Tuesday, 18 November 2025

 Mary-Anne THOMAS (Macedon – Leader of the House, Minister for Health, Minister for Ambulance Services) (13:22): I move:

That the amendments be agreed to.

I support the modest amendments that have been made in the Legislative Council and that are now in this place to be debated and approved. The amendments do two important things. They ensure that our commitment to lifting the gag clause remains, and it is now lifted in relation to medical practitioners, nurse practitioners, registered nurses, psychologists and, importantly, Aboriginal and Torres Strait Islander health practitioners. Secondly, the amendments ensure that practitioners who hold a conscientious objection to voluntary assisted dying are still required to provide minimum information to a person who initiates a conversation with them in relation to VAD, but that will now be part of the act. It was obviously explained in the explanatory memorandum, but I was happy to agree to see that now in the act. What we have with the amended bill is a bill that will now achieve what we set out to achieve – and that was, from the get-go, that we would move to ensure that Victoria’s laws are more in line with those of other states and territories, and the amended bill before us does that.

I will only speak very briefly, but I do want to take the opportunity to thank all members of this house and indeed the Legislative Council for the way in which, by and large, the debate was conducted. I do want to acknowledge of course the member for Pakenham – who really needs no more acknowledgement – who has been a steadfast inspiration through this entire policy development and the debate here in the chamber. So I really want to acknowledge you, member for Pakenham, and also advocates from Dying With Dignity and advocates from Go Gentle. But, do you know what, even more importantly, people in my own community have told me of their experiences and why it is so important that we have made the changes that we have made. So on that note, I do want to commend the amendments to the house.

 Michael O’BRIEN (Malvern) (13:25): I rise to speak on the amendments to the Voluntary Assisted Dying Amendment Bill 2025 made by the Legislative Council. My concern about this bill related in many ways to the loosening of safeguards which had been put in place under the original legislation. Given the gravity of the subject with which we are dealing, I think it is important to have very strong legislative safeguards to protect vulnerable people who may be at risk of abuse or exploitation. A number of the amendments that were made in the Council were actually also sought to be moved here. It is a bit of a shame, really, that perhaps there was not adequate consideration given to those amendments in this place. Certainly the upper house has acted as a house of review, perhaps for the first time in a little while, in making –

A member: That’s their job.

Michael O’BRIEN: Well, it is our job to get it right as well. When you look at these amendments that have been made – and I note the Minister for Health has said she accepts them – the question is: why were they so vehemently fought against in this place? To my mind and obviously to the mind of people in the other place, these are commonsense amendments not designed to take away anyone’s rights but to protect people.

Mary-Anne Thomas interjected.

Michael O’BRIEN: You have had your go. Let us have a look, first of all, at the backflip on the secretary’s authority, which is one of the amendments. We are not talking about a little tick of the box here. There are five pages of amendments that have been made in the other place. For the ministers to seek to dismiss them as being minor – they are not minor at all; they are important amendments. They are safeguards dealing with a very important and sensitive issue that affects many people. Quoting from Hansard, the member for Murray Plains asked:

Minister, in your response to the member for Greenvale you set out your expectations of what would be required of a doctor that was a conscientious objector. Given that the legislation actually gives that power to the secretary to determine what happens, how can you guarantee that your expectation will be delivered if the secretary has a different opinion?

The minister went on to say:

I have confidence in the secretaries of the departments right across government being highly competent, ethical people in the way in which they perform their duties.

That is not the point, Minister. The point is it should not be left to the discretion of a bureaucrat in relation to what information must be provided, particularly in circumstances where we are dealing with a conscientious objection. For a conscientious objection to actually have any meaning it needs to be very, very clear what that objector is being asked to do. Now, as a result of these amendments, thankfully, it is very clear what that conscientious objector is being asked to do, and it is fairly limited, unlike the unlimited matters which were provided for in the initial drafting of this bill where it could be anything the secretary decided to tell a conscientious objector to provide – anything at all. Now it is actually quite limited. Now it is, with amendment 6 to clause 6, to give the person the following information:

(i)   contact details for the prescribed voluntary assisted dying care navigator service;

(ii)   the address of an Internet site of the Department of Health that provides information about voluntary assisted dying …

Whatever people’s views on the substance of these matters, one might think that these are very important safeguards not just to safeguard the rights of people who wish to seek voluntary assisted dying and seek advice from a medical practitioner who may have a conscientious objection but also to protect the rights of that person with a conscientious objection. We have to get the balance right. The fact is the initial drafting of this bill failed to get the balance right, and even members in the other place saw that. Members of the other place amended the bill to ensure that on this issue the balance was restored. I certainly support that amendment, because it is important, yes, that people who want to seek VAD are provided with the information as to how to do so. It is also important we protect the rights of people who have got conscientious objections. Being a long-term member of this place, I am not used to showering praise on the other place; it is quite foreign to me. But in this case I will do so – under sufferance, member for Brighton. I am very pleased in fact, and my understanding is, that members of the Labor Party may have initiated these particular amendments. It was certainly not a partisan issue. It was an issue of common sense: looking at where the original drafting of the bill had failed to provide proper safeguards and trying to correct that. That is the first aspect of these amendments: to protect the rights of people who wish to seek information about voluntary assisted dying but also to protect the rights of those who have a conscientious objection.

The other substantial element of the amendments that were made in the other place relates to health practitioners and the so-called gag clause.

Mary-Anne Thomas interjected.

Michael O’BRIEN: We are in agreement on that, Minister for Health. We are in heated agreement on that. The government felt that any registered health practitioner should be able to initiate a discussion about voluntary assisted dying with a patient. We are talking about people like podiatrists, dentists, physiotherapists, Chinese medicine practitioners, chiropractors, optometrists and osteopaths.

Members interjecting.

Michael O’BRIEN: We hear that there are some members who believe that that is entirely appropriate – that people qualified in Chinese herbal medicine should be able to initiate discussions with patients about voluntary assisted dying.

Belinda Wilson interjected.

Michael O’BRIEN: I look forward to the member for Narre Warren North opposing this amendment then. I look forward to the member for Narre Warren North having the courage of her convictions.

Mary-Anne Thomas interjected.

Michael O’BRIEN: I will take my time, thank you, Minister. I will take my full 30 minutes if you keep on with that. I look forward to the member for Narre Warren North opposing this amendment on the basis that she does believe that Chinese herbal medicine practitioners should be able to initiate discussions about voluntary assisted dying. We are talking about having safeguards about something that is about as critical as it gets.

The other place made a number of amendments. No longer is it just any registered health practitioner; they need to be a registered medical practitioner or nurse practitioner. That would seem to be a far more sensible safeguard to have in place. There are obviously arguments for and against whether there should be an ability to initiate discussion about voluntary assisted dying by a doctor or a nurse, but the idea that somebody looking at your teeth should be able to suggest it to you does seem bizarre and certainly unnecessary.

I remember the days when the government first brought this legislation to the Parliament. They were boasting about how conservative it was, boasting about the number of safeguards that were put in place to try to ensure that there would be the least possible prospect of exploitation of vulnerable people. Now the government is making a show of how many safeguards they are removing. Again I praise the members in the other place for putting back in place some safeguards, which should have always been there from the start. Clearly the attitude of some members in this place is to push things as far as they possibly can, constantly pushing the envelope. No doubt the government will be back here – well, hopefully it will not be the government, but members who are of that mind will be back here in a couple of years time – trying to push the envelope yet again. I do hope that we have a more balanced view taken next time.

What is the government now agreeing to? It is that voluntary assisted dying must not be initiated by other classes of registered health practitioners. So if you are not a registered medical practitioner – if you are not a registered nurse, if you are not a registered psychologist and if you are not a registered Aboriginal and Torres Strait Islander health practitioner – then you must not –

Mary-Anne Thomas interjected.

Michael O’BRIEN: No, I mentioned nurse practitioners. I said ‘registered nurse’.

Mary-Anne Thomas interjected.

Michael O’BRIEN: I am talking about what is actually in the legislation. I will ignore the disorderly interjections from the Minister for Health. She is just going to make me stand up here and speak for longer anyway. As I say, I am just quoting from the amendments which have been circulated by the Clerk, so I am assuming the clerks have got it right. I would certainly trust the clerks before I trusted the minister.

New section 8B applies to a registered health practitioner who provides health services or professional care services to a person and is not a registered medical practitioner, registered nurse, registered psychologist or registered Aboriginal and Torres Strait Islander health practitioner. New section 8B(2) goes on to say:

A registered health practitioner to whom this section applies must not, in the course of providing health services or professional care services to a person –

initiate discussion with the person that is in substance about voluntary assisted dying; or

in substance, suggest voluntary assisted dying to that person.

Again this would seem to be an absolutely baseline safeguard that is important in trying to avoid exploitation of vulnerable people. It is one thing for a doctor or a nurse or a psychologist to initiate these sorts of discussions, another thing entirely for a podiatrist or a chiropractor to do the same thing. I do not want to steal the member for Mornington’s thunder, but he raised this during the debate in the consideration-in-detail stage when this bill was before this chamber originally. He raised concerns about the breadth of health practitioners who would have been authorised to initiate discussions about voluntary assisted dying, and there was an amendment moved to effectively do what the other place has now done. The minister’s response was:

We do not support this amendment. Fundamental to the amendments in this bill is that there should be no wrong door for patients who are receiving end-of-life care. Therefore if a person has a life-limiting disease or illness and they are receiving care, that will most likely be from a care team. What this clause seeks to do is to enable registered health practitioners who are providing end-of-life care to use their professional judgement and potentially advise that voluntary assisted dying is a lawful end-of-life care choice here in the state of Victoria.

Why the minister thinks that podiatrists, dentists and Chinese medicine practitioners have the expertise to initiate voluntary assisted dying discussions – I mean, I have great respect for all those health practitioners. In their own fields they do outstanding and important work for the community, and nothing I say is any knock on the important contribution that they make to healthcare outcomes in the community. But there is a difference between somebody who has the medical expertise and qualifications to initiate a discussion about voluntary assisted dying and those who do not. I am very pleased to see that the Council has at least made those amendments. As I have mentioned in my previous commentary, this bill is now substantially amended to that effect. Those safeguards have now been restored, and only registered medical practitioners, nurse practitioners, Aboriginal and Torres Strait Islander health practitioners and registered psychologists have that ability to initiate voluntary assisted dying discussions.

Now that I do not have the interjections from the Minister for Health, I am probably in a position where I can discontinue my remarks, other than to say these safeguards that are being restored by the other place are important. I do support them, and it is a real shame that they were not given the proper consideration on the first run-through that they deserved, because this would have been a better bill initially if the government, or those members who are supporting this bill, had taken those considerations on board. I think that sometimes when it comes to not just these matters but all matters of legislation, this Parliament tends to operate on a bit of a tribal basis, and the tribe is that you are for it or the tribe is that you are agin it. On these sorts of matters I think we do need to bring individual judgement to bear on important issues, particularly when we are talking about safeguards to prevent exploitation of the vulnerable. With that, I commend these amendments.

 Emma VULIN (Pakenham) (13:39): I would like to speak briefly on the amendments to the Voluntary Assisted Dying Amendment Bill 2025 made in the Legislative Council. It was always going to be the case with a bill such as this that compromises needed to be made by way of amendments in order to gain the broader support necessary to ensure its passage. Whilst I personally believe some of the amendments made are not particularly necessary, they are ultimately relatively minor, and I am happy to support them in the interest of ensuring that this bill is passed into law. The amendments to the gag clause, for instance, still leave the confusing situation where any of the members in this chamber can initiate a conversation with someone about voluntary assisted dying but a podiatrist or a dentist, for example, who may have built up a long and trusted relationship with someone who has been diagnosed with a terminal illness, cannot. Nevertheless the amendments are an improvement to the gag clause as it is now, and I support them to ensure passage of this important bill.

I sat through or read almost the entirety of the debate of this bill in this place, as well as the debate and committee stage in the other place. I want to thank the Minister for Health and her team for the work they did in developing and bringing this bill to the Parliament. I also want to thank the Minister for Mental Health in the other place for her tireless work taking the bill through the committee stage. My thanks also to Dr Sarah Mansfield and indeed members of this place, including members of the opposition and the crossbench, for their constructive and genuine engagement on this bill.

As many members both here and in the Council have noted, the debate and consideration of this bill have brought out the best in many of us. It has been a debate that has seen members on all sides engage, for the most part, in a respectful and considerate manner. It has been an example of how we should always strive to behave and conduct ourselves as elected members, working constructively and respectively with one another to craft legislation for the overall betterment of our state.

It is unfortunate, though, that this was somewhat tarnished by the language used by some members, both here and in the other place, during debate on this bill. Whilst I appreciate that this is an issue on which some, not just here in the Parliament but in the broader community, have differing views, it was I believe unhelpful, distasteful and unnecessary to refer to voluntary assisted dying as assisted suicide. The decision to access voluntary assisted dying is one never taken lightly. Those who do make the decision to access it often find themselves wracked with guilt for the families that they will leave behind, fearful that others may perceive them as selfish for their decision. It is a very difficult decision to make, and one that an individual comes to only after a period of serious consideration. I am not ashamed to admit that hearing this sort of language used by my colleagues brought me to tears. I cried for myself, but I also cried for others who have been through this difficult journey and those who have lost loved ones to suicide. I felt it necessary to call this out, and I hope to encourage them to further reflect and consider that words we use in this place really do matter. Not everyone has the same views, and I absolutely respect that, but we are here for all Victorians and empathy goes a long way. I commend the amendments to the house.

 Peter WALSH (Murray Plains) (13:43): I rise to speak on the Voluntary Assisted Dying Amendment Bill 2025. Starting out can I say to the member for Malvern: ditto. I absolutely agree with everything the member for Malvern said, and I will in my time repeat some of those things. I think it is important to repeat them, because I did raise these issues when we were in consideration in detail and I think we actually saw the Parliament working as this chamber should work by taking that bill into consideration in detail. It is a pity that does not happen more. But this is not a debate about whether we have VAD or whether we do not have VAD. We have it; it is law here in Victoria, and for those people that want to access it, that is their personal choice.

I suppose I looked at the bill from a legislator’s point of view. When we debated this bill in 2017 we talked about the safeguards that were in the bill and making sure that there were those safeguards and that no bill could erode those safeguards any more than was necessary to make it function appropriately in the future, particularly on the issues around the definition of those health professionals that could give advice, like the member for Malvern said. The podiatrist I go to I have the utmost respect for as a podiatrist, but I do not think it is appropriate that that person would be giving me advice about voluntary assisted dying, and the same goes for my dentist. I trust my dentist to fix my teeth, but again, I do not think it is appropriate that my dentist is actually giving me advice about voluntary assisted dying. With the changes that the upper house made, to their credit, with people from both sides of the chamber and the crossbench supporting those changes, I think we have landed at a good compromise to what was a very long list of health professionals that were going to be able to give advice on voluntary assisted dying.

The cynic in me, as a politician, says the government probably put that huge, long list in to allow it to be amended, so those opposed to some of the issues could be seen to have a win. I think that probably those on one side of the Labor Party who wanted to see these amendments felt they had had a win. But I think it was in some ways a hollow win, because I expect the government always expected to lose some of those health professionals out of that particular definition.

The other point I just want to make some comments on is the issues around clause 6, particularly around the powers of the secretary. I have said numerous times that this enabling legislation, where we pass some legislation where a bureaucrat sometime in the future who is not elected by the people of Victoria can make changes – as a legislator I find it wrong. I know sometimes if we have got prescriptive legislation, it is tedious to bring that back to the house for amendment. But I think that is the safeguard that has been built into 700 years of Westminster history, that if it is done by the Parliament, it can be changed by the Parliament. It should not be done by the Parliament to allow a bureaucrat to change it into the future.

I think a lot of Victorians lost faith in the health system through COVID, rightly or wrongly. Decisions that were made through COVID around lockdowns and around restrictions on what people could or could not do meant that a lot of Victorians have lost faith in the health system in Victoria and the decision-makers in it. My community of Echuca, Swan Hill and Koondrook–Barham along the river saw these two different lots of rules across the river because we had someone in Victoria that had a very different view to someone in New South Wales. There was no parliamentary scrutiny about the fact that schoolchildren actually had to get off a bus and present their certificate to go to school on the other side of the river. It just defies logic as to how that was. Having a great big burly policeman lining up grade 4 and 5 kids to check whether they can go to school, I do not think is the way that our society wants to work. That was the unfettered power of health professionals.

Fortunately, with common sense in the upper house, we have taken away that unfettered power of the secretary to make rules in the future. I know the minister gave some assurances from questions in the committee stage about the second-reading speech and her expressed intentions for what the secretary should do in the future. But as time goes by, as ministers change, as secretaries change, there is a real risk that there could be creep around that, and you would have that unfettered power of the secretary in the future. A bit like the member for Malvern I know the jealousy between the two houses; we feel that we do all the work down here and the house of review up there sometimes gets it right. In this case they have very much got it right, and I think it is the parliamentary system working as it should that there have been sensible amendments. I wish the bill a speedy passage now.

 Will FOWLES (Ringwood) (13:48): I rise to make a contribution around these amendments that have come back from the other place in relation to the Voluntary Assisted Dying Amendment Bill ‍2025. I note that the minimum information has now been prescribed in legislation. I have got to say I do not have a particularly strong view about that. I was not uncomfortable with that idea when it was put in this chamber. I note that the Minister for Health vocally and strongly defended the construction of the bill. I was happy to take her view on that. On the minimum information, the stated view is that it would be very weird to have a website in an act – I do not know if it is weird or not; I cannot say I have seen a great many websites in bills before this place – but I think the minimum information clause that has come back from the other place is probably the least controversial of the matters that have come back.

I want to talk a little bit, though, about the restrictions on practitioners raising voluntary assisted dying, and I thank the member for Pakenham for her contribution and for speaking too about the sensible, pragmatic approach where it is not a perfect bill, but it is nonetheless a good bill and warrants our support, and I certainly fall into that category. But I do say that as a general principle I would caution all legislators against telling any Victorian that they cannot tell any other Victorian about a Victorian law. I think on first principles we know that ignorance of the law is no defence, be it criminal law, taxation law or any other law, and yet we now have a statute where we proscribe Victorians discussing the law with other Victorians. That is counterintuitive, and I think, from my perspective anyway, it is a substantial overreach on the part of the Parliament. I do not think we should ever, ever be constraining people from alerting people to the existence of a law. I would have been happy to have had a debate in this chamber about what other things can and cannot be countenanced in that discussion. I do not think that podiatrists ought to be going chapter and verse through treatment options, for example. But the very existence of a scheme, the very existence of a law, I think is something we ought to protect the right for all Victorians to discuss. I think it is a shame that this gag clause remains there, in part. In circumstances where someone is an allied health practitioner, they cannot even alert a patient to the very existence of that rule. For that reason I do not support any rule that limits those conversations about what the law says. That of course is different to detailed conversations about what a path of treatment might look like. But the very existence of the law I think ought to be a matter that Parliament does not seek to constrain in any way. I support the idea that protecting people from coercion is important – of course it is – but by the same token, this in effect elevates ignorance of the law to a level that is thoroughly, thoroughly inappropriate, in my view.

Members in this debate have spent a bit of time talking about undertakings that were given in 2017 or features of the debate in 2017, and I would just say that nothing stands still. The community does not; medicine does not. The law certainly should not. I think in the 1900s the US patent office considered closing because everything that could be invented had been invented. That is where this argument is based, in the very strange place of saying, ‘Undertakings were given in 2017, so we shouldn’t be amending the law now in 2025.’ Well, eight years have transpired. Society is not a static place; medicine is not a static place. The law ought not to be a static place. Frankly, if it was, we could probably shut up shop and go home. This place needs to respond to the issues of the day, and it needs to respond in a way that is sensitive to evolution in thinking amongst our constituents and amongst society and in a way that reflects the views of our own constituents. To those who say that in the 2017 debate a bunch of undertakings were made or certain things were said, I would say there is no need or reason to rely on those things. We are of course a different Parliament to that Parliament. In fact we are two parliaments gone since that Parliament was in place, and we ought to be focused always on the needs of our constituents in a contemporary framework. I am sure things were said about the sorry decline of the blacksmithing industry at some point too, but life goes on.

I do want to raise a couple of matters regarding the interpreter provisions. I maintain that these interpreter provisions ought to have been amended in both this place and the other place. It is a derogation of sovereignty to allow what is effectively a COAG body that is federally funded to determine the scope of the languages that are able to be used to discuss voluntary assisted dying. It is most unfortunate. That is the Victorian Parliament abrogating its duty to determine the administration and the rules that surround this scheme, and I think it is a shame that we have done that. It would be far, far better, in my view, to say that the minister can control the list or that tertiary-educated translators can be in control of this process. It is a great shame that the other place did not see fit to make those amendments.

As to future debates, I know I share a view with others that there will be future debates that canvass some of the big issues that were not canvassed this time. The role of institutions – we heard lots and lots of stories, including from the Cahills and others, about the role of conscientious objection from institutions thwarting the will of patients and their families to access this lawful medication, this lawful service. I just cannot accept these gut-wrenching stories of frail and dying people being wheeled out to the car park or kerbside in order to receive a lawful medication to end their life. We owe it to the patients and the families to fix it. Institutions can hold of course particular faith-informed views, but they ought not to be able to obstruct lawful care in a way that forces people into undignified or traumatic arrangements at the end of their lives.

We also need – and I would hope that future debates countenance people with neurodegenerative conditions and whether there is an ability to create declarations binding –

The DEPUTY SPEAKER: I bring the member back to the amendments, please.

Will FOWLES: Deputy Speaker, I thank you for your forbearance. I can see you have been struggling with this for a few minutes now. I thank you for your patience.

These amendments have limited the scheme in a couple of important ways, but they do not in any way mean the end of it. They do not mean in any way the end of this bill. This is a good bill that advances the debate in Victoria and in Australia and indeed internationally. It is a bill that is the first review of a voluntary assisted dying scheme, and for that reason alone it stands as an important step. It follows on of course from Victoria being the first jurisdiction to introduce a voluntary assisted dying scheme in Australia. For all of those reasons it is important. I do thank the minister and the department for their work in bringing it up.

I reflect on the comments of the member for Pakenham about some of the language in this debate having been very unfortunate on both sides of the aisle. I would hope that all members take an opportunity from this debate to take away two things. One is that there is an opportunity to work in a bipartisan or multipartisan way in this place for the betterment of Victoria and Victorians. The second thing is that when we approach debates like this it is always important to do so with the utmost sensitivity and to be live to the very real lived experience of people right across both chambers who have had that experience. Again, whilst I do not support the amendments that have been made, I do support the bill, and I ask that the house also support this bill and ensure its speedy passage from here.

 Chris CREWTHER (Mornington) (13:57): I rise to speak on the amendments to the Voluntary Assisted Dying Amendment Bill 2025 that have returned from the Legislative Council. The first point I want to make is this: these amendments in substance reflect similar amendments moved in this chamber only a few weeks ago. At that time, under a free vote, the majority of the members of the Legislative Assembly voted them down, albeit there were a number of Labor and Liberal members and at least one National, the member for Murray Plains, who did back those amendments. Today they return from the Council with these important variations. As I said then and as I say again today, I support these amendments, even though as a whole I do not support the bill. These are sensible and responsible and provide additional safeguards in an extraordinarily sensitive and consequential area of Victorian law. As noted by the member for Malvern, these are commonsense and do protect people.

Firstly, there has been a backflip with respect to the secretary’s authority. It should not be left, as the member for Malvern noted, to the discretion of bureaucrats as to what information is provided, particularly with serious life-and-death situations and with conscientious objection at play. Now these amendments ensure, under clause 6, that there are more limited and prescriptive requirements – that information be given in terms of contact details for the prescribed voluntary assisted dying care navigator service and the address of an internet site of the Department of Health. This is a lot more limited than before.

On the other key point, originally we had a situation where podiatrists, dentists, Chinese medicine practitioners, osteopaths and others could initiate voluntary assisted dying conversations. This has now been restricted to registered medical practitioners and nurse practitioners while ensuring that this must not now be initiated by other practitioners, such as Chinese medicine practitioners and others, as I mentioned. It is important to support these amendments, but overall I still oppose this bill.

Business interrupted under sessional orders.

The SPEAKER: I acknowledge in the gallery the former member for Bennettswood Ron Wilson and the former MLC Marg Lewis.