the demand for drug and alcohol rehabilitation in South-West Coast. It is now the only place without a funding commitment or a facility, and we have just had the record overdoses and deaths in South-West Coast. We do not need another feasibility study. We do not need more people dying from overdose. We need all the hard work that the committee of Lookout have put in to be recognised and the facility to be built, with no games being played about where it can go and where it cannot go, no games around more hoops and no patronising words about how proud the government is of all the work that has been done – just getting on and doing it.

Back to the bill: I support medication safety and I support clinical oversight, but I do not support legislation that is rushed. In the bill briefing we asked a question about what will happen in communities like mine where we just do not have the staff. I sat on a perinatal inquiry in about 2017, where we identified that there will be a very large shortage of nurses, and perhaps if the member for Frankston is awake he might remember that we identified quite a few deficits that will happen in the future in health needs. This has not happened in the last few years; this has been going on for 10 years, and I am not seeing the workforce planning. I hear from some of the members recognition that there are 600 nurses or 650 nurses that will be needed to fill this deficit, but this is something we are just not seeing addressed in South-West Coast. I am not seeing the incentives offered, and therefore continuity of care is very difficult in aged care facilities. I have nursed in these facilities. My mum is in an aged care facility and my dad died in an aged care facility last year, so I have been very much at the coalface for some time now, and they do a wonderful job under extraordinary circumstances, but having enough staff to be able to administer the medication when needed is one of the challenges.

I am not sure if we have got a bill in front of us like we have now that does not have any answers to the questions we asked about what will happen if they cannot actually meet the requirements of having the right ratio of staff or the right qualification of staff. What they said was very ambiguous, actually. They would not actually fine people, but there could be a fine, and that fine could be up to $120,000. Is it the staff that are fined or the facility that is fined? They said, ‘Well, we’ll just put an educational focus on it.’ What is the point of the legislation if there is no actual change that can be identified from the changes that are being made? That was really what we were told during the bill briefing.

I do support this legislation, because it is something that needs to happen, but it just does not have the consequences, it does not have the support. It needs to be considered with proper consultation with the sector to get an understanding of what they need, backed by real workforce planning and investment, not just penalties and promises. This is another example of this government trying to look like they are addressing issues but with no real solutions that will work in the real world and certainly not in South-West Coast.

Our aged care workers deserve better, our elderly residents deserve better and our communities deserve better than a government just doing token-gesture bills like the one we have here.

Sarah CONNOLLY (Laverton) (18:06): I too rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. It is great to hear the member for South-West Coast say she will be supporting this bill. I might remind the member for South-West Coast that almost for a decade we had a federal Liberal government who did absolutely nothing in this sector. I know this because my long-suffering mother was working in the sector for that decade where workers and homes were absolutely falling down around the ears of that federal Liberal government, and they did nothing. It was not until an Albanese Labor government was elected and the Honourable Anika Wells became the Minister for Aged Care, got off her butt and started doing things in that sector, that something was done. So I am really pleased that the member for South-West Coast is going to support this bill, but saying that this side of the house and Labor governments have never done anything to reform this sector is absolute and utter nonsense.

The aim of this bill is to make a number of important changes to the settings that govern our state-run residential aged care facilities here in Victoria. At the core of this bill is the principle that older Victorians living in these residential aged care settings deserve quality care. I am pleased to say that compared to the privately regulated aged care facilities, our state-managed care facilities, of which there are about 180 here in Victoria, outperform the private sector again and again. We certainly saw that during the height of the COVID-19 pandemic.

It goes without saying that an important part of our aged care setting is the administering of medication. For years I had conversations with my mother about the settings in New South Wales in which to prescribe medication to elderly residents. These were people who live in the facilities and experience all kinds of vulnerabilities and conditions, things like Alzheimer’s and dementia, that mean some of those folks require extra assistance in taking their daily medications. My father-in-law has recently been diagnosed with Alzheimer’s. He is taking stroke medication and blood pressure medication and the whole gamut, and he requires assistance from my mother-in-law to help him on a daily basis take all of that medication. When you go into an aged care facility, quite often residents do need that kind of assistance as well. What we know is that, according to the Pharmaceutical Society of Australia, about 20 per cent – one in five – of unplanned hospital admissions from residential aged care facilities are the result of inappropriate and unsatisfactory medicine use. We also know that the Royal Commission into Aged Care Quality and Safety clearly identified that medication management and safety is a key area that needs improvement. That is what this bill is doing here in this place this afternoon.

We heard reports of medicine not being administered correctly and residents being given medication with no oversight to ensure that they actually take them. I know that here in this place we can agree that this kind of neglect is just simply unacceptable in any form of aged care setting. We know that in our aged care facilities here in Victoria about 36 per cent of residents are actually prescribed – get this; this is just so many tablets – more than nine medications, and that is the highest rate of polypharmacy anywhere in Australia. About 19 per cent of residents are prescribed antipsychotics, which, if not managed correctly, can present major risks to the safety of residents and also to the safety of staff – such as my mum, who has worked in those facilities.

Fortunately, we have seen the federal government make some really positive improvements to the aged care sector since the royal commission handed down its recommendations. Mandatory care minutes were introduced so that residents have an appropriate amount of dedicated care time, which includes 44 minutes with a registered nurse. The federal government have also reformed funding to the sector through a new funding model that gives providers greater clarity over the funding they receive. In fact one of the things we are hearing is that these changes are actually delivering better outcomes for aged care workers themselves. We are hearing it is becoming faster to attract and keep aged care workers. I will say that that is a stark contrast from the disaster the industry was in under the previous federal Liberal government that led to the royal commission’s initial report simply titled – remember this – Neglect.

As for our government, we here in this state have been working on reforms in this space for much longer, and that started back in 2018 with a review of the administration of medication in residential aged care settings. What this review went ahead and identified was that there was room for improvement in this space to meet basic practice. So in 2022 we undertook sector-wide consultation to strengthen medication management and administration in our state residential care centres. We consulted with unions, with providers, with personal care workers and, most importantly, with those with lived experience in care. I think it is quite often forgotten that for those in aged care facilities, it is not an aged care facility to them; it is their home, it is their bedroom and it is the place where they are going to see out the end of their days. We needed to be able to consult with them, and we did.

What this bill delivers on is it makes a number of critical changes in this sector, which will come into effect by July next year, in order to give the sector the time it needs to adjust or make workforce changes. What this bill will actually do is place a requirement on all Victorian aged care providers to make sure that only registered and enrolled nurses can administer prescribed and dispensed drugs of dependence, as well as schedule 4, 8 and 9 medications. In addition, the bill is going to go ahead and allow for regulations to prescribe any exemptions where this obligation may not apply, as well as how these circumstances, most importantly, going ahead should actually be managed.

The regulatory framework is not something that we have made up. It has been implemented based on the feedback we have heard from the industry, which is that we need to account for unforeseen circumstances that may limit nursing ability. We are talking about things like serious residential emergencies, temporary unexpected staff shortages or other factors that may go ahead and impact the ability of nurses to administer that really important medication on time. This does not always cover insufficient nursing all of the time, but it does account for those unplanned situations that can happen in these settings, and there will be no need for providers to go ahead and seek an exemption.

What I will say is that registered nurses – and my mum actually used to be one, until she gave up being a registered nurse to become a family day care worker when she had children; she could not do the shift work as a registered nurse, having given birth to me and with her husband being a milkman – are the ones that work regularly in aged care settings. Mum would often comment that in New South Wales those registered nurses would come in and dispense the medication. They are also equipped with the skills and the training to administer medications safely.

That is just so important when you are dealing with elderly people who are vulnerable and have all kinds of challenges ahead of them and that they are experiencing based on their age. The skills and the training to administer that medication safely are so important. That is something, as any aged care worker will attest, that aged workers do not always have experience in. My mum said in her experience a lot of aged care workers quite often did not or would not have the confidence to administer those drugs at the levels and the volumes that people needed to take them. They did not have the confidence to go ahead and actually administer them in the first place, so it was a no-brainer to have the registered nurses come in.

I do want to give a big shout-out, in summing up in the last 40-odd seconds, to the aged care workers. They do a really tough job day in, day out. They often do not get thanked. They have to deal with immense challenges. I know that there is job satisfaction; people that really enjoy being there and enjoy that kind of work get immense job satisfaction in looking after our elderly, quite often at the end stages of their life. Like I said, some of them are facing significant challenges when we are talking about Alzheimer’s and dementia. They get to know the families of their aged care residents. I know my mum felt very deeply and was passionate about the work that she did, which is why I wholeheartedly commend the bill to the house.

David SOUTHWICK (Caulfield) (18:16): It is my pleasure to rise and speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025 dealing with residential aged care. Can I begin by just acknowledging the great work that many of our aged care facilities do in my electorate of Caulfield.

Only a few weeks ago as part of aged care worker recognition day, in fact on 7 August, I had the great opportunity to go along with Ageing Australia to attend a couple of our residential aged care facilities and see firsthand what they do. There were two facilities that we joined to recognise workers and carers, provide wonderful birthday cakes and reflect on some great stories. The first was Jewish Care. Jewish Care do an amazing job. We had the opportunity to talk to many of the staff that unfortunately are under-recognised, that would probably be the best way to describe it, in terms of what they do. But I must say the people who do recognise them are many of the families. I did have a family member come up to me during that visit, and she just said, ‘I want to thank the staff and thank you’. When she goes home of a night, she knows that her mother is safe, because they have the care and the support around them.

We then went on to a second facility in Calvary Bethlehem. Now, Calvary Bethlehem is a facility that used to deal just with end of life. It is a fantastic facility that is now taking people on a journey from early retirement all the way through to end of life, through all of those moments along the way. Again, listening to the programs, talking firsthand to the staff and hearing some of their stories was just an amazing thing. I know we all get the opportunity to do that as members of Parliament, particularly when you have got a recognition day where you can understand and support and hear the stories. We had many of the residents come together with the workers, and the residents and families said thank you.

What this bill does – and I was going to get on to the bill – is ensure that we have a tighter framework around medication within our aged care facilities, which is absolutely important. Many of us that have had or currently have ageing parents know how important it is to make sure that their care is absolutely a number one priority. Particularly when you think of the lives that our families, our parents, have given and what they have contributed along the way, at their later years in life we want to make sure they are supported and cared for. For many of us it is the first journey. I know for me, going through with both my mum and dad, who ended up in a local facility called Arcare – firstly in Arcare in Brighton but later on in Arcare in Caulfield, literally just at the end of my street – to see the work that was done was absolutely important.

We talk about the medication. As a carer for my parents, it was often my responsibility to organise the medication and to make sure everything was done properly.

But of course you would often wonder about all the tablets and the medication and what was being prescribed. I think any safeguards we can make to protect our loved ones we should be supporting and we should be encouraging, and that is why the opposition certainly support this bill.

At the moment I have my father-in-law in another facility in Monash, also in my electorate. Again, these are unbelievable facilities. These are places which have full wraparound support. My wife goes in on a daily basis to see her dad. I think it was only yesterday they were going through, and they have a news and sports round-up and they get an expert to come in and talk about sport. They read the papers about what happened and their favourite football teams and everything else. I actually rang her yesterday when all that was happening and heard my father-in-law in the background.

Again, it is just so important to make sure we get the care right and to have the framework in place. The bill amends the Drugs, Poisons and Controlled Substances Act 1981 to strengthen medication safety for aged care; to ensure that there is a framework for governing medication; to ensure that the legislation fits into a national framework; to make sure that there is clinical governance around the framework and that there are proper, accountable processes in place; and also to ensure personal care workers will no longer be able to administer drugs of dependence in schedules 4, 8 and 9 in the medication of aged care residents. This is really important because the personal care workers do an unbelievable job – they become almost part of the family – but you want to make sure that there is a framework around some of this care. The bill also addresses the risk of harm from the current practice, which allows personal care workers without the education and regulation of a proper registered nurse to administer high-risk medications. Again, this is often just about awareness and it is often about education, and that is why we need to make sure that there are proper parameters of support around that.

Interestingly, looking at the bill, some of the statistics absolutely surprised me. Thirty-six per cent of Victorian aged care residents have been prescribed nine or more medications, and 19 per cent take antipsychotics. That is a big number and a big amount of medication. As I said earlier, watching Mum and Dad and the amount of different medication and tablets that they are on and just having to manage that – I actually remember a story where Dad had one of his moments and he said, ‘Right, that’s it, I’m not taking any more medication,’ and we had to manage that. The next minute my dad rang my brother and said, ‘Get me out of this place.’ Next minute I went to go and visit Dad. He was not at the aged care facility, and my brother had kidnapped him – well, not kidnapped him; he had taken him because my dad said, ‘I want out.’ My brother took him to Yarrawonga because my brother lives up there, and my dad spent a lot of time in his life in Yarrawonga. For three days my dad had the best time of his life in those later years, going back and spending that time, but without medication. So he did not have his medication. He literally broke out of the aged care facility and had this three-day holiday, and then finally I called my brother and said, ‘That’s wonderful, but we’ve got to get him back.’ So we got him back in the facility, and by about that stage he did need his medication again. So we got him back on the medication and everything was all hunky-dory. But it was really interesting to think, in a very nervous way, that he had been living on medication for probably 15 years – all of these tablets – and he was just going to be completely free of that, free of the aged care facility and enjoying life in those later years. It was a nervous period, but reflecting on it now and just the fact that we were able to have our father enjoy those really important moments, I am sure that will be a moment that my brother and his family will cherish forever, being able to enjoy that.

Just in finishing, again, I want to give a shout-out to all of our aged care workers and all of the facilities. As I say, we are very lucky in Caulfield to have A1-standard facilities. We have lots of choice, both in Jewish and non-Jewish facilities – Emmy Monash, Jewish Care, as I say, Calvary, Arcare and a number of others that do a wonderful job, an amazing job – and we are seeing things evolve.

I think probably the most difficult thing that we still need to focus on is staffing, because it is a real issue, getting staffing and attracting staffing. I think the government could absolutely do more to ensure that we get more staff into aged care facilities, have some more training programs and particularly for people coming from overseas ensure that they are able to come and work in some of the facilities. That is by and large a bit of a federal issue as well, but we should be trying to support whatever we can so we do not have under-resourced facilities. We should be supporting our workers in health care in any way we possibly can. That is why we on this side will be supporting the bill before the chamber.

Paul EDBROOKE (Frankston) (18:26): Can I first just go on the record as saying my thoughts are with the entire police family tonight. We have all spoken before about how dangerous their job is, how unexpected things can be. Even a run-of-the-mill traffic stop can turn into a very serious incident, as we have seen today. Without saying too much and without knowing too much at this stage, some police officers in their duty have been fired upon and we have had tragic circumstances, so our thoughts are with them tonight. I know that everybody in this chamber is united in that and has our solidarity. It is always very shocking to hear, and I am sure it has rocked a lot of worlds up at Porepunkah too. It is such a quiet, beautiful place up at Porepunkah and Bright – I love that area – and unfortunately now it has changed forever. I wish the police who are active on duty at the moment hunting this person the very best overnight and for the hours to come.

Just on this bill, I was sitting here listening to people on this side of the chamber and the opposition as well, and I think there is some commonality between this bill and the bill that we spoke about earlier today in regard to the working with children check, and that is that our work is never done. Our work here is constant, and these bills are the result of constant diligence. They are the result of measuring issues that come up and then managing those issues, but it is a reminder that our work in here is never done. It is not a case of coming in here, passing a bill and saying, ‘Yep, onto the next one. What is the next problem?’ It is a case of consistently monitoring the environment, policies and laws that affect the most vulnerable people in our community. As technologies change, as our communities change, our diligence must increase as well.

It has been really interesting hearing some of the stories from people on both sides of the chamber, and I cannot help myself; I will add to those. I, as a firefighter, went to many retirement homes and retirement villages. I love old people. I think we do not have to learn the lessons –

Steve McGhie: You’re not old.

Paul EDBROOKE: I love Steve McGhie. I love the member for Melton. Anyone with a pensioner card is my mate. You do not have to live the lessons that they have learned. Honestly, some of the stories you will hear are just wise beyond words, but they are also very funny as well. When you go into a retirement home with a couple of hoses and a breathing apparatus on your back, often people want to pull you up and tell you jokes and everything. One that sticks with me – and I will get to the bill in a second, member for Hawthorn, so do not worry – was in Frankston South when we walked into a retirement village one day. As another member said, this is where these people live. It is their home. It is not just their house. It is not a retirement home. I guess I always saw it as a workplace, and we walk in. But this gentleman says to me, ‘Oh, do you know why the fire alarm went off, son?’ I could hear the fire alarm, we were looking around to reset it and everything, and he said, ‘Because the women in this place are so hot.’

Part of me was just like ‘Oh!’

Steve McGhie interjected.

Paul EDBROOKE: It reminded me of the fact that it is another stage of life. It is not a stage of life that I had considered until then, but it is a normal stage of life. I will talk to you later, member for Melton; I will get some hints on this. But it is a stage of life that we do not think about that much, because it is an uncomfortable truth that we hopefully all will get old – some of us will not, unfortunately – and we have moved away from getting old in situ with the extended nuclear family. Now people tend to retire – the empty-nesters downsize. I see you looking at me, member for Melton. The way we do things has changed and so has the service we provide people who live in these arrangements.

Unfortunately, we saw some horrible home truths during the royal commission into elderly services. I mean, it was not a surprise to many of us. There are good operators and there are bad operators, public and private. I certainly remember with some of the nursing homes we went into it was almost like as random volunteer visitor who has to come in to check a fire alarm you would smell there was something wrong with certain places. You would see that there were not enough people on shift. You would see nurses checking whether people were breathing by putting a mirror in front of their face. Certainly the contents of this bill – it rings true that we have often not upheld the standards that we needed to in this sector.

This bill, going onto a state stream, goes a long way to making sure that we do uphold the highest standards possible for those people and their families as well, because let us not forget that it is a traumatic time for many people to be put in these arrangements – arrangements they need to be in for their own safety and their family’s safety. Whether it is a neurological issue or whether it is a medical issue, most people have been put into this arrangement and cannot live at home for a reason. It would be absolutely horrible to suggest to family members or even have that doubt that your mum, your dad, your uncle, your aunty or even the younger people who often are in homes for the elderly or retirement homes are not being looked after properly. To get to a stage that we need to introduce a bill that says only qualified people can give these schedule 9, 5 and 4 medicines says that something has gone wrong. In this case, we have measured what has gone wrong. We have seen it. We have got the data, and we have managed that issue as well.

I would like to know that when I get older or when my folks are somewhere where they need care, they get the very best of care – not someone who will not watch them swallow the pills, not someone who is not qualified to draw up a needle and give an intramuscular or intravenous injection. These are all things that require specialist skills. My daughter at the moment is doing paramedicine at uni, and it is only more than a year in that she has actually started giving injections. These are things for which you just cannot get someone who has done a certificate IV in community work, or whatever the qualification is, and say, ‘Because we’re short-staffed tonight, I need you to do this.’ That is an absolute recipe for disaster. I understand the pressure that puts on people; I understand the workforce pressures that have been mentioned as well. There are quite a few issues here that need to be dealt with, and they will not be dealt with with this bill. But what this bill does is set that standard and makes sure that we do meet the standard that we are setting. We do that by having things like free TAFE courses for nurses. We do that by making sure we monitor the Victorian Tertiary Admissions Centre system, encourage people from a young age to look at different careers, look at different streams and things they might like to make their career.

Certainly I thank the minister and her staff but also the Australian Nursing and Midwifery Federation. Like the member for South-West Coast, I was on that inquiry. I had the pleasure of working with some very, very experienced ANMF delegates, and I learned a lot.

I think they see it at the coalface. They do not have to hear from a 23-year-old person in the department that has been given a task: ‘We need you to create this to solve this problem.’ These people work this every day. They are at the coalface. They see the humanity of this, when it goes right and when it goes very wrong, so it is very, very important to listen to them and get that consultation piece right. In this case I think we did.

The Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025 is a bill that I think has bipartisan support across the chamber, as it should have. It has been very interesting hearing some of the stories. I am probably going to have to buy the member for Melton a bottle of wine after this, because he –

Steve McGhie interjected.

Paul EDBROOKE: Now he has perked up; he is looking like he is 50 again. But in all seriousness, the way we treat our most vulnerable people in our community, whether it be children, the elderly, people who are disabled or anyone else, is a measure of us as a government, indeed us as a community, and this bill goes a long way to ensuring that. I guess the reason I came to Parliament was to have bills like this and commend them to the house.

John PESUTTO (Hawthorn) (18:36): I am happy to rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. As others before me have said, we certainly will not be opposing this bill. I think this bill is a bit like the bill were talking about earlier – it touches all of us. It has been interesting to listen to the debate this afternoon and this evening from members on both sides of the chamber and to very touching stories about our parents and our grandparents. It affects us all. I think we all found the Royal Commission into Aged Care Quality and Safety very confronting, because we all know that if we have not yet reached that stage of dealing with our grandparents or parents, we will at some point. Some of the stories were quite harrowing, and whilst this bill does not deal with some of the more confronting aspects of the royal commission’s work, dealing with the qualifications, expertise and knowledge of those who are dispensing medications and administering them for those in aged care settings is obviously a crucial part of the reforms.

All of us, as I said, have our own stories. I know my siblings and I are going through this at the moment. Both our parents are living, I am happy to say, but one of them is experiencing quite a severe condition. It is something that as siblings – and I know we have all got our own stories – is very challenging, because you are often dealing with your folks, who for almost the entirety of your life you have seen as invincible and unbreakable, and you see them in a different and evolving light. It is very challenging I think for all of us to deal with that aspect. So I think a bill like this is something that we all come to with an understanding of how important it is to make sure that our parents and grandparents, and we eventually, will be receiving the very best of care.

I guess the key points that I want to touch on in my remarks tonight relate to how ready we are for this new system. I think it is important to ensure that nurses, both registered and enrolled, and doctors and pharmacists are sufficient in numbers to be able to meet the demand across the sector. I think aged care providers, the administrators, the executives who run both public sector and non-government sector facilities, the staff and the union leaders – everybody – have a shared commitment to ensuring that the very best of care is there. But there is little in this bill, I am afraid to say, that gives us an assurance that we will be ready for that by 1 July next year; it is not far away. There will be many parts of our state where facilities will simply not nearly be in a position to comply, not because they do not want to but because they will not be able to find particularly the nursing staff but also the medical and pharmacological staff who will be available on hand to deal with demand. And we know that demand is rising. We have intergenerational report after intergenerational report pointing out that our population is ageing – that is not likely to change any time soon – and the costs of providing aged care on our community will continue to grow. So as our population ages and as the costs of providing care rise, particularly where you have complex morbidities, evolving acuity and very diverse levels of acuity within a given facility, it is not going to be easy, particularly for regional and rural facilities, to provide that workforce need to cover off on that demand.

In this bill and in the materials that support it and in the briefing that has been provided, we simply hear that the government cites its free TAFE for nursing courses, which no-one is cavilling with. But when you have a predicted shortfall of nearly 700, which I think is lowballing the shortfall that we are likely to see, that does give rise to concerns, certainly on my part, that we are not going to have the workforce that we need. So it is a lot more than about the TAFE system. I think what the government needs to demonstrate is that the career pathway for people coming into the sector is such that we can attract and retain staff, and I am just not confident that we are going to get there.

Which leads to a second point that I want to mention, which is that if you concede that you are going to have shortages, what is the legislative and regulatory mechanism to accommodate that? What I would suggest to the government is that whilst we are not opposing the bill and we are not moving amendments, the explanation in the second-reading speech and obviously in the bill that is provided that there will be regulations published that can prescribe the circumstances in which people can administer medications where there are unplanned or unexpected shortages, I do not think will give facilities in particular the comfort that they need in the lead-up to 1 July. Even with the grace period, it is not going to leave them much headroom to plan for how they are going to manage that.

I think it is unfortunate that the government, with all the support that it has for this bill, has not seen fit to bring to this house a proposed regulatory regime that will accommodate those unplanned absences or those unforeseen circumstances – and we have to assume that they are going to occur. No-one is pretending that you can have a legislative or regulatory exemption for facilities that simply do not want to staff up. It is expected that, in a world where we want our parents and our grandparents to receive the very best of care, we want facilities to recruit the staff. But given that they are not going to be able to do that, I do not think it is satisfactory that the government says to this house and upstairs that it will make regulations in due course. People need to plan, and when aged care facilities, which are, amongst their many challenges, not least of which is providing the best care they can but also navigating through what is a complex set of financial arrangements with a mixture of state and federal government and sometimes local government funding streams – it is incredibly difficult for these facilities to be able to plan for how they are going to meet those unexpected needs, and they will be many and varied. It is not going to be a simple case of facilities not being able to recruit the staff in particularly rural and regional areas, but I would have to say in other areas as well – on the outskirts of metropolitan Melbourne I think we are going to see a similar phenomenon where they are going to struggle to ensure that there are qualified staff on hand all of the time. We all expect as a Parliament that very best of care, but we have always been willing to work with the government on a matter like this, where we can work towards ensuring that that regulatory framework exists. What I would say to the government is that it should demonstrate – despite the passage of this bill through this house this week – that it should work without delay to publish a set of proposed regulatory guidelines so there is a regulatory framework and a financial framework to ensure that facilities can meet the need as and when it arises.

I should say that in supporting this bill, I do not want those personal carers who assist so many people in our aged care facilities with their medications to feel like this is somehow a criticism of them, or a slight on them. They do fantastic work.

All but I dare say a very small number are so dedicated and should not be made to feel, with the passage of this bill, that they are not providing the very best of care. But the government might do well to work with that part of the sector to ensure that as part of the transition we are not going to miss things. Because at the end of the day – and I will finish on this – if this transition is not managed as best as it can be and you do have the uncertainty that will surround what is an unexpected or unplanned absence that justifies the administration of a medication by somebody who is not registered or authorised, let us remember that is a life-and-death decision and we need to equip those facilities with the powers that they will need to respond to those urgent situations.

We will not be opposing this bill, but I do not think the government should walk away from this debate thinking that it does not have urgent work to do. The bill itself is one part of it, but fixing that uncertainty is the other.

Steve McGHIE (Melton) (18:46): I rise to speak in support of the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. Firstly, I was out at an aged care facility only a couple of weeks ago to celebrate aged care worker day, and it was fantastic to be out there. I just want to pick up on one thing that the member for Hawthorn raised about personal care attendants. I think this is not about replacing them or whatever. This is actually about protecting personal care attendants in the treatment and support that they give to aged care residents and patients. I am sure that some personal care attendants have been put in positions where they have not wanted to administer some of the drugs but have probably been forced to do that, not knowing the ramifications of some of the drugs if things went wrong or if they happened to overdose the person. I think it does protect personal care attendants. They do a fantastic job, and it was great to be out there a couple of weeks ago celebrating aged care worker day.

This bill is about one of the most fundamental responsibilities that we have here in Parliament: ensuring that our older Victorians, who built this state – our parents, our grandparents, our neighbours and of course our loved ones – are protected. There have been many, many stories from all the contributions made on this bill about people’s experiences in regard to aged care facilities. Those residents need to receive the dignity, the safety and of course the professional care that they deserve in their later years. What must come first is the welfare of those people, and that is what this bill is all about – that is, making sure that those residents are protected. This bill enshrines a clear and important obligation that in Victorian residential aged care facilities only registered nurses and enrolled nurses or other registered health practitioners can administer certain classes of medications. Those medications might be schedule 9 poisons, schedule 8 controlled drugs, schedule 4 prescription medications or drugs of dependence.

As I have said, we have all had aged care experiences. Some will be because of parents or family members that are in aged care facilities. In my situation, I was a paramedic responding to aged care facilities for medical episodes. Some of those would have been due to the administration of medication where the resident had some negative response to it, whether that was because of an overdose or the type of drug they were given. It might have led to a fall of that elderly patient where they sustained a fracture. So my experiences in aged care facilities were as a responding paramedic. I have not had relatives in any aged care facilities. My parents did not live long enough to get to aged care, unfortunately, so I have not had that experience of having parents in an aged care facility.

This reform is not just a simple technical adjustment. It is about protecting residents, as we have said, from medication errors, upholding professional standards of nursing and responding to the longstanding calls of the aged care workforce, the unions and of course the families.

It is all about keeping faith with the commitments this government made, and it is about delivering on those commitments.

The importance of medication safety in aged care has been recognised for years now, and the 2021 Royal Commission into Aged Care Quality and Safety was unequivocal in its findings that medication management was one of the weakest links in that chain of care yet one of the most important things to maintain a patient’s health and welfare. The royal commission documented many cases where residents were given tablets without any oversight whatsoever, where medicines were administered incorrectly and where errors went uncorrected. Again, that can be under instructions. Whether it be a personal care attendant or someone else within the facility, they might have been given a direction to give a medication that they knew nothing about and known nothing about the ramifications of that drug and how they counteract the administration of any effects of that drug. So it was not their fault and it is not their fault, and it is not about patient care assistants versus nurses. This is about, again, the welfare and care of elderly residents. The royal commission showed that medication errors can be quite devastating in some cases. They can shorten someone’s life – they certainly diminish quality of life – and of course they can shatter a family’s trust in how their parent, probably, or grandparent has been treated within an aged care facility.

The reform was demanded by the industry and by, as I said, families and unions. I want to give a shout-out to the Australian Nursing and Midwifery Federation (ANMF) for their calls to ensure that only nurses with the training, the accountability and the professional expertise – and it does take professional expertise – administer medications in residential aged care. It takes many years of training for a nurse to become qualified, to be able to administer these medications, as it does for other registered medical professionals. One of those other registered groups in the future may be paramedic practitioners that may be called to an aged care facility, where they may have to administer some drugs. The professionalism of our registered medical professionals, such as nurses and paramedic practitioners, is second to none, and we want to maintain and keep that standard very high.

As I referred to before, this bill delivers on the commitment made by our government at the 2022 state election to the Victorian branch of the ANMF to amend the Drugs, Poisons and Controlled Substances Act 1981 so that only nurses can administer medications in residential aged care facilities. We made that promise, and we have stuck to that promise by introducing this bill. It is very important, because backing nurses means that we are backing safety – that is exactly what it is all about – and of course backing the unions means backing the voice of those on the front line. Again, I cannot thank the ANMF enough for their leadership and all of their members for the fantastic work that they do in making sure that people are safe and that their welfare is protected. They do an amazing job in many, many different circumstances under very trying conditions, sometimes, in aged care facilities. They do a fantastic job, but in all health facilities nurses do an amazing job.

Victorian residential aged care providers will be required by law to ensure that only registered nurses, enrolled nurses or another authorised registered health practitioner administers high-risk medications. As I said before, this could mean that in the future paramedic practitioners may be one of those other authorised registered health professionals.

We recognise that there will be circumstances where strict application of the rule could cause harm. For example, in rural settings a delay – and people have spoken to this – in access to a nurse could result in a resident missing urgent medication because they do not have someone that is qualified to administer that medication. That is why this bill gives some level of regulation-making powers to prescribe exemptions and safeguards, and it ensures that where flexibility is needed it can be delivered.

But of course again, the core principle here is that for the majority of cases only nurses will administer those types of medicines that were referred to previously.

This bill is not working in isolation. It complements many major reforms already underway at the Commonwealth level, including new staffing models, funding changes and the introduction of minimum care minutes, which require 44 minutes of direct care by a registered nurse per resident per day, which is really important. Forty-four minutes does not sound like a lot, but when you have a large aged care facility, that is amazing work by our registered nurses. As I said before, they do a fantastic job, and we cannot thank them enough.

This bill is a really important bill for the welfare of our elderly citizens that are in these facilities. It is important that nurses deliver this care. I thank them for what they do, and I thank the ANMF for their leadership in regard to this bill. I commend the bill to the house.

Richard RIORDAN (Polwarth) (18:56): I rise this evening to contribute also to the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. As the member for Polwarth, residential aged care is a big part of many of my communities. Whether it is Colac, Winchelsea, Torquay, Lorne, Apollo Bay, Timboon, Cobden, or Camperdown, right throughout the region there are aged care services that are important to those communities, and they are important because they allow elderly people to remain close to their families and friends and loved ones and be connected in the community. Across my electorate these facilities are provided by both the state – and Victoria has quite a strong reputation for providing a fairly strong state-backed aged care service – and also a mixture of not-for-profit and for-profit organisations who will provide more residential care and then more supported aged care services.

There are a range of issues that pop up from time to time, and medication supply and administering basic health care to elderly people in these homes can be a problem. And the smaller the community, the more difficult it is. A seat like Polwarth has that in spades in many of its communities. Apollo Bay, Lorne, Cobden and Timboon are all communities that are some distance from other larger areas and continually have difficulty attracting a GP workforce but also a nursing workforce. Smaller regional healthcare facilities and aged care facilities often will go through periods where they have a stable workforce; things tick along quite nicely, and all is well on the home front. The staff are well connected to the residents and the patients, and there is a good service provided. But of course it only takes, often, the departure of one nurse, a skilled professional, a GP, from a community, and aged care in particular can be left in a very fraught position.

The intent of this legislation today is the result of the Royal Commission into Aged Care Quality and Safety, which decided that we really only want registered nurses and enrolled nurses assisting with the distribution of important medications. And while at first glance that makes a lot of sense and that is a noble objective, of course it is an extra cost and an extra pressure on many smaller health services that simply cannot access the skilled staff on a regular basis sometimes and sometimes can go for quite some time without.

The other thing that often separates out regional aged care services is the general care staff. The personal care attendants that work in these facilities are often people who have lived and worked in the community. They often have longstanding relationships with many of the clients and residents that they are supporting and looking after, and it is often a very unique and at times quite a different service to what might be experienced in larger metropolitan and larger regional centres, in a country town, and this is a service that makes them more unique.

And so while this legislation seeks to be very prescriptive –

The SPEAKER: Order! I am required under sessional orders to interrupt business now. The member may continue his speech when the matter is next before the house.

Mary-Anne THOMAS (Macedon – Leader of the House, Minister for Health, Minister for Ambulance Services) (19:00): I move:

That the sitting be continued.

Motion agreed to.

The SPEAKER: The house will adjourn for 1 hour for dinner and return at 8 pm.

Sitting suspended 7:00 pm until 8:02 pm

Richard RIORDAN: The member for Mordialloc walks in just in time to see how we can discuss these things. We are back on Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025 after the half-time break. As we were discussing before the dinner adjournment this evening, we were talking about the fact that in my electorate aged care of course is a really, really important social service that occurs in many of my communities. Across the Polwarth area we have a mixture of private, public and not-for-profit aged care providers offering a range of levels of service. Whether it is in Torquay, Colac, Winchelsea, Lorne, Apollo Bay, Timboon, Cobden or Camperdown, providing aged care is a really essential service to these communities. The aged care facilities enable our elderly folk to remain close to their communities, close to their farms and close to their families and provide a quality of life in the later parts of their lives that they are deserving of.

This bill that we are discussing today of course is about making that experience a safer one, and that is something that this side of Parliament agrees with. We fully agree with the sentiments of the royal commission on how we avoid medication disasters. I have a personal view that in aged care it is a whole-of-community approach to making those days, months and years that people spend in these facilities a good time in their lives and a dignified way to see out the twilight of their years. This cannot be done alone. Particularly in rural and regional Victoria, aged care really relies on the goodwill and support of the local communities, whether it is the local groups that come by and visit or whether it is the personal care attendants and nursing staff who have had a long-term relationship and commitment to the service. Whatever it is, it provides a different level of care to perhaps what might be experienced in the larger metropolitan areas.

It is often a very personal level of care. Country Victorians are often short-changed on many things, but often in aged care, from my experience, having been involved with an aged care service for many years but also now as a member of Parliament, you visit these centres and you see how connected communities can often be there.

This legislation is trying to alleviate risk and problems that may arise by insisting that the distribution of various levels of medication on schedules 4, 8 and 9 in aged care settings are only done by registered or enrolled nurses. If you say it very quickly, it makes sense and it is probably hard to argue with. The problem is the legislation really does not set up the necessary safeguards for rural and regional communities where that level of expertise and staffing is not there, so the challenge that the government has with legislation like this is they are going to be left in the situation where we are going to have to turn a blind eye to the legislation on a regular basis because the skills required are not there when you need them. Quite frankly, having legislation that you are forced to turn a blind eye to is legislation that is really not worded and structured as well as it could be, and that causes problems ultimately. You cannot pick and choose when you want to abide by legislation. So this side of the house has a concern: while we support the intent of the government, we would also say that more needs to be done to make sure that in particular rural and regional health services and aged care services have the capacity and the support to make sure that at all times they have got the staff and the skilled staff that this government says they now have to have. That of course can at times require more funding and more support from the state to ensure that the necessary people are on hand in communities.

The reality is that some of our aged care services are in sometimes quite small communities. Take Lorne, Apollo Bay and Timboon, all three in my electorate: they are relatively small communities, and from the outside people looking in think, ‘Lorne, Apollo Bay and Timboon are busy, bustling towns.’ But these are quite small communities. They do not have a whole bunch of state-enrolled nurses or registered nurses at their beck and call to call upon. So where this legislation could be improved really is by having a structure that acknowledges the shortfall in skills and services, particularly in regional areas, and actually provides more practical and lived experience of how you might solve that problem. These things could include where we have had personal care attendants who may have been working in these facilities for many, many years, have got to know their patients and are capable of doing more, particularly with better support, training and accreditation. This would be an obvious solution to how you might ensure there are necessary safeguards in place to ensure that there are not medication problems along the way.

This legislation, when we look at it, is all of seven pages, and my suggestion to the government is: this is again an opportunity where the government has failed to really think about the needs of rural and regional Victoria and has failed to put enough thought into it and, at seven pages, to solve what is an important problem they are trying to solve but which could have been done better.

Pauline RICHARDS (Cranbourne) (20:08): I am very pleased to have the opportunity to speak in support of the Drugs, Poisons and Controlled Substances Amendment (Medication Administration in Residential Aged Care) Bill 2025. I was reflecting while listening very attentively to the member for Polwarth and thinking how much I agreed with so much of his contribution until right at the end. But anyway, I was grateful to hear what have been important contributions from both sides of the chamber really going to the heart of what we know in our communities to be extraordinarily important reforms that also speak so much to so many of us from our own experiences with, usually, our parents and the importance of making sure that we have the right staff – that people who are qualified are doing that incredibly important and complex care.

This bill does represent a significant step forward in ensuring the safety and dignity of older Victorians, because too many residents in aged care live with so many complex health conditions and they do take multiple medications, and there are risks of harm from misuse and poor oversight.

[The Legislative Assembly report is being published progressively.]