Thursday, 4 May 2023

Bills

Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023

Second reading

Debate resumed on motion of Jaclyn Symes:

That the bill be now read a second time.

Georgie CROZIER (Southern Metropolitan) (09:55): I rise to speak to this important piece of legislation that we are debating today because it has been subject to enormous community concern for many years. It is of course the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. The bill does a number of things, and my colleague in the Assembly Emma Kealy has done an excellent job in prosecuting the case around the concerns that we have heard of for many years and putting together some sensible amendments that will improve this flawed bill.

I want to go through this bill, and I want to speak to the Ryan report. Obviously during the committee stage there will be more to say, and I will have more questions for the government about various aspects that have been raised with me, Ms Kealy and my other colleagues around the impacts of this bill. But more specifically, if I can just go to what the bill does, the bill amends, as I said, the Drugs, Poisons and Controlled Substances Act 1981 to provide for the ongoing licensing of the operation of a medically supervised injecting centre. It also allows for more than one medically supervised injecting centre licence to be issued, but no more than one licence can be enforced at a time. It provides for the transfer of a medically supervised injecting centre licence and makes changes in relation to the roles of the supervisors and the directors of the licensed medically supervised injecting centre. It allows the Secretary of the Department of Health to delegate certain powers regarding the amendment of internal management protocols of the licensed medically supervised injecting centre and provides for further provision for the operation of planning schemes and planning amendments in relation to the centre.

Of course we have had, as I said, a number of issues that have arisen over the last number of years. There have been two reviews; this is the second trial period for the injecting centre, and there have been two reviews. The Hamilton review was published in the middle of COVID, in June 2020. I think that is important to state, and I will come back to the issues around COVID, because that did have an impact on what all Melburnians could do in their movement and ability to move around the city and the state. Then of course we have had the more recent Ryan review. We have got a copy of the Ryan review. It is 25 pages long – it is not very long – and I will be asking about this in committee. But I make a point about the Ryan review: the terms of reference for the review did go to a number of things, particularly around considering the operation and use of the injecting room, but they did not actually go to the specific site or the current location. And that is really where the Liberals’ and Nationals’ concerns lie – that this injecting centre is situated right next to a primary school.

For the residents and the children that attend that school, you have to say that it has been an abject failure, because that school has security guards, it has CCTV and it has other security measures that are in place to protect children. They were not there before this trial started. We have been very adamant that no injecting centre should be next to a primary school or a childcare centre. And can I say that we are very understanding about the complexity of drug use and the impacts to those people that are addicted to these heinous drugs like heroin and ice and that support, education and treatment must be provided for them to get off these heinous drugs.

Our concern is about the complexity for drug users – that they do receive that support and that the stakeholders that are involved with supporting drug users do have that support as well from government. Despite all of that, those concerns around this site remain absolutely of huge concern because of what we have seen. There have been many, many reports and many images around not just drug use but also the dealing of drugs and explicit sexual and antisocial behaviours that have occurred and that children have had to witness. Unfortunately children have seen fatal drug overdoses not in the injecting room but in the vicinity of the injecting room and of course the thousands and thousands of discarded syringes and needles that are evident every single day around this facility.

I remain concerned about the impacts of this on the local amenity and the residents. I was going to the community meetings when they first started years ago. In fact I was the only MP that actually turned up to those community meetings – not the then local member Richard Wynne; not the then responsible minister Martin Foley; nor the education minister James Merlino, and he was also mental health minister; nor the local members at the time, none of them. At the very first meeting I was the only MP to go and listen to the residents, and there were residents who were very supportive of the injecting centre, but equally there were concerned residents who had been living in the area for a long time and had seen just what had occurred. They described it as a honey pot for users, and I think that was backed up by Police Association Victoria secretary Wayne Gatt. When their members were surveyed on this and throughout this trial period, that was the case – that it did have a honey pot effect and that antisocial behaviour and an increase in crime had occurred. The government will argue that it is saving lives and that there is a decrease in ambulance call-outs and a decrease in overdoses et cetera. I will speak to the government in committee about this, because I want to question and get to the bottom of that.

Having worked in the health sector for a number of years and having worked with drug-affected pregnant women when I was at the Royal Women’s Hospital and also when I worked at the Alfred hospital, I have seen the impacts of overdose and I have seen the terrible impacts of withdrawing babies of addicted mothers. Again I say I understand the complexity of this for those drug users and how they need to be supported, but we need to be doing as much as we can to be supporting them and getting people off these drugs because of those impacts to not only themselves, not only those that are close to them, like I have explained – pregnant women and their newborn babies that are withdrawing – but equally the community and the broader Victorian community in terms of the impacts of crime and other antisocial behaviour that occur. Some of that antisocial behaviour, as I have said, has been quite awful. I make the point that both the Hamilton review and the Ryan review did identify that deterioration of the amenity around the injecting centre had occurred since its opening. Those two reviews did say that there was a deterioration in amenity, and that has not changed.

I was at a residents meeting with my colleague Mr Mulholland on Monday evening, and those residents spoke about the impacts of what is occurring. I have received some emails from residents around this very point that really highlight some of that, and I just want to read from one of them. This is an email I received from a concerned resident. She is a 79-year-old woman. She has lived in the public housing estate near the injecting room for over 47 years, and she has been using the facilities at the North Richmond Community Health centre, which is right next door to the injecting room, for all of that time. She needs to access the services of the North Richmond Community Health centre for doctor and dental appointments. As she says, she has been living in this area, and that public housing tower, which I know very well, is just metres away from the injecting centre and the community health centre. She says in this email:

On many occasions over the last few years going to my doctor or dentist appointments my experiences have been marred by drug affected people loitering around the health centre. I have been intimidated and verbally abused by people under the influence of drugs while walking from my home to the centre. I do not feel safe …

She is a 79-year-old woman. She does not feel safe going from the public housing towers, which are not very far from the community health centre, to get that medical treatment that she requires because of what is occurring. She goes on to say, which is extremely concerning:

I have been barricaded in my home on many occasions because of drug users injecting in front of my door, some passing out, using the area as a toilet, leaving used and bloody syringes behind.

She goes on to explain in really graphic detail the impact to her as a woman who has lived in this area, and she has seen the difference in what is occurring since the injecting centre has opened. She says:

The trauma caused by these incidents had taken a toll on my health.

I think that is really concerning. She also says in her email that she has had to contact security and the police on multiple occasions, too many to count, to have drug users removed:

… it’s been a horrific experience each time I’ve opened my front door to see them there.

How is that fair and reasonable for somebody who has lived in the area for 47 years? The government’s rationale for having an injecting centre here is that this is where drug use was occurring and there were too many overdoses. There are too many overdoses; I do not disagree with any of that. But when you have got residents who do not feel safe and when you have got vulnerable elderly women who are subjected to that sort of behaviour, how is that fair and reasonable? It tells the story about the reality of what is happening on the ground. The most disappointing thing about what we see from the government is that they are just ploughing through with this legislation.

Members interjecting.

Georgie CROZIER: What was the interjection?

A member: Look at the Sydney research.

Georgie CROZIER: I will come to the Sydney research. The Sydney injecting centre is not next to a school, it is not next to a childcare centre and it does not have the same issues that are occurring in North Richmond or at this local primary school. That is the difference here. I would urge you to support our amendments, which reflect exactly what is in New South Wales. I know those in the government just want to plough on with this legislation, but it is not right for this local area to have this injecting centre where it is located. We have been consistent about this, consistent about the impacts on the local amenity, and we have also put forward a number of sensible suggestions.

As I said, my colleague Emma Kealy took to the election last year an opioid replacement therapy, hydromorphone, to assist those people that are addicted to heroin to be able to get off it. I know Mr Limbrick has an amendment that goes exactly to this point, which I will speak to and which we will be supporting. They are sensible measures. The government has not listened to any of this. If I can go back to my initial point before the interjection: you have not listened to the local community. You have been selective. You have been selective with the Ryan review. You have been selective with the data that you present. You have been selective on a whole range of things. You have been selective with the terms of reference for the Ryan review – it did not even look at the location, where the most contentious issue arises.

As I said, I have spoken to a lot of those community members, and many of them were very supportive of the injecting room. They understand the complexity that this has for people who are addicted to drugs. But after living there, living in the very vicinity where this is located, they want improvements, and they want it moved because of what is going on. And surely that should be a reason for the government to take some note, but they just have not. They have not listened.

There is no other place in the world where an injecting centre is right next to a primary school, and let us just reflect back on that. When this was put up with the first initial legislation, the government botched the legislation; they botched the planning requirement. They said it was going to be metres away from a primary school, but actually they botched it with the planning aspect of where the building had to go to. It was an absolute shambles. Now, most of you sitting in this chamber, in fact all of you except for the President, were not here when we debated that and that shambolic legislation that was brought in at that time. So I make the point: while this is an important issue about giving support to those that have drug addictions, there should be consideration to those people that are living within the vicinity.

As I said, this bill goes to doing a number of things in relation to how it will be providing the services, and I want to just go to a point around how we have got no reviews. It is proposed the recommissioning of the injecting centre will occur over the coming year, with a new operator to be appointed by tender and expected to be a consortium of a community health provider, a hospital and an alcohol and other drug (AOD) service provider. Reviews are to commence within five years, no later than 30 June 2028; however, the issuing and extension of licences is in four-year terms. There is no date specified for a review to be completed at all. It is extraordinary that we are not having these reviews. We are not having the reviews that we need to. Every other health service and agency has to have an annual review, and we will be moving amendments along these lines. We really want to see how we can improve that aspect.

Another area of concern that has been raised by various stakeholders, including the AOD sector, is around those people that will be attending it and their health records – as in that bill we passed a few weeks ago – and how that information will be shared. It goes to the point of what we were concerned about in terms of sharing of data and people having no ability to opt out. Again, this just goes to the heart of how the government operates and just takes on board a whole range of things without actually putting into place some reasonable and sensible considerations.

I make the point around the Ryan review again, which I will speak more about in committee, that the government relied on this report to inform the current legislation that we are debating. I am concerned about the level of stakeholder consultation that was done in the AOD sector around the specifics that I have just mentioned. There was some concern expressed around the lack of consultation by the government with these various stakeholders. We have not seen the full Ryan review – we know there is one but we have not seen it – and I do not think that is in the interests of transparency either for what the government is trying to achieve here. If they were truly open and transparent about the reason they are bringing in this legislation, they would release that entire review. They have not done that. There are many issues around that aspect. There are also concerns around licensing, as I have noted.

As I said, I will be moving a reasoned amendment. In fact, President, I am wondering if I could just move that reasoned amendment now. It is very specific. It is exactly what was moved in the Assembly. I move:

That all the words after ‘That’ be omitted and replaced with the words ‘this bill be withdrawn and redrafted to prevent a medically supervised injecting centre from operating in near proximity to schools, childcare centres and community centres.’.

It is very clear that the Liberals and Nationals do not believe that an injecting centre should be next to a primary school, and that is why the shadow minister and member for Lowan Emma Kealy in the other place also moved this reasoned amendment.

Can I go to the other amendments. I urge the government and the crossbench to support the reasoned amendment so that we can get this right, but should it not be successful, we have other amendments to move that align with New South Wales so that we will have a 250-metre buffer zone around any further injecting centres that the government might provide or might be putting in place in Victoria – a 250-metre buffer zone from an education facility or a childcare centre. We think that is incredibly important. It is very clear, and it is what is happening in New South Wales. They also have an issue around the visibility of the premises, and our amendments go to the aspect around public safety.

The other parts of our amendments go to the measure of eligibility of a licensee to be a fit and proper person, including strict requirements that a person with a prior conviction for a drug-related offence must not be deemed eligible for appointment as licensee, and ensure that the review panel that is spoken about aligns with the period of licensing – reviews must be completed before any licence is extended.

Amendments circulated pursuant to standing orders.

Georgie CROZIER: These amendments that we are bringing into place are aimed at improving what this bill is trying to achieve. We feel that annual reviews should be in line with any other review that is provided for a public health facility. If the government is fair dinkum about this being in the interests of public health, then have an annual review. Have an annual report so that there is reporting done on an annual basis. It just seems extraordinary that that is not being taken into consideration for this bill.

There is just so much more that we could say on this, but I wanted to just finally make this point: the government put in funding to improve amenity in last year’s budget. They have failed. They have failed to consult with the community around the real impacts to those people living around this facility. They have failed to provide proper transparency around the data. Actually how many people have been fully rehabilitated? What are the criteria for those that have had an overdose reversed? I have done that. I know what that means. But I am not sure of the criteria that the government is relying on. There are the ambulance call-outs. Why has the government not taken any notice of the concerns raised by the police association? The police are called out there continuously. The residents will tell you that.

Some of the vision, as I said previously, is absolutely unacceptable. Children should not be having to witness what is going on in the streets. These are the streets where these children are going to school, where they play, and they have to look at what is on the streets – not only what people are doing but the numbers of syringes that are discarded. We know that before the injecting room was set up there were 6000 discarded syringes and needles that were collected a month. It is now 12,000 to 18,000 a month that have to be picked up every month by the City of Yarra. How is that a success, when you are saying that you have got all of this use around?

It is clear that there is a lot of activity around this centre, that they are not all going through the centre. They are actually not – 12,000 to 18,000 discarded syringes and needles a month. That tells you the level of activity, and so it is no wonder the residents have got an enormous concern about those people coming into this area. They will tell you. They see people injecting and then driving off in cars – high as a kite – sometimes with children in them. How is that safe? How is that responsible? What is it telling you? There is a problem here; that is what it is telling you. And for the government to gloss over all of these concerns again demonstrates a government that is actually not listening to some really major concerns, and I think that is incredibly disappointing.

I will say more in committee when we get to committee, but in my final few minutes I do want to thank all of those residents who have spoken to me over the last five years since this trial has been going – nearly five years. I want to thank them for expressing to me the reality, for being really clear about what the impacts to them are. I read out the concerns from the 79-year-old who lives in the public housing tower. That is what I heard when I attended those community meetings – stories like that. It is a pity the government has never attended those community meetings. They just selectively speak to people. Well, I have spoken to those proponents that are supportive of the injecting room and those residents and others that have got concerns. So I just want to say I thank them for doing that.

A lot of their concerns are the reasons why we are moving these amendments. We are moving the amendments so that an injecting facility is not located next to a primary school; so that any future injecting facility will not be located next to a primary school or childcare centre – or within 250 metres, let us be reasonable about it; so that there is proper support for people that are addicted to these heinous drugs; and so that we protect the community, we protect the amenity and we importantly listen to those residents and others who are trying to do this work on behalf of those people in the sector, rather than taking this government’s continual bulldoze approach.

Just because they made this election commitment does not mean they got it right. They did not. They got it very, very wrong. There should never, ever have been an injecting facility next to a primary school. I urge all members to support the Liberals’ and Nationals’ amendment.

Sheena WATT (Northern Metropolitan) (10:25): I rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023, which is a bill that seeks to establish the North Richmond medically supervised injecting room (MSIR) in my electorate of Northern Metropolitan Region as a permanent facility as well as improve the services that this facility provides and set the facility up for longevity.

First and foremost, I want to put on the record that this bill will save lives, that medically supervised injecting rooms save lives and that the North Richmond facility has already saved lives. I send my sincere thanks to the health professionals who choose every day to save lives at North Richmond Community Health and to the board, who have stood strongly in their leadership to save lives. Our work in this place should be guided by achieving better outcomes for Victoria, and that is what this bill will do for some the most vulnerable in our community. This bill will mean that people that need support the most will get the help they need to break habits and get back on their feet, it will mean that families will not have to mourn the loss of loved ones and it will mean less people dying on our streets from preventable causes.

The supervised injecting room in North Richmond works. In late 2017 the Andrews Labor government announced the first trial of a medically supervised injecting room in our state’s history. This was bold, brave action, taking a safety-first medical approach to addressing the decades of harm caused by drugs in the City of Yarra. Can I take this opportunity to commend the Premier Daniel Andrews, the Minister for Mental Health at the time Martin Foley and the former member for Richmond Richard Wynne for their leadership and compassion in announcing the opening of that facility. I recall being at a community celebration last year and how, unprompted, members of the community came up to Mr Wynne and expressed their heartfelt thanks. They told stories to him that would bring tears to your eyes, frankly. They shook his hand, and some members felt such warmth and affection for Mr Wynne that they came up and gave him big, solid hugs. You see, for all the stories that we hear from those opposite, there are stories of grateful thanks. I have seen them firsthand, and I heard those stories being shared with Mr Wynne. It is something that I know he took on board with such pride, and so he should have. Their work will not soon be forgotten, and they can indeed be proud of the legacy they have left. Richard Wynne, Martin Foley and indeed our Premier will be remembered as giants of public health on this side of the house.

The establishment of the trial followed growing concerns about the number of heroin-related deaths, two parliamentary inquiries and coronial findings that an injecting room would reduce the risk of death from heroin overdose. Two independent reviews were conducted over the trial period. In June 2020 an independent panel chaired by Professor Margaret Hamilton AO delivered the first review of the trial, and following that in February 2023 an independent panel, which was chaired by Mr John Ryan, delivered the second review. These reviews have provided solid evidence that the service is doing what it was designed to do: save lives and change lives. Since opening in June 2018 the facility has safely managed more than 6750 overdoses and saved 63 lives. It has taken pressure off the local hospitals, reduced ambulance call-outs and led to a reduction in the spread of bloodborne viruses within the City of Yarra. There have also been more than 3200 referrals to health and social services, including general practitioners, oral health services, housing services, drug treatment services and bloodborne virus testing and treatment services.

One of the most significant recommendations that the Ryan review made is to keep the North Richmond service as an ongoing service, which is why we have introduced this amendment bill to achieve exactly that. This legislation will pave the way for immediate measures to be taken to further boost safety and amenity in the North Richmond precinct and increase wraparound supports for clients of the service. You see, every single life lost to drugs is a terrible, terrible tragedy for the families and friends affected and for the wider community. The government remains unwavering in its work to reduce drug harms in the North Richmond community. These changes will strengthen the service, ensuring it continues to do what it was designed to do, which is – I will say it again – save lives and change lives. This bill is not about politics, it is about lives – the lives of people who are loved. Only a Labor government can be trusted to reduce drug harm and support those who are struggling with addiction to get the support they need for a better life.

Those opposite continue to use the injecting room to drive what is moral panic. They have no regard for the value of human life, and if they had their way, they would close the service that we know has saved at least 63 lives and changed thousands more. The first supervised injecting room has a long history right around the globe. In fact it opened in Switzerland in the 1980s. There are now more than 120 legal services operating worldwide. Most recently the Australian Capital Territory expressed its commitment to join Victoria and New South Wales in providing these critical services that save lives and sometimes change them as well.

A medically supervised injecting centre (MSIC) provides a safer place for people to inject drugs of dependence in a supervised health setting. It is an alternative to injecting in the home or in public, where people are far more likely to die, suffer other harms from drug use and raise risks and concerns for family members or indeed the general public. It also provides life-changing interventions for people who often have a full range of health needs and may otherwise experience significant barriers to accessing health care and other services. It is intended to be a gateway to broader support, such as medical care, drug treatment and hepatitis C screening and treatment. It offers referrals to other health and social support, such as mental health counselling, treatment for alcohol and other drug issues and housing services. Dealing with drug addiction in the community is incredibly complex, in large part because it requires people with complex needs to interact with a complex web of social, legal and other support systems. Governments committed to addressing addiction must find solutions within this complexity while balancing a set of sometimes competing aims, including preventing deaths, promoting health, offering pathways out of addiction, protecting safety and amenity and generating community support. Supervised injecting facilities are not a silver bullet, but there is a growing body of evidence, including from supervised injecting facilities established in other jurisdictions, that they are an effective intervention that can reduce deaths and health burdens while also addressing safety and amenity concerns.

As I mentioned earlier, two independent reviews were conducted over that trial period. In June 2020 we had the independent panel chaired by Professor Margaret Hamilton AO. Later, in February 2023, the independent panel chaired by Mr John Ryan delivered the second review. The terms of reference for those reviews asked panel members to consider the North Richmond service’s operation and use and the extent to which the service has advanced the goals as set out in the underpinning legislation and to provide advice to government on any recommended changes. I think it is worth reintroducing now that the goals of the service as set out in that legislation are (1) to reduce overdose deaths and overdose harm, (2) to provide a gateway to health and social services for people who inject drugs, (3) to reduce ambulance attendances and emergency department presentations attributed to overdoses, (4) to reduce the number of discarded needles and syringes in public places, (5) to improve neighbourhood amenity for residents and local businesses and (6) to assist in reducing the spread of bloodborne diseases.

The recently released Ryan review report is the culmination of more than a year of research and hundreds of stakeholder consultations. The panel spent hundreds of hours speaking with people living and working in the local area and those directly involved in the MSIR to develop a deeper understanding of people’s experiences, perspectives and suggestions. The panel’s report tells us not only that this trial is saving lives but that the service has been successful in providing access to general health, housing support and social and emotional wellbeing assistance.

The facility has safely managed around 6000 overdoses and saved 63 lives. It has taken pressure off local hospitals and reduced ambulance call-outs. In the 3½ years before the service opened there were 818 ambulance attendances involving naloxone administration – that is the one used to reverse a heroin overdose – within 1 kilometre of the service, compared to 459 ambulance attendances in the 3½ years after the MSIR opened. There has also been a declining trend in opioid overdose presentation at St Vincent’s – that is the nearest public hospital emergency department – since the service began operating. We have not seen this trend in other comparable hospitals in Melbourne, suggesting that the MSIC is helping drive these reductions. There have also been more than 112,000 people accessing health and social services providing onsite hepatitis C testing and treatment, homelessness support, mental health support, dental care, general practice and addiction support and treatment. Between September 2019 and December 2022 more than 500 clients commenced long-acting injectable buprenorphine treatment through the MSIC’s pharmacotherapy clinic. The pharmacotherapy clinic has more than twice as many appointments as any other service offered in the consulting area of the MSIC.

As outlined in the Ryan review, these achievements are all the more significant because of the complex needs of MSIC clients, who are often living in the margins of our society. Many of the 6191 registered clients have experienced high levels of psychological distress, the result of other life stressors such as housing uncertainty, unemployment, food instability and high rates of chronic and complex health issues. On behalf of the Andrews Labor government I commend North Richmond Community Health and the dedicated healthcare workers at this facility for leading these incredible outcomes and continuing to provide unwavering support and care to clients. We acknowledge that there is more work to do to further improve safety and amenity in the area, and we will absolutely work with the community to action that. But we know that the MSIC is clearly saving lives and changing lives exactly where it is.

I will say that I am absolutely supporting this bill. I know that in the neighbourhood right there in North Richmond there have been new and upgraded public housing, improvements to the housing estate grounds and communal areas, a new playground, a futsal pitch, lighting, landscaping and community room upgrades, all with a focus on improving amenity and safety in the precinct. They have gone down incredibly well with the community. That was one of the recent trips that I made to that area. This investment has also included projects to activate and encourage community usage around the area of North Richmond Community Health and the creation of a separate entrance to provide a new private screened area for clients to gather when exiting the facility. There is more work underway, and we might hear about that work from others that are familiar with and equally passionate about the MSIC continuing its operation in North Richmond, in its current location. But I say I am proudly, proudly supporting this bill because I believe it is the responsibility of governments to treat people with compassion and dignity. I believe governments should be supporting the most vulnerable instead of leaving them without support, and I commend this bill to the chamber.

Aiv PUGLIELLI (North-Eastern Metropolitan) (10:40): I am proud to rise today to speak in support of the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. This bill will make the medically supervised injecting room, or MSIR, in North Richmond a permanent site by allowing for a medically supervised injecting centre licence to be renewed more than once, among other more technical changes to both licensing and operation. The Greens wholeheartedly welcome this bill because supervised injecting centres save lives and assist drug users to get on the pathway of treatment and recovery. This is something the Greens have always supported, and I thank my Greens predecessors in this place who carried this work before me.

Drug use is a health issue. The Greens have always believed that, and the evidence and experts continue to back us up. Applying a law-and-order lens to drug issues has simply never worked. Prohibition does not work. Locking people up for drug use and possession does not decrease use of drugs in our communities; it just increases the number of prisoners in our justice system – prisoners who then do not receive adequate support to overcome drug dependence or address the underlying causes of their drug use. But what does work? What does help people who use drugs and the communities around them? Supervised injecting facilities, opioid substitution therapies like buprenorphine and harm reduction measures that acknowledge the reality that people are using injectable drugs in our communities. Leaving people out in the open without medical supervision to use these substances will lead to more deaths and more harm done to people and communities. Many people hear the words ‘heroin’ or ‘overdose’ and they switch off. They think, ‘These people knew what they were in for.’ But every Victorian deserves to get support for their health issues, particularly when those health issues are life threatening and have such a huge impact on our health system, our emergency services and our local communities.

In its time of operation the MSIR trial in North Richmond has been an undeniable success in achieving its key objective: saving lives. Overdose from heroin or other opiates can stop people from breathing, and when this occurs in the MSIR there are skilled staff to treat people, to resuscitate them and to prevent their death. On average there are around six overdoses a day in the North Richmond centre, and they have been treated with a 100 per cent success rate. There have been almost 6000 overdose events in the MSIR during the trial, and none have been fatal. Conservative modelling suggests that during its time in operation the MSIR has prevented up to 63 deaths. As at September of last year the North Richmond site had had to close to 350,000 visits. That is 350,000 times members of our community had access to a hygienic, safe place to inject drugs with healthcare staff on call to manage an overdose.

But of course the North Richmond site does so much more than just provide that supervision and rapid overdose response. It is also a place to access other crucial health and social services. The North Richmond site offers a range of healthcare services, including primary care, oral health, hepatitis C testing and treatment, drug treatment, wound care and blood testing. Moreover, by partnering with other organisations the North Richmond site is able to offer co-located legal, employment and housing support services. Altogether, the site has provided 112,000 health and social support service interactions on site, including over 2500 homelessness support service interactions through Launch Housing. It is also important to note that the site does not just offer a gateway to health and social services for people who inject drugs – it also provides treatment for drug dependence on site. More than 700 people have commenced opioid agonist treatment, and more than 3200 people have been referred on to external drug dependence related health and social support services.

The MSIR’s impact on the local community is undeniable. It has played a crucial role in dramatically reducing ambulance call-outs for opioid overdoses in its vicinity and led to far fewer overdose-related admissions at its nearest public hospital emergency department. It has also contributed to reducing the spread of bloodborne illnesses such as hepatitis C. I applaud the team from North Richmond Community Health. They have done an extraordinary job developing and managing the centre and all of the complexity that this brings. The exemplary performance of the North Richmond site has more than proved the utility of and need for a facility like this.

However, the Greens do have some concerns about this bill in its current form. We are disappointed to see that the government is not accepting all of the evidence-based recommendations from the expert panel they commissioned to undertake the Ryan review of the MSIR’s performance. The Ryan review’s recommendations clearly identify the need to expand the eligibility criteria for clients of the MSIR. Creating barriers to accessing safe injecting services will not reduce the number of injecting drugs being used; all it will do is ensure people use these drugs on the streets without supervision or a safety net. It is unclear why the government refused to accept the expert panel’s recommendation to expand the eligibility criteria for use of the MSIR. As it stands, currently people under the age of 18 years, pregnant people and those under a court order, as well as people requiring peer- and partner-assisted injecting, cannot access the safe injecting room. These groups are some of the most vulnerable, and denying them access to supervised injecting or referring them away to another site when they are standing at the front desk of the North Richmond site is putting them at risk of more harm.

There is also no sense in needlessly delaying the establishment of further supervised injecting facilities where there is evidence of need. We know the government has bought a building for a community health service incorporating a discrete supervised injecting room in Melbourne’s CBD. Every day in Melbourne people are risking death by injecting drugs on the streets and in car parks, laneways and public toilets. Approximately one person a month dies after using heroin in the City of Melbourne. Just last month a joint letter in support of a trial of a CBD safe injecting room was signed by 78 CEOs and other leaders from a range of community organisations. Drug and alcohol, health, housing, legal, religious and welfare and support services all came together to support this life-saving facility.

Every day we delay, more people are at risk of overdose and death. The government seems to be backing away from evidence-based harm reduction in places where we are seeing an increase in use, overdoses and deaths, including in the Melbourne CBD, Dandenong, St Kilda, Geelong and beyond. These communities are crying out for support. The Greens want to make sure that where there is a need for a safe injecting site, one can be provided. And this does not have to mean that every safe injecting centre has to be a permanent, purpose-built site – we certainly do need more of those – but we should also be able to provide pop-up-style clinics or rooms that could be rolled out more quickly to respond to changing community needs. The evidence is in: safe injecting rooms save people’s lives. So building more of these rooms will save more lives.

Another concern we have is about the implications for the service if an MSIR licence is granted to a hospital. Having spoken to the management at the North Richmond Community Health service, as well as a number of other stakeholders, both the Greens and these stakeholders are deeply concerned about the consequences of a hospital playing a more significant role in the operation of the MSIR. We all know that hospitals are under incredible pressure; doctors, nurses and all hospital staff are overworked, they are burning out and they are leaving health care are many instances. The pandemic laid bare the pressures on our health system, and there is much to be done to ensure that our public hospitals are the fully resourced institutions that we all need and want. But for the provision of a medically supervised safe injecting room, I implore the government to continue with the community health model of service. A community health service has already been exemplary in the running of the MSIR. They are closest to the ground, and they are expertly able to provide the responsive and holistic care required for clients of a safe injecting centre. We already know that there are barriers preventing effective referrals for MSIR clients, even to the services next door. It is about building relationships, reducing stigma and creating a comfortable environment for people to seek support. Community health services have the skills and knowledge to offer specialised and holistic care for clients of the MSIR. I strongly believe that the government should continue to support community health services in the provision of this service.

The Greens are proposing some straightforward amendments that will allow the government to be more responsive and more comprehensive in minimising the harms of opioid use in our community. I am happy for those amendments to be circulated now.

Amendments circulated pursuant to standing orders.

Aiv PUGLIELLI: These amendments have been led by the government’s own Ryan review into the performance of the North Richmond site. I will speak to them in more detail during the committee stage, but in brief they seek to allow for multiple MSIR licences to operate at the same time at multiple locations so that if and when more safe injecting rooms are announced, there is no need to write new legislation to grant the licences for additional centres. Our amendments put in place the provisions that will allow this to occur as required.

Secondly, our amendments expand the eligibility for people to access the MSIR. As I have mentioned already, there are currently certain groups of very vulnerable people who do not have access to safe injecting at the MSIR. Our amendments would permit access to this service to pregnant people, those under 18 and those on a court order, provided that the court order does not prohibit them from attending the centre or accessing its services. They also provide for those who require peer- or partner-assisted injecting to have access to the MSIR. Our amendments are based on a health-led response to drug use. They acknowledge the reality that all sorts of people inject drugs and that if this is occurring, then we want them to have access to safe injecting and wraparound services to provide them with medical supervision and support pathways that reduce harm. As I have said, I will speak more to this in committee.

The Greens also understand that supervised injecting facilities are only one part of a holistic approach to reducing drug-related harms and lifting people out of drug dependence. As the recent Royal Commission into Victoria’s Mental Health System found, there are strong links between drug addiction and poor mental health. Moreover, Victoria’s mental health support sector is in urgent need of reform, with services continually under-resourced and often extremely difficult to navigate. Mental health is of course a complex issue that is impacted by a range of social and physical determinants. Right now the system is so fragmented and so difficult to access for those most in need of support that for many people it does more harm than good. This is particularly true for people struggling with drug dependence. Clients accessing the MSIR are nearly 40 times more likely to exhibit signs of PTSD than the general population. They are far more likely to have experienced multiple serious life events or traumas – for example, family violence, abuse, death of family members and so on. The government must ensure that an MSIR site is set up to provide best practice, wraparound mental health care that is supported by an integrated, well-resourced mental health sector, as recommended by the royal commission.

This is also true of MSIR’s clients’ current ability to receive pharmacotherapy treatment. Pharmacotherapy is crucial to helping people end or reduce their drug use. It provides chemical relief from the symptoms of chronic pain and withdrawal. When MSIR clients were asked to select a single statement that best described what they wanted in regard to their drug use, 42 per cent had abstinence-related goals, with a further 20 per cent aiming to reduce use or get it under control. Additionally, almost 90 per cent of MSIR clients have received treatment in the past for heroin use. This demonstrates an extremely high level of willingness to overcome drug dependence. What we need to step up is Victoria’s pharmacotherapy system to support that desire to change. Victoria’s pharmacotherapy system is currently unable to meet the needs of the community, with major workforce issues and a dwindling pool of doctors and pharmacists willing to take on pharmacotherapy patients. We need a massive injection of public funding into the sector and urgent statewide reform to meet the need of our community.

We welcome the government committing to accepting several of the recommendations from the Ryan review, including making the North Richmond site permanent and expanding and better integrating mental health and pharmacotherapy services.

Before I conclude my remarks I would like to remind people that we are talking about life-saving health care. These reforms will very literally save lives and lift people out of drug dependence and instability. The MSIR should be above politics. People are using injectable drugs. Leaving people out in the open without medical supervision to use these substances will lead to more deaths and will put people and communities in harm’s way. We have to do better. I reiterate the Greens’ strong commitment to a harm-reduction response to drug use and to the amazing and ongoing success of the North Richmond medically supervised injecting room. I commend this bill to the house.

Evan MULHOLLAND (Northern Metropolitan) (10:56): This is an important debate, and I see it as an important duty to stand up for my constituents today, being the Liberal member for Northern Metropolitan and having consulted with my local constituents. I am very keen to address the proposed permanent enshrining of the Labor government’s medically supervised injecting centre (MSIC) in Richmond.

If passed, this bill will ensure that a policy program whose intent has merit will forever be tarred with the failures of its execution. I do not come to this debate as an opponent of the idea of a medically supervised injecting centre. The evidence is clear that these centres, when integrated and when they have appropriate consultation and preventative measures with their surrounding communities, can drive effective harm minimisation and rehabilitation of some of our state’s most vulnerable and most disadvantaged people.

I am very glad that the coalition has come to this position. I remember being a candidate for the Liberal Party in the 2018 election. I was given a corflute to put up of a needle going into someone’s arm saying ‘Stop the injecting room in x suburb’. From memory I very quickly put that corflute in the back of my car and did not put it out for voters to see as they were coming in to the polling booth, so I am very pleased about the position. I guess that might be the libertarian in me in terms of my personal views towards harm minimisation and drugs in general, which are probably more in line with Mr Puglielli than some of my colleagues.

There is no debate around the injecting room in New South Wales. There is no debate – politicians do not talk about it really – around the Kings Cross facility, so we know that this can be done right. But that is not what has happened in Victoria. It is not what happened in Richmond. Residents have not been listened to by the state government. The government have not even really thought to investigate how things have happened and been done in New South Wales. There has been no feedback, consultation, advice or research at all. I know they have failed to consult because as their local member in the upper house it is my job to listen to residents, and that is exactly what I did on Monday night with members of the Richmond community. I was there at the All Nations Hotel with my colleague the Shadow Minister for Health Georgie Crozier and many of the residents that are joining us in the gallery this morning, and I urge all of you to have a chat to those locals and see the effect the injecting room is having. Like me, locals in the North Richmond community are not against an injecting room. What they are against is it being next to a primary school.

I think it is important to hear the views of locals first. I have been listening to parents of the children who attend Richmond West Primary School and some of the stories of what school students have had to see. No child should ever see what these students have had to see. As I said, most residents support the idea of the facility. The site’s location has never been suitable for the work required of this centre, and we know some of the site’s problems. It is located less than 50 steps from Richmond West Primary School and continues to distress parents, who are rightly concerned when they see injecting needles scattered across school grounds and violent abuse on the surrounding streets. It has a massive effect on the Victoria Street traders, whose businesses have been pushed to the wall as a result of this centre, and they are concerned for their safety. I have spoken to Ha Nguyen, the head of the traders association. There are only a couple of businesses that are profiting locally: the illegal drug market and if you are a glass repair business, because about every third day a shop on Victoria Street has their front glass broken. I am not sure how many of you on the other side have tried to run a small business, but that seems pretty unsustainable to me, and I come as someone who has lived in the area. I used to live in Abbotsford. I remember a time when Victoria Street was somewhere you would travel to. Now it is just somewhere that you travel through, and it is quite disappointing and quite sad to see the state of Victoria Street. I urge some of you to catch the tram down and have a look for yourselves.

At the time the government announced it would make this facility permanent, I condemned the government for not allowing the review to consider the location of the injecting room. As I said, it is like announcing a review into the effectiveness of Victoria’s quarantine system and not allowing the use of private security guards into that review. The main point of contention was left out of the terms of reference.

I want to say that advocates agree – and I have spoken to them, I hear them and they have told me – that the location of this centre has ruined the reputation of injecting rooms and made it a lot harder to put any injecting rooms elsewhere, in places like Springvale, in places like Dandenong, where an injecting room could possibly go. It is much harder to do so because of the location of this centre. So what we are saying is let us have a reset. Let us pass our sensible amendments to move the injecting room so it can be 250 metres away from a school or childcare centre. The research from the Sydney injecting room literally says that the best location for it is next to a train station so as to not create an ant trail of harm and abuse, and that is exactly what has happened. If any of you have been to North Richmond station, between North Richmond station and Lennox Street is an ant trail of harm and abuse. As I said, I am not against the idea of a supervised injecting room, but the location is the most crucial factor when making such a decision.

I thought it was best put when I heard one mother, Josie Carberry from Richmond West, who highlighted that her kids, like other kids, have seen things that no kids should see and that locals do not send their kids to a school to learn about knuckledusters and flick-knives. We heard from Tilly, a nine-year-old student at the school, who bravely spoke to Neil Mitchell about what it was like to have classes put into lockdown because of the drug users from next door. Asked what she wanted to do when she grows up, she simply said:

… move somewhere else where there’s not these sorts of people.

Just today we have heard from Ky, a 15-year-old student who was on the front steps of Parliament. As I was saying before, some of these students have seen things that no 15-year-old should see and no primary school student should see.

The Ryan report, while it was a closed shop on assessing the suitability of location, did at least admit there were some negative sentiments from members of the community. One resident commented that:

I walk my daughter to school, witness fights, brazen drug deals, drug use, drug-affected people.

Another local resident expressed disappointment that her five-year-old daughter:

… is familiar with what a syringe looks like, and what to do if she sees one.

The antisocial behaviour stemming from the injecting room is not only affecting the primary school next door. The Ryan report highlights that locals are intimidated as they seek access to other essential health services that are co-located at the same site of the North Richmond community complex. The Ryan report itself includes:

Safety and amenity is the key issue –

as families –

… need to be able to have a picnic and run barefoot in their backyard and not fear stepping on needles.

My final excerpt from the review is from a harm reduction expert, who is quoted as saying:

When the public see [intoxicated people], that is not a good outcome for the injecting room. We need to address the visibility of people … and how they are … seen. Unless we do that, we won’t convince the community of the benefits.

For such an initiative to work, I repeat once again that the government must work with the community, not against it. This has not been done in Richmond to date, and I am concerned that by pushing through this law, the Andrews government never will listen to the community. The Premier, despite all of this evidence in the government-commissioned report, has deemed this a successful trial in Richmond – no introspection, no remorse. With every proposal that the Labor government have come up with to date there has been strong local backlash from businesses and communities. The government is indeed adamant about opening a second injecting room. They first need to listen to the lessons of Richmond and fix that first. I speak to plenty of industry sources who say the latest round of consultations is more about finding out for the government than actual serious consultations about a CBD injecting room.

As I mentioned earlier, we do not have to look far for a successful model. Sydney’s Kings Cross has a notorious history of illicit drug use, which reached unprecedented peaks in the mid-1990s. The 1997 Royal Commission into the New South Wales Police Service recommended the establishment of a safe injecting site within the precinct. The initial proposal was that it be set up in a residential area, but this naturally elicited a strong response, as we have seen in Richmond. I note that it was actually the Sisters of Charity that did the research and operationalised the centre. In the year 2000, upon invitation from the New South Wales government, the medically supervised injecting centre began its operation under the guise of the Uniting Church. The key condition that the New South Wales government set for granting the licence to the church was ‘successful community acceptance’. Those are key words. All it took to achieve this was a simple reversion of the location to a more commercial part of Darlinghurst Road – as I said, next to a train station – so as to not create an ant trail of harm and abuse – funny that. Sydney’s service placed strong emphasis on community consultation and approval, which it enjoys to this day. It was established as a small and discreet facility, removing the associated stigma and keeping the social fabric of the neighbourhood.

I do want to comment on something that Ms Watt said in her contribution earlier. She said that my side of politics ‘has no regard for human life.’ What an absolutely offensive remark. I will just point out that the Uniting MSIC celebrated its 21st anniversary last May. In 20 years it has supervised over 1.2 million injections and 18,000 registered clients and successfully managed 11,000 overdoses without a single fatality, which is not something that North Richmond can boast of. So to say that we have got no regard for human life is completely offensive. In a Victorian setting it may not necessarily be the case that we need to involve a church group, but it is an example of a successful program that can be easily replicated here in this state and, more importantly, a program that works. But the government has not listened. What we need to do is take a step back, listen to the community and make the right decision about where these facilities go.

I am not against supervised injecting rooms, but Labor’s model is broken. I am against a government approach that treats community feedback as a hostile attack rather than an opportunity to improve. It is arrogant and out of touch. As my colleague the Shadow Minister for Health Emma Kealy has pointed out time and time again, Labor’s broken model does no more than pose a critical danger to the safety of children, families and the wider community. She has cited data that the local community is seeing more needles on streets, not less, and seeing droves of people coming into the otherwise vibrant community and injecting drugs.

I ask the house to support our sensible amendment so a centre cannot be closer than 250 metres from an education or care service. It will require annual reporting so that we can see the evidence stack up. This is something that advocates like my friends, like Mr Puglielli, should support, because we want that evidence and we want that consistent annual evidence. So we will be moving that as a separate amendment. Police Association Victoria secretary Wayne Gatt said we do not want, in three years time, to come back with a report that says, ‘we’ve got a problem with amenity’. He is someone that agrees with that. So I call on the Andrews government to be up-front and be honest with the community about its plan for a second site but commit to a genuine process of community consultation and finally commit to ensuring community amenity and safety. (Time expired)

Jacinta ERMACORA (Western Victoria) (11:11): I am pleased to offer my contribution on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023, which seeks to make permanent the current medically supervised injecting centre in Richmond. I will start off by acknowledging Father Bob and his support for this concept. The state funeral of Father Bob will be held tomorrow at St Patrick’s Cathedral. He was an advocate for people experiencing drug addiction and related issues for a very long time.

Father Bob dedicated his life to supporting those in need. He is known for his work with the homeless, marginalised and disadvantaged in the community and his commitment to social justice and equality. He was a generous, sharp, exceptional maverick Catholic priest who epitomised values of love and generosity towards the most disadvantaged in our community. He was not interested in issues of hierarchy of the church but rather doggedly persistent in his support for all people in his neighbourhood. He believed community is made up of compassion, care, common sense and communication. He established the Father Bob Maguire Foundation to provide material, emotional and social support to whomever, whenever and wherever necessary. His motto was, ‘We leave no-one behind.’

The advocacy of his foundation is based on the principle of working actively with the community and with like-minded organisations to implement new and sustainable solutions for people who need support, so it is hardly surprising that the Father Bob Maguire Foundation was one of 80 organisations to recently write to the Premier Daniel Andrews in support of the concept of medically supervised injecting rooms and in fact, as reported in the Age on Friday 10 March 2023, requested that a second medically supervised injecting centre be established. I feel it is very apt to channel the values of Father Bob as I speak to the bill, which seeks to help and support those who find themselves in difficult circumstances, rather than judge or police them. The evidence supports a response to drug addiction as a health issue requiring treatment and support rather than as a moral failing or a criminal activity. It should not be used to drive fear and panic in communities. It is about regard for human lives and the lives of people who are loved.

The trial of the current medically supervised injecting centre in North Richmond began in 2017 and was unprecedented in our state. It was a brave step to take – a safety-first medical approach to address the decades of harm caused by drugs in the City of Yarra. For decades the City of Yarra had experienced the harm caused by drugs. In 2015, before the medically supervised injecting centre was established, 35 people died from overdoses related to heroin purchased or used in the City of Yarra. This government wanted to stop people from dying of drug overdoses. Medically supervised injecting centres provide controlled, safe and hygienic environments for individuals to inject drugs. The centres are staffed by trained medical professionals, who are equipped to respond to overdoses and other medical emergencies that may arise from drug use.

From a health and human service practice model perspective, this approach is often referred to as a ‘health promotion’ or ‘harm minimisation’ strategy in contrast to one of judgement and punishment. No evidence supports punishing someone for being drug addicted, but there is plenty of evidence that a punishment approach makes others feel righteous. The centre provides sterile injection equipment and disposal facilities, and the service is designed to be a non-judgemental and welcoming environment that provides access to additional healthcare services, drug treatment and other support services. This provides a safe environment that encourages drug users to seek help, as evidenced by the reviews, and can lead to improved health outcomes.

In addition to supervising injections the medically supervised injecting centre provides access to health and support services, including mental health services, drug treatment and rehabilitation support. Two independent reviews have been conducted over the trial period. An independent panel chaired by Professor Margaret Hamilton AO recommended a further review be undertaken, resulting in the Ryan review chaired by John Ryan in 2023.

Since opening in June 2018 the facility has safely managed more than 6750 overdoses and saved 63 lives. This has taken critical pressure off hospitals and, critically, achieved a 55 per cent reduction in ambulance call-outs in the area. Ambulances are therefore freed up to be called out elsewhere, potentially saving even more lives. Significantly, for many it has led to a reduction in the spread of bloodborne diseases such as hepatitis C and HIV within the City of Yarra. The trial has been a valuable tool in helping us learn what works well and what can be improved. A lot of new ground has been broken, and I commend and appreciate the work done by North Richmond Community Health and the dedicated healthcare staff workers for their unwavering support and care to their clients during this time.

This bill aims to strengthen the current medically supervised injecting centre experience and continue saving lives with an enhanced outreach service, drawing on the evidence emerging from the reviews and local health data. The terms of reference for these reviews asked panel members to consider the North Richmond service’s operation and use and the extent to which the service has advanced its goals as set out in the underpinning legislation and to provide advice to government on the recommended changes. If we have a look at the goals of the service as set out in the existing legislation, they are: to reduce overdose deaths and overdose harm – tick; to provide a gateway to health and social services for people who inject drugs – tick; to reduce ambulance attendances and emergency department presentations attributable to overdoses – again successful; to reduce the number of discarded needles and syringes going to public places – progress made; to improve neighbourhood amenity for residents and local businesses – again improved; and to assist in reducing the spread of bloodborne diseases – again improved. Significantly, the Ryan review made the recommendation to make permanent the North Richmond service as an ongoing service in recognition of the critical lifesaving service it provides. This bill draws on the results of the reviews and implements the recommendations.

Knowing that the future of the service is permanent will greatly facilitate making ongoing improvements. It will include coordinated care to support clients to access key health and social issues. It will deliver specialised services for vulnerable cohorts, including women and Aboriginal and Torres Strait Islander peoples. A recommended recommissioning process will be put in place following this amendment to identify a provider with capacity to deliver an improved model of care that will support the needs of medically supervised injecting centre clients. The enhanced and more assertive outreach service will play an important role in supporting safety and amenity in the community.

We acknowledge as most reasonable the recommendation to deliver a visible service presence across North Richmond to engage people who inject drugs. Outreach workers will patrol for discarded needles and promote safe and appropriate needle disposal. It needs to be recognised that long before the centre was established the issue of amenity was clearly of grave concern within the Richmond community, and it is recognised there remains more to be done to improve safety and amenity in the community. Evidence shows that if the medically supervised injecting centre was not located in North Richmond, most people would continue to visit the area to access the street-based drug market that has operated in the area for at least two decades.

The enhanced outreach service model will provide additional support to the North Richmond community, including with increased hours of operation, and will be delivered by a multidisciplinary team which includes nurses, Aboriginal health workers and those workers with lived experience. The service will work to improve coordination and response between Victoria Police and housing estate security and strengthen partnerships with existing outreach services for the network of homelessness, mental health, case management, alcohol and other drug treatment, legal, post-corrections and harm reduction service providers. The service will engage with local businesses and community members to respond to community concerns. Through the enhanced outreach and continued presence of the medically supervised injecting centre, public amenity will also continue to proactively improve.

Already the Victorian government has been investing across the North Richmond precinct, investing over $200 million to upgrade and develop new public housing accommodation and to upgrade the housing estate grounds and communal buildings. This includes new playgrounds, a futsal pitch, lighting, landscaping and community room upgrades. There has been more than $14 million invested in place-based action for additional CCTV cameras on the North Richmond estate, homelessness outreach and improving the Richmond West Primary School drop-off zone. An additional $1.7 million has been spent to improve the entrance to North Richmond Community Health, to improve the landscape and to reduce congregation outside the medically supervised injecting room.

I know there has been a lot of angst aired by the opposition regarding the medically supervised injecting centre being located next to a school, but let us be realistic: we know previously the area near the school was completely unregulated and the amenity was poor and worsening over the years. The centre was established in the area due to the dire need. Richmond West Primary School is a great school with a strong academic record and a wonderfully diverse student population from culturally, linguistically and socio-economically diverse backgrounds. Richmond West Primary School have been strong supporters of the medically supervised injecting centre since it was established, and we thank them for their ongoing cooperation. They are aware of plans to make the service ongoing at its current location, and we will continue to work with them as we implement the Ryan review’s safety and amenity recommendations. Department of Education enrolment data shows that student numbers at Richmond West Primary School have largely remained stable over the last five years.

In conclusion, I note that this issue is complex. The medically supervised injection centre addresses the complex array of problems. The Andrews government is actively seeking solutions. Sometimes the facts and evidence do not line up with our personal views and opinions. In fact sometimes new evidence, such as the improvements in the health outcomes and amenity, challenges us to change our position on an issue, even if we have long-held opinions and even if they are views that are emotionally based rather than evidence based. I call on those involved in this debate today to put aside hard and fixed positions and to collaborate with the Andrews government to save lives and make North Richmond a safer community.

David LIMBRICK (South-Eastern Metropolitan) (11:25): I am pleased to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I have said many times in this place my views on drug prohibition: I believe that it has been one of the most catastrophic policy failures of the Western world. People often talk about the harm caused by drugs, but we also must talk about the harms caused by prohibition. As we can see, drug prohibition does not protect drug users, it does not protect the wider community. There is only one group that it protects, and that is organised crime. The drugs that have been coming into Australia are usually from war-torn nations where they are harvested by war lords and distributed in our local networks by organised crime. This is a direct result of drug prohibition. That money that these people spend on drugs goes to these foreign networks and props up this evil trade.

To our credit, Australia resisted international efforts between the 1930s and the 1950s. For almost two decades we resisted international efforts to criminalise heroin. We did this much later than many other countries, and one of the reasons that we did this later is because our medical community – doctors – believed that they could treat people with addiction. Eventually, through international pressure, we caved and joined in on the catastrophic war on drugs that has been going now for a very long time. When we see the negative effects of prohibition, especially in this state – the gangland wars, the Lawyer X saga, the murders, the people suffering from overdoses – all of this ultimately is rooted in our catastrophic drug prohibition and war on drugs policy. In a mad scramble, many governments throughout the world have tried to alleviate some of these harms caused by prohibition. To our credit, after much to-ing and fro-ing under the Bracks government, who had plans to open five of these centres but did not go ahead with them, eventually we opened up the medically supervised injecting room in Melbourne.

Before I talk about the room, I want to talk about the people that are affected by drugs. In 2021, in metro Melbourne alone, 151 people died of heroin overdoses. These people, they are not junkies. They are our fellow Victorians, they are people with families that love them, and we need to be compassionate about the situation that they have found themselves in. I have been very impressed by some private organisations, charities and others, that have done work to try and help these people. One in particular I would like to mention is Family Drug Support, I have gone along to a lot of their events now. They acknowledge that ultimately the people that help those with drug problems the most are their families. Families can feel very alone when they have got someone close to them with severe addiction issues, and this organisation provides families with tools and support for how to deal with those challenging scenarios.

The goal of the supervised injecting room was firstly to help save people’s lives, and I think in that goal it has been quite successful. Another of the goals of the centre was to get people who were isolated and in the streets into our medical system so that they could get treatment not just for drug issues but also – as I found out when I went on a tour of the centre – simple things like dental treatment, because many people have dental issues and that can be a huge problem. I met someone who had serious dental problems, and getting their teeth fixed changed their life. They were able to get a job; they did not feel confident enough before because they were missing teeth and stuff. Simple things like this can really change people’s lives.

But one of the other things that really struck me when I visited the centre was something that I did not fully appreciate. There is a lot of talk about stopping people dying from overdose, and that is what the focus is on, but one of the more insidious effects of overdose is acquired brain injury. When someone overdoses on heroin their respiratory system slows down and sometimes unfortunately they can die, but in other cases they can acquire a brain injury, and this can be a lifelong injury. In some cases it is really severe; in other cases it is mild. But this can result in a lifetime disability that means that this person may not be able to ever get a job, socially integrate or do all of the normal things that someone without this sort of injury could do, so saving people from that is a wonderful thing.

However, on some of the things that the injecting room was proposed to do, such as improve local amenity, from the Ryan review and after talking with residents – I was very pleased to meet some residents yesterday – I think it is very clear that it is right to question the location and to question whether amenity has been improved in the local area. I do not really see a problem with having that conversation about whether this is the right location for it. I share Mr Mulholland’s view that it is important that a centre like this succeeds, because if it does not succeed, that means that it will be resisted everywhere that the government attempts it. It is very important that it succeeds not only in helping drug users but also in getting the buy-in and the support of the local community. I do feel that discussing the location of the centre is an appropriate discussion that we should be having.

The other thing I would note is that the residents that I have met do not oppose having a centre. In fact I was struck by their compassion for drug users and their understanding that these are our fellow Victorians and that we need to help these people. But they were also concerned about criminals dealing drugs in the area and many of the other local amenity issues that have been canvassed at length through this debate. I think it is important to think about what we could do better here. To that end one of the things that I am proposing in an amendment – I will not circulate it now; I will wait until the committee stage – relates to one of the things that they do at the centre. One of the treatments for people is they can get pharmacotherapy, which is basically providing some other drug, often an opiate, as a substitution – drugs like methadone, suboxone and buprenorphine. I am proposing that we give the centre the ability to expand those options. In particular I am thinking of a drug called hydromorphone.

It is my view that every single person that we get onto opiate substitution therapy instead of taking heroin, every single person that gets onto one of these substitutes is one person that we are taking out of the hands of organised crime, it is one person that we are bringing into the medical system. And I think that eventually we will have an opportunity to seriously undermine organised crime in this state through ensuring that doctors can provide prescriptions for these substitutes so that people will not have to deal with organised crime, we will not have to worry about dealers on the street and we will not have to have people having adulterated substances and all this sort of stuff. I think that this was recommended by the Ryan review – to expand pharmacotherapy options.

If my amendment fails today, at the very least I would urge the government to be more bold in this area. As I say, the more options that we can provide, the more people that we can take out of the hands of organised crime and help to bring them to the support of the medical system and their families and communities, the more advantage. I do not think that it was ever anticipated that the centre would have a positive effect on undermining crime and drug dealing in the area, but I think we really need to take this opportunity to look at what more we can do to stop this in Victoria or at least reduce it to a level that we might be more comfortable with.

With regard to other amendments, I believe that the opposition will be moving an amendment to look at changing the location, to put restrictions on the location with a transition period. I will be supporting that amendment, but opposing this bill overall is not an option in my mind. Regardless of whether you support the injecting centre or not, the consequences of this bill failing will be a public health catastrophe. What it will mean is at the end of the trial period the centre will immediately shut down, and the consequences of that are almost too horrendous to think about.

I will not be opposing the bill overall. I will be supporting some amendments and proposing my own to expand pharmacotherapy options, but I would urge everyone in this place to seriously consider the consequences of this centre abruptly shutting down with no transition period. I think that would be a catastrophe for this city, and I would urge everyone, regardless of whether they support the centre or not, to at least think about the consequences of that.

Matthew BACH (North-Eastern Metropolitan) (11:37): I am pleased to rise and make a contribution on this debate as a representative of the original parties of harm reduction here in Victoria. We have heard some interesting contributions from the government and from the crossbench and, dare I say it, from members on this side of the house, and it is worth noting, given the tone and tenor of some of that commentary, that on this side of the house we have always had a deep commitment to evidence-based harm reduction policies.

Jeff Kennett famously put the wonderful Professor David Penington at the head of his drug advisory council, who provided frank and fearless advice to government – something we could have more of these days – and advocated for reforms, many of which of course Mr Kennett picked up and ran with. Then of course during the long and fruitful period of coalition government in Canberra between 1996 and 2007 Mr Howard and his government, albeit quietly, invested very significantly in needle and syringe programs, expanded those harm reduction programs and methadone programs – and we have just heard about replacement programs from Mr Limbrick. This was done at a state level under Mr Baillieu and Mr Napthine, and at that time I had the great privilege of being an adviser to the minister for drug abuse, and so I know some of the great work that was done in expanding rehabilitation options as well. So never let it be said, at least not with a straight face, that on this side of the house we do not support evidence-based harm reduction policy.

My understanding, however – I did not hear her remarks – is that Ms Watt took the government’s ongoing position that anybody who has any problem with the current arrangement in North Richmond is against policy that saves lives. She took the government’s position, I understand, to the grotesque extreme of arguing that on this side of the house we have no regard for human life. That is my understanding of what she said, which is a disgusting slur.

I am Shadow Minister for Child Protection, and under this Labor government record numbers of children are dying in care. Record numbers of children have been dying under the five different child protection ministers I have faced off against in the last two years. I think there is incompetence. I think there is policy failure. I think there is a lack of priority. I would never in a million years say that any of those Labor ministers do not care that vulnerable children are dying in state care. That would be a disgusting and despicable thing to say, yet it is my understanding that that is where Ms Watt went in this debate.

The last Labor speaker talked at length about the situation at West Richmond primary school, and I would like to start my contribution there, in particular because I have responsibilities on this side of the house as spokesperson for education. I have engaged extensively with parents in West Richmond. I am not aware that any member opposite has done that, so it was interesting to hear about collaboration. I think we should be collaborating with the local community. In particular, when it comes to the placement of this facility, we should be collaborating with parents and children at the primary school. We heard from the last Labor speaker that everything is going swimmingly, actually, at West Richmond primary school. We heard that enrolments are very strong and that things are going very well. Well, my advice from a parent after she finished speaking was that prep enrolments have collapsed at that school. That is despite the fact that this Labor government has a rigid and archaic system of school zoning that basically forces parents to send their children to a certain school. I would ditch that system of school zoning, but that is an argument for another day.

So despite this Labor government’s archaic system of school zoning, which basically forces parents to go to one particular school, prep enrolments, I am advised – by a parent at Richmond West Primary School, no less – have in fact collapsed over this period. And that does not surprise me, because, unlike any member of the Labor Party, I attended a huge community meeting back in 2021 at the All Nations pub. The local member was invited – a Labor member at the time – the minister was invited and numerous other Labor members were invited. I was there, Ms Crozier was there and numerous other members of Parliament were there, and to be fair to those of other parties there were numerous members of other parties there. My understanding, my recollection, is that there was a Greens member there and there was a socialist from the local council there but not a Labor member in sight. And the mood in the room was very different from, respectfully may I say, the mood described by the previous Labor speaker. Nobody – no parent who was there, and many parents were there from the primary school – was in favour of the placement of the injecting room.

At one point a question was asked of parents about whether or not their children had found used needles on their way to school, and more than half of those in the room said they had. There are various other harms that have been experienced by children at that school that have been extensively discussed, and in particular I want to recognise in the gallery today several residents of North Richmond – some parents from the school. I would note that one lady in the gallery nearly had a fit at one point when the previous speaker was banging on about the regard that local residents have for the current arrangements. Sadly, she is not able to speak today, but I am. Like her and like other members of the local community, I have much sympathy for, much empathy for, those unfortunate members of our community who find themselves, often as a result of many complex circumstances, addicted to various drugs. We should have an evidence-based approach in place to support them that could even involve something like a safe injecting room. But next to a primary school? No.

The harms that this has caused have even been noted by our otherwise largely silent education minister. She has in fact spoken about what is occurring in this community at the primary school, and she has acknowledged that there is now far more security at Richmond West Primary School. Well, if everything is hunky-dory, if there are no problems in that community, I am not entirely sure why you would need so much more security.

Young children from that community have been speaking. I am very interested in the views of their parents, but as a former teacher, I am always first and foremost interested in the voices and views of children themselves. A different young person to the one described by Mr Mulholland also spoke on the radio and was asked a relatively soft question in the interview about what she wants to do when she grows up, and she simply said, ‘Move somewhere else.’

It is not a safe thing and it is not a reasonable thing to have a facility like this, no matter how much we may empathise with the unfortunate souls who need it, directly next door to a primary school, so I will support the amendments that are being moved by those of us on this side of the house simply to ensure that a facility like this is in a more proper location. I do not think it is possible to argue that that entails a deep disregard for human life. I think that is simply a sensible approach that seeks to balance, if you like, the rights of children and their families to a safe education and a good education and our obligations – the obligations of the state – to unfortunate people in our community, oftentimes who themselves have experienced significant trauma and, through a range of complex circumstances, find themselves addicted to various drugs.

I was interested to hear about collaboration from a backbench member of the Andrews Labor government, no less. Nonetheless let us do that today – let us listen to one another, let us have a respectful discussion, let us not engage in shocking slurs. Let us listen, let us pay due regard through this debate to the voices of children and the voices of local people in North Richmond who have a different view from the views of some experts who have been quoted by the government – not necessarily that facilities like this should simply be shut down. I confess when I have been engaging with parents, I have not heard the backward views being expressed that the government is purporting to have heard about people who are addicted to drugs. I have not heard those views. I confess that all I have heard and all I have seen is people who have deep empathy for unfortunate members of our community who find themselves experiencing very troubled times but who, nonetheless, simply want their children to be safe. I actually think that there is a sensible way forward embodied in the coalition’s amendments that will allow us to do both of those things.

Sonja TERPSTRA (North-Eastern Metropolitan) (11:47): I rise to make a contribution on this bill, the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I have had the benefit of listening to some of the contributions that have been made this morning, and certainly Dr Bach’s contribution just a moment ago. I will comment that, strangely, I find myself actually agreeing with some of what Mr Limbrick said earlier about the fact that people who find themselves with a drug problem or a drug habit need therapeutic responses. I think what we are hearing a lot from the opposition is that we have got to lock them up and we need a punitive approach to these things. That does not work; it does not actually work.

Nicholas McGowan interjected.

Sonja TERPSTRA: I will take up the interjection from those opposite because it is implicit in everything they say. You will not come out and say these things directly, but it is implicit in every single thing you say. I can categorically say that despite Dr Bach talking about empathy, there is a complete lack of empathy in the way in which the coalition is dealing with this particular issue. You sit here wanting to lecture people, but I can tell you one thing: the views of some of those opposite are ‘Lock them up and throw away the key.’ They are very simplistic in their views and lack an understanding and have completely ridiculous notions about how people who have complex medical needs should be treated.

This program is about harm minimisation. I can say that from experience with people in my community. Certainly growing up and working in various places, I have seen people fall over when they have had an overdose of heroin. In fact I have witnessed somebody actually having an overdose after they had a hit of heroin. They were seeking treatment through a methadone program. They had gone in and had some methadone and fallen over on the pavement. They had young children with them. This was in New South Wales. I was relieved to see people come out of that facility to render aid and assistance, because that person would have died.

What you opposite want is for no-one to have any help ever and just for them to rot in jail. That is what you want. You will not say it because you are gutless. It is implicit in everything you say. I listen to the constant carping from those opposite about, ‘We shouldn’t do this, it shouldn’t be there and we can’t do this.’ But you offer no alternatives. You offer no alternatives whatsoever, because you have got no new ideas. All you listen to is Sky after dark and you talk to yourselves constantly. I wonder if when you join up to the Liberal Party you get a free subscription to Sky News,for those people to write your talking points and your speaking notes over there, because honestly, what I have heard from people on the opposition benches today is absolutely disgraceful. You have used the debate to malign Ms Watt in terms of what she had to say – someone who is a very fine representative for her community and deeply understands the issues affecting people in her community. But, no, those opposite seek to malign people in this debate, and it is a thorough disgrace.

Again, you have got no new ideas over there. All you have done is use this debate to continually attack people who need medical assistance. It is nothing short of an embarrassment over there, the way you conduct yourselves.

Members interjecting.

The PRESIDENT: Order! Other contributions have been heard in relative silence, so I ask the member to continue.

Sonja TERPSTRA: Thank you, President. As I say, it is an embarrassment and it is shameful that all those opposite have done today is really try and weaponise this issue and upset people who are really looking for solutions to this problem. No-one on the government benches is saying that this is an easy problem to fix. In fact Mr Limbrick’s contribution touched on the fact that drugs and organised crime are longstanding problems. If it was easily fixed, governments around the world would have found the solution a long time ago and fixed it. But those opposite just want to lecture us and say, ‘You’ve got to do this. You’ve got to do something different. You’ve got to have a different approach.’ Again you have got no real solutions, because you do not consult with people. All you do is make stuff up that is going to hurt people. You want to hurt families, and you certainly do not have any sympathy for victims or for people in some of the contributions I heard earlier. From Mr Mulholland there was the conflation of someone who might be suffering a drug habit and talking about crime – I mean, this is the way that you just make out that everyone is the same. Not everybody who has a drug habit is necessarily going to commit crime. There are people from all different strata of society who might have a drug habit or actually take recreational drugs. But, again, because you do not understand – you fundamentally do not understand, you do not have it in you to fundamentally understand the nuances.

Members interjecting.

The PRESIDENT: Order!

Sonja TERPSTRA: They fundamentally do not have it in them to understand, on the opposition benches, the nuances that are involved in these things. Again, this is about making sure that people can get the help that they need when they need it. I just talked earlier about an experience I had with someone who went in to have their methadone, they came out and they OD’d because they had previously had a hit of heroin. They fell over on the pavement. There were young children with that mother, and so if there was no medical facility available for that person, she would have died. So what are you saying? Those opposite actually do not want people –

Nicholas McGowan interjected.

The PRESIDENT: Order!

Sonja TERPSTRA: So again, the point is that someone who needs medical attention should be able to get that. They should not then suffer an overdose and potentially die. And that is the issue here, so the point is –

Nicholas McGowan interjected.

The PRESIDENT: Mr McGowan, you actually have not had your contribution yet. You will have a chance to rebut anything anyone says in here, if you wish, when you get your time.

Sonja TERPSTRA: Thank you, President, and I will continue. Again, Mr McGowan and his constant interjections just show how incredibly rude and disrespectful he is being in this debate.

Nicholas McGowan interjected.

Sonja TERPSTRA: As the President just remarked, you will have your turn to say whatever you want to say, but in the meantime I should be able to continue my contribution and talk about the important work this government is doing in supporting people. I will say it again: I still have not heard in any of the contributions from those opposite about what their idea or response is for helping people who are addicted to drugs. They do not understand the nuances and the complexities around this.

Sometimes when people have a drug habit they have what are called comorbidities going on. That is a really big word and what it means is that there are other things that might be going on. There could be medical conditions, there could be psychological conditions, there could be acquired brain injuries, so sometimes people use drugs as a coping mechanism. Sometimes, if people have psychological problems, they also use drugs to self-soothe. It can be a form of escapism, and it does not mean that they are all criminals either.

Nicholas McGowan: No-one said that.

Sonja TERPSTRA: The contributions that I have heard this morning have all been about conflating this issue with crime. Again you just embarrass yourselves over there constantly with your total lack of understanding about what people need. I heard Mr Bach say the medically supervised injecting room should not really be in West Richmond. If it is not meant to be there, then where can it go? Everyone would have some type of objection. I can say that as someone who was growing up in Sydney at around the time the Kings Cross medically supervised injecting room was going. It is still there today. There is a level of concern around it, but people have come to understand the benefits that are provided through that service and the harm minimisation. People felt that they did not want to see people fall over and overdose on the pavement and then have to call an ambulance and wait for that service to come, so to have that medical assistance available right then and there is something that is still very important in that community today.

As someone who has come from New South Wales and has had decades of understanding how that facility works and then seeing it in action in Victoria with further discussion about expanding it or opening different ones, it is disappointing. I think Ms Ermacora talked about it earlier. Coming together and working on this is what is really important and collaborating and making sure that we can get the best response for people. No-one wants to see someone die on the pavement, with their children next to them. That is what you really want to see over there. Again, it is just a disgrace and an embarrassment.

Members interjecting.

Sonja TERPSTRA: Like I said, I wonder if when you join the Liberal Party it is part of your tick-a-box kind of form that you have got to fill in that says ‘Yes, I would like a subscription to Sky News so you can publish my ridiculous rantings about all manner of things –

Members interjecting.

Sonja TERPSTRA: The ridiculous rantings about all manner of things that you know Sky News will publish so you can keep talking to yourselves. There are no new ideas that I am hearing from those opposite on the opposition benches today.

Again, it is up to us, the party of government, to make sure we help people in their communities when they need it and when they need it the most. We will continue to make sure that we support people who might need assistance when they need it.

Members interjecting.

The PRESIDENT: Order! I have not been here the whole time, but I think most of the contributions have been heard in relative silence. I will call Ms Terpstra to continue without any help for a couple more minutes before we get to question time.

Sonja TERPSTRA: Thank you, President. I might note that since the trial commenced the Victorian government has invested more than $200 million across the North Richmond precinct. This has included new and upgraded public housing and improvements to housing estate grounds and communal buildings, including new playgrounds, a futsal pitch, lighting, landscaping and community room upgrades, all with a focus on improving amenity and safety in the precinct. And we will continue to engage and communicate with locals in the area about what they need and what they tell us about what needs to happen.

In terms of the school, the Department of Education continues to support Richmond West Primary School to ensure the medically supervised injecting centre operates in a way that accounts for the needs of the school. Supports that have been introduced to support the local community include upgraded secure fencing; electronic lock and video intercom systems; closed-circuit television; strong protocols to support students, including a comprehensive student wellbeing program; and employment of community liaison workers during school drop off and pick up. Department of Education enrolment data shows that student numbers at Richmond West have largely been stable over the past five years.

As Ms Ermacora noted in her contribution, this really is a time for all of us to come together and try and work together to resolve these problems, because again those opposite would never have any new ideas about how to actually resolve a problem. It will be up to –

Business interrupted pursuant to standing orders.