Thursday, 4 May 2023

Bills

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

Second reading

Debate resumed.

Sonja TERPSTRA (North-Eastern Metropolitan) (12:52): I note I do not have much time left on the clock, so it is worthwhile just finishing that off. Again, I note the response from those on the opposition benches throughout my contribution was to constantly interject and heckle, and it is just disappointing. It is a poor reflection on them over there.

There are two things I want to point out in the short time that I have left. If those opposite are saying that the medically supervised injecting room should not be where it is, well, if not there, where is the point, because no-one will want it to be anywhere. And if we do not have it anywhere, we will not have the important ability to minimise harm and provide medical assistance to those who need it if they have an overdose.

The other thing that I think is lost on those opposite is that often when you are treating someone who has a drug addiction they do participate in a methadone program. There are many chemists right across Melbourne that dispense methadone, and there are many people who go into those chemists and take their prescription methadone and then leave. The idea that this supervised injecting room is a bad thing to be placed where it is conflates a whole bunch of things. It just shows that they do not understand the suite of options that are available to treat people who have drug addictions. Like I said, there are many chemists in many communities right across Melbourne who dispense methadone. That is about helping people get off whatever it is they are on and then treating them in a therapeutic way to help them overcome their drug addiction. Again, I commend this bill to the house, and I look forward to the continuation of the debate.

Sitting suspended 12:54 pm until 2:04 pm.

Ann-Marie HERMANS (South-Eastern Metropolitan) (14:05): I rise today to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I do recognise that a lot has been said about the injecting room in North Richmond attached to the North Richmond Community Health centre. I do want to also add that while we will be talking about the injecting room, a focus of the Liberals and Nationals at the last election was people with alcohol and drug addiction and looking at ways that we can help people who choose to reject this form of lifestyle, who have been on alcohol and drugs and who have got to a point where they want to break free of them. The government put out a $40 million cut to the sector. We wanted to bring about opportunities for people to have access to health support networks and to put more money into this area. In fact, after looking at the Ryan report, we felt that it was really important to introduce a hydromorphone therapy program in Victoria, and this is a policy that we took to the last election.

The Victorian Liberals and Nationals will be moving amendments to the Andrews government’s injecting room laws and calling for an explicit ban on injecting rooms being located within 250 metres of schools. This amendment mirrors New South Wales legislation. This bill, which has been introduced in other areas, has been a concern because it does not address the impact of poisoning. While we acknowledge the need for services to help addicts break the cycle and live full, healthy lives, we need evidence-based solutions where there are pathways to help those with addictions to be treated in a suitable area that would benefit both users and the community, particularly our young schoolchildren.

I do feel very passionate about this issue because I am a mother of four children and I have worked in schools. I have worked in social work, I have worked with the homeless, I have worked with young people who have had to deal with really difficult areas in their lives, and yes, I have worked with young people who use drugs. I feel very strongly that the location of an injecting room needs to be considered. Objections to the drug-injecting room facility being based in areas which impact local communities are based on the negative impacts on North Richmond residents, who have suffered for years with unacceptable and dangerous behaviour on their front doorsteps. In fact Wayne Gatt, the Victorian police union secretary, said that the positioning of drug-injecting facilities impacts police work enormously, with a rise in offences such as property crime, crimes against the person, robberies and assault. He also said that unless the government were to dump a significant number of police on us specifically for the management of a safe drug-injecting facility in the city, undoubtedly Victoria Police would have to divert resources from other work that it is doing today. His suggestion that the facility should be put in or near a hospital is one that would save lives. It is a valid suggestion and worth considering.

Police have been called to dozens of violent crime incidents. Data obtained by the Herald Sun under the freedom-of-information laws – this is from Susan Delibasic and Olivia Jenkins, 26 March 2023 – has shown the true extent of violent incidents and medical episodes that both police and paramedics have responded to in Lennox Street, Richmond. Statistics show that from June 2018, when the facility in Richmond opened, until June 2022, the following incidents have been recorded – and I would like these recorded, and I would like people to take note – 162 incidents of people causing trouble, 83 reports of assault, 57 reports of street drugs on Lennox Street, 20 suicide attempts, nine reports of gunshots and stabbings, 10 overdoses, and paramedics also responded to five deaths in Lennox Street.

I ask you: is this the type of environment that we want for an area near a school? For those of you who have children and have any empathy for what it must be like to raise your family in an area with a drug-injecting room, think of these families in Richmond where this primary school is in their zone. It is where they have to take their kids to school. Grandparents have to walk their children to school, and we find that we are having all of these incidents. I ask this house and I ask the government to consider: would you want your parents and grandparents and children to have to be surrounded by this type of crime? Would you want them to have to witness this sort of thing?

During the COVID lockdowns we were well aware that there was a rise in issues of mental health and that there was a lack of support and networks that were available to people, and we are aware that during this time many people were turning to alcohol and drugs to self-medicate. The Liberals and Nationals had a proactive policy to help drug addicts. We feel very, very strongly about not just looking at the drug-injecting room in isolation but actually considering it in conjunction with the community which it is in. It is very, very important that we look at this in a holistic way, because if you are looking at reducing harm and the only people you are looking at are the drug addicts who are using the injecting room, then you are missing the whole point of being purposeful in looking after people in the community. You must consider the actual location for a drug-injecting room.

It is just, I find, an incredible thing that this government thinks that it is appropriate to put a drug-injecting room next to a primary school. Having worked in schools and having worked with young people and knowing the issues of peer pressure and groupthink, I find it an assault on the family and an irresponsible decision of this government to put a drug-injecting room near a primary school. So I do hope that the government and the crossbench will consider our amendment.

I wonder: if it was your child, would you want to have to put up with primary school aged children coming home with needlestick injuries? Would you want that to be the topic of your conversation when you meet your child after school? And what about children, once they have had a needlestick injury, having to be tested regularly for hepatitis? Or your parents or your grandparents walking your children home past drug deals – is that what you want? Is that okay? I think we need to seriously consider when we are looking into these issues the impact that these things are having on the community.

I also want to consider the comment that was made by Sheena Watt that this side of the house, the opposition, has no regard for human life. That is an absolute lie. What an insult. This is a party that has always cared for people. It has been founded on the principles of caring for people and of valuing people’s lives.

I want you also to consider that in 2021, after the trials of these injecting rooms began, a community meeting took place, and over 100 residents and anxious parents from Richmond West Primary School were asked if their child had found a needle in the school grounds. You need to understand that half of them raised their hand. That is just not okay. It is not okay to have that many people at a community meeting who can say that their children have come home because they have found a needle in the school grounds.

What are we doing to this community? What avenue of responsibility is this government taking for everybody, for our children, for your children? If we are really going to care about what happens when we look at the issue of drugs and drug-injecting rooms, we need to consider this from a holistic perspective. What impact is the drug-injecting room in Richmond having on the community?

I think that the other thing to consider is that we have a number of people who feel that they actually need to move. In another case I think you would remember, there is a situation where a nine-year-old girl named Tilly – and this may have been mentioned – who attends Richmond West Primary went on radio with Neil Mitchell and described what it was like to be sent into lockdown at school because of drug users at the neighbouring Richmond drug-injecting room:

They just say stay in your classrooms, they say the school is all safe and locked up.

And when Neil Mitchell asked Tilly what she wants to do when she grows up, she said:

I’m probably going to move somewhere else where there’s not these sorts of people.

This government has claimed that the school community supports the location of the injecting room, but, you know what, it is not a consultation. It is not okay, and we need to consider how we keep school environments safe. So I do urge the house to consider the amendments that we have proposed. We need to also remember that when the Ryan report was produced it was not considering the data and how it was impacted by COVID. COVID did impact the data. Lockdowns did impact the data. And so we need to remember that in a holistic position you cannot be caring for people if you are going to have a drug-injecting room near a school.

I would like to conclude simply by reminding the house that the opposition has proposed an amendment that this facility be at least 250 metres away from the nearest school, and we hope that all of you will have the foresight, the compassion for humanity and the care for the families in this community to genuinely be bipartisan in the way you approach this and consider our amendment.

Tom McINTOSH (Eastern Victoria) (14:18): In late 2017 the Andrews Labor government announced the first trial of a medically supervised injecting room (MSIR) in this state’s history. This was bold, brave action taking a safety-first medical approach to address the decades of harm caused by drugs in the City of Yarra. The establishment of the trial followed growing concern 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 have been 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 in February 2023 an independent panel chaired by Mr John Ryan delivered the second review. These reviews provided solid evidence that the service is doing what it is designed to do – saving lives and changing lives. Since opening in June 2018 the facility has safely managed more than 6750 overdoses and saved 63 lives. There have also been more than 3200 referrals to health and social services, including general practitioners, oral health, housing, drug treatment and bloodborne virus testing and treatment.

One of the most significant recommendations the Ryan review made is to keep North Richmond as an ongoing service, which is why we have introduced this amendment bill to achieve exactly that. Key changes in the bill include making the North Richmond medically supervised injecting centre an ongoing service at its current location, the ability to transfer or reissue an MSIC licence to another provider, the ability to extend a licence and the ability for a service to have clinical nursing oversight as an alternative to supervision by a medical professional.

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. Every single life lost to drugs is a 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 is designed to do: save lives and change lives.

Just about medically supervised injecting centres: the first supervised injecting facility opened in Switzerland in the 1980s. There are now more than 120 legal services worldwide. Most recently the Australian Capital Territory has 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 provides a safer place for people to inject drugs of dependence in a supervised health setting. It is an alternative to injecting at home or in public, where people are more likely to die, suffer other harms from drug use and raise risks and concerns for family members or the general public. It also provides life-saving interventions for people who 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 into broader supports such as medical care, drug treatment and hepatitis C screening and treatment. It offers referrals to other health and social supports such as mental health counselling, treatment for alcohol and other drug (AOD) issues and housing services.

Dealing with drug addiction in the community is a complex task, 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 first 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 whilst also addressing safety and amenity concerns.

To the review of the North Richmond service: two independent reviews have been conducted over the trial period. In June 2020 an independent panel chaired by Professor Margaret Hamilton AO delivered the first review of the trial, recommending a further review be undertaken, and in February 2023 an independent panel chaired by Mr John Ryan delivered the second review. 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 any recommended changes. The goals of the service as set out in legislation are to reduce overdose deaths and overdose harm, to provide a gateway to health and social services for people who inject drugs, to reduce ambulance attendances and emergency department presentations attributable to overdose, to improve neighbourhood amenity for residents and local businesses, to reduce the number of discarded needles and syringes in public places and to assist in reducing the spread of bloodborne diseases.

The recently released Ryan review report is a 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 medically supervised injecting room to develop a deep understanding of people’s experience, perspectives and suggestions. The panel held 102 local consultations, which involved listening to local residents, businesses, people who inject drugs, MSIR workers and police and ambulance representatives. They also held four round tables with health practitioners, human service providers and AOD harm reduction experts, and commissioned research and sought advice from experts in Australia and overseas on models of care, community engagement, approaches to improving amenity and opportunities for service system improvement. The panel also reviewed relevant literature, looked at communications and security processes and analysed the evidence to determine the extent to which each of the service’s six goals has been advanced to date.

The panel’s report tells us that the trial has not only saved lives but the service has been successful in providing access to general health, housing support, GPs and social and 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 to reverse a heroin overdose within 1 kilometre of the service, compared to 459 ambulance attendances in the 3½ years after the MSIC opened. That is a 55 per cent reduction. As tweeted by Danny Hill, secretary of the Victorian Ambulance Union, 6000 overdoses managed by the MSIC means 6000 less ambulance call-outs.

There has also been a declining trend in opioid overdose presentations at St Vincent’s, the nearest public hospital emergency department, since the service began operating. We have not seen this trend in other comparable hospitals in Melbourne, suggesting the MSIC is helping drive these reductions. There have also been more than 112,000 health and social services provided on site, including 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 had 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 at the margins of society. Many of the 6191 registered clients have experienced high levels of psychological distress as a result of other life stressors, such as housing uncertainty, unemployment, food instability and high rates of chronic and complex health issues. A MSIC client told researchers:

I remember when I first started using heroin, you’d go down two sets of floors (in the Richmond flats) and use in the stairway. It wasn’t an uncommon sight to see three or four people dead in the hallways. So, to have these rooms is a blessing.

A paraphrased client interview transcript published on the North Richmond Community Health website gives a firsthand account of the immense value of this service. It says:

The addicts go to the injecting room because they think their life is worth saving. They should be treated as people who want to live their life, so let’s help them. No-one is out there to hurt anyone. All an addict wants to do when they go to use an injecting room is walk out alive. And by going to the injecting room, there is an avenue to get some help.

It’s ground-breaking, I would be dead without the injecting room. Or I’d probably still be using.

On behalf of the Andrews Labor government, I commend North Richmond Community Health and the dedicated healthcare workers at the facility for leading these incredible outcomes and continuing to provide unwavering support and care to clients.

The North Richmond trial has been a valuable tool in helping us learn more about what works and what does not in the operation of the MSIC. The panel have made 10 recommendations, including continuing the MSIC as an ongoing service, expanding support for clients and addressing safety and amenity through stronger collaboration between agencies. We are getting on with implementation of the most immediate priority recommendations.

One of the most significant recommendations the panel made was to keep the MSIR as an ongoing service, which is why we have introduced an amendment bill to Parliament – to achieve exactly that. The 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 MSIR clients. An interdepartmental committee will be established in mid 2023, formally bringing together efforts by the Department of Health, Victoria Police, Ambulance Victoria and the Department of Families, Fairness and Housing (DFFH), including Homes Victoria and other departments as required.

The vast majority of people who use the MSIR have experienced considerable trauma, and the review recommended that more should be done to provide better access to integrated treatment, care and support for vulnerable groups, including women, Aboriginal clients and those who are living with mental illness. The review recognised the incredible outcomes delivered by the dedicated team at North Richmond Community Health during the trial and recommended a recommissioning process be undertaken to identify a provider with capacity to deliver the expanded care model at the existing North Richmond site. By ensuring the MSIC can deliver more integrated health and social services we will be aligning with recommendations from the Royal Commission into Victoria’s Mental Health System and better meeting the long-term needs of both clients and the broader North Richmond community.

We acknowledge there is work we must do to further improve safety and amenity in the area and will absolutely work with the community to action that. But we know the MSIC is clearly saving and changing lives exactly where it is. Since the trial’s commencement the Andrews Labor government has invested more than $200 million across the North Richmond precinct. This has included new and upgraded public housing and improvements to the housing estate grounds and communal buildings, including new playgrounds, a futsal pitch, lighting, landscaping and community rooms. This investment has also included projects specifically around the MSIC to activate and encourage community usage of the area and create a separate entrance to provide a new, private, screened area for clients to gather when exiting the facility. There is also work underway led by DFFH and Homes Victoria to improve coordination between security providers in the North Richmond precinct. The Department of Health is also establishing a new North Richmond enhanced outreach service that will address gaps in current outreach services. The enhanced outreach service will provide additional support to the North Richmond community, including increased hours of operation, and will be delivered by a multidisciplinary team which includes nurses, Aboriginal health workers and lived and living experience workers. The service will work to improve coordination and response between Victoria Police and housing estate security and strengthen partnerships with existing outreach services and networks of homelessness, mental health, case management, alcohol and other drug treatment, legal, post corrections and harm reduction service providers. The service will also engage with local businesses and community members to respond to community concerns. We are confident that the implementation of these recommendations will go a long way to improving the experience of the precinct as well as the capacity of the service to proactively engage people who inject drugs in North Richmond.

The bill will amend the Drugs, Poisons and Controlled Substances Act 1981 to allow the North Richmond MSIC to become an ongoing service at its current location; to allow for the transfer and reissuing of an injecting room licence to maintain service continuity in the event an operator is subject to profound organisational change or is unable or unfit to continue to operate the service; to allow for the secretary to extend a service licence for a duration specified at their discretion to support service continuity during the recommissioning process and to extend the licence as many times as the secretary deems appropriate; to allow for a more flexible model of care by allowing for clinical nursing, oversight as an alternative to mandated supervision by a medical professional and a greater clarity of governance roles; to allow for a more efficient process for modifications to the MSIR operators’ internal management protocols; and to allow for a further review of the operation of the MSIR. These amendments will implement key recommendations from both the Hamilton and Ryan reviews. I absolutely support this bill and hope that its implementation supports those workers and those with addictions alike.

Jeff BOURMAN (Eastern Victoria) (14:33): We are here today to have a look at the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I cannot speak for the other person in this room that has had the pleasure of cleaning up after the carnage of drug users, but I can tell you from my personal experience: I do not really care what people do to themselves; if they want to inject themselves, that is fine – but it is the carnage that they create around them. I find it mystifying, in a way, that a government is facilitating an illegal activity. But in letting that go, no amount of thought has been given to the residents. Clearly the people in the Richmond area have issues – and they are real issues. There is footage everywhere of people overdosing and people lying in the gutter and all sorts of stuff going on. Being so close to a primary school is just appalling. There must be a better place, and I am really disappointed that the bill does not even allow for it to be moved. It should be moved. For a second room to be proposed or implemented or whatever before the kinks are ironed out of the first one is just wrong. I will not be supporting the bill. As I said, I do not really mind what people do to themselves – I never really have – but considering what they do to get and what they do after they use those drugs, unless we look at how we can offset that, I think implementing another room is just the wrong way.

Trung LUU (Western Metropolitan) (14:35): I rise today to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I rise today to speak on the amendment and this bill with, dare I say, some experience and some personal encounters in relation to this particular topic. I would say that that experience would cover a range of over two decades, having observed and interacted with the community in relation to the matter, having dealt with those affected by drugs, having dealt with families who have been affected by drugs and having had encounters with people who have been caught in the legal system because of drug use and the drug cycle they have been in. I am not too sure how that is going to compare to the one year of research or the consultation hours for the report, but I do speak with a small amount of experience in relation to the matter.

My concern in relation to the medically supervised injecting centre is that by supporting this bill we are not really prioritising helping those unfortunates who have fallen into the cycle of drug use. Instead we are conceding and giving up on helping them to get rid of their drug addictions and the cycle of drug abuse that they are in. It also severely aids and abets drug pushers, drug dealers and organised crime syndicates. My concern is that when we say this bill will save lives, what we do not really say is how it will affect lives – those lives in the community and the livelihoods of all those people that it has touched in the area, where there is business, where there are residents and where there are families that have been involved in the drug abuse. In promoting this sort of centre and in constructing it in this sort of setting, we are actually not only preventing deaths by overdose, but we are actually sending a message to the wider community that it is acceptable to use drugs, and we are sending a message to kids saying that it is okay to use drugs.

But the real tragedy of this bill and putting the medically supervised injecting room (MSIR) in the particular location that the government has put it in is that we are encouraging the wider community to come along to Victoria Street, Richmond, not because of the fabulous Vietnamese cuisine which it has been known for but instead to score and to shoot up without getting arrested.

Having worked in the area for the past 20 years in Collingwood police station, in Fitzroy police station and in Richmond police station, which involves the whole Yarra precinct, I have seen over the decades what drug operations can do to minimise drug use and the harm to residents and those caught in the drug cycle. I have seen the way in which the drug cycle can repeat itself. Unfortunately, people try to get out but occasionally they have to fall back in. That is an unfortunate situation, but we have to keep trying to get those who are caught in the cycle off it, not encouraging them to keep using.

Before I continue going on in relation to talking about overdoses and drugs, I just want to bring it back to what we are actually encouraging. Instead of focusing on getting drug users over their addictions, we are promoting them. Let us have a closer look at what we are actually promoting – injecting poisons and various hazardous chemicals into a person’s body. We are just using ‘drugs’ and ‘overdose’ as words that we just seem to throw about in here, but what are they really?

I will just look at one drug among many which have been in use at the centre by drug users. I will focus on one which is on the streets. It is more like a natural substance, being heroin, which originates from a poppy in the form of a tar-like substance. To break that substance down into what we see now on the streets as a white powder, you have to break it down or dilute it with bleach or with various chemicals. From that substance, if you want it to hit the streets, you have got to cut it down, and to do that there are various layers of poisonous substances being used, because it is too poisonous – it is too toxic – to inject into your body. You can use baking soda, sugar or starch. People have used painkillers, talcum powder, milk powder, detergent, rat poison and caffeine. So all this stuff is cut down into a small dose of heroin which can be injected into your body, and yet we are just talking about it as some sort of substance which it is okay for us to encourage its use. Just think about it.

Heroin is one drug which, from a drug user’s point of view, is a natural substance which originates from a plant. Yet all this poisonous stuff, we are saying, is okay to inject into your body. Are we really saving lives or are we prolonging their lives in agony instead of trying to assist them to get off the drug, to get away from the drug and to not use it anymore? Resources should be put into that, not into encouraging its use. There is no doubt they are saving lives when the MSIR people respond to an overdose. I encourage that and I applaud those emergency services workers for saving those lives. But we as legislators should be trying to encourage all those on drugs to get off them first, rather than just throwing up our hands and saying, ‘No, it’s okay. You can use it. We’ve given up on you. We will make sure you inject and go home okay.’ That should not be our priority. That should be the second priority – making sure you go home okay – but we should make sure the first priority is that we try to help you get off it first. I just want to emphasise that.

That is just one substance being used at the moment. Fentanyl is another artificial substance, next to opium, but it is 30 or 50 times more poisonous. Again, to break that down there are various poisonous substances or agents being used to cut it down. I just want to emphasise what kinds of substances we are encouraging people to put into their body.

In relation to the people living there, the issue of great concern to me is the location of the MSIR. One, it is in a high-density population area, with the high-rise flats. Secondly, it is right next to a school. I want to focus on the school part first. Besides the syringes, which have been statistically shown in the report itself, of the over 6000 registered MSIR clients, only 51 per cent attend to use the facility and 49 per cent attend the Richmond area to purchase the drug of their choice. With that, Yarra City Council has noted that in the vicinity prior to the COVID pandemic, 8000 syringes were collected each month – which had been used. But after the pandemic it skyrocketed to 18,000 being collected each month. This is outside the premises. This does not include those that have been discarded in the bin and does not include those that have been used in the centre itself. So that is a side effect in relation to having the centre in the area and the discarding of syringes in the area and how that affects residents.

I just want to read an email, one of a few, which will give you a clearer picture in relation to people living in the area, not just from what I am saying. One email – this is from one of the parents – says:

My family are refugees from a war-torn country, we live in the estate too – my children are scared everyday when I drop them at school – they are scared for me getting home safely.

Another says:

My son has autism, walking him to and from school is so stressful – he touches surfaces and picks things up – the area is littered with … body fluids – blood, urine … there are constantly needles on the street that I have to try and stop him picking up. It is so unhealthy.

Another person said:

My son can now spot the difference between a person affected by Ice versus a person affected by Heroin.

This is a kid. And it goes on in various emails and letters I have received from constituents in the area. And that is not including all the people I spoke to over two decades in the Yarra area when I was working at police stations in Richmond, which is a couple of blocks away from where the centre is, Fitzroy and Collingwood.

Moving forward in relation to Victoria Street, I want to touch on this very quickly before I run out of time. I have seen the devastating effects it has on businesses and those living in the area. Victoria Street used to be one of the most recognised festival streets in Victoria. It was not only national, it was worldwide. Now half the shops are gone and half the restaurants have gone over the past six years, and we cannot blame it on COVID. This happened before, and it was mainly because of the increase in drugs in the area, moving south from Fitzroy. They moved people from Fitzroy down toward the estate in Richmond. Then this centre was built in 2021, which was supposed to be a trial – a trial to save lives, which some residents did support because they said it was going to save lives and that it was a trial. They tell me now they were misled: ‘They said it was a trial and they were going to move it on, yet now they are saying it is a permanent spot.’ They have approached us to say, ‘We have been misled. We supported it to save lives, and we are all 100 per cent behind it doing that, yet it has brought all this antisocial behaviour and violence.’ I will not go into all the other serious issues it has led to in the area.

I will speak briefly in relation to seeing deaths and overdoses. Prior to working at those stations I worked for 12 years in the major crimes team where I responded to overdoses prior to the ambos coming. It has been increasing in relation to the centre. Whatever the reports say, the number has increased. Prior to me coming into this Parliament the number of responses outside the centre increased in relation to overdoses. Responses to those, whether just a lapse or an overdose where they did Narcan straightaway or not, have increased surrounding the centre. On whether the centre has attracted more people coming from the wider community, I do suggest and the report says the centre should record where these people are coming from – are they from the area or are you increasing and promoting the use of drugs from outer areas in Victoria Street, Richmond?

I will give you a good example. Footscray 10 years ago was flooded with drugs. The police put on operation after operation, and they got rid of it – gone. Now it has all moved over to Richmond because we agreed to have this trial and now they want it permanently. I want to emphasise how the people of Richmond have been misled by this government going ‘It’s a trial’ and placing this centre in an area of high density and also in a school area.

In closing, I would like to say I do not support the bill. I strongly support the reasoned amendment about moving the centre away from the school, because it is affecting our future – Australians’ future – and the kids in the area. I do hope all the people in this chamber will think closely in relation to what message we are sending out there. Are we endorsing the use of drugs and encouraging people to use drugs, or are we trying help them? Please support this reasoned amendment, and if you can, vote against the bill.

Ryan BATCHELOR (Southern Metropolitan) (14:50): I rise to speak on this bill, which I am a strong supporter of. In beginning my contribution today I want to start with the experiences of Judy Ryan, a local North Richmond resident and one of the activists whose advocacy led to the establishment of Australia’s second safe injecting room, right here in Melbourne. In her book You Talk, We Die Judy spoke about life in the community before the injecting room opened. She described walking past overdoses in the area in public and local residents becoming immune to the sight of overdosed persons in car parks and other local places. Obviously the local primary school, Richmond West Primary School, a school with which I am familiar, has been a focal point for debate in the chamber today. For them, they have been dealing with the realities of injecting drug use in their community and surrounds for decades, long before this centre opened. We can also look at the firsthand experiences of one of the clients of the medically supervised injecting centre, who said:

No-one is out to hurt anyone. All an addict wants to do when they go to use the injecting room is walk out alive. And by going to the injecting room, there is an avenue to get some help.

It’s ground-breaking, I would be dead without the injecting room.

Fundamentally that is what this bill is all about. It is about saving lives.

Some who oppose the medically supervised injecting centre and this bill to establish it permanently would have you believe that the centre is causing some sort of honey pot effect, attracting drug users to North Richmond. Well, as Judy and other locals would tell you themselves, the drug trade in North Richmond was operating well before the establishment of the medically supervised injecting facility five years ago, and in fact the existing drug trade was the key reason that North Richmond was chosen as the location for the medically supervised injecting centre.

That does not mean that there is not work to be done to improve the amenity of the area for locals, and a strong theme to come across in both of the independent reviews of the centre has been the safety and amenity of the area around the centre. Since the commencement of the trial the Victorian government has invested considerably in the local community. More than $200 million is being spent to develop and upgrade new public housing accommodation and housing estates in the local area, including new playgrounds and community rooms; more than $14 million is in place for closed-circuit television cameras on the housing estate and improvements to the Richmond West Primary School drop-off zone; and there is also $1.7 million to improve the entrance to the North Richmond Community Health centre, which houses the medically supervised injecting centre, to reduce congregation outside the service.

But in addition to the physical works that are being done and the capital that is being spent, the Department of Health is establishing a new North Richmond enhanced outreach service which will address gaps in current outreach services. While the centre is primarily a place for people to safely inject drugs of dependence, one of its benefits is that it also functions as an onsite healthcare service which facilitates referrals to drug treatment and health and other supports. The enhanced outreach services will include multidisciplinary teams of nurses, Aboriginal health workers and lived and living experience workers to support the local community. This service will work to improve coordination and responses between police and housing estate security and strengthen partnerships with existing outreach services. So the safety and the amenity of the local community in North Richmond are a top priority for the government. The expansion of the service model at the existing centre will allow medical practitioners to address the complex health needs of the clients of the centre, which we can do to help improve the local amenity in the area.

The permanent establishment and the recommissioning process introduced in the legislation will allow for this enhanced model of outreach services and provide coordinated outreach to those who publicly use drugs in North Richmond. It will provide harm reduction, case management and support services as well as a proactive community-wide outreach response, which is a response that has been raised by many in the local community.

Others have mentioned the importance of the recommendation that the Ryan review made in respect of improvements to the service, and it made several recommendations to improve safety and amenity in the local area. This bill paves the way for immediate measures to be taken to increase safety and wraparound supports for the clients of the medically supervised injecting centre.

The review was tasked with assessing the trial against its objectives, which include contributing to a reduced number of overdose deaths, ambulance attendances, discarded injecting equipment in public spaces and the spread of bloodborne viruses as well as increasing clients’ access to health and other social support services and the consequent effects that would have on improving safety and amenity in the local area.

The report itself is an important piece of work that is a culmination of significant research, extensive community consultation and consultation with users of the centre, health services and other interested parties. There were more than 100 local consultations, to be exact, in addition to the desktop research undertaken as part of the report’s development. The report, on which many of the government’s subsequent actions have been based, was driven by data and lived experience, and it tells us in no uncertain terms that the medically supervised injecting centre has saved lives – 63 lives, to be exact. Sixty-three lives have been saved in the five years since the medically supervised injecting centre opened in North Richmond. So there are families right across Victoria whose loved ones are still with them today because of the services offered in North Richmond. Six thousand overdoses have been managed, with zero fatalities, at the centre. Ambulance call-outs have been reduced by 55 per cent. Opioid-related overdose presentations to St Vincent’s Hospital, which is just up the road, have declined, a trend that has not been seen in other hospitals in Melbourne. More than 3200 referrals have been made to external wraparound health services, including to general practitioners, oral health, housing, drug treatment and bloodborne virus testing and treatment, and more than 112,000 health and social services have been provided on site, including hepatitis C testing and treatment, homelessness support, mental health support, addiction support and treatment. Those are the facts. Lives are being saved and services are being delivered, all because the centre is operating as it should be.

The government is also focused on getting on with the implementation of the priority recommendations of the Ryan review, including the introduction of this bill, to make the service permanent – to make sure that the gains that we have made are locked in. In addition to listening to and implementing the recommendations of the Ryan review, the government’s actions to ensure the centre can deliver integrated health and social services to some of our most vulnerable citizens also align with recommendations from the Royal Commission into Victoria’s Mental Health System.

The legislation will pave the way for some immediate changes to the service based on the Ryan review. These include introducing a more flexible model of care by allowing for clinical nursing oversight as an alternative approach to supervision by a medical professional, a more efficient internal management process, the ability to transfer or reissue an injecting room licence to maintain service continuity and a further review of the operations of the centre to commence before June 2028. The review recommended changes to the operating model at the centre, many of which will occur through the recommissioning process this year.

In the bill, amendments in clause 7 to section 55F of the substantive act allow for service continuity during the recommissioning process, which means that the Department of Health can identify providers with greater capacity to deliver an improved model of care as recommended by the review, which includes assertive outreach programs to deliver a visible street presence around North Richmond to engage with people who publicly inject drugs. The program will engage individuals in the community who are not currently using the service and actively remove inappropriately discarded injecting equipment. Outreach workers will also promote safe and appropriate needle disposal and will contribute to the strategies that I have already discussed to improve the safety and amenity of the local area.

Expanding the services available to provide greater support for clients with complex needs will occur through the recommissioning process. Just as community health services are renowned for building trust and engaging with people who might otherwise fall through the cracks of the system, more advanced and tertiary services can also offer streamlined pathways into specialist care, and this range of services are required and will be driven through the recommissioning process. Importantly, making the medically supervised injecting centre permanent allows the government to invest properly in the long-term strategies to improve service delivery. By giving that certainty we show our commitment to this model of care, which demonstrably works, and provide confidence to those people who have come to rely upon it that those services not only will be continued into the future but will be made permanent so they know that they are there to help.

Ultimately we want to stop people dying from drug overdoses, and it is very clear that for decades across different parts of Melbourne that has been the reality of the severe harm that can be caused by drug use. We know that in 2015, 35 people died from overdoses related to heroin purchased or used in the City of Yarra. The trial of the medically supervised injecting centre in North Richmond tells us that many of the clients accessing the service have complex and trauma-filled backgrounds, and the centre provides them with help and support from a broad range of services, including mental health, drug treatment and rehabilitation. So it is what they get – the range of services they get – when they walk through the door that is so very, very important for not only saving their lives but providing them with the support that they need. The centre also includes a pharmacotherapy clinic, 35 hours a week, with more than 500 clients accessing long-acting or monthly injectable treatments, treatments that allow people to stop using heroin without withdrawal symptoms. That is 500 people who have now been able to safely access rehabilitation services.

In making this contribution today, I would like to take this opportunity – while I obviously acknowledge the complex needs of the clients who are accessing the centre – to thank the staff who work there, who are doing such an incredibly important job to save people’s lives, and obviously doing it in the understanding that there is a lot of public debate and public scrutiny on the work that they are doing. But they are not faltering in their work, in their attempts to make sure that injecting drug users are treated and supported, and that is something which I think we can all be grateful for and thank those staff for. So day in, day out, they are working tirelessly to save lives and create a safe and hygienic place for their clients to receive support and treatment.

In considering and supporting any piece of legislation, it is important to understand the policy intent and potential impacts of this legislation. This bill, I believe, is an important and integral part of the Andrews Labor government’s plan to tackle issues associated with drugs and drug harm here in Victoria. The reviews of the trial have clearly shown that the centre is saving lives and reducing ambulance call-outs and the number of people needlessly dying in our streets.

The bill makes the centre permanent and facilitates sensible changes to the service model and other operational improvements. The bill attempts to lock in these gains and make improvements for the future, because the evidence coming out of the medically supervised injecting centre in North Richmond speaks for itself: saving lives, reducing instances of public injecting, and taking a safety-first medical approach to addressing the decades of harm that have been caused by drug use in the City of Yarra. It is working, we should support it, and that is why I am proud to support this bill in the chamber today.

Sarah MANSFIELD (Western Victoria) (15:03): I am pleased to speak in support of this bill today, while also arguing that we would like to see some aspects of it go further, just as my colleague Mr Puglielli has outlined earlier this morning. There are three premises on which our position on this debate are based: (1) people who inject drugs are people and have the same rights as anyone else; (2) drug use happens and will continue to happen, regardless of what laws are in place; and (3) the medically supervised injecting room (MSIR) is a health service.

Point 1: people who inject drugs are just that – they are people first and foremost. People who inject drugs are of all ages, genders and stages of life, including sometimes children and pregnant people. Drug use is just one aspect of their life. They have a broader life story. They have families, they have friends, they are members of our community. One in 20 Australians over 16 has a substance use disorder. We would all likely know someone who has experienced substance addictions. Statistically there are likely to be several members in this chamber who have themselves experienced substance addiction; 1.5 per cent of people have injected drugs during their lifetime, and it is possible statistically that some people in this chamber may have as well. While not everyone who injects drugs has a substance use disorder or addiction, many do. Despite how common it is, addiction is the most stigmatised health condition globally. This perhaps explains why whenever a discussion of treatment options comes up they are seen as controversial and not just as a routine part of clinical care. We have heard several contributions today that implore us to think of the children. I agree; we should think of the kids and the message we are sending them. We should be sending them the message that as a society we care for and include everyone and that when people experience health issues, we provide health services to support them.

Number 2: drug use happens and will continue to happen. The argument from some that the MSIR condones drug use is almost not worth bothering to address. I am really not sure what more evidence is required to demonstrate that injecting drug use will continue to happen regardless of whether the MSIR exists or not. Rates of injecting drug use are much more closely linked to things like poverty, housing affordability, systemic racism, rates of family violence, childhood abuse and neglect, poor mental health and allowing the black market to control drug supply by sticking to a prohibition approach. Those are the things we should be tackling if we really want to prevent substance addiction and the harm that can come from it. Preventing certain people from accessing the MSIR or practices like peer injecting from occurring there only shifts them to more unsafe environments; it does not stop it happening. And the people the proposed model excludes are precisely the people that most need support – the most vulnerable, the ones who would benefit most from access to the services the MSIR can provide. While we acknowledge that there are complexities in supporting the treatment of some population groups, these are by no means insurmountable. This is the same situation that is faced in the provision of any health service for certain population groups.

Number 3: the MSIR should be seen as a health service. Injecting drugs carries inherent risk, but the MSIR provides a safer, hygienic environment for the injecting to occur in. The opportunity to use the facility provides access to immediate treatment for an overdose and treatment options for addiction, like support programs and opioid replacement therapies. In addition, they can provide access to other vital health services, like hepatitis C treatment, and connections to social supports.

I am one of the few people here who has worked with people who inject drugs, and I was a prescriber of opioid substitution therapies like methadone and buprenorphine. I have also provided care for people who have overdosed, including administering naloxone. Sometimes people who inject drugs are seriously injured or die as a result of their drug use. Some of my patients died as a result of overdoses. Some of the people I have known in my personal life have died from drug overdoses. Overdoses happen relatively frequently, and there is some evidence to suggest that they are getting more frequent. These overdoses are sometimes, but not always, fatal. Non-fatal overdoses also do damage. They are much more frequent than fatal overdoses, and the damage that occurs is particularly severe if it is the result of a prolonged period of oxygen deprivation to the brain. We have heard from Mr Limbrick earlier about the harms of these prolonged periods of oxygen deprivation and the acquired brain injury that can result from an overdose.

These harms, these deaths, are all preventable, and we have a range of tools to do that. These treatments save lives. I have seen it, and the evidence from the MSIR demonstrates this. I will not repeat the statistics that really show the impact that the MSIR has had. We have heard from Mr Puglielli and Mr Batchelor about some of that evidence. We know that the best location for an MSIR is close to where the injecting drug use is already happening, which is why the current facility is in the place that it is. What we should be aiming for is to have many medically supervised injecting rooms integrated with other healthcare services readily accessible by people who inject drugs – a discreet, unremarkable service that is part of routine care.

By restricting the MSIR to just one location, we are failing to serve the needs of many in our community who do not live nearby that facility. In my hometown in the City of Greater Geelong, for example, there are a similar number of heroin overdose deaths to the City of Yarra, yet they do not have access to the MSIR, and it is certainly not practical for them to go up there. By not having more centres we are placing a tremendous burden on just one location, and that is leading to some of the issues that we are hearing about. Rather than simply changing the location and keeping it as a single site – it will be just as busy no matter where it is – having more services in many locations would address many of the perceived problems with the current one. This is why we are advocating for this legislation to facilitate the possibility of more sites. If the government and opposition both generally care about providing this service for people who inject drugs and want to address the concerns of some community members, I would urge them to support this sensible amendment. Everyone deserves the right to resuscitation.

David ETTERSHANK (Western Metropolitan) (15:11): I rise to speak to the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. Harm minimisation is a pillar of the Legalise Cannabis Victoria program, so it gives me great pleasure to rise in support of this bill that will establish the medically supervised injecting room in North Richmond as a permanent service. I visited the centre some months ago, and as I have said in this chamber before, you can only appreciate the centre’s true worth when you see it in action. As we have already heard, it has successfully managed over 6000 overdoses and has been quantified as saving the lives of 63 Victorians – 63 sons or daughters, brothers or sisters, friends or family who would not otherwise be with us today. That is truly important.

It is saving lives and reducing demand on ambulances and first responders, but it is doing so much more. The centre’s success in transitioning patients from heroin to long-acting buprenorphine is hugely significant and so too is their remarkable success rate in treating hepatitis C because of their ability to complete diagnostic pathology on site immediately and then treat on the same day. In fact the centre is the largest treater of hepatitis C in Victoria. As part of the recent international harm reduction conference held here in Melbourne, former New Zealand Prime Minister Helen Clark visited the centre, noting that it was the busiest overdose prevention centre in the world.

Critics time and again fail to acknowledge that the centre is sited in the suburb that was the heart of Victoria’s heroin trade for decades and in the specific area with the greatest loss of life to heroin overdoses. Its location is a response to the drug trade, not a cause of it, and anyone who asserts the opposite is either poorly informed or disingenuous. It is a vital facility, and I hope that we are legislating for more soon.

In relation to the amendments that are before the house, I make these comments. Consistent with the findings of the Ryan and Hamilton reviews, the centre should allow under 18-year-olds, pregnant women and people on court orders or parole, as well as partner injecting. It would be naive to think that refusing entry to these cohorts will stop them injecting. Rather, they will inject in more dangerous circumstances where they are more likely to do harm to themselves or their unborn children and where there are not the wraparound supports to help transition them away from heroin use. Additionally, it is also discriminatory to deny some members of our community access to this life-saving centre.

We also believe that there should be more safe injecting rooms, and we should plan for this in anticipation of the deadly scourge of fentanyl which will soon be reaching our shores. To that end, the Greens amendment has our support. We think that hydromorphone can be hugely important as an intervention to break the nexus between heroin addiction and crime and to replace what for some can be a chaotic lifestyle focused on trying to score with some structure, time and space to seek housing or medical interventions, for example. Hydromorphone has been found to be a very effective opioid replacement therapy for people for whom methadone and Suboxone have not worked. This will be a critical ongoing element to our support for this bill.

We too will move amendments for the purpose of renaming the medically supervised injecting room to the overdose prevention and recovery centre. It is a concept supported by the centre itself and an extensive list of stakeholders, including the Health and Community Services Union, the Victorian Alcohol and Drug Association, Harm Reduction Australia, Harm Reduction Victoria, the Australian Drug Law Reform Foundation, Victoria Street Drug Solutions and a range of others. It goes to reducing stigma associated with injecting drug use, better reflects its actual purpose and is reflective of best practice globally. The centre is so much more than an injecting space, and its name should reflect that. It includes a dental service; mental health services; opioid replacement therapy, including long-acting buprenorphine; general practice health; homeless services; legal services; hep C treatment; vaccinations and more. Now might be a good opportunity to circulate the amendments we are proposing.

Amendments circulated pursuant to standing orders.

David ETTERSHANK: With that done, I congratulate the North Richmond Community Health centre for the services they have provided, and on behalf of Legalise Cannabis Victoria I commend the bill to the house.

Adem SOMYUREK (Northern Metropolitan) (15:17): I instinctively do not like the idea of a government sanctioned and facilitated injecting room, but I am not dogmatic about it. I am willing to be convinced based on science – that is, the science of empirical evidence – and I do not think this report does that. In terms of empirical evidence, the report ought to have measured the outcomes, yes, for drug users but also for the community, and this report does not do that. In fact the report makes it clear that it has a very limited scope of review. For example, the report states that the facility improved the mental health of the users. The report talks about the mental health of the users without giving any weighting to the mental health of the community. The report states that the mental health of the users is in line with the mental health policies of the government, so that is one example, without actually talking about the mental health of the community being impacted by the facility itself.

You have got to say that a facility that is located so close to the community must have mental health consequences for the community if there are 10,000 more discarded syringes being found in the community – when residents report that every time they take their children to the school they have to run the gauntlet of fights, brazen drug deals, drug use –

Sorry, President. I am not supporting this, but I have got to sit down because I am physically not well from running up those stairs.

David DAVIS (Southern Metropolitan) (15:20): I am pleased to make a brief contribution to this bill. It is a bill that has a long genesis, a long history, behind it, and we obviously have a number of concerns about aspects of it. A series of opposition amendments will be moved, and we would urge the chamber to consider those amendments and consider the support of those amendments. One of the things about the Andrews Labor government is, whatever project it embarks upon, it seeks to impose that project on the community. Its ability to consult and its preparedness to listen is always limited, and so it is with this particular project. I, like others, have had significant correspondence with people in and around the heroin-injecting facility, and it is true to say that there is enormous opposition – there are some who support it, but there are many who are opposed.

There are two key points here; one is the principle of the issue, and then the second issue is the location of the centre and the checks, the balances and the protections put in place around it. Now, the government in this case foisted this centre on the community, and the community has been upset ever since. We do not believe that the location near a primary school is appropriate – and I am not going to repeat the enormous amount of comments that have been made about some of these points, but I am just laying out some very broad principles here – and for that reason, we believe it was put in the wrong location. The government is actively considering a second location for a facility, and the idea of putting it at the Yooralla site – near Degraves Street, near Fed Square, near Flinders Street, near the largest railway station in the state with the most movements and with many small businesses impacted and many cultural institutions potentially impacted as well – is another example of the government’s approach where it sort of foists things upon the community rather than working with councils, communities and institutions to actually develop a better alternative.

A very simple way of explaining this is that we have a freedom-of-information request which is still live – it is stayed for a period now but still effectively able to be reinvigorated – where the government has sought to deny access to the consultation material for the immediate institutions: Metro, Fed Square, traders groups and others. We asked a very simple question: have you consulted, and can we see the results of that consultation? It was a very reasonable question, a very reasonable point, and the government has refused, to date, to provide that information. In the same way, the report by the former police commissioner has not been provided to the community, it has been held back again and again and again.

If you want the community involved, if you want to better outcomes, you need to move in a different way than this government moves. My essential point here is that whatever the merits or otherwise of the overall proposal are, there are these serious matters about the actual location and the actual impact on local communities. And I pay tribute to the work of Ms Crozier, Mr Mulholland and our shadow minister, who has done a very good job in this area. She has been very active, talking to people, understanding alternatives and proposing options and alternatives that would be better or that would get better outcomes for local communities. And that is the way I think we have to look at it. We have to say, ‘Well, how are we going to improve this? It does seem that this facility is here to stay in one form or another. How are we going to get a better approach?’ The amendments that have been proposed are clearly focused on that outcome, on ensuring that a better result is achieved.

But I say the community has every right to be angry. The community has every right to be furious in fact with Daniel Andrews and his ministers at the way that they have behaved here. The current location and proposed future locations – these should be health decisions, on one hand, but they are fundamentally also planning decisions about the impact of these facilities on other nearby people, other nearby institutions, other nearby facilities. It does not seem the government has got at its heart a proper process with planning. The legislation seems to lay out extreme powers for the government to plonk one of these facilities pretty much wherever it likes, overwhelm local communities and do that in a way that is unfair and fundamentally not focused on getting the best outcomes. Do you know what? When you behave in that way, you are probably not going to get the best outcomes. You are probably going to get suboptimal outcomes, and in some cases very suboptimal outcomes. That is my essential point. Whatever you think about the facility, it is about how this is integrated, how this works with local communities, what the impact is on neighbouring institutions and what it is on neighbouring people.

There have been lots of sensational stories told today in the chamber about the impact on a local school and the impact on local people, and that is legitimate. Some want to dismiss that and say that that should not be a factor considered. I say that is what we are here to do – to find solutions in this way. We are here to propose alternatives and to propose a sensible way forward, and that is why the recommendations have been put forward and that is why the opposition is taking the decision that it is to move those amendments. I would urge people to look at that closely and think about it in that light. How do they want this to proceed, what is the future of other locations and what are the principles that should be applying for these other locations? Should it be able to be imposed right near Degraves Street, near the tourist strip, right near an educational institution, right near a major station? I can vouch for the fact that since the injecting facility has been in Abbotsford it has had an effect on the 109 tram; it has. My kids report that. There is a different group of people who are sometimes unsettling for older people, for frail people, on the 109 tram. I accept that wherever a facility is there will be some impact, but you would have thought this could have been thought through much, much more carefully. With those remarks, I just urge people to look closely at the sensible, practical, fair amendments that the opposition has proposed and to look at a way to thereby improve outcomes for the community.

Gaelle BROAD (Northern Victoria) (15:29): I rise today to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. The bill itself focuses on the medically supervised injecting room in North Richmond, attached to the community health centre. A key objective of this bill is to establish it as a permanent service in its current location. I find it very disturbing that the facility was placed right next to a primary school. I firmly believe that injecting rooms should not be near schools at all. Research tells us that no other injecting room in the world is located next door to a primary school.

This bill has sparked some serious and long overdue discussion on the support we give to people battling with drugs and alcohol. We are talking about serious, life-threatening addictions which are ripping families apart as people wait to gain access to vital detox and rehabilitation facilities. On the day I was elected I received a phone call from a woman who called me to tell me about her son. He started using marijuana at age 29. He stole money from her, and she had to learn to speak in code with friends when he lived in her home. Now aged 36, he is in a psychiatric centre for the fourth time after suffering a series of mental health breakdowns.

In Northern Victoria, the electorate I represent, Mildura has had its fair share of drug and alcohol issues. Just last year, after lobbying since 2014 by the Nationals, the government committed to building an alcohol and other drugs rehabilitation and withdrawal facility in Mildura. Local AOD alliance members are working extremely hard to bring this to fruition. For some, this news is too late. But until this facility opens, those who desperately need it still need to travel 4 hours to Bendigo. Alcohol and drug problems are complex, and they affect not just individuals but their family and friends and the local community. The shortage of services, particularly in regional areas, is difficult because it forces people to travel hundreds of kilometres away from their home and support networks. This bill has highlighted a range of issues, but key among them is that much more needs to be done when it comes to supporting people facing drug and alcohol addiction in Victoria.

Figures from the Coroners Court of Victoria show that in 2021, 500 people in Victoria lost their lives to a drug overdose. Across regional Victoria the rate for ambulance attendances relating to substance use is significantly higher than for Melbourne, as well as hospitalisations for alcohol and other drug treatments. In Greater Shepparton, six people lost their lives to drug overdoses in 2021 and over the past 10 years 64 people have died. The feedback from those working in services on the ground indicates that the actual damage that alcohol causes in the community is much greater than all the illicit drugs put together. I also want to acknowledge that in Bendigo we constantly read news reports of drugs in the community and want to acknowledge the work of local police in really stopping the spread of drugs in our region.

For too long people with substance addictions have been either ignored or shoved into the too hard basket, especially in regional Victoria. And in recent years there have been growing calls from local communities, health services and alcohol and other drug support providers for access to additional treatment and rehabilitation services across the state. At the last election the Liberals and Nationals had a very positive suite of policies focused on providing more treatment services. We committed to establishing Australia’s first hydromorphone treatment program for heroin addiction. This is the top-level drug treatment for people with a heroin addiction where other treatments have failed. This was supported by the John Ryan review and the independent panel as well as the drug and alcohol sector. I strongly urge this government to adopt this policy regarding the hydromorphone program.

The coalition also committed to opening 180 alcohol or other drug rehabilitation and withdrawal beds across six sites: in Mildura, Warrnambool, Shepparton, Latrobe Valley, Frankston and Melbourne. These would provide vital services for people in these regions. In last year’s budget we saw cuts to drug treatment and rehabilitation services and mental health support services. According to news reports in the Wangaratta Chronicle last year, the 2022–23 budget made an overall cut of $39 million to the AOD sector when Victoria had a list of more than 4000 people waiting to receive publicly funded AOD counselling.

I hope that in the coming state budget we see a greater focus on providing more AOD residential withdrawal and rehabilitation beds across the state. But with regard to this bill, there is no doubt that there has been damage to the amenity of the local area in Richmond. It has been well documented in the media that there has been a major impact on the local community, which has some of the highest densities of public housing in the state of Victoria, and of course the impact on the young school children that attend Richmond West Primary School.

As I mentioned earlier, no other injecting room in the world is located next door to a primary school. And as revealed in the Herald Sun, a 2021 letter penned by the school council to former education and health ministers James Merlino and Martin Foley raised explicit concerns. It warned that students did not ‘enjoy an acceptable level of safety and security in their learning environment – either while at school, or when travelling to and from school’. ‘This is as a result of exposure to drug-related criminal and anti-social behaviour driven by the growth of the drug industry since the Medically Supervised Injecting Room has opened next door,’ it said. The school council identified a likely and foreseeable risk of catastrophic harm and called on the Victorian government for urgent and immediate intervention. It is evident from this bill that no-one in the government is listening to their concerns.

Since the opening of the North Richmond injecting room there has been a considerable increase in drug-related antisocial activity on the grounds of Richmond West Primary School and in the immediate vicinity. This includes drug injecting, drug dealing, needlestick injuries and even a dead body on the ground in full view of children as they walked to school. The number of needles in the City of Yarra has skyrocketed from 600 discarded needles a month in the street prior to the injecting room opening to between 1200 and 1800 needles a month since it opened.

Both the well-regarded Hamilton review and the Ryan review have identified the deterioration in the amenity of the precinct since its opening. The government promised they would improve the amenity of the North Richmond precinct on numerous occasions, but the amenity of the precinct has never been worse. The AOD sector was not consulted about this legislation and holds concerns that Labor’s revised injecting room model will again fail as experts in the field are being excluded from the process. The Ryan review was used as a primary reference to inform this bill, but the full review has not been published; only the findings and recommendations report, the 25-page executive summary, has been published.

Section 55A of the principal act outlines the objectives of the injecting room. These objectives have never been met. There is no requirement in the legislation to report on these objectives on an annual basis. There is also concern in the AOD sector that the bill is now so restrictive that no-one will want to take on the role of licensee. This includes concern that you cannot surrender your licence unless approved by the Secretary of the Department of Health.

There is also concern that the operation of the facility has been watered down by shifting the supervisor role from the medical practitioner to a registered nurse and that this may not be sufficient qualification to manage the extremely complex cases that present to a medically supervised injecting room. There is no fit and proper person test for a licensee to meet, which means that anyone could be appointed as a licensee, including those convicted of drug-related offences.

The AOD sector is concerned that attendance at the injecting room will be incorporated into a public health record and therefore subjected to open access as part of recently debated information sharing legislation. This is a significant concern to the sector as they feel that the injecting room simply will not be used, as it will assist in perpetuating the stigma of drug use.

In closing, I am astounded that this government established a drug-injecting room next to a school. It is a storyline so far-fetched the ABC TV series Utopia could not have even thought it up. My Nationals colleague Emma Kealy put forward a very sensible amendment in the lower house to prevent a medically supervised injecting centre from operating in near proximity to schools, childcare centres and community centres. It was an amendment that makes complete sense, yet it was rejected by government members in the lower house. In this chamber we are fortunate to have a better balance in numbers, and in considering the evidence I hope that we will achieve more balanced legislation. This bill has brought a range of issues to the surface, and it is clear that a lot more work needs to be done.

Melina BATH (Eastern Victoria) (15:39): I have been sitting listening very interestedly. Acting President, I do appreciate your calling me to give my contribution on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I have listened quite intently over the past probably 5 hours to the contributions on various sides, and I have also very much appreciated that people do come from different aspects, different understandings and different policy settings, and I very much appreciate it when people speak with integrity and do not seek to attack for the sake of it just because ideas and policies have been challenged.

One of the things that I have understood in my time in having the honour of being a member for Eastern Victoria Region is that drugs – legal, alcohol, but particularly illicit drugs – can impoverish lives, can ruin lives, can tear apart families, can stress communities, can financially and socially tarnish businesses, can burden our health system and presently do burden our health system and our policing and judiciary systems as well.

I have met families whose loved ones have perished due to addiction, and they are often the most compelling advocates in this space. As I said, I have had the opportunity to meet many of them in the region. I know people and families whose children have survived these shocking drug addictions and who have somehow, with the whole force of their families, been able to pull them back from the grips of demise and self-destruction and family carnage and pull them out, and I just marvel at what an incredible blessing that must be as a parent or loved one of one of those people. But also there is that fear that they know where they went and they hope that it will not happen again. I also know people who are still in the grip of the degradation of addiction and the shredding of relationship that comes with that. These are some of the things that people have been honestly speaking about today with varying levels of capacity. We have some doctors in the house, which is most interesting, and it was very interesting to hear from Trung in terms of his direct contact as a policeman.

But the objectives within the Ryan report and indeed the Andrews Labor government’s objectives in relation to a supervised injecting centre are about reducing deaths, reducing overdose harm, providing a gateway to accessing medical services for people who inject drugs and reducing ambulance call-outs, and we know how desperately under pressure our ambulance system is in Australia and in Victoria particularly. But goals 4 and 5 are something that I think I would like to spend some time on: to reduce the number of discarded needles and syringes in neighbouring public spaces and to improve neighbourhood amenity for residents and local businesses. And naturally the last one, to reduce the spread of bloodborne disease, is also incredibly important.

We have had the Ryan review, we had Hamilton before that and we have got the hidden Lay report that sits somewhere in the government’s coffers, bowels, tables. It has not been released, and I know that with the great integrity that Ken Lay deals with things he must be quite frustrated with this. But one of the key things about the Ryan review is the fact that there was an omission in the terms of reference about the location of the facility. You cannot investigate and deliberate on something that is not in your purview, and I think that has been a great omission and a frustration certainly for us on this side but particularly for the families and children of those people who live next to and take their children to Richmond West Primary School. Despite John Ryan’s concerns in the report – and he cites deep concerns about its location – Labor is legislating for an injecting room to be permanently located so close to that primary school.

Some of the comments that are in the Ryan report I would like to put on record in relation to goal 5 and goal 4, ‘Reduce public injecting and discarding injecting equipment’. This is from a local resident:

I’m upset that my daughter, at five years old, is familiar with what a syringe looks like, and what to do if she sees one … This is a heavy cost for a child and family to bear.

The next local resident said:

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

This is in the Ryan report. A community development worker said:

Safety and amenity is the key issue – people need to be able to have a picnic and run barefoot in their backyard and not fear stepping on needles.

In relation to amenity again, a local resident said:

It’s not a positive experience going to maternal and child health when people are having loud arguments outside. Other mums have been intimidated, people trying to touch their baby, so don’t go back. The entrance is right next to the room.

Finally, from a local business owner – they have been significantly affected – I read this:

Two things that are clearly true to me – drug-affected people need help –

and we agree upon that, I am sure –

as a society we have to try to provide that in some form. That’s an absolute truth. MSIR at its current location and in its current working model is causing harm to the … community. These facts aren’t mutually exclusive … A solution has to be found where we can talk about the two things openly and clearly.

I appreciate being able to put that on the record. My colleague Emma Kealy in the other place, the Shadow Minister for Mental Health, and Georgie Crozier here have highlighted the lack of community consultation and also the fact – I heard it in one of the speeches today – that there is fencing. Now, we have fencing in regional Victoria – it is about so high, and you could hurdle over it if you wanted to – but the fencing around the school in this precinct is head height and steel, and it must feel like a fortress to be on the inside. It is very sad that we need to have this fortress effect.

I take the point that was raised again, I think, by Mr Ettershank about this area in Richmond as being in the proximity of Victoria’s largest drug market. I appreciate that drugs would still be taken and overdoses would occur, so there is an issue that needs to be dealt with. I also really appreciate my colleague Gaelle Broad for talking about regional Victoria. I will do that in a very short space of time. It is not without its significant drug and alcohol – both illicit and legal drug and alcohol – problems. In the seat of Morwell in the Latrobe Valley during the election we had Emma Kealy come down and commit, as part of a suite of mitigation programs, $36 million for 30 withdrawal and rehabilitation beds for the critical shortage that we know exists in the region. This key one was about all ages.

I understand and I see when I drive past it that the Andrews government has produced a rehab centre for ages 16 to 24 in the Latrobe Valley. They need it. What I also want to know is how many of those people actually come from Gippsland and Eastern Victoria Region and how many come from other parts of the state. Our area needs those services for a critical shortage. But what about when you reach 24? Our policy really worked for the rest, the majority of people who suffer from addiction, and I think it is so very important. The commitment to supporting people who come to this position has degraded to a point where they know they need to change. It is very disappointing. I see I have touched a nerve with the government, and that is a good thing. They need to be reminded of it. We need to be able to support those people of all ages and also create more detox programs there.

I would like to briefly comment on the amendment that is to be moved by Mr Limbrick. I support his position on hydromorphone, and indeed again the Liberals and Nationals had an election commitment about a TGA-approved opioid. I support that, and I think it is quite wise. It is a pharmacotherapy support that is needed to be able to put people on the pathway to better health and cleaner lives.

The Greens amendment, in short, we do not support. I could go into it in detail, but we do not want children under 18 injecting themselves, we do not need peer-to-peer injections and we do not need a free licence to create other centres without the rigour and oversight of a parliamentary process.

Finally, New South Wales have for the last 17 years had a subdued public interface in Kings Cross with success. The reasoned amendment that we are putting up is followed by very reasonable amendments to mimic the New South Wales restrictions – and to exclude that area from around primary schools is a must. It is sensible. It is reasonable. We support an evidence-based solution to help addicts break the cycle, live full lives and become the people that their families so desperately want them to be. There is a better way, there is a better way forward and we ask this house to support our amendments.

Nicholas McGOWAN (North-Eastern Metropolitan) (15:50): It is a little difficult to know where to start on this bill – perhaps at the beginning. I want to make clear at the outset that I am already on the public record as saying that I am not against trials of pretty much anything, in fact. I do think in today’s society trials are important. I would like to think those who begin the trials have the right intentions, so I will give the government the benefit of any doubt I have. This was also true of the medically supervised injecting room.

I had significant concerns when this first was discussed publicly, I had even more concerns when the trial commenced, and I suppose my concerns were most heightened when the interim report was released. Having listened to almost all the speakers today – either in the chamber or in my own office and elsewhere – I think what alarms me the most is what I think has occurred here, and that is that so few people have actually read that first report. It is inescapable, had anyone read that first report – all 139 pages plus the appendices. I recall that when that report was released the appendices were not even included. It had skipped the minds and imaginations of journalists, politicians and stakeholders, and no-one even asked where they were. They were not even released with the report.

It went through the objectives of the act, as it is required to do. In what is a little unusual, this act actually beautifully sets out very clearly what the objectives of the act are – God forbid. I want to just repeat them because I think that is critical. Page 131 of the substantive act states:

(a) to reduce the number of avoidable deaths and the harm caused by overdoses of drugs of dependence; and

(b) to deliver more effective health services for clients of the licensed medically supervised injecting centre by providing a gateway to health and social assistance which includes drug treatment, rehabilitation support, health care, mental health treatment and support and counselling; and

(c) to reduce attendance by ambulance services, paramedic services and emergency services and attendances at hospitals due to overdoses of drugs of dependence; and

(d) to reduce the number of discarded needles and syringes in public places and the incidence of injecting of drugs of dependence in public places in the vicinity of the licensed medically supervised injecting centre; and

(e) to improve the amenity of the neighbourhood for residents and businesses in the vicinity of the licensed medically supervised injecting centre; and –

finally –

(f) to assist in reducing the spread of bloodborne diseases in respect of clients of the licensed medically supervised injecting centre including, but not limited to, HIV and hepatitis C.

They are the objectives of the act – noble, sound, commonsense – and yet the interim review, the penultimate review, actually found, if anyone bothered to read it, that on every one of those criteria, all six of them, the centre was failing. It was the canary in the mine shaft. There is no doubt in my mind. If anyone cares to look at those figures and go through them – and I will go through them as quickly as I can today. I think it is critical because it also critically speaks to the importance of data. If we are going to make decisions in this place, then let them be based on the science. I hear this all the time from those opposite and I hear this all the time from people in my own party. I agree with it, but unless we have the data and unless we then rely on the data to make informed, accurate decisions, then I am afraid it is a complete folly.

Let us go through some of that. The centre was opened on 30 June 2018. In the first 12 months there were 2908 registered users, and then it went up to 3936 in the first 18 months. No quarter has seen fewer than 452 new users registered. Between 30 June 2018 and 31 December 2019, 30 people were refused entry. On average the user, according to the report, was 41 years old. Three-quarters of users were male, 92 per cent had been injecting for more than five years and 61 per cent had been injecting for at least 20 years. Thirteen per cent identified as Aboriginal, 23 per cent were released from prison or juvenile detention in the preceding three months and 34 per cent were homeless or in insecure accommodation. The average user injected 14 times a week, and 56 per cent had had overdoses previously. The most common age of initiation for injecting drug use was 16 years.

In the first 18 months there were 119,223 visits – that is 236 visits a day. This number went up substantially when the site went from the temporary site to the permanent site. In the first 12 months there were 61,823 visits – that is 183 a day. In the first 18 months – that is, six months later – that number had skyrocketed to 116,802. That is 231 injections a day. 96.6 per cent of users were injecting heroin.

Now we look at the actual results in that period, the coronial data. The coronial data is the difference in the number of people who died from heroin overdose before and after the trial. This is what the report says:

However, as at the end of September 2019, coronial data show no observable difference in the number of people who have died from heroin overdoses before and after the establishment of the MSIR, either in the City of Yarra or across Victoria.

It went on to say that the number of deaths recorded since the injecting room opened were largely similar to those recorded before the injecting room opened. In actual fact when you look at the data in that report, what it says is there were 15 deaths in the 15 months prior to the opening of the centre and there were 16 deaths in the 15 months after the opening of the centre. That is one death more. And yet for years now the government have been running around – the Premier chief among them – telling Victorians the injecting room saves lives. It is a lie. It is verbal diarrhoea. It has no place in this discussion. I will come to where they get these figures from, because this is touted time and time again. It is the most macabre and craven distortion of a public debate I have seen in a very, very long time. If you are going to say it saves lives, then explain how that is the case. Quantity it, qualify it and prove it. They simply do not do this.

It gets worse. Regarding overdoses inside the centre, in the first 12 months there were 1232 overdoses, or 3.6 a day. By the end of the first 18 months there were 2657 overdoses, or 5.2 a day. And – wait for it – by the end of the first 21 months there were 3200 overdoses, or 5.4 overdoses a day. So when people say in this place that it is doing no harm, in actual fact what the facts show, what the science shows, is that you have gone from an overdose rate of 3.6 per day to 5.4 – almost a doubling. So if you think you are not doing any harm, think again.

As I said at the outset, our guiding principle should be to do no harm. I am not against a trial, but when a trial and a report of this nature speaks – and speaks so loudly – you have to look at the data for fear of doing more harm. And unfortunately, in this place we have gone from this report to the next, the Ryan report. The Ryan report is almost comic, it is that bad. I urge you all to go back and read it. Take a look at it. It refers to the previous report when it relies upon the deaths and the lives so-called saved. It is a piece of mastery in terms of spin; I give it that much. But the problem is we have spun from one report to the next. Where is the Lay report? It was never released, not in three years. That is disgraceful conduct – absolutely despicable.

In relation to harm from overdoses inside the medical injecting room during the first 12 months – this is quoting the report itself:

A detailed analysis of the first 12 months’ instances of overdose within the injecting room showed that the overdoses ranged from less severe (reduced respiratory rate and reduced conscious state), which require oxygen and physical manoeuvres to keep the airway open, to severe overdoses with profound unconsciousness (21.1 per cent), with no breathing at all over five minutes (13.5 per cent), that are life threatening and could result in death and required either assisted ventilation with a bag valve mask (13.8 per cent) and/or naloxone (14.2 per cent). An experienced doctor who worked as a volunteer in the facility commented that some of the overdoses were ‘at least as acute an emergency as those we receive in an [emergency department]’.

Put it this way: when you do the math, what you actually have is those users – 259 users – profoundly unconscious, with 35 users not breathing for over 5 minutes. What do you think that does to their brain, if they do not breathe for 5 minutes? It is an untold toll on their lives. Then you look at figures in terms of the disposed syringes – the needles. They have just absolutely skyrocketed beyond compare. Any suggestion that this is just because they were there previously or this has always been the case is nonsense.

Then you look at the ambulance attendances. This is what the report says:

Ambulance Victoria data show a trend towards a reduction in ambulance attendances –

after the injection room opening –

… that just failed to reach statistical significance …

Brilliantly worded. Well done, wordsmith. But what that actually means is there is no difference – no difference – when it comes to ambulance attendances in that report. It is actually scandalous.

Emergency department presentations – and I quote the report:

There have been no observable changes in emergency department presentations overall that can be attributed to the …

medically supervised injecting room. Has anyone read this report? Has anyone seriously read this report, come in this chamber, talked whole lot of shit and wanted to stand there and tell me –

The ACTING PRESIDENT (John Berger): Mr McGowan, would you like to withdraw that remark?

Nicholas McGOWAN: No, I would not like to withdraw the remark. I have heard that remark used by other speakers, including in their maiden speeches in this place. I have no intention of withdrawing that remark.

Harriet Shing: It’s the context.

Nicholas McGOWAN: It is context. Context is king, and if you are going to come into this place –

Harriet Shing: On a point of order, Acting President, just further to your request, the context in which that word has been used in other speeches was by way of levity and affection rather than the tone taken by Mr McGowan in what he just said now. I think it is probably, given the gravity of the issue we are talking about, an appropriate withdrawal to seek.

The ACTING PRESIDENT (John Berger): Mr McGowan?

Nicholas McGOWAN: Thank you. I withdraw the remark.

In respect to the services provided, the report also covers and extensively looks at the other issues covered in the act in terms of reduction of spread of bloodborne diseases, including trial clients, and it says:

… most people were already reporting not sharing needles and syringes (an important measure to reduce the spread of blood-borne viruses), with no significant difference –

in needle-sharing rates between medically supervised injecting room service users –

… and other people who inject drugs.

If we are going to make these kinds of informed decisions, if we are going to make these decisions about the welfare of drug users – and there is no dispute, and these words should not be twisted in any way, shape or form – let it be known, and let it be known very clearly, what I have is the best interests of drug users. I would not wish that upon anyone, and I do want to see a trial if a trial can show that it is going to succeed. In fact I spoke to Ken Lay himself when he was doing his review, and my words to him were that my view was that the trial actually probably needed more time to show the statistical reality.

But the reality that is presented in that report was stark and clear, and we continue to ignore it. We continue to actually then suppress his report, which would have been a fundamental and useful part of this discussion here, and yet this Parliament is forging ahead regardless, is going to make this a permanent site when we know that the evidence says to us clearly overdoses have skyrocketed, which means you are doing more harm, not less. Make no mistake about it. Kid yourself when you go home and think that you are actually improving the situation – it is a lie. I wish we were. I do not stand here wanting the trial to fail. None of us want that, I genuinely believe, but that is precisely what it was doing according to the report at that point in time.

For those who want to point to the future and the more recent reports, once you consider COVID, once you look at how they actually extrapolated their figures, once you go through them line by line, including the Ryan report, it is almost comical. They look at the objectives of the act and how they actually start to justify it. And even they concede, one after the other after the other, that in actual fact while they think there has been some success there are still significant concerns or there are qualified successes or they have not quite achieved what they set out to achieve. If this place is to set goals, then it should meet them. It should be about saving lives and doing no harm.

Harriet SHING (Eastern Victoria – Minister for Water, Minister for Regional Development, Minister for Commonwealth Games Legacy, Minister for Equality) (16:05): It has been an extensive debate with a range of contributions throughout the course of the parliamentary process. I want to acknowledge the work that has gone into this discussion, the development of the bill and the debate, irrespective of the views taken, by members around this chamber and indeed around the chamber in the Assembly. This is a conversation and a discussion which resonates very personally for people on a number of levels. This is about people at their most broken. This is about people in situations of deep dependency and deep vulnerability. And this bill at its heart is about those people and about changing their lives and their access to services and to assistance and to care – often life-saving care – that they deserve.

We have heard from a number of people who have raised concerns about the scope and the contemplation of this bill and the permanency proposed by it of the medically supervised injecting centre. We have heard a range of concerns about the way in which community amenity or safety might be compromised or affected as a consequence of the operation of this bill. We have also heard about a range of areas where people remain alarmed as a consequence of what is known as the honey pot effect, and I am looking forward to going into the nature of those concerns in the committee stage of this bill.

When we look at the operation of the bill itself and we look at what is proposed to be done, the objectives are set out very, very clearly. In making accommodations for a permanent facility we are acknowledging the reality of prolific drug use in various parts of our community. We are acknowledging the very real damage occasioned to the bodies, to the minds, to the lives and to the prospects of people in addiction and also to the communities in which those drug-taking activities take place.

There is no easy answer to this particular problem. There is not a law-and-order answer. There is not a silver bullet. Medically supervised injecting facilities are not the complete answer to this challenge that we have. They are, however, a crucial part of making sure that harm minimisation principles are at the fore, that an evidence-based process in policy development is informed by what has happened through trials such as the one that we have seen at North Richmond and that we are in a position to understand the social and community impact of what is, at large, a consequence of a medically supervised injecting room on the one hand versus intravenous drug use at large on the other.

This is, as many have noted, not an easy conversation, but it is not a conversation that we can or indeed ever should shy away from, because to do so would be to turn our backs on, as has been said in this chamber and in the other place too, the more than 6000 people who have overdosed and the more than 63 people who would otherwise be dead. The challenge of drug addiction is not unique to Victoria or indeed to Australia, and we do see that the ACT is looking to join Victoria and New South Wales in the work that it does in terms of managing a supervised injecting facility or concern and the way in which wraparound services can be provided.

We know from the advent of supervised injecting facilities in Switzerland back in the 1980s that it has never been an easy conversation – that it is about proximity, that it is about the impact on community, but more importantly, that it is about a recognition I think of the prevalence of drug use, of intravenous drug use, in every community in every part of the world where in fact a health response is necessary and is appropriate.

There have been a number of amendments proposed in the course of this debate, and I am looking forward to an opportunity in committee to go through those proposed amendments. I also want to acknowledge the work of the staff at the facility and the work of people who have contributed to a vast number of consultations and discussions in the course of the Hamilton and Ryan reviews and reports. There have been more than 102 consultations, multiple round tables and discussions with community, with health practitioners, with experts in addiction – those people who are in a position to share through lived experience the context within which this discussion more broadly is taking place in our Parliament. We should not forget that very close to the building in which we are standing now and having this debate there are people whose lives will be lost or who will sustain long-term damage to their physical and psychological health and wellbeing but for wraparound services and care, pathways to treatment and the sort of options for dignity, for autonomy and for the prospect of a life lived beyond drugs.

I think this is going to be a detailed committee consideration. I am looking forward to an opportunity to go through the detail of what is proposed in these clauses and also to flesh out some of the concerns and the issues that have been raised in the course of this debate, because there are a few things that we need to correct in terms of misapprehension on the impact of the facility, on the trial itself, on the nature of mitigation measures and on the work that is going on to better understand where to from here.

Thank you to everybody who has been part of this debate. Thank you for the respectful way that this has occurred. I am looking forward, as I said, to continuing that process as we work through an issue which has touched far too many people and which deserves our attention and our respect.

Council divided on amendment:

Ayes (14): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Renee Heath, Ann-Marie Hermans, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (22): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, David Limbrick, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Amendment negatived.

Motion agreed to.

Read second time.

Committed.

Committee

The DEPUTY PRESIDENT: We will have quite a long first stage because we have many, many amendments to clause 1. Before we start on questions, I invite Mr Limbrick to circulate his amendments.

David LIMBRICK: I would like to circulate amendment 1 in my name, please.

Clause 1 (16:23)

Georgie CROZIER: Minister, I have got a number of questions in relation to clause 1. My first series of questions is around the issue of discarded needles. I am wanting to understand, does the medically supervised injecting room (MSIR) record how many discarded needles it collects in the vicinity outside the North Richmond Community Health (NRCH) centre and the injecting room building itself, if there is an estimate? Or if it doesn’t, why doesn’t that occur?

Harriet SHING: Thank you, Ms Crozier, for that question. The Yarra City Council collects discarded needles from the area, which is consistent with local government practice in that area since before the trial commenced.

Georgie Crozier interjected.

Harriet SHING: Yarra City Council is the body which has been collecting needles and ancillary user products. That has occurred since before the trial began. NRCH security collects the needles themselves, so the data sits with the council.

Georgie CROZIER: Thank you for that response, Minister. Does the government have that data? If it sits with the council, what data is provided to government in relation to those numbers?

Harriet SHING: That is a matter with Yarra council. The data on the number of needles collected from around the area is a matter for the local government authority, and the North Richmond Community Health security collects that used equipment from the supervised injecting facility.

Georgie CROZIER: I understand that Yarra City Council do the pick-up of the discarded needles and there are various biohazard containers around the injecting room. But what support is given to the council in terms of that cost, because as I said in my contribution, before the injecting room commenced there were around 6000 discarded needles picked up a month. Those figures have now gone to 12,000 to 18,000 – it can vary between 12,000 and 18,000 – a month. In terms of that collection and the Yarra City Council doing that, is the government providing additional resources for that to be undertaken?

Harriet SHING: As has occurred in a range of areas around the state, intravenous drug use has increased and, with that, the number of syringes and associated items in and around streets throughout the entire state. We are actually expanding outreach services to include that expanded collection of syringes.

To go to your earlier point about the support for council workers, I think you said, in terms of biohazard and biosecurity matters, that is something which is already part of the work that Yarra council provides by way of training and assistance to staff. Any handling of biohazardous material is subject to specific processes and systems, including in the donning and doffing of gloves and other materials and the handling of syringes and other items.

Georgie CROZIER: Thank you for your response, Minister. You just alluded to the fact that the use of needles is expanding around the state. What is the government’s estimate of those numbers that are being discarded around the state?

A member interjected.

Georgie CROZIER: You do not have that? No. We know that there are yellow containers in public facilities. What I am concerned about is: if there is expanded use around the state, there is not support that has been put in place to support these people. Just to get back to North Richmond, though: of the discarded needles, how many are on the North Richmond Community Health grounds and how many are on the adjoining public housing property grounds? Because we know that the needles and discarded syringes are very prominent – we have seen many pictures of this – so surely the government would have an estimate from council about what they are picking up in these areas. I would like to understand: how many are within the centre and also in public housing and adjacent to the school and the community health centre?

Harriet SHING: There are a few categories of location that you have referred to in that question, so what I might do is take that on notice if I can. We will see if we can get some information for you from the city and to get some detail that might help to answer that question. But obviously we have got, as I said, a range of locations that will be regulated and oversighted by different parts of either state or local government.

Georgie CROZIER: Thank you, Minister, for undertaking that. Can I just get that clarification, then: you are saying that the discarded needles and syringes that are in the surrounding North Richmond Community Health centre and on the public grounds – all of the needles that are outside the actual building, the internal workings of the injecting room – are all collected by Yarra city staff, that none are collected by the injecting room staff?

Harriet SHING: This comes, I think, down to the heart of many of the things that we are talking about here around amendments that are being proposed. They are in proximity to the supervised injecting room and its location.

Georgie CROZIER: What I am trying to understand is: in the City of Yarra we know that there are many workers that are undertaking picking up the discarded syringes and there are thousands a week, but do any of the staff from within the facility? When you say around the precinct, well, where does that extend to? How far out are they going to undertake their work? What is their purview? Is it outside the buildings? Is it in the grounds of the public housing areas? What is the responsibility of the staff that work within the injecting room? How far out do they go outside the building where they have responsibility?

Harriet SHING: It might help to clarify that within the grounds of the precinct that is the work that the staff do. More broadly, that is the work that the council do, and the North Richmond Community Health service security then collects from there. Does that help?

Georgie CROZIER: Well, actually it does, because if they are working on the grounds and picking up syringes – that was my original question – how many are discarded within that precinct that then the injecting room staff are doing, or is it all the Yarra City Council who deal with it?

Harriet SHING: You mean on the site itself?

Georgie CROZIER: No, no, not inside the building. I am talking just outside or in the surrounds. You said the surrounds and the grounds. I am just trying to get an understanding of their responsibility and how far they extend.

Harriet SHING: Okay, I think we have probably clarified perhaps where you might be going with this. I am happy to get some numbers for you on that to give you a bit more clarity, because it is a fair degree of detail and overlap there.

Georgie CROZIER: In the operating procedure, what is the criteria to classify an overdose?

Harriet SHING: It is a seizing of airways that is the definition of ‘overdose’.

Georgie CROZIER: A seizing of airways?

Harriet SHING: As a consequence of –

Georgie CROZIER: Okay, a seizing of airways. Could you please provide to the committee what that means in terms of oxygenation for a patient? What are the oxygen levels that that is seizing, or whatever that term was you just used?

Harriet SHING: A seizing of airways as far as a threshold consideration goes for the purposes of ‘overdose’ definition?

Georgie CROZIER: Yes.

Harriet SHING: Ms Crozier, it relates to the capacity to inhale or exhale rather than a level of oxygenation, and what I just want to add to that which might give you some assistance is that the staff who are responsible for assessing and determining overdose are really well trained in understanding and detecting where that seizing has occurred, in the same way that paramedics are able to determine where there is a seizing of airways as a consequence of the training and the work that they do.

Georgie CROZIER: I find that really extraordinary, I have to say, that there is no definition about the oxygenation levels for a client who is using in this facility, and I will explain why. From my experience, when people use heroin they can slump. It can mean that they have overdosed and they are at a very high risk of dying. It could mean that they need some naloxone, which reverses the effects of the drug. Just as somebody who falls asleep, that is the seizing of an airway if they are obese. If they are obese –

You nod your head. I am telling you now: if you are grossly obese and you fall asleep, that is the seizing of an airway potentially. You are saying that there is no criteria about seizing of the airway. My question to you then is: could you give me the definition of what an overdose is in the Kings Cross facility?

Harriet SHING: I will do that, Ms Crozier, by way of suggesting that you consult with Kings Cross about the way in which they have their practices to determine when overdose occurs. You have raised a couple of examples about drug use and then slumping and then compared that to somebody who is morbidly obese, for example, and falling asleep. The seizing of airway and the inability to inhale or exhale as a proximate response to drug use is in the circumstances the basis upon which overdose is determined. If somebody has not injected or has not used drugs, then this is not a question of an overdose situation in the context of what you have talked about with someone falling asleep.

Georgie CROZIER: I definitely take your point there, Minister, but my point is that the criterion for an overdose is a seizing of an airway. I simply asked surely you would have an oxygenation point, something that is a low oxygenation point that would indicate that there is a significant issue for that client, or patient or whoever it is, that is not getting enough oxygen into their airways and is at significant risk. That is my point in terms of seizing of an airway. I found that extraordinary. Do they not put an oximeter on to monitor the patient’s oxygenation? They just go around and tip the head up? Is that then described as a reversal of an overdose if they tip the chin so that their oxygenation, or the seizure of the airway as you described, is therefore flowing? Is that what happens? Is that the overdose criteria or to reverse an overdose?

Harriet SHING: Ms Crozier, this is about the assessment that is made by suitably trained professionals in each individual circumstance about the situation in which somebody presents, whether that is in an environment of intravenous or other drug use or not, and this is where staff are qualified to administer oxygen or naloxone for the purpose of reversing the effect of drug use. It is also about a range of other considerations for which training is so important, and observation is part of that. And people can be moved, for example. You have referred to tipping the chin. There are a range of things which people trained in basic first aid and more sophisticated training will understand to open up the airways, as you have said, or to administer oxygen or naloxone. They are factors which are taken into consideration by those trained staff in the context of each situation as it presents.

Georgie CROZIER: The reason I am questioning this is because in Kings Cross, from what I am reading in an article, there have been 43 overdoses per month at the Kings Cross injecting room since it opened in 2001. Twenty-two years they have been open for and they have 43 overdoses a month, yet that is compared to North Richmond at 124 per month and that has been open for the last five years, since 2018. So you can see why I am asking: what is the criteria for overdoses, because clearly when you say, ‘We’ve saved 6000 lives’ or whatever the figure the government says, because you are counting the oxygenations – what was that term again that you said? The severity thing. I have never heard that. I said, ‘What is the criteria for an overdose’ and you called it a –

Harriet SHING: Seizure of an airway.

Georgie CROZIER: Yes, a seizure of an airway. My point is that Kings Cross is not having as many overdoses as North Richmond. North Richmond is having three times as many, and I am trying to get an understanding about the criteria, because the government comes out and says, ‘We’ve saved 6000 lives.’ Well, these overdoses are not reversing with naloxone. So my next question is: how many have been reversed with naloxone, how many have required oxygen treatment and how many then have required an ambulance to intubate the patient and take them off to a tertiary facility?

Harriet SHING: I might be able to provide you again with a bit more context there in light of the comparison that you have made with Kings Cross and the numbers there that you have talked about with overdose figures. New South Wales has a smaller number of booths available, so fewer people can actually access the facility. We have more capacity to in fact –

Georgie CROZIER: What are the booth comparisons?

Harriet SHING: New South Wales also has a much higher rate of methamphetamine use than we do, so heroin use is much more prevalent here in Victoria than in New South Wales. There are 16 booths in New South Wales compared with 20 here in Richmond.

Georgie CROZIER: You have just given me some detailed stats on Kings Cross, so perhaps your advisers would be able to find out for me that overdose criteria, because I really do want to understand the difference. Four booths difference and there is a high use of methamphetamine or whatever you said in terms of what is happening in Sydney. It still goes to the fact that there are only 43 per month that are overdosing compared to 124 here. Something is out of kilter here. Have we got a massive, massive heroin and ice problem? The next question I would like to ask off the back of those questions I asked about how many have received naloxone or oxygen treatment and how many have required paramedic assistance or been taken off to a tertiary facility is: how many of those are heroin-related overdoses and how many are ice-related overdoses?

Harriet SHING: I will take the request for that data on the split for you on notice if I may and we can work our way through that. It is just important to note that, by way of distinction, people who are injecting heroin are significantly more vulnerable than people who are injecting, for example, methamphetamine. That is one point of distinction that should perhaps inform this conversation that we are having here. It is also really important to come back to the principles that set the foundation for this bill. It is about saving lives and if someone is not breathing, then they are not breathing.

Georgie CROZIER: But that is my point. If they are not breathing, then they are in a really severe situation. If they are not breathing, they are needing emergency treatment and resuscitation. If they are not breathing, they will need a paramedic there. But if they are slow breathing or shallow breathing, they might just need oxygen. If they are slumped and just not as severe as you have said – they are not breathing – that is quite different.

Harriet Shing interjected.

Georgie CROZIER: You say no, but I am telling you if they are not breathing they are going to need emergency treatment. To go to my original point, I would like to know why they are not getting an oximeter on their finger to find out what their oxygenation level is, because that would give a clinical indication of their ability to have oxygenation, which is very critical to be able to function. I am not questioning those that are in there, but I do know – and I will come to this question – about the staff and how many agency staff are used in the facility, and their experience may not be as pronounced or they may not have as much experience as someone else. I am concerned about the criteria that is being used by the government to quantify these overdoses.

Harriet SHING: But for the facility – might be a good way to put it. But for the facility, people who have limited or shallow breathing who then cannot get access to oxygen, who then stop breathing and who are then not able to access paramedic support, oxygen or naloxone to reverse the effects of a drug are then much more vulnerable because they do not have access to that support, and the supervised injecting room actually does provide oxygen and does provide immediate proximity to those suitably trained staff who are in a position to administer as soon as that deterioration is detected. That is why they have that training in order to be able to meet that need immediately, and that is where again it is about reducing the number of call-outs of ambulances and the severity because of being able to address those needs in the shortest amount of time possible and then also make sure that a patient and a client can be monitored almost immediately.

Georgie CROZIER: I understand all that, but what I am saying is I am trying to get a comparison. I am trying to understand why this injecting room and why the surrounding areas are having so many issues. I think there are still some doubts in my mind about the data that is coming out of here because we have not got that transparency and we have not got that ability to fully understand what is actually happening. To go to my question, could I have the numbers for how many people have been treated for overdose by the injecting room staff or the North Richmond Community Health staff for those people who have injected drugs outside the injecting room, including on the grounds or in the neighbouring public housing towers?

Harriet SHING: By way of clarity, are you seeking to exclude paramedic responses from that?

Georgie CROZIER: Yes, I would like to know how many have been treated for overdose by injecting room staff or North Richmond Community Health staff. That is what I am trying to understand. I know that the ambulance call-outs happen far too frequently, but I would just like to have an understanding of that.

Harriet SHING: Yes. I have said I will take that notice.

Georgie CROZIER: Thank you very much. Now moving on, I think you are getting me those figures. Thank you, Minister, for doing that. If I could move to the Ryan review now, in the briefing that the coalition received we were told that only the public Ryan report has been released by the government, so what has the government got that is not included in this 25-page Ryan review?

Harriet SHING: The final report has been released.

Georgie CROZIER: Yes, I understand this is the final report – the public report, as we were told – but we were told that only the public Ryan report has been released by the government, so what other material in relation to the Ryan report does the government have?

Harriet SHING: No. We have publicly released the final report and all recommendations.

Georgie CROZIER: I understand that you have released the final report with all recommendations. That is not my question. My question is about the other data around this report. I would ask that you provide to the committee all further data, appendices and the full report submitted to the government by the independent panel led by John Ryan.

Harriet SHING: Again I would say we have released the final report and all the recommendations.

Georgie CROZIER: So you are refusing to provide to the committee the appendices and the information that was provided for this summary report? You are saying it is the final report. We were told it was only the public report that was going to be provided by the government. Are there any other reports other than this report that is in the public domain that the government has from the work undertaken by John Ryan and the panel?

Harriet SHING: No. This is the final report and the recommendations, and they have been publicly released.

Georgie CROZIER: That is not the question I asked. You just said no. You are saying no, this is –

Harriet SHING: No, no. This is the final report, and it has been publicly released.

Georgie CROZIER: I understand that; it is the final report. What I am asking is: was there another report with more appendices and more information provided to the government in addition to this public final report with recommendations?

Harriet SHING: This report as publicly released is the final report, and it has been publicly released with those recommendations.

Georgie CROZIER: I am not going to go on about this. Clearly there is more information.

Harriet SHING: There are no appendices.

Georgie CROZIER: Is there any more information or data provided –

Harriet SHING: There are not any appendices to the report. The report is the report.

Georgie CROZIER: No further information? No data?

Harriet SHING: There are no appendices. That is the report.

Georgie CROZIER: I know that, but was there any more information provided to the government? The briefing we received was that this was the public report released by the government, indicating that there was more information.

Harriet SHING: I am not sure that is the case, Ms Crozier. The final report has been publicly released, and the report itself does not contain any reference to appendices, so I am not sure what you are taking from that to indicate that there is something missing here.

Georgie CROZIER: Well, it is 25 pages long, and it is an important issue. One of your government MPs said there were hundreds of consultations. This is very brief. If 120 consultations took place, there has got to be data somewhere with that information from those consultations. Surely there is additional information. Otherwise I would suggest that this is a very poor report provided by this panel if this is all the public are receiving after all the work they have done. 120 consultations – we do not know who those stakeholders are. They are not listed in here. What is the full data the government has regarding the information that the Ryan panel undertook to put this brief report together?

Harriet SHING: I in fact referred in my summing up to the work of the panel and to the extensive engagement that it had with community, with health services, with experts and –

Georgie CROZIER: Who are they?

Harriet SHING: That is a separate issue to the one that you have just raised. The work of the Ryan report is set out in the Ryan report. Simply because something is condensed and distilled into a shorter document does not mean that an awful lot of work, time, effort, consultation and discussion has not gone into it. Were that to be the case, then in this Parliament we would be surrounded by hundreds of thousands of pages of documents when in fact the work of reports like this and this report is to distil into a series of recommendations the essence of what is being discussed here, which builds on the other work of parliamentary inquiries and the Hamilton review and also the Lay work as well.

Georgie CROZIER: We would like to see the Lay work. That would be great.

Harriet SHING: Well, you will, Ms Crozier, at the end of May.

Georgie CROZIER: End of May? Excellent.

Harriet SHING: That has been said publicly numerous times.

Georgie CROZIER: Minister, as I said – as your members have said – this was an extensive consultation by the John Ryan panel. And if I can just say, there are only 210 words about deaths in the area in this report, and 85 of those words were about interviewing a random local. Only one stat is given, and the effect of COVID is not even contemplated when we know that the city was locked down for nearly two years when this report and other consultation was taking place.

Compare the number of deaths and the number of words around those deaths in this report – 210 words – with the Hamilton report that had over 3500 words on the same topic. You see where I am coming from: this cannot possibly be the full work of the panel. This is a public report with recommendations that the government has released, but it is not as extensive as the Hamilton review even though you are saying there was extensive consultation undertaken. What we are asking is: how do we know that? Who was interviewed? Where are the stakeholders listed? Surely any work that is commissioned by the government would have that level of detail so that we can have full insight as to what this panel actually did.

Harriet SHING: The panel undertook a really detailed piece of work which is referred to extensively in the document that you have just spoken to. The further work following the Hamilton review was about the independent engagement of the panel by Mr Ryan, which engaged with community, with health services, with experts, with people immediately impacted in a range of ways by the issue of intravenous drug use and also the challenges to safety and to amenity.

Georgie CROZIER: Well, how do we know? There’s no numbers.

Harriet SHING: Ms Crozier, the way in which government is responding not only to the Ryan review but also to the Hamilton review is what has led us here today to this bill. Ultimately the assessment of the supervised injecting centre is that it has achieved its core objectives: it has reduced harm and saved lives. Many people, as they have spoken to today, have said there have been almost 6000 overdose events in the centre with zero fatalities, meaning that at least 63 deaths have been prevented. As indicated in a number of speeches today and in the other place, the centre is reducing ambulance attendances, overdose-related hospital presentations and the spread of bloodborne viruses. It has also been successful in providing access to general health, social and wellbeing, and supported housing services. It has then been about an ongoing conversation about impact on the broader community. This is why we are here: to implement the work of the Hamilton and Ryan reports and the discussions around where we get to from here as far as a permanent operation of this facility is concerned and the ongoing work that it can do.

Georgie CROZIER: Minister, can you confirm that this was the only document provided to government by the Ryan panel – this document I am holding?

Harriet SHING: I don’t know what you’re holding.

Georgie CROZIER: This report. Is that the only document, the Ryan review? Was that the only document provided to your government from the work done by the panel?

Harriet SHING: That is the Ryan review report with the recommendations, and that is the result of the Ryan review’s panel and its engagement.

The DEPUTY PRESIDENT: This is going to be a long committee stage, so can people just please wait for the Chair and refrain from the banter between the minister and the member, because it is not helpful to progressing the committee stage.

Georgie CROZIER: My apologies, Deputy President. I am somewhat frustrated because my issue is that I cannot believe that John Ryan and his experienced panel would provide this document to government. It is a pretty reasonable question to ask on behalf of the Victorian public: is this the only document the panel provided to the government? The minister is going around and around in circles, so I am going to take that as government spin and that she is actually not telling the truth. She knows the truth. This is not the only document provided by John Ryan and his panel to the government. I am right, aren’t I?

Harriet SHING: Ms Crozier, it probably reflects more on you than on me that you would seek to say that I am lying or that I am deceiving you in some way about this. The terms of reference for the panel review stipulated that a report be provided, and we have publicly released the report and the recommendations.

Georgie CROZIER: I will move on, because I am not getting anywhere here, and I am very disappointed by the minister’s answers to that. So I will go to the terms of reference. Why did the government not include something in the terms of reference about the site? That is why we are having this extensive debate today: because of the site where the injecting room is located – next to a primary school. Why was that not included in the terms of reference?

Harriet SHING: The Ryan review itself is consistent with the Hamilton review in that it was focused on the objects of the act.

Georgie CROZIER: It was, but the review panels have gone and spoken to the residents. The community has been concerned. There have been many, many issues. We have had the drug dealings and the drug use by those that work within the centre – we have had a lot of issues. And it does say:

The terms of reference for the review ask the Panel to consider the … operation and use, the extent to which the –

injecting room –

… has advanced its goals as set out in the underpinning legislation, and to provide advice to government on any recommended changes.

And they go on and name the goals. I will not go through that. It says:

While determining the suitability of the current location of the –

injecting room –

… was not within the scope of the Review Panel, we did hear from many in the North Richmond community and other stakeholders that they held deep concerns around this issue, especially the proximity to Richmond West Primary School and the general impact on residents and other clients attending …

They acknowledge that, and I think it is somewhat frustrating that that was not included, because it is in the objectives of the bill. And you have put in additional funding to improve amenity. Surely part of improving the amenity, after the money you have put into the budget over the last few years, is around some of those objectives as well. It is not just those people using the facility but those people living around the facility. So my question is: would the government in future reviews consider suitability of location, or is that just never going to be considered?

Harriet SHING: Ms Crozier, I would draw your attention again to the extensive consultation and round tables that took place in the course of the panel’s work, which have then been extrapolated into the detail that you have referred to around community positions on the impact of the injecting facility on their community that has given rise to the concerns they have expressed about safety and about amenity. What I think we need to do is just actually note that that is part of what the report itself has acknowledged. But recommissioning in the terms that we are now talking about here in this bill will actually ensure that we can enhance the service and deliver a really full range of much-needed wraparound services and care to users and clients but also address those safety and amenity concerns. You have talked about investment in the surrounding area. You are right – that does actually go to a range of things that have been highlighted by members of the community, including lighting, security and the design of various mechanisms such as fences in and around the area to address the concerns that have been raised.

This has been, again, outlined pretty extensively in the debate: there has been around $200 million invested in and around the precinct, and it has gone to issues just like the matters where safety and security are concerns. But it is also really important to note that the service needs to be where the drug use is occurring and that prior to this trial commencing the drug use was there. Anybody who had been living in that area or had been visiting that area, who had been along Victoria Street and tried to enjoy a meal or to enjoy some of the extraordinary culture and community there, could not have escaped the reality of drug use there in that area and drug-related activity in that area before that trial began. We know that ambulance sirens were a frequent interference in the environment in and around that area well before the trial began.

Georgie CROZIER: You talk about the recommissioning. Can I get some indication about that. In relation to all of these recommendations, what are the time lines for when they will actually occur, and can you give us some indications for each and every one of them?

Harriet SHING: The recommissioning process will begin in July 2023 and we will be looking for an outcome by December. To account for that process in the recommissioning framework, we have included provision in the bill today for allowance of an extension of the current North Richmond Community Health licence during that recommissioning process.

Georgie CROZIER: I know you referred to Victoria Street but, really, go and have a look at it now, Minister. It is decimated. The Ryan review talks about the facility giving:

… highly vulnerable and disadvantaged members of the community better access to vital social and health support, including housing, addiction treatment, legal and other services.

Could the committee have a breakdown for each of those points – what the social and health support is – how many people have accessed those supports, how many have accessed housing, how many have accessed addiction treatment and legal advice, and what are the other services that they are referring to?

Harriet SHING: There is a lot in that. I might take that on notice, if I can, to get you that breakdown.

Georgie CROZIER: What did the panel get paid to produce this report? Is that a public figure, for the consultation and the work they have done – is that known?

Harriet SHING: I do not know, Ms Crozier. I am very happy to look into that for you.

David LIMBRICK: One of the biggest concerns around this whole centre is the location. What considerations were given by the government on changing the potential location after the review? The government must have come to a positive decision to keep the current location. What consideration was given to changing the location?

Harriet SHING: Thank you, Mr Limbrick, for that question, which again I think goes to the heart of a number of the areas of concern that we have heard here in the chamber and also in the course of this debate and as raised by the community. The Ryan review actually shows that it is saving lives where that drug use is occurring. To place the trial site – what we are now proposing to be the permanent site – in the location that it is means it is immediately approximate to the centre of drug use in an area where amenity, security, loss of life and serious injury have been sustained for a really long period of time. So in the current location it is in a position to be able to continue to deliver on that life-saving work, and that has been a part of the Ryan report’s concluding that in its current location it is serving those purposes.

David LIMBRICK: I thank the minister for her answer. But isn’t it the case though that many people travel to this area because of the centre? With the honey pot effect, if the centre happened to be located in a different area, then wouldn’t the people using this centre and the drug activity in that area move to wherever the new location might be?

Harriet SHING: What I do want to do – and I did flag this in summing up – is address the issue of what you have referred to as the ‘honey pot effect’. A really common concern raised by residents in the North Richmond community is that this centre has acted as a honey pot since the trial began, and that it has attracted drug users to North Richmond who would otherwise not be there. Evidence in fact shows that if the medically supervised injecting centre were not located in Richmond, most people would continue to visit the area, and they would be doing so to access the street-based drug market that has operated in the area for at least two decades.

To go back to the point that Ms Crozier raised before and my response to one of those questions: this location was already, prior to the introduction of the trial, a very key area for the sale and use of drugs. It was in fact the site, when the Premier made this announcement, of an overdose that occurred in the course of a media event. Fortunately for the person who did overdose, that event was being attended by paramedics who were able to immediately attend to that person in need and in overdose.

So this has been a feature of the landscape, for better or for worse, for a really long period of time. We do know that there had been significant anguish expressed by the community about the risk to safety, about the challenges to amenity and about, as was referenced earlier, people and their kids seeing overdosed drug users, including deceased overdosed drug users, in the area. That has been something which I think has been a relevant consideration. The Ryan review actually surveyed people who use drugs in the area and found that only 6 per cent of drug users reported coming to the North Richmond facility solely to use the medically supervised injecting centre.

David LIMBRICK: I thank the minister for her answer. Much of the concern about amenity is around drug dealing in the area – people selling drugs. In the second-reading debate I spoke about having extra pharmacotherapy options. I brought up the option of hydromorphone, but it is my understanding that there are other options as well. This would potentially solve some of that amenity issue, or at least make it much less prevalent. What sort of consideration has been given by the government to increasing pharmacotherapy options in order to undermine criminal activity and sales in the area?

Harriet SHING: What I would say at the outset and to build on the premise of your question and the contribution you made in your speech earlier is that no Victorians have died inside the medically supervised injecting centre. Obviously, as I have said earlier and as other people have said, any deaths that do occur outside the medically supervised injecting centre are subject to a coroner’s investigation. But what we have heard are the discussions around recommendations and pharmacotherapy across its different platforms. The Premier made reference to this in March this year and talked about community pharmacies, GPs, community health and the work of hydromorphone being one area that they want to see and said that the review wants to see an expansion there. So you are right to identify that as being part of the review. The Premier has indicated that we will do the work together with the broader recommendations around pharmacotherapy and that pathway. Whether it is buprenorphine or methadone, there is obviously very clear evidence that that works, that it saves and changes lives itself, not just in North Richmond but across the board, and the Premier has indicated in his press conference that we will look at those recommendations across our alcohol and other drug services.

Evan MULHOLLAND: I thank the chamber and I thank the minister. I wanted to talk about a few things, but I want to talk about school enrolments at Richmond West Primary School. I am just wanting to confirm some statements that other government members have made about enrolments – that they are normal, they are going well. We now know that prep enrolments at Richmond West Primary School have fallen sharply since 2020 while at the same time enrolments have actually increased at surrounding primary schools, including Trinity, Yarra and Abbotsford primary schools. Does the minister stand by the claim there are no issues with enrolments at Richmond West Primary School?

Harriet SHING: Thank you, Mr Mulholland, for that question. Enrolments at the school overall have remained stable. This is something which has been referenced a number of times in the course of this debate and also in the other place. Richmond West Primary School is a really great school. It has got a really strong academic record. It has got a really activated and diverse student population and school community. The school has been a really strident supporter of the measures and the harm minimisation activities that have taken place and of the medically supervised injecting centre since its establishment, and we thank them for not just the cooperation in this matter but also the partnership and the engagement and the preparedness to participate, including through stakeholder discussions with the panel. We will continue to work with the school as we implement the Ryan review safety and amenity recommendations.

Importantly – and I think it should not go without saying – the Department of Education does continue to work with this school to ensure that the MSIC operates in a way that accounts for the needs of the school, and balances the needs of students and their teachers, staff and family members against the operation of the centre, and preserves and protects safety. There are a range of supports that have been introduced to support the school community, and they have been alluded to in the debate. But just to put them on the record, there are upgraded secure fencing, an electronic lock and video intercom system, closed-circuit television and strong protocols to support students, including a comprehensive student wellbeing program and employment of community liaison workers during school drop-off and pick-up periods, and as I said, we do see from data that student numbers have remained largely stable over the past five years. That might help you in terms of those additional pieces of work that have occurred.

Evan MULHOLLAND: I thank you for your answer, Minister. Just reflecting on that, you have referenced the word ‘stable’ in terms of enrolments and that they are largely stable. I am just trying to figure out what that means. In 2018 prep enrolments were at 56. In 2022 prep enrolments were at 36. Is that stable or largely stable?

Harriet SHING: I was referring to the last five years, so ‘largely stable’ is the entire period. Again, there have been a number of changes across the board across the state to enrolments, and we have seen that there has been a really significant degree of lumpiness in enrolments, whether that is in the middle of Melbourne or right out to the borders of the state. Again, largely stable over the period of the past five years would be my answer to that question of yours.

Evan MULHOLLAND: As I said, there have been commensurate increases in prep enrolments at the three surrounding primary schools, all in my electorate – Trinity, Yarra and Abbotsford primary schools. Are you aware of this trend, and would you still describe it as stable?

Harriet SHING: I would not describe what you have just said, Mr Mulholland, as a trend, but what I will do is maintain that enrolments at Richmond West Primary School have been stable and largely stable over the past five years.

Evan MULHOLLAND: Given the police have admitted a honey pot effect around the centre, how many overdoses have occurred outside the centre since 2018, and how many deaths have occurred outside the centre since 2018?

Harriet SHING: Bear with me, Mr Mulholland; I am going through quite a volume of material here. What I would say, Mr Mulholland, while I am in the process of finding that information for you, is that I want to ensure that we are not heading down the path of ascribing a cause of death to any person who died in the surrounding area. As I mentioned earlier in my response to Ms Crozier, there have been coronial processes deployed for anybody who has passed away in the area around the medically supervised injecting room, and we have not had, as I indicated in my response to Mr Limbrick, any deaths inside the centre since it commenced operation. To go to some of your earlier comments as well, we have seen – and this is set out in the Ryan report – 63 lives saved and 6000 overdoses managed. I cannot comment on the cause of death of people outside the service on the basis that that is work for the coroner to investigate and determine.

Evan MULHOLLAND: I am just going to clarify whether you are going to still look for those numbers and get back to me on those numbers. It was a legitimate question. I hope you are still looking for those numbers of overdoses outside the centre since 2018 and deaths outside the centre since 2018. I do understand what you were saying about that – how there have been no deaths inside the centre – but there have clearly been several overdose deaths outside the centre that have been widely reported in the media and clarified as such, so I would still seek that information.

Harriet SHING: I will not comment on the way in which deaths have been reported on the basis that I do not have that information to hand and I am not sure what the coroner has determined on that. Again, this is where a coronial investigation and determination should always, in my view, take precedence over any reporting and any theories that might be advanced for the purposes of press coverage. What I can also do is indicate to you that the coroner does provide information, data and reporting in accordance with that work under statute.

Evan MULHOLLAND: I am looking forward to receiving the numbers at some point. I have just a couple more questions. I want the government to hopefully confirm something for me. Labor’s candidate for Richmond Lauren O’Dwyer at the 2022 election claimed the room had become a meeting place for Aboriginal elders, a claim that was disputed by Wurundjeri senior elder Ron Jones from the Wurundjeri Woi Wurrung Cultural Heritage Aboriginal Corporation, who responded to Ms O’Dwyer’s remarks by saying she had created a bad image for all Aboriginal elders and that he disputed the claim. Does the government agree that it is a gathering place for Aboriginal elders?

Harriet SHING: Thank you, Mr Mulholland, for that question. Any comments made by candidates in the course of campaigns or public discussions are matters for them. The Wurundjeri and Woiwurrung council have made it very clear that their position is not that the location of the medically supervised injecting centre has been or is a gathering place. It is also really important to note that as we talk about First Nations engagement we also engage respectfully with the fact that Wurundjeri and Woiwurrung people and representatives will have divergent views about a range of things, and they are in fact best empowered to speak to their own views about what it is that they have as positions on various locations and various matters that might be put to them.

Evan MULHOLLAND: I appreciate the response, and it was good to clarify that that is not the view of the government. You mentioned the New South Wales report and originally said you did not have the research but then had some of the New South Wales experience.

Harriet SHING: Which New South Wales report?

Evan MULHOLLAND: Of the New South Wales experience of the injecting room at Kings Cross.

Harriet SHING: A report?

Evan MULHOLLAND: Not a report, just the experience in terms of some data you did have. I want to go to the experience with Kings Cross compared to here. Theirs is next to a train station, and their research points out that that was a good approach to not create an ant trail of harm and abuse between the said public transport option and the centre, and we have quite clearly seen in North Richmond that go on between North Richmond train station and Lennox Street. Was this considered when deciding on the permanent location of the facility?

Harriet SHING: Was what considered? Can you just –

Evan MULHOLLAND: In terms of other research, like that out of New South Wales, that points to where injecting centres should be located, was that kind of research considered as part of the government’s determination?

Harriet SHING: That is a useful clarification. When you do talk about the Kings Cross station location, again to perhaps dispel a bit of misinformation on this issue, that location, being as it is proximate to a railway station, is a site which is passed by people of all ages, young and old – kids, their parents and community members – all day, every day. The fact of the matter is that this is not, as you have sought to describe it, an ant trail, I think you said.

Evan MULHOLLAND: Not my words – words experts used in research about the New South Wales experience.

Harriet SHING: In research? Okay. Well, I am happy to get a clarification. But going back to first principles, the location of the centre is based on the location of drug use, and as I indicated to Mr Limbrick and to others in answering their questions, drug use had been taking place in the area for decades. It had been having a really devastating impact on the community and on safety and on amenity, and it was not just about drug use, it was about drug dealing, it was about interference to quality of life and peaceful enjoyment of people’s environments – whether it was in a park or being able to walk the dog or being able to get home without constantly seeing needles or constantly being at risk of seeing somebody who had overdosed or, in a number of cases all too tragically, people who had died. So this very much comes back to the location of the centre being where the drug use is and has been demonstrated to be.

Evan MULHOLLAND: Why was the Ryan review consultation only conducted in English?

Harriet SHING: The starting point was that information in the course of the consultations and those 102 local consultations that I referred to earlier and the round tables that took place with health practitioners, human services providers, alcohol and other drug harm reduction experts and people who are directly involved – so local residents, businesses, people who inject drugs and workers and police and ambulance representatives – was in English. However, as occurs frequently in interface between communities and access to services, interpreter services are made available and were made available to people who needed them.

Evan MULHOLLAND: Do you acknowledge what residents have been saying, that many could not participate in the review? Were there and have there been attempts to consult with CALD communities in the area?

Harriet SHING: There was a process whereby the Ryan review engaged with local communities, including through a letterbox drop, and that was actually done in multiple languages. I am advised that there have not been any issues raised about CALD community difficulty in participating in the review and that the process of engaging in multiple languages occurred from that letterbox drop right through to access to interpreter services.

Evan MULHOLLAND: Can we obtain a list of who attended the consultations? You mentioned the number before.

Harriet SHING: I am a bit loath to do so, Mr Mulholland, given that the consultations were attended by a range of people, including intravenous drug users, and privacy is obviously a significant part of the capacity for people to be frank and to participate in conversations about this. There are consent issues around having that information provided. There are obviously privacy principles that apply and, again, that is often a precondition for people to participate in consultation and discussion. So that is the basis upon which the report refers to the consultations having occurred as they did.

Evan MULHOLLAND: I will put it in another way. When did the consultations occur; how many people attended each session; and would we be able to get a breakdown – I understand your points about privacy – of perhaps users, residents and businesses that were involved in the consultation?

Harriet SHING: The consultations, Mr Mulholland, occurred over an 18-month period. They happened from 2021 into 2022. That is a really extensive process and that also is subject to privacy. Government has received the report and the recommendations, and they are the publicly available documents.

Evan MULHOLLAND: I just wanted to go to a point that Ms Crozier mentioned earlier. The Ryan review report is 25 pages. This compares to a previous report that was 387 pages. Has the minister or the government received any other documentation from the Ryan review or its expert panel?

Harriet SHING: Sorry, I am not sure what you mean by ‘from the Ryan review or its expert panel’. The final report has been released and that has got the recommendations in it, so that is the basis upon which the government is providing that response.

David ETTERSHANK: Minister, in the treatment of heroin addiction one of the most effective cutting-edge medications is the drug hydromorphone. On 7 March the Premier, commenting on the recommendations of the Ryan report, stated that:

… there is one recommendation that speaks about pharmacotherapy across all of its different platforms – community pharmacy, GPs, community health. Hydromorphone is one area they want to see, the review wants to see an expansion there. And we’ll do that work together with the broader recommendations around pharmacotherapy and that pathway, whether it’s buprenorphine or methadone … there’s very clear evidence that that works, it saves and changes lives itself, not just in North Richmond but across the board. We’ll look at those recommendations across our alcohol and other drug services.

That was the Premier on 7 March. Will the minister confirm that this commitment from the Premier on working with agencies to expand pharmacotherapy options, including hydromorphone, remains a priority for the government?

Harriet SHING: Thank you, Mr Ettershank, for that question and the continuation of that discussion that I had with Mr Limbrick earlier. You are right to identify the Premier’s comments on 7 March, and as he stated, when we release the final report we are going to work on the recommendations around pharmacotherapy, noting, as the report has done, the relevance that it has to managing this particular set of psychosocial issues. So in principle we do support the expansion of pharmacotherapy.

David ETTERSHANK: Thank you, Minister, for that answer. Can I confirm that, consistent with the Ryan report recommendations, this expansion of pharmacotherapy options would be part of a likely recommissioning process at the North Richmond site.

Harriet SHING: As part of a recommissioning process as opposed to scope more broadly? I am just trying to see whether it is linked to this facility or whether it is more broadly?

David ETTERSHANK: I am keen to understand whether it would be envisaged that this expansion of pharmacotherapy services would likely form part of the recommissioning process – in other words, in the new calendar year, as I understand the government is proposing its time frames.

Harriet SHING: That is helpful. Thank you, Mr Ettershank. The recommissioning process does include reviewing options for pharmacotherapy, but also, to take you back again to what the Premier said on 7 March, he did actually talk about hydromorphone being one area that the review wants to see an expansion of, and community pharmacies, GPs and community health, and that that work has been identified as an area where there is very clear evidence that this sort of work on pharmacotherapy saves and changes lives, not just in North Richmond – to quote the Premier – but across the board. So again this would be part of the work considered in the recommissioning process, if that helps you.

Ann-Marie HERMANS: Minister, obviously one of the largest objections that the opposition has is to the location of this injecting room. In terms of recent Ambulance Victoria data, which has been obtained through freedom-of-information laws, the call-outs for paramedics in 2017 to Lennox Street before the injecting room opened were 61. Could you please give us the data on the increase that has taken place – as a result – of paramedics to Lennox Street in 2019, 2020, 2021 and 2022?

Harriet SHING: Thank you very much for that question. In the 3½ years before the service opened there were 818 ambulance attendances involving naloxone administration – to reverse a heroin overdose – within 1 kilometre of the service compared to 459 ambulance attendances in the 3½ years after the medically supervised injecting room opened. That is a 55 per cent reduction. To distinguish that from perhaps the question which Mr Mulholland asked earlier in relation to fatalities, this is about ambulance attendances to reverse an overdose – it is about the administration of naloxone rather than a coronial process that would occur following a death in the surrounding area.

It is also important to note that, as indicated by the secretary of the Victorian Ambulance Union, 6000 overdoses managed by the medically supervised injecting centre means 6000 less ambulance call-outs. We have seen the follow-through benefit in releasing pressure on frontline service and emergency responders, but there has also been a declining trend in opioid overdose presentations at St Vincent’s, the nearest public hospital emergency department – noting that staff at the medically supervised injecting centre have the same skill set as people who are working in emergency departments (ED) around managing overdoses – since the service began operating. We have not seen this trend in other comparable hospitals around Melbourne, which suggests, and I am not going to conclude that correlation equals causation, that the supervised injecting centre is helping to drive those reductions in the emergency department presentations at St Vincent’s.

Ann-Marie HERMANS: Minister, thank you for your response. It is concerning to me that the location is close to a school. Whilst I hear you saying that there is an impact that is taking place in terms of the community, the impact that I am aware of is the holistic impact in terms of what it is doing to school communities and families in the area – the number of syringes that children are finding and the number of incident reports that are taking place where people are feeling unsafe. I think one of the things I would like to know is, between what your statistics are in terms of the facility from the time that it opened – from, say, June 2018 – until June 2022 what is your understanding of the reports of gunshots and stabbings that have taken place in and around Lennox Street? Because it is the increase in crime that takes place when we are dealing with drugs, and it is the honey pot, as you have said –

Harriet SHING: No, I didn’t say that.

Ann-Marie HERMANS: Or as Mr Limbrick has said and as others have said. I am just trying to understand the type of environment that we are creating near a school by having this injecting room in this location. Do you have that data that you could present please to the house?

Harriet SHING: Again, to come back to something that I said earlier, correlation does not equal causation, and when we are talking about crime rates, we are talking about what you referred to as incidents and reports around people feeling compromised in their safety. I am perhaps after a bit more detail of what you are looking for because it does not necessarily follow that because of the operation of the medically supervised injecting centre an increase in crime or changes to the nature of reportable crime has been occasioned by virtue of the operation of that centre.

We know that in metropolitan areas we see statistics and reports from police around crime rates, and that is broken down, as you would know, into different subsets of crime as reported. That is something which takes place across the board. It is also about acknowledging that we did have crime in the area before the service began. In fact when you talk about drug-related crime, this is an area where drugs have been bought and sold for decades. Therefore if we are going to talk about correlation and causation, it stands to reason that drug-related crime – including, as you have referred to, violent crime – would be a consequence of that street and market trade occurring separately and aside from the supervised injecting centre.

Aiv PUGLIELLI: Minister, in my meetings with key stakeholders in and around the North Richmond site and the sector more broadly there has been a great deal of concern expressed to me about the possibility of the MSIR licence being granted to a hospital. We all know how much pressure our hospitals are already under, and while I understand this has come from the recommendation in the Ryan review, the Greens and much of the sector that I have engaged with strongly support the current community health model and would like to see this continue. What assurances can you give that community health, who are well placed to deliver the on-the-ground services and care, will not be sidelined by a large hospital provider?

Harriet SHING: The North Richmond Community Health model provides a really valuable service and does exceptional work, as we have seen in the course of the trial. The recommissioning process is about enhancing services that have been delivered through that model and about making sure that we are aware of the uptake and interface and the community buy-in and trust that is delivered as part of the DNA of community health services. That would be part of the community health or partnership conversation that is at the centre of this recommissioning process.

Aiv PUGLIELLI: Minister, from what I have seen and heard, community health providers are well connected to vulnerable and marginalised communities, particularly in the area of North Richmond in this case. They often take on the complex work that hospitals cannot provide. Do the nearby public hospitals have the capacity to take on this complex and sensitive service provision?

Harriet SHING: As I said, the North Richmond model has been a really valuable tool in helping us to learn more about what works and what does not work. The Ryan review’s recommendation, as you would know, was to grow and to expand the services that are available. You are right to say that community health services do have that reputation of building trust and creating that element of engagement with vulnerable people who, for a range of reasons – and this was referred to in multiple contributions throughout the second-reading debate – are not inclined to trust easily and are very averse to opening up and having conversations, including about access to other services.

We want to make sure that we are not reducing that trust around access to health and social services and that tertiary health services are well regarded for providing those pathways into specialist care. Ultimately, the medically supervised injecting facility could be achieved by one large service or by a consortium of services working in partnership. We want to make sure that there is a tendering process that is based on proponents being capable of delivering a full range of expanded services that achieve those greater ends. This comes back again to the principles and the objectives of the act and of the review, which are about pathways and about engagement and ultimately about better outcomes for individuals and for the community.

Aiv PUGLIELLI: Minister, you are probably aware that there already exist some barriers in referring clients of the MSIR to other services. When I visited the North Richmond site they explained to me that even referring people to the next-door building is sometimes too much of an ask. So my question is: in a scenario where a hospital is granted the licence, how can you ensure that clients of the MSIR are not faced with additional barriers by referrals to offsite services and care?

Harriet SHING: To go back to the answer that I just gave, the full service offering, I suppose, is the answer that you might be looking for in response to that question. The process of tender and the intent of recommissioning is to provide that full service. The anchor for this really is the objectives of the act and the starting point for the Ryan review, and that builds on the Hamilton review as well. We want to make sure that we are delivering on that intent for development and implementation of those pathways and of those solutions to barriers and to gaps in the system, as you have identified.

Aiv PUGLIELLI: One more from me: what assurances can you provide as to the scope of information provided in the annual reporting of the MSIR?

Harriet SHING: Annual reporting is a term of the contract, so it is about delivering under the terms of that contract to demonstrate that various objectives have been met. That is actually part and parcel of it. Then, separate and aside from that, community health services have their own separate process of reporting, which is then about demonstrating output and value for money as well as objectives that have been achieved through delivery of important outcomes for individuals, whether they are clients and consumers, whether they are community benefits or whether it is outreach and those pathways.

Aiv PUGLIELLI: Will those reports consistently be released publicly?

Harriet SHING: Under the terms of the contract this is about the non-profit and charitable commission obligations and reporting. That sits aside from the work of perhaps what might otherwise be a reporting framework for community health services. The process of terms as they are set rests with the Department of Health. There are a few different themes here. It is separate and aside from a tabling process, but it is published because of the charitable non-profit organisation commission’s obligations.

Georgie CROZIER: I am just wondering: does a code grey occur on any occasion in the injecting room?

Harriet SHING: That is violence due to drug-affected –

Georgie CROZIER: No, code grey if there is a security issue.

Harriet SHING: Yes, but not necessarily because of drugs?

Georgie CROZIER: Any.

Harriet SHING: Any code grey?

Georgie CROZIER: Yes.

Harriet SHING: It comes down to a question of scale. In a hospital setting, for example, you have a code grey. There may be circumstances which are very similar to or present the same way as a code grey, but because the service itself is small – we are talking about 20 booths – it will be responded to with the same level of expertise and treatment pathways, including by way of call for transfer if necessary. But as a code grey situation itself, that is not the system that is deployed, simply because the scale is not there.

Georgie CROZIER: Thank you for that clarification. So if there is a security issue, the police are called. Is that correct?

Harriet SHING: Security are trained, so they have –

Georgie Crozier interjected.

Harriet SHING: Yes. So –

The DEPUTY PRESIDENT: Sorry, for Hansard, could you clarify what that was.

Harriet SHING: Yes. Ms Crozier and I are trying to be as efficient as possible, so I will perhaps just give you the clarity that you are after on the record, Ms Crozier. There are security staff there, and they are trained to work in that context. We are not talking about people who are coming in cold into a situation that does require de-escalation or management of a very particular and time-sensitive issue. Security staff are really well trained to respond to those issues, and indeed to seek responses from frontline service response as required. That might mean police, but again it is about making sure we are taking care of the safety of staff and of other people in and around the area – and the safety of the person in question or people in question.

Georgie CROZIER: Thanks for the clarification. I have got a couple of questions then. When an incident occurs, what reporting mechanism is undertaken? Is there an incident report that is written?

Harriet SHING: Yes.

Georgie CROZIER: Could the committee have an indication, or could you take on notice, how many incident reports around security issues inside the precinct and inside the injecting room have occurred?

Harriet SHING: Yes, I am happy to seek that information for you, noting that, as anybody in the situation of understanding how a code grey works would appreciate, there is a spectrum of severity engaging with –

Georgie Crozier interjected.

Harriet SHING: No, no. Well, to come back to the definition of a code grey in a situation of a large-scale hospital response, there will be a very well established and uniformly understood definition of what constitutes a code grey which might assist with the data that you are looking for. That is not the same situation as here, despite that the circumstances may be the same. So I will take it on notice, just noting that there is a variation here that will not sit neatly within a code grey setting because it is not a code grey situation.

Georgie CROZIER: I think you have misunderstood me. I was asking if there was a code grey. So there is a variation of code grey. So I am happy to get that data if you could get that data.

Harriet SHING: There is not a code grey. That is what I am saying.

Georgie CROZIER: Okay. What I am asking for is the number of incident reports that have been written because there has been a security-related issue. So do not worry about the code grey; it is a security-related issue – if we could have that data. And then in addition, the number of times the police have been called out because the security have needed backup – so for the five years.

The DEPUTY PRESIDENT: Sorry, Minister, just before I call you, can we refrain from having questions asked in the middle of an answer, or answers given in the middle of a question, because it does not help Hansard, and as we all know the committee stage is a very important part of a bill because it is read in conjunction with the legislation and the second-reading speech and any legal cases to interpret the intent of the act. So we want to get everything as clear as possible on the record.

Harriet SHING: Being familiar with the parol evidence rule, I do apologise to Hansard and indeed anybody who may have found these exchanges confusing. Thank you, Ms Crozier, for clarifying that. I think we are in heated agreement following that exchange. We are after information on incident reports that have or may not have involved a call to police to respond and the total number of those incidents over the relevant period. I will take that on notice. I am very happy to have that information for you.

Georgie CROZIER: Thank you for that assurance, Minister. Could I go to a point around issues inside the injecting room. Previously I asked about the number of agency nurses that have been used – if you could put that on notice – but I also want to understand whether there have been any issues around conduct from the nursing staff that have occurred. There are two workers that are, as we know, on the public record who had been using drugs on the precinct, but have there been any other issues of a legal nature that have breached any regulations or laws in relation to the conduct of how the clinicians practise inside the injecting room? Has that occurred at all over the five years?

Harriet SHING: I am trying to perhaps read through what you have said when you say ‘at law’ – that that refers to conduct that may constitute a requirement to notify a breach in the terms that you referred to around those two nursing staff, as reported. If you could provide some clarification, that would be really helpful.

Georgie CROZIER: I do not think I expressed myself particularly well. What I am trying to say is that we know – that is on the public record – that there are two workers that are known to have used drugs, so I am not talking about those. What I am trying to understand is: have there been any other instances where nurses or any other workers have breached any laws in relation to the conduct under their professional requirements – of a nurse, for instance? Have there been any breaches or any legal concerns that have occurred inside the injecting room by any of the staff?

Harriet SHING: You referred variously to nurses and to any of the staff. I will take it as meaning everybody. No, there have not been any legal breaches. What I do want to do at this point is also just acknowledge the really hard work that happens within North Richmond Community Health and the supervised injecting centre. We have a cohort of staff who are absolutely dedicated to the work that they do, and they are emblematic of the best of care. The dedication, the skill and the compassion that they provide in often really challenging situations are commendable, and it is important that we recognise that the very trust, the reputation and the engagement that are built and developed through this model are due in large part to the work that they do to recognise, to engage with and to provide dignity to the people who attend the centre. This is an opportunity for us to recognise the human impact that can be made and felt under this model that has a very real and a very enduring and positive consequence for people who are otherwise extremely vulnerable for all sorts of reasons, including as it relates to the stigma of intravenous drug use and addiction, and that was referred to again in a number of the other contributions. But the answer to your question, in short, Ms Crozier, is no.

Nicholas McGOWAN: Minister, just for the sake of brevity – there are number of figures I am interested in – if you do not mind, I will go through those, perhaps in one question, and then ask whether it is possible to provide those. Would that be okay?

Harriet SHING: Yes, I will do my best.

Nicholas McGOWAN: Is it possible to provide, at least up until the end of last month, so the end of April, the number of registered users – this is since the centre opened, so including the temporary centre, but perhaps differentiating from the temporary to the permanent – those that have been refused entry and the visits to the centre? Some of this information, I am well aware, may not be held by the department per se, but do the department hold and collect information – I think they would; I hope they do – on deaths outside the centre within 1 kilometre? I am particularly interested in the extremely serious overdoses that required naloxone and then also required an ambulance to attend the site, whether those cases are actually tracked from the site to the hospital or wherever the ambulance takes them and what their welfare might be, if it is tracked from that point. The number of overdoses inside the centre – the number of extremely serious overdoses –

Harriet SHING: What do you mean by that?

Nicholas McGOWAN: In the reports they differentiate an overdose from an extremely serious overdose – that is, usually those requiring naloxone.

What are the latest figures available in respect of: disposed needles and syringes in the local area surrounding the medically supervised injecting room; the total number of ambulances that have attended the injecting room; the difference in ambulance attendances where naloxone was used and administered and those where they did not administer it and – you spoke about this earlier and I did not quite catch it, so yes I apologise – ambulance attendances within 1 kilometre of the injecting room where naloxone has been administered by paramedics since the trial began; any figures they have in respect of emergency department presentations at nearby hospitals, including St Vincent’s but others if they are available; any information in respect of GP visits by medically supervised injecting room users, noting the previous data from the Burnet Institute; any information in respect of substitution therapy; and whether there are any current police investigations into any aspect of the centre, either those who worked there – I think you have answered this previously – or those who have attended the centre as users?

Harriet SHING: There is a lot in what you have just asked for and, as you have also indicated, there are also a number of things that I have responded to in earlier questions. Just to start at the end of what you said, I have indicated no legal breaches have been identified in matters of conduct around the centre. I do not know about current police investigations. That is a matter for the police.

When you talk about information on substitution therapy, I do not know what you mean by ‘information’, so again if you can provide some clarity on that. It is also important to note that I have indicated already that in the centre itself there have been no fatalities. There have been 6000 overdoses that have been addressed and 63 deaths that have been prevented.

There are a range of additional things that you have asked for which may be available in whole or in part. There is a degree of wooliness around a couple of the things that you have asked for. If you would like to perhaps just list them with as much clarity as you can, because you referred to perimeters and proximities and various distances from the centre, perhaps we can actually work something through for you with a bit more clarity.

Nicholas McGOWAN: Yes, I am happy to do that. If I can provide it post today, that would be great. Is that what you are suggesting, or are you suggesting I do that now?

Harriet SHING: In order to provide assistance to you on the matters that we can get you data on, if you are able to perhaps put that list to me with the detail that you are after and the specificity that you are after, I am very happy to seek that information for you. But there is a caveat to that that many of the issues that you have raised are matters that sit with Victoria Police. VicPol is one agency, and there are other agencies as well that go beyond the scope of the bill that we are here to talk about today. So perhaps let us see what we can do in relation to what you have talked about and, drilling down beyond perhaps asking for information on substitution therapy, what it is that you are after in more granular terms to assist with the discussion on this bill.

Nicholas McGOWAN: Thank you, Minister. I appreciate that. In respect of the substitution therapy, the initial report, the Hamilton report, specifically noted that clients at the centre are significantly less likely to be on opioid substitution therapy or registration than people who did not inject drugs, so I really wanted to know whether there was an update on that analysis, because obviously that report was some time ago now.

Harriet SHING: That last sentence creates a bit of clarity for me. It has been a bit of time since the Hamilton review, but that is where the Ryan review comes in. It builds upon the work that was done in that initial review, and that is then about where to from here. Perhaps we will see what we can do beyond the matters that cannot be the subject of what you are asking within this bill because they sit with Victoria Police, for example, and with other agencies. But we can perhaps look at what it is that you are after and where you would like to go with that. Let us continue the conversation.

David LIMBRICK: I have I suppose a technical question around clause 35. It makes a change to the licensing arrangement from an entity to a person. Could the minister provide some clarity on why that change was made?

Harriet SHING: The objective here is a clarification that the licence-holder is not to be a non-legal entity, if that assists. Again, talking about the amendment –

The DEPUTY PRESIDENT: Sorry, Minister, just a second. Photography is not permitted in the chamber, I am sorry. Could people refrain from taking photos on their phones.

Harriet SHING: When we talk about the amendment from entity to person as it relates to a board and to multiple persons being the licence-holder, there is no challenge there around the definition of a person under section 38 of the Interpretation of Legislation Act 1984, so that includes a body politic, corporate politic or individual, so a natural person. Generally, a board refers to the board of directors of a corporate entity, and therefore this amendment will not be a barrier to a licence being granted to a corporate entity.

David LIMBRICK: I thank the minister for her answer. Just to clarify this – I am not an expert in this area of law – when we say ‘to a person’ it could be a corporate entity as well? To clarify my question: are we talking about an individual person, like a natural person, or are we talking about some sort of corporate entity here?

Harriet SHING: A person is defined under the Interpretation of Legislation Act as including a body politic, a corporate politic or an individual, so a natural person. When we talk about a board of directors of a corporate entity, the amendment itself will not be a barrier to, as I said, a licence being granted to a corporate entity, if that helps by way of the inclusive definition in the Interpretation of Legislation Act 1984.

David LIMBRICK: I thank the minister for her answer. Is it not the intent of the government then that the licence would be granted to an individual, a natural person, in that case? Is it the intent that it would be granted to a board or some other corporate entity?

Harriet SHING: The intent is that the provision of services would be delivered by a body capable of satisfying the objectives and the obligations under the recommissioning tender. This is about providing clarification of the intent of the bill and what those objectives are as they are set out in the bill, in the same way that those purposes were established in the course of the establishment of the trial and of the terms of reference about linking in the creation of the trial site with the efficacy that it sought to deliver around safety and amenity as an analogy to what it is that we are talking about in the example you have given.

David LIMBRICK: I thank the minister for clarifying that. Would this change have any effect on legal liability, because before it was an entity. But are we talking about effectively the same corporate entity, just clarifying here, and it would not really change it, or will it have some material effect on liability?

Harriet SHING: No, it would not have a material effect on liability. It is about making sure that we anchor definitions in the Interpretation of Legislation Act 1984 through that inclusive definition that I have talked us through.

David ETTERSHANK: I move:

1. Clause 1, after line 4 insert –

‘(aa) to provide for a change in terminology from “medically supervised injecting centre” to “overdose prevention and recovery centre”; and’.

2. Clause 1, lines 5 and 6, omit “medically supervised injecting” and insert “overdose prevention and recovery”.

3. Clause 1, lines 8 and 9, omit “a medically supervised injecting” and insert “an overdose prevention and recovery”.

4. Clause 1, page 2, lines 7 and 8, omit “medically supervised injecting” and insert “overdose prevention and recovery”.

I have addressed this question briefly in my previous presentation, but the amendment that we are proposing is to replace in all references in the bill the term ‘medically supervised injecting centre’ with the words ‘overdose prevention and recovery centre’. Our purpose in moving this amendment is to try and more accurately reflect the extraordinary work that is undertaken at the North Richmond site. The centre is so much more than simply an injecting space, and its name should reflect this broad range of functions, which include dental services, mental health and opioid replacement therapy. There is a general practice provided, there are homelessness and legal services provided and there is, as I mentioned previously, the most successful or the largest hepatitis C treatment program in Victoria. It is in that context that we move this amendment, and we seek support for it to give due recognition to the extraordinary work that is conducted at the centre.

Harriet SHING: Thank you, Mr Ettershank, for moving that amendment. You referred to this in your contribution in the second-reading debate and indicated that the centre agreed in principle with a name change along the lines sought. We are not aware, I am advised, that there had been any request by the centre to change the name or that the department had received any such request. We want to ensure that any name change is not actually stigmatising clients of the service, and we would need to do a proper community consultation before making these changes. It is intended that the service continues to be referred to as the medically supervised injecting centre, as broader consultation with stakeholders and the community is required before determining an appropriate name for the service into the future.

David ETTERSHANK: Could I just clarify for the record that it was not our suggestion, nor did we state that this was requested by the centre, this name change. This name change arose from discussions at the harm minimisation conference. There were a whole range of stakeholders that we have subsequently discussed it with, and I think I mentioned them in my previous speech, or I mentioned some of those. It is in that context, just so we are clear.

Harriet SHING: Thank you for that clarification, Mr Ettershank. I do apologise. I did not mean to verbal you. It was my understanding from what I thought you had said that this had come from the centre, which is why I just wanted to perhaps address that.

This is about, as I said, making sure that we are not actually entrenching stigma by changing the name and that we do have the relevant level of consultation that takes place around that in the same way that we have had ongoing discussions as part of the panel work, and we have seen a really extensive set of conversations from a range of stakeholders, including the community, users, alcohol and other drug service providers and community health and frontline service personnel.

Georgie CROZIER: I just want to make a very brief comment. I obviously appreciate where Mr Ettershank is coming from in terms of his reasoning for this amendment, but the Liberals and Nationals do not feel that legislation is required for a name change and that it could be done through regulation. I do appreciate his sentiment on this, but on this occasion the Liberals–Nationals will not be supporting this amendment.

Aiv PUGLIELLI: I wish to note on the record that the Greens are in support of this proposed amendment by David Ettershank.

The DEPUTY PRESIDENT: The question is that Mr Ettershank’s amendments 1 to 4, which are a test for all his remaining amendments on sheet DE01C, be agreed to.

Amendments negatived.

Aiv PUGLIELLI: I move:

1. Clause 1, page 2, lines 10 and 11, omit “there must not be more than one such licence in force at a time” and insert “more than one licensed medically supervised injecting centre may operate”.

2. Clause 1, page 2, after line 11 insert –

“(iii) there may be more than one location that is a permitted site for the operation of a licensed medically supervised injecting centre; and”.

My first set of amendments seek to allow for more than one supervised injecting centre licence to operate at the same time at more than one location. People are dying from preventable overdoses and drug-related harm across Victoria. The government needs to provide similar services where there is urgent need, not just in Richmond and not just in the CBD but across Victoria. By moving the designation of permitted sites for supervised injecting centres from legislation to regulation, the government can more swiftly respond to the needs of the community without the need for legislation every time a new site is opened.

A new and additional licence can be granted by the Secretary of the Department of Health, and the permitted site of a proposed centre is still subject to parliamentary oversight, as a disallowance motion in either house of Parliament would repeal the regulation. This does not force the government’s hand to establish new centres, although they absolutely should; it simply means that when the government decides to, the process is faster and less inhibited. The data is in – there is great need for more safe injecting centres across Victoria. While I do hope that with the release of the Ken Lay report the Melbourne CBD may become a second site, as I have said before, I am also concerned that this may not become a reality and that any future sites are at risk of stalling or abandonment.

Experts have also warned about the threat of the arrival of fentanyl in Victoria. This terribly dangerous drug has had devastating impacts overseas, and if it were to arrive on our streets, the harm would be disastrous. It is another reason why having an agile system that allows for new supervised injecting centres to be stood up is a critically important harm reduction measure.

Harriet SHING: I think Mr Limbrick is also going to comment after I have responded to this. This proposal in the Greens amendment is beyond the scope of the bill itself. The bill is focused on North Richmond, so the immediate changes are needed to the operation of the North Richmond centre because if they are not urgently considered and if they are not part of this legislative process now, we are going to see an expiration of the service licence in late June.

Under the current act it is really important to note that licences cannot be transferred from one provider to another. We do not want to see a risk to service continuity in instances of underperformance or where there is a profound organisational change or some unexpected departure from the way in which services are delivered. Mr Puglielli, you have referred in earlier contributions to the importance of that model and of the continuity and the trust and the reputation, and I think we all agree it is germane to the success of this model that that should not be at risk.

The proposed bill allows for more than one licence to be created to allow service delivery to transfer from one provider to another, but it prevents both licences from being in force at the same time and it does not introduce any provisions to enable the establishment of additional medically supervised injecting centres. So the response to your amendment would be that the government does not support the amendment and indeed that it goes beyond the scope of a bill and a policy framework which has been centred around North Richmond since the trial commenced.

David LIMBRICK: Whilst I appreciate Mr Puglielli’s reasoning here – and I do appreciate the idea of having more flexibility – I am very concerned about this approach of doing it through regulation and having it be disallowable, because just as Mr Puglielli points out that it could easily be put in through regulation, it could also easily be shut down immediately through a disallowance motion – and I am also concerned about disallowance motions coming up every Wednesday in general business to try and shut down a new centre. For those reasons I will not be supporting this amendment.

Georgie CROZIER: The Liberals and the Nationals will not be supporting the Greens amendment.

David ETTERSHANK: Legalise Cannabis Victoria will be supporting this amendment. We believe this is a really important principle, and we will be voting accordingly.

Lee TARLAMIS: I move:

That the dinner break be taken for 45 minutes.

Motion agreed to.

Sitting suspended 6:28 pm until 7:17 pm.

Samantha RATNAM: I will speak to the amendment. Thank you, Mr Puglielli, for expanding this debate into the place that this chamber and this Parliament really need to go to. It is really disappointing that the government have indicated that they will not support this amendment and almost even more disappointing that they did not include this in the first place in this bill. We know that the work to establish this safe injecting room was indeed courageous – a really courageous act of the Labor government – and we commend the government for this bravery in the face of huge opposition at that time as well. We know the safe injecting space has helped hundreds if not thousands of lives and saved lives because of this courage and conviction to set up this really important space in the first place. We also know that your government has been working on more safe injecting spaces to continue this harm minimisation approach, and we know that the work is well advanced. The building of community engagement and support for it is also well advanced. I want to, on that note, commend the previous minister Martin Foley for being a really strong advocate for advancing that work.

Stalling this work by not only refusing to agree to this amendment but by not opening up the space in this bill where this chamber has an opportunity to really advance harm minimisation approaches in Victoria risks making the problem worse. It essentially sets up this site for failure. And while I have confidence that this operator and any future operator of the site will not let the site fail, it puts huge pressure on the existing site. It does not give us the chance to keep expanding the harm minimisation approach that we know is going to save thousands of lives across Victoria and hopefully across the country as more governments get confidence from the first jurisdictions that are willing to use their courage and conviction to open this door to more and more harm minimisation. I implore, on behalf of the Greens, the government to remember and maintain that courage. While you might not want to support this amendment today, do not abandon this work that you have created – a door to advancing and progressing in this state. It was hard fought. It was long overdue. The momentum is there. The community is there to back you. Please do not give up on expanding safe injecting spaces right across Victoria.

Harriet SHING: Thank you, Dr Ratnam, for your contribution and for the contributions of your colleagues and indeed others around this chamber. Again, for avoidance of any doubt, the bill needs to be urgently considered, and we want to make sure that we are not left in a situation where the service licence expires in late June this year. The bill itself contemplates only one site and only the North Richmond site.

Council divided on amendments:

Ayes (7): Katherine Copsey, David Ettershank, Sarah Mansfield, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam

Noes (30): Matthew Bach, Ryan Batchelor, Melina Bath, John Berger, Lizzie Blandthorn, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Enver Erdogan, Jacinta Ermacora, Michael Galea, Renee Heath, Ann-Marie Hermans, Shaun Leane, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Tom McIntosh, Evan Mulholland, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Rikkie-Lee Tyrrell, Sheena Watt

Amendments negatived.

The DEPUTY PRESIDENT: We move to Mr Limbrick’s first amendment, which tests his amendment 2.

David LIMBRICK: I move:

1. Clause 1, page 2, after line 29 insert –

“(da) to provide that internal management protocols for a medically supervised injecting centre must include certain requirements in relation to the prescription of Schedule 8 poisons and Schedule 9 poisons; and”.

My amendment intends to expand the possible range of pharmacotherapy options for the centre. In my mind was hydromorphone, but I am not prescriptive of what drugs could be used in order to provide pharmacotherapy options. To my mind, for every person who stops using heroin and starts using something that is prescribed by a doctor, like hydromorphone, that is one less person interacting with organised crime, that is one more person brought into the medical system rather than dealing with criminals and that is one less person who will have to steal and commit petty crime to feed their habit. I am of the opinion that this will help improve amenity around the centre. One of the main complaints of residents has been around drug dealing. If people can get pharmacotherapy options such as hydromorphone when other options may have not worked for that particular person, I think that is a good thing. It will reduce crime. It will help people; it will bring them into the care of medical professionals rather than dealing with criminals.

Georgie CROZIER: I rise to just make a few brief comments in support of Mr Limbrick’s amendment that he is moving, and I would also urge other members to think about what Mr Limbrick is putting forward. Indeed it is a policy that the Liberals and Nationals took to the last election, so we are strongly supportive of pharmacotherapy alternatives to these heinous drugs, and I think anything we can do to support people to get off drugs like heroin and give them opportunity and give them some support going into the future is absolutely necessary. So I want to commend Mr Limbrick for bringing forward these amendments, and I would urge all members to support them as well.

Sarah MANSFIELD: As Greens we support evidence-based approaches to drug harm reduction, and that includes access to all appropriate therapeutic interventions, including hydromorphone and other future therapies should they become available. We believe that they should be affordable and readily accessible, and in that respect we agree with Mr Limbrick and recognise this aspect of his motivation for putting forward these amendments. We are open to working with him and others who want to achieve this by finding a way to make it more accessible. I was heartened to hear the assurances that the minister provided earlier regarding hydromorphone and perhaps in future work to look at improving its availability. However, we will not be supporting the amendments proposed, not because we do not support access to therapies like hydromorphone but because these amendments to the internal clinical management protocols will not make these therapies any easier to access.

Perhaps it is worth explaining what the different schedules of drugs mean and how that is relevant in this situation. There is no barrier in the existing legislation or indeed in the internal management protocols to the prescribing of any schedule 8 medication, including hydromorphone. If hydromorphone was a therapy available for opioid addiction, it could be prescribed. The current barriers to access to hydromorphone are related primarily to cost – it is extraordinarily expensive – and also to the regulatory processes around its prescribing. If some people had done a little bit more homework, they would know that it is not approved for use by the TGA at the moment for opioid addiction. It is not an approved use, although that might change – there is a trial underway in Sydney – and neither the cost nor regulatory issues would be addressed by this amendment.

The Ryan review did indeed recommend expanding options for pharmacotherapy, but it called for more funding of it. It did not recommend legislative changes to the management protocols. The cost issue is a significant one, and while we would like to see investment in this treatment option, it is important to note that we also need much greater investment in measures to increase the number of people able to prescribe opioid replacement therapies. Even if we had hydromorphone available for therapeutic use, there may not be enough people trained to prescribe it. As it stands we do not have enough prescribers for existing treatment options like methadone and buprenorphine.

There are also technical issues with the proposed amendment. It calls for the issuing at the centre of prescriptions for schedule 8 and schedule 9 poisons when it is clinically appropriate for those substances to be prescribed. As stated already, there is no need for an amendment to the legislation with respect to schedule 8 medicines. They can already be prescribed. For reference, schedule 8 drugs, according to the Standard for the Uniform Scheduling of Medicines and Poisons, are:

Substances which should be available for use but require restriction of manufacture, supply, distribution, possession and use to reduce abuse, misuse and physical or psychological dependence.

In practice what that means is that they are drugs that are carefully regulated and often require clinicians to obtain a permit or other authority to prescribe. They include opioids like fentanyl, morphine, oxycodone, methadone, buprenorphine and hydromorphone. They also include medicinal cannabis and ketamine. They are your schedule 8 drugs.

Not only is the reference to schedule 9 drugs redundant, but it does not quite make sense. Schedule 9 drugs are by definition prohibited substances which may be abused or misused and can only be used for research purposes. They cannot be prescribed for a therapeutic purpose. That is the whole point of schedule 9: they cannot be used for a therapeutic purpose. If a drug is currently classified as schedule 9, it might at some stage be approved for therapeutic use. If that happens, it will be reclassified to a different schedule. A good example is cannabis. It used to only be listed as schedule 9. Some forms remain schedule 9, but approved forms of medicinal cannabis are now schedule 8, so they can be prescribed in a therapeutic situation. For example, if heroin was to be approved for therapeutic use, which it has in some countries, it would become a schedule 8 drug. So there is no need to have this reference to schedule 9 in this amendment, and in fact it actually does not make a lot of sense.

So we certainly support improving access to the full suite of available therapies but we want to see it done in a meaningful way that actually does improve access, and we will not be supporting this amendment.

Harriet SHING: There have been a range of matters discussed in the contribution from the Greens around the distinction between schedule 8 and schedule 9 substances, and this is a relevant matter for understanding the position of the opposition and Ms Crozier’s indication that Mr Limbrick’s amendment is supported. In that regard I want to highlight in perhaps very simple terms the effect of what it is that the opposition is proposing by virtue of supporting prescription of schedule 9 medicines which are, as has been indicated, only available for clinical trials. This may lead, by logical extension, to the perverse outcome whereby those opposite are saying that heroin could be prescribed. Is this in fact the intent of what is –

Members interjecting.

Harriet SHING: So I am hearing from those opposite that that is not the intent. Well, that would be the effect of creating an opportunity to provide access to schedule 9 substances. So –

Matthew BACH: It’s the end of the world as we know it.

Harriet SHING: Well, Dr Bach, I will take up that interjection. You think that it is the end of the world as we know it. Well, I think by you saying, by effect and by extension, that you would be in a position, in supporting this amendment, to provide schedule 9 substances, including, as they may, heroin, you are in a position to perhaps be compounding the problem which has brought us to this particular point and the bill and the trial and what it is that we would like to achieve.

To go back perhaps to the earlier comment about the work that we are continuing to do around pharmacotherapy and the commitments that have been made around further work that needs to happen and picking that reference up from the review, this is an important next step, but amending the legislation –

Members interjecting.

The DEPUTY PRESIDENT: Order! Can we have a little bit more respect for the minister, please.

Harriet SHING: It is a low base, perhaps, Deputy President. Amending the legislation is not in and of itself an appropriate mechanism to expand access to pharmacotherapy options, so on that basis we do not support the amendment proposed by Mr Limbrick for those reasons associated with schedule 8 and schedule 9 distinctions and for the reasons outlined around the ongoing work for pharmacotherapy incorporation.

David LIMBRICK: I would like to just briefly respond to the minister. One of the areas in this amendment, as it states very clearly, is ‘when it is clinically appropriate’ and only when it is clinically appropriate for a particular medicine to be prescribed as an opioid substitute. I am intentionally not defining what that drug is. I am leaving that to the experts who run these things. If they decide that it is clinically appropriate to approve hydromorphone, as has been suggested many times, then that is fine. If there are other substances in the future that come up that may be clinically appropriate, then they also could be used under this amendment.

Harriet SHING: To respond perhaps to what Mr Limbrick has just said, given that schedule 9s are available through clinical trials and given the challenges that we have around what has been discussed with pharmacotherapy work as ongoing and the work that needs to continue following the Ryan recommendations, this would lead to a conflict between the act and the regulations. So on that basis it is really important to distinguish between what is proposed to be developed, including through TGA and other regulatory approvals, the problem that you are seeking to address and the limitations of the act that we are working with here and the bill as it is proposed to in effect deliver on the objectives and the findings of the Ryan review and to continue the discussion around pharmacotherapy options and opportunities.

Council divided on amendment:

Ayes (15): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland

Noes (22): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Rikkie-Lee Tyrrell, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Ms Crozier, I invite you to move your amendment 1, which tests amendments 5 to 10 on sheet GC47C.

Georgie CROZIER: I move:

1. Clause 1, page 2, after line 33 insert –

“(ea) to require that the Secretary must not issue a medically supervised injecting centre licence for a facility unless –

(i) the facility is at least 250 metres away from the nearest school or service of a specified kind; and

(ii) the Secretary is satisfied that the facility is suitable for use as a licensed medically supervised injecting centre –

and to provide for various consequences if a facility ceases to meet these standards; and”.

As I said in my contribution, the Liberals and Nationals are very concerned about the location of the North Richmond facility. It is right next to a primary school. It should not be; it just simply should not be placed next to a primary school. In New South Wales that does not occur. They have a far more sensible approach. What this amendment does is aligned with what occurs in New South Wales around those restrictions – they may not operate in near proximity to schools, childcare centres and community centres and must have regard to the visibility of the premises and must have regard to the impact on public safety. That is what we are aligning with, and that is why we think this is a sensible measure to ensure that public safety is protected and that we do not continue to have what is occurring now, with amenity absolutely trashed, residents living in fear more often than not and children having to visualise and experience what they do as a far too regular occurrence. It is a sensible measure, and I would urge the house to support the amendment.

Aiv PUGLIELLI: The Greens acknowledge the community concerns around the current MSIR’s location being close to Richmond West Primary School as well as concerns around amenity of the surrounding neighbourhood. However, it is important to note the reasons why the MSIR is established in its current location on Lennox Street. Firstly, MSIR needed to be located where people were already injecting drugs. The research shows that people consume the drugs they purchase within minutes. Given the drug trade is concentrated in this area, it is crucial for MSIR to be here. Secondly, the MSIR site was chosen to be co-located with the existing North Richmond Community Health site given the wraparound services and treatments MSIR offers. Finally, we cannot just upturn the licensing arrangements of the existing MSIR site without jeopardising the operation of the existing site. If the opposition was seriously considering community need, they would not have proposed this without providing an immediate solution – in this case, a suitable alternate location. Not having this life-saving health service where it is in North Richmond is only going to increase the risk of overdoses and death for drug users in North Richmond. The Greens will be opposing this amendment from the opposition.

David LIMBRICK: I would like to briefly speak to this amendment. As I outlined in my second-reading speech, I am alive to the concerns of the local community around amenity. I think this amendment is sensible in that it has a one-year transition period so that there is time to find a different site or manage it in a way that is in line with the conditions that are put in this amendment. I think that it is sensible to keep it away from schools and other sensitive facilities, and so for that reason, although I will be supporting the bill, I will also be supporting this amendment.

Harriet SHING: To speak to this amendment, I want to canvass a number of matters that have been raised in the second-reading debate and in the other place, because I think that context is very important, and I want to pick up on the point that I have made in response to questions from Ms Crozier and others in this committee stage.

The centre is located where drug activity has been occurring for decades. The centre is located in an area where people have been injecting drugs, overdosing and dying for many, many years. As a consequence of the centre being located where it is, we have seen 6000 overdoses addressed and around 63 lives saved. People who live in and around the area know all too well the impact that intravenous drug use and addiction has on their community and that it has had on their community for decades. They know all too well the volume of syringes and of other items associated with intravenous drug use being an everyday part of the landscape in that part of Melbourne.

What we do know from the introduction of supervised injecting facilities around the world is that they work. What we also know from the introduction of medically supervised injecting facilities – some 120 now since the first one was introduced in Switzerland – is that but for medically supervised injecting facilities and environments within which people can inject drugs in a way that is immediately able to be addressed if there is an overdose situation or in a way that provides context and contact with pathways and services is that we see beneficial health outcomes, and those beneficial health outcomes, yes, relate to lives being saved and, yes, relate to overdoses being averted, but they also deliver pathways to programs, to services, to care and to the sort of wraparound engagement that vulnerable drug users need.

We are talking about cohorts, communities and people who are often very long term intravenous drug users. We are talking about people who are often vulnerable because of a range of other factors – the intersectionality of disability, of our Aboriginal and Torres Strait Islander communities and of people that are homeless or at risk of homelessness. Addiction causes a slide in every sense. It distracts from people’s ability to be able to connect and to participate in everyday life. Injecting facilities in a supervised setting are not, as I said in my summing up remarks, a silver bullet, but we do know from the Ryan review and from the Hamilton work that there is a growing body of evidence that they are an effective intervention that can reduce deaths and health burdens while also addressing safety and amenity concerns.

As we move toward a much greater concentration of people in Melbourne, and we know on current modelling we will get to 9 million people in Melbourne by the late 2050s, it is important to note that in seeking to bed down an amendment – to give effect to an amendment – in the terms proposed by Ms Crozier we are saying that should there be a childcare centre, a school or a health facility established anywhere in the proximity of any such facility it would not be able to operate, it would in fact not be able to deliver the care and the services and the wraparound engagement and those pathways toward improved health outcomes – life quality, connection to family, opportunities to participate in the workforce – and that would all in fact be up for grabs as a consequence of population growth and concentrated density in the delivery of services such as those that Ms Crozier has contemplated in that amendment.

So again I come back to the goals of the legislation: to reduce overdose deaths and overdose harms – that relates to the current location, the centre of much of the drug-taking and drug-dealing activity, which is well established and well known in the area; to provide a gateway to health and social services for people who inject drugs; to reduce ambulance attendances and emergency department presentations attributable to overdose; to reduce the number of discarded needles and syringes in public places; to improve neighbourhood amenity for residents and local businesses; and to assist in reducing the spread of bloodborne diseases. The Ryan review is the culmination of more than a year of research and hundreds of stakeholder consultations and discussions – an enormous body of work.

Evan Mulholland interjected.

Harriet SHING: Mr Mulholland, I will take you up on that interjection. There is so much work that has gone into building upon the work of the Hamilton review and of the work associated with the trial of engagement – the things that precipitated the Premier’s announcement that this trial would take place in a public event at which frontline responders were responsible for reviving somebody who had overdosed just out of camera. This is a very real issue, and it is not an easy one because it does force us to contemplate the reality of drug use in our neighbourhoods and the reality of drug use, as Ms Broad picked up in her contribution, everywhere in the state. Ms Bath has referred to it also in seeking additional recommendations and investment in residential rehabilitation beds and detox beds.

Matthew BACH: A fine contribution.

Harriet SHING: Dr Bach, they are good contributions. That is why this is a really significant debate to have, because it is so multifaceted and because we need to take account of the positions and the concerns of community members. This is not a straightforward proposition, but it is one which but for a medically supervised injecting centre – the very trial that has saved so many lives, that has averted so many overdose situations: people who are family members, who are loved ones and people who have been lost to addiction but who should have the opportunity to come back from it – but for that service at which there has been no death, we would be in a situation where that part of Melbourne would be riven with an ever-growing volume of drug-related activity the type of which has caused so much concern for so many people speaking in the chamber this evening.

It is also important to note that, when we talk about the Ryan review and about the accommodations and the concern and the engagement with the community, there is a lot of work happening not just to decrease the number of ambulance attendances or the volume of illegal activity around the area but also around the establishment of outreach services. The new North Richmond enhanced outreach service is about addressing gaps in the system. There is work underway to coordinate security providers in the North Richmond precinct in and around the estate, for new and upgraded public housing and improvements to the estate grounds and communal buildings, for new playgrounds, a futsal pitch, lighting, landscaping and community room upgrades with a focus on improving amenity and safety in the precinct, because perceptions of safety are as important as safety itself. And we know that implementing the recommendations will go a long way toward improving the experience of the precinct as well as the capacity of the service itself to proactively engage with people who inject drugs in North Richmond.

There will never be a straightforward answer to such a complex social and health issue. The concerns of the community continue to be part of the work that government is doing to address and to identify options and to continue discussions about what the future looks like. But bedding this facility down into a permanent operation will enable more lives to be saved, will enable more issues to be triaged for vulnerable people and will in and of itself improve and increase amenity and lean into the reality that drug use is part of every community in this state, in Australia and around the world. In opposing this amendment, we look forward to continuing to engage with communities, with stakeholders and with individuals who need and deserve a nuanced and respectful solution to this issue. That is why the bill is proposed in the way that it is, and that is why the bill is grounded in the Ryan review and the recommendations, the Hamilton work and the benefit that we have seen delivered time and time again to make and keep people safe and to keep people, quite literally, alive.

Council divided on amendment:

Ayes (16): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Ms Crozier, I invite you to move your amendment 2 and speak to it. It tests your amendments 12 to 16 on sheet GC47C.

Georgie CROZIER: I move:

2. Clause 1, page 3, line 1, omit “a further review” and insert “further reviews”.

This is a simple amendment to have periodic reviews of the injecting centre, as the minister herself said, to take account of the positions and concerns of community members. Having periodic reviews is a necessary item in relation to what is actually happening. The bill only allows for one more review, and so this amendment takes that commonsense approach of having periodic reviews so that the community and others can understand exactly what is happening with the injecting room.

David LIMBRICK: I will be supporting this amendment from the opposition. I think it seems like a sensible thing to have periodic reviews, so I will be supporting this amendment.

Harriet SHING: The government has a couple of reasons for opposing this particular amendment. One relates to reporting, which takes place in accordance with the terms of the contract for provision of the services and the way in which the health service’s report is published under the charitable and not-for-profit organisation commission website, available federally. In addition to that, there is a further review component which is set out in this bill to amend the act for a further review of the service undertaken in similar terms to that which was conducted in both the Hamilton and the Ryan reviews. This particular review will be undertaken in relation to both the operation and the use of the medically supervised injecting centre and the extent to which those objects have been advanced. So it is not just about the nature of the operation following passage of this bill and a permanent location being established, it is about linking that back to the way in which the objects of the centre have been advanced. That is where again the pathway comes in and the engagement, the wraparound and the access to additional services are concerned.

This is about making sure that that review commences before the end of the licence has extended – so that is 30 June 2028 – and the review will play a really important role in allowing government and the community to learn more about effective approaches to supporting people who inject drugs and the experience of the community that lives and works around the North Richmond drug market. As I said before, this is an ongoing engagement. This is about working beyond a periodic review as proposed in the amendment. It is about engaging with work as it takes place on the ground every day, making sure that communities and stakeholders are part of a conversation on what is working, the continuous improvement that is being delivered and the ongoing work as it sits within our broader framework of alcohol and drug dependency investment.

Importantly, this was established as part of a much broader landscape of commitment from this government to tackle alcohol and drug abuse. To take us back to a number of contributions in the second-reading debate, we know that drug and alcohol dependency, whether prescription or illicit drugs are involved, is something which requires a wraparound solution. It requires detox. It requires rehabilitation beds. It requires access to services, and that is precisely what happens on the ground. It is about making sure that, when we put that investment of more than $2 billion to work to more than double the number of residential rehabilitation beds, we are also increasing withdrawal beds and we are implementing, for example, the Ice Action Plan and the Drug Rehabilitation Plan. And as I indicated in an answer to Ms Crozier before, when we look at New South Wales and the comparatively higher rate of methamphetamine use in the Kings Cross facility, we know that there are a range of different presentations around different types of intravenous drug use that require different responses and solutions based around the themes of addiction but tailored accordingly.

We also want to make sure that as we invest in alcohol and other drug services we are supporting First Nations people, we are responding to alcohol and other drug treatment demand, we are responding to global supply pressures for critical harm reduction products like naloxone and also we are establishing facilities for rehabilitation and residential treatment. This is something which Ms Broad raised earlier, and it includes a $36 million investment for a 30-bed facility in Mildura. This is about an aggregate approach to a really complex health challenge, a community challenge and a challenge for governments. These investments provide support to approximately 40,000 people every year in accessing alcohol and other drug treatment and in the care and support that helps them to those pathways of recovery. It is a landscape rather than a point in time or rather than a single issue. And that is where we oppose the notion of a periodic review because of what the broader work is delivering and in light of the commitments and investments that have been made, as I have said, and in light of the further review of the medically supervised injecting centre as it is proposed by amendment of the act.

Council divided on amendment:

Ayes (16): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Ms Crozier, I invite you to move your amendment 3, which tests your amendment 17 on sheet GC47C.

Georgie CROZIER: I move:

3. Clause 1, page 3, after line 3 insert –

“(fa) to provide –

(i) that the Secretary must not issue a medically supervised injecting centre licence to a person unless satisfied that the person is a fit and proper person to hold the licence; and

(ii) that a person must not be appointed as a director or supervisor of the licensed medically supervised injecting centre unless the person making the appointment is satisfied that the proposed appointee is a fit and proper person to be a director or supervisor; and”.

I am moving this amendment around the fit and proper person test because the act currently describes a licensee as an entity, whilst the bill as it stands will change the licensee to a person, so there is no current test for the licensee to be a fit and proper person. What this amendment will do is reflect what is currently required under the Liquor Licensing Act 1997. So again, it is a commonsense measure. If you have got to be a fit and proper person to run a bottle shop, surely you should be a fit and proper person to run a drug-injecting room. This is a very commonsense approach to what is required to ensure that the fit and proper test is applied.

Jeff BOURMAN: I will be supporting this because I find it rather strange that you need to have a fit and proper person test for a shooters licence but not to run a drug-injecting centre.

Harriet SHING: The government will not be supporting the amendment proposed by Ms Crozier and supported by Mr Bourman. To go back to the questions that I answered before about ‘person’ and ‘entity’ and those changes and the inclusive list, which is referred to in the Interpretation of Legislation Act 1984, this is an inclusive list which does describe a corporate or politic or other entity or person falling within that definition. This is in fact a process that would be incorporated, for example, into tender documents, not legislation. This is something which is part and parcel of making sure that there is a responsible and fit-for-purpose delivery of the services which are intended to be acquitted as part of the permanent operation of this centre. It is not to say – and I would hate to think that anyone would say – that it is therefore not a requirement that fit and proper approaches and conduct be part of, and an intrinsic part of, the delivery of these services. This is a matter for tender documents, it is not a matter for legislation. That also links in directly, as I said, with the acts interpretation act and the questions asked by Mr Limbrick – and answered – earlier this evening.

Evan MULHOLLAND: I just want to speak in support of the amendment. We have had a case before where the CEO was stood down and there was trafficking going on at the centre, so this is nothing new. So I think it is only right that this house does support this amendment to have it there in legislation that it is a fit and proper person that is running this facility. I think it is important that we provide the facility with that extra layer of good governance and good reputation and in doing so that we can make sure what has happened in the past does not happen again.

Council divided on amendment:

Ayes (16): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Ms Crozier, I invite you to your amendment 4, which tests your amendment 18 on sheet GC47C.

Georgie CROZIER: I move:

4. Clause 1, page 3, after line 7 insert –

“(ga) to require the holder of a medically supervised injecting centre licence to prepare an annual report that will be laid before each House of the Parliament; and”.

Again, this is around transparency and accountability and to have annual reporting. Surely to goodness, if we expect hospitals and community health centres and other entities to provide annual reports to the Parliament, we should ensure that the injecting room also provides an annual report to understand exactly what is going on, understand exactly the financial positions – all of those issues that the minister has raised around meeting objectives. I mean, as I have previously stated, the Ryan review, 25 pages long, is clearly not the extent of their work. It is only the public document that has been provided, but it does not go anywhere near what has been described with the work that they have done. As the minister also said, and I repeat, she takes into account the positions and concerns of the community members. While we understand that, we also understand the numbers of people that are going through. What has happened to them? The rehabilitation – whether they have actually been supported through that rehabilitation process. How many? Is there an increase in the usage? What is actually happening? So I would urge all members, in the interests of transparency and accountability, that annual reporting is undertaken and that an annual report on the injecting room is provided to the Parliament.

Harriet SHING: Thank you, Ms Crozier, for moving that amendment. There are a couple of things in what you have just said which point to the concern I have and that we have around the distinction between reports and operational decisions. And what it is that I think you are looking for here is a measure which goes beyond reporting in the sense of annual reports and goes more to a blow-by-blow description of operationalised decision-making on the ground and within this centre.

So as part of the service agreement, the licensee is currently required to maintain records within relevant legislation and those obligations to understand client needs as well as drug trends, service delivery and the way in which we can inform the pattern and volume of referrals. The licensee also undergoes biannual audits by the Department of Health’s medicines, poisons and regulations team to ensure the service is meeting appropriate standards.

When we also talk about reporting, it is something I have touched on before in answering other questions around the way in which documents setting out annual reports are set in the federal space and published according to the charitable and non-profit organisation commission’s obligations. It is therefore something which is about transparency, it is about providing information about the overall functioning of the centre. But as far as operational work is concerned, those day-to-day decisions, this is not something that ordinarily falls within the contemplation of an annual report. So to say that by extension of a discussion of annual reports this would provide the sort of answers that you are looking for would be to misunderstand or misrepresent the nature of annual reports as they operate in the world at large.

Georgie CROZIER: Well, Minister, I was only using that to describe exactly why we need to have annual reporting in terms of having an understanding about the operation of the injecting room, as with any annual report that is provided to this place. A health service has a range of objectives. Does it meet the service delivery? Looking at the budgets, the staffing and having all of those aspects included in their annual reports, for example. But we do not know some of these points. So I am not being prescriptive about the annual reports. I am just saying that an annual report for this facility should be provided to the Parliament on an annual basis, like every other health facility in the state is required to do.

Harriet SHING: What you have just said is that you are not trying to be prescriptive, but your opening marks were exactly about being prescriptive about what you want to see in reporting. It is important to note that the provider has reporting requirements through the service agreement and with the department and they have got reporting obligations under the Commonwealth Corporations Act 2001, so that is why their annual reports, as I have indicated already, are available publicly under the Australian Charities and Not-for-profits Commission website.

Again, what you are looking for, Ms Crozier, is not able to be nor appropriate to be acquitted through an annual reporting process. There are operational processes, as I have indicated in earlier answers to questions and to comments, which are about determining the extent to which this model is delivering on the objects of the act, the extent to which this model is delivering on the recommendations of the Ryan review and the extent to which a permanent facility is enabling us to take the evidence and the material provided to that review in the course of 102 consultations and multiple round tables. There have been ongoing conversations with the community, with frontline responders, with people who live with and experience intravenous and other drug addiction, with service providers and with experts to have a proper basis on which to make the right decisions on a day-to-day basis that deliver life-saving care and support and that prevent overdose and death but which also provide those pathways for people to re-emerge from the depths of addiction into something which enables them to participate in the community, to have access to accommodation and to have good health care.

Mr Ettershank referred earlier to the way in which everything from hepatitis C through to other health conditions can be managed and treated and referral pathways can be given where there is an aligned set of priorities around community or other health service delivery in that tertiary context and availability for other acute or specialist care when and as it is needed. This is about delivering on those objectives. Those objectives are what have informed this bill, the objectives by which the measure of success and areas for improvement and recognition of the models that are working and have worked, now and into the future, will deliver.

Council divided on amendment:

Ayes (16): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Mr Puglielli, I invite you to move your amendment 7, which tests your amendment 24 on your sheet AP02C, and speak to that now.

Aiv PUGLIELLI: My second set of amendments I so move:

7. Clause 1, page 3, after line 11 insert –

“(ha) to make it a condition of a medically supervised injecting centre licence that persons must not be refused admission on the basis of pregnancy or childhood, or on the basis that they are subject to certain orders and conditions; and”.

This next set of amendments seeks to stipulate that access to the MSIR cannot be refused to people on the basis of them being pregnant, under 18 years of age or subject to a court or tribunal order, a parole condition or a bail condition other than an order or condition that has the effect of prohibiting the person from attending the centre or from accessing services or assistance at the centre. These amendments come from the Ryan review recommendation that expanding MSIR access will minimise the number of people injecting in public and are strongly supported by harm reduction and addiction specialists.

Expanding the eligibility for access to the MSIR means that people are provided with a safer environment for injecting, medical supervision and resuscitation support. It also means that people are not being turned away from this service and instead injecting themselves in unsafe places such as nearby parks or toilets et cetera. For those in this chamber who are concerned about public drug use around the North Richmond centre, this amendment will help address and reduce this.

In the Ryan review the panel acknowledged the success of the North Richmond site in saving lives and reducing the harms caused by injectable drugs. The government has accepted all recommendations made by the panel, except one – that the Minister for Mental Health:

Minimises the number of people injecting in public by expanding MSIR access to include peer/partner injecting and that the Clinical Advisory Council … consider the removal of other eligibility barriers including people on court orders.

The Greens believe that it is paramount that we remove obstacles to people accessing this life-saving service. It bears repeating: banning people from using the MSIR does not stop them injecting drugs. It only pushes them to inject in public without trained medical staff able to step in in cases of overdose, as well as to provide critical pathways to holistic health and wellbeing services. These amendments are a choice between providing access to a safe environment for injecting or refusing that and pushing people into an unsafe environment. We cannot draw arbitrary lines based on who we think should have access to this service based on optics or political narrative. Everyone deserves to be resuscitated. Everyone has a right to medical care. We do not take these changes lightly. It is not pleasant to think about pregnant people or children injecting heroin, but it is not just a thought, it is a reality in Victoria. Every day there are pregnant people and minors using heroin. Just a few years ago a teenager died of a drug overdose just a few hundred metres from the Richmond site. It is such a terrible tragedy that might have been prevented if they had been able to access the MSIR. It is a particularly cruel irony to force some of the most vulnerable members of our community into an environment where they are taking drugs in a manner that is less safe than their peers just because they are more vulnerable, as well as to prevent them from accessing the wraparound services that the MSIR provides to their clients.

Again, our amendments are about the option of allowing access to an environment which is safe versus one that is unsafe, as well as access to holistic health and wellbeing support, addiction specialists, pharmacotherapy, mental health workers, housing providers and so much more. Expanding the eligibility of those who can access the MSIR will also expand the number of people who are offered pathways to health care and stability.

Georgie CROZIER: The Liberals and Nationals will not be supporting the Greens amendment.

David LIMBRICK: Whilst I share Mr Puglielli’s concerns about children and drug use – it is particularly tragic – I cannot bring myself to see this injecting centre as somewhere that is suitable for children. I acknowledge that there are children that have problems with drugs, but I do not think that this is a solution. I think that the government needs to come up with a different solution to help these children. I do not think that this is a place for children, and therefore I will not be supporting this amendment.

Harriet SHING: Thank you, Mr Puglielli, for your amendments and for the basis upon which you have put them and put that on the record. One of the things I think that we need to make clear in this particular issue is the complexity of the impact of drug use on women and their unborn babies and the fact that this requires a very careful, considered and often very nuanced approach to care, and in the internal management protocols of the service it is clear that pregnant women cannot inject in the facility.

That, however – I want to be really clear – is not a reason to then conclude that a pregnant woman who attends the facility who is not able to inject at the facility is then turned away. It is important to note that this is adjacent to the health service. It is about being able to engage, and that is precisely what staff do. They are trained to talk with somebody who does wish to use the facility and who presents as being pregnant and to actually provide pathways and access to care and to wraparound support.

It is also really important that we note the operation of the facility and that use by minors of intravenous drugs is not permissible. This is also about engagement. What is it that young people need to address the causes of addiction? Often there is that vulnerability and that disconnect between the wraparound services, care, family, kinship networks and support that often exacerbates the vulnerability that is there.

This is where we will look at the report and at that recommendation on how best to strengthen the service, but we will not be proceeding with that recommendation as made in the report. But we want to continue to engage with experts on how best to provide that support, how to make sure that women can access services that will help them in their pregnancy and help them with access to services not just during their pregnancy but afterwards and how to address the really complex medical challenges that often exist in these circumstances, where that again is a contact point for pathways and for outreach and for ongoing engagement. That meets the objectives of the act as proposed. It meets the objectives of the service, which are about harm minimisation, about pathways, about care and, through that referral pathway, about being able to prevent or minimise overdose or death. This is, again, a nuanced response that is required and appropriate in circumstances which themselves are not straightforward. So the service, together with broader alcohol and other drug services, will continue to connect pregnant women with those pathways, and on that basis it is not an amendment that the government will support.

David LIMBRICK: I have a question for the minister on this point around pregnant women. How is the current prohibition on pregnant women using the centre enforced? How do they know that a woman is pregnant when they present?

Harriet SHING: This is a really important question, because again, when somebody attends the centre privacy is a really significant concern. Often people will not want to identify their status, their age. This is not a situation where people who attend will necessarily have a form of identification, for example, with their date of birth. And in the same context as has been raised earlier around fit and proper and access to certain forms of activity and rights that might exist at large and concerns that this is not the case here, we will have a situation where staff who are really well trained are able to talk with and engage with people who wish to use the service and through that engagement be in a position to determine age, likely age and the vulnerabilities associated with somebody who is possibly, probably or more likely under the age of 18 or indeed who is pregnant. These are hard conversations to have, because we all know just how delicate a conversation it is to ask somebody about pregnancy. We sit here in a very privileged position in this chamber knowing how hard it is, let alone somebody who is in a situation where they have purchased drugs or they have got drugs on their person or they are with somebody and they want to inject, and the last thing they want to do is talk about the fact that they are pregnant.

This is where the expertise of the staff comes in. Again, talking with them is the best way to determine their presentation, whether that is in relation to age or pregnancy status.

Aiv PUGLIELLI: I thank the chamber for the sensitivity of the debate about the amendment we are speaking on. I also appreciate the government raising these concerns and issues in relation to our amendments. This is, as has been said, quite complex, and there is a broad conversation that I think needs to be had across the political divide to make sure that we can provide health care to vulnerable cohorts within our community. I particularly also highlight the interaction that this amendment, as has been noted, would have with current child protection legislation and those requirements that are currently in place. I take the position that our first step should be to expand the eligibility for access to the MSIR so that people, including those who are young – minors – have access to a safe environment for injecting rather than them staying in an environment which is unsafe, but I would certainly welcome the opportunity to work collaboratively to address these concerns with the government and others as well. It is crucial that these cohorts are afforded this life-saving health care. Drug use in our community does not discriminate.

Council divided on amendment:

Ayes (7): Katherine Copsey, David Ettershank, Sarah Mansfield, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam

Noes (29): Matthew Bach, Ryan Batchelor, Melina Bath, John Berger, Lizzie Blandthorn, Jeff Bourman, Gaelle Broad, Georgie Crozier, Enver Erdogan, Jacinta Ermacora, Michael Galea, Renee Heath, Ann-Marie Hermans, Shaun Leane, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Tom McIntosh, Evan Mulholland, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Rikkie-Lee Tyrrell, Sheena Watt

Amendment negatived.

The DEPUTY PRESIDENT: Mr Puglielli, I invite you to move your amendment 8, which tests your amendment 5 on sheet AP02C.

Aiv PUGLIELLI: My third set of amendments I do so move:

8. Clause 1, page 3, after line 15 insert –

“(ia) to make provision in relation to adults attending a licensed medically supervised injecting centre to facilitate or enable other adults to use the centre; and”.

This final set of amendments from me seeks to admit adult peer and partner injecting wherein an associate, friend or partner of the client of the MSIR is able to facilitate that client injecting a drug on premises. For a variety of reasons there are people who are unable to inject themselves and rely on the assistance of a friend or a partner to help them inject drugs. This could be due to inexperience or it could be due to physical impediment. Our amendment will allow a support person to enter the MSIR to assist and will afford them the same protections as the client of the MSIR. Again, this is providing a safe space for injecting for people instead of one that is unsafe. We make no judgements on the clients of the MSIR. We simply want to make sure that vulnerable people have access to immediate medical support in the event of an overdose and can be offered referrals and wraparound services to support their health and wellbeing. Again, this is a particularly vulnerable cohort, so I implore the house to consider this amendment.

Georgie CROZIER: The Liberals and Nationals have concerns regarding the Greens amendment. We do not want this facility to be an enabler. We want it to support people to get off these heinous drugs. We want it to be safe. We do not think it is at all appropriate to have peer-to-peer injecting, and so the Liberal–Nationals will not be supporting the Greens amendment.

David LIMBRICK: I understand the motivation behind this amendment. My concerns are of a more technical nature. I am quite concerned about the exemptions from liability that are introduced in this. I have concerns about the possible unintended consequences of removing some of these liabilities, and therefore I will not be supporting this amendment.

Harriet SHING: Thank you, Mr Puglielli, for your amendments. There have been a couple of things raised by Mr Limbrick which go directly to the reason as to why the government does not support this amendment. I will take up the liability point first if I may. It is really important that we make sure that we are not creating a situation of liability or of criminal conduct occasioned from the peer-to-peer injecting process where consent may not be able to be clearly established in a way that indicates that injecting of a drug has taken place with the consent and the authorisation of a person who is not able to do it themselves. There are a couple of issues here that arise from limitations in physical mobility and the capacity to inject, but then there is also the issue of cognitive capacity.

Going to the point that was discussed earlier around people under the age of 18, the issue of peer-to-peer injecting gives rise to serious concern around consent, and there are a number of potential unintended consequences – for example, situations of power imbalance in a relationship where there may be coercive control. If, for example, people in a relationship attend the service and engage in a request for peer-to-peer injecting but there is no capacity to determine whether consent has been freely given, that is where we have really, really serious challenges around the way that criminal law, the way that civil law and the way that duties of care operate. On that basis we do not support this amendment.

It is also really important to note that in reality we know there are people with disability who are intravenous drug users. It is a matter of fact. We know also that there is an intersectionality between drug use, intravenous drug use, both illicit and prescription medication overuse, and self-medication in a range of ways that occurs within cohorts of people with disabilities and within cohorts of people with diminished capacity or capacity which affects their ability to demonstrably exercise free will. Given the challenges associated with that issue it is not something that the government will support.

Aiv PUGLIELLI: Again I thank the chamber for their sensitivity in discussion of this issue, as it is often a vulnerable cohort. I am noting it specifically is a cohort mentioned in the Ryan review. Again, I welcome comments on these amendments. The issues that are raised are significant ones with significant complexity, and it is important that they be considered. Of course I hear the views that are being raised in the chamber, particularly as has been noted on the risk of peer and partner injecting being used as a tool for family violence and coercive control. There is absolute complexity there, and the corresponding legislation to wrap around this would be substantive, so there is I think collaboration to be had to ensure that this particular cohort is looked after so that they are afforded the care that the MSIR can offer.

As I have mentioned before, these amendments are about providing an environment for injecting that is safe, as opposed to one where people are restricted in using an environment that is unsafe, as recommended in the Ryan review. That is why these amendments have been proposed. The chamber will have their views, but that is why they have been proposed. I would like to think that if someone is experiencing, for example, a scenario of family violence, an iteration of the MSIR could provide an opportunity for referral to an appropriate service. Again, I would welcome the opportunity to work with the government and others in this place to collaborate to address the concerns raised.

Harriet SHING: I just want to make a couple of very, very brief comments. I am aware of the forbearance of the chamber in canvassing so many issues across the course of this debate. Referral pathways are provided, and that is a key part of the engagement that happens as soon as anybody enters the service. Being adjacent to the health service is also another part of what that connection point looks like for vulnerable people who are all too often disconnected. So this is something that again provides pathways through to mental health support services, to family violence support services. It is about the work continuing beyond the two royal commissions that we have had to identify areas and pathways of access that lean into the challenges that exist, the psychosocial issues that present all too often with intravenous drug users, and making sure that in practical terms the access to support and wraparound care and pathways to support are available immediately. Again, that is consistent with the objects of the act and the pillars that sit underneath the Ryan review and the terms of licences.

Council divided on amendment:

Ayes (7): Katherine Copsey, David Ettershank, Sarah Mansfield, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam

Noes (29): Matthew Bach, Ryan Batchelor, Melina Bath, John Berger, Lizzie Blandthorn, Jeff Bourman, Gaelle Broad, Georgie Crozier, Enver Erdogan, Jacinta Ermacora, Michael Galea, Renee Heath, Ann-Marie Hermans, Shaun Leane, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Tom McIntosh, Evan Mulholland, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Rikkie-Lee Tyrrell, Sheena Watt

Amendment negatived.

Clause agreed to; clauses 2 to 8 agreed to.

Clause 9 (21:18)

Georgie CROZIER: Minister, thank you for going through the last clause. Just going to the licensing now, when a new licence is issued is there a requirement under law or regulation that the secretary makes that licence and location public – that is, through the Government Gazette or a public statement?

Harriet SHING: The licence must be for the permitted site.

Georgie CROZIER: Thank you for the response, Minister. What is the time frame between the licence being issued and the disclosure of that licence to the general public?

Harriet SHING: I am very happy to get back to you on that.

Georgie CROZIER: Thank you very much, Minister. Just in relation to community consultation, will the department undertake that prior to granting a licence, and if so, what would that actually look like? How much consultation is required? Does the department have a view to that?

Harriet SHING: Will there be community consultation as to the granting of a licence? There is a tender process, and the tender process will set out the terms upon which the licence is issued, but the tender outcome is then the notification. I am just wondering –

Georgie CROZIER: So, no, there won’t be.

Harriet SHING: No.

Georgie CROZIER: Thank you, Minister, for the response. In terms of that tender process that you just mentioned, what are the metrics identified by the department in awarding a licence to a particular organisation?

Harriet SHING: The tender documents themselves have not yet been developed, and that would be premature given that we are yet to actually determine the outcome of this process that we are doing at the moment, but they are based on service specifications. It is then about the enhanced service offering, and that is the discussion on the pathways that we have talked about today and that greater level of outreach and care that has been determined by reference to the Ryan review and its recommendations.

Georgie CROZIER: During the briefing we were told that there was a plan to transition the licence to a new licensee in July 2024. What services have been shortlisted? I know the site is there, but are any services going to move? And who has been shortlisted to provide any additional services if any have gone through that process as of yet?

Harriet SHING: That, Ms Crozier, is a process that will be undertaken, but it is about the site as determined and as outlined by this bill and as a consequence of the Ryan review.

Georgie CROZIER: What I am trying to say is I know that the Ryan review was looking at an expansion of services. So would the services that the government is looking at in relation to those recommendations that have been made be provided in the North Richmond site or would they be referred elsewhere?

Harriet SHING: Thank you, Ms Crozier, that is a helpful request for clarification there. Referrals are possible. The process of recommissioning will commence in July, so that is then about understanding the most effective process for delivery of those services, and as I have indicated, I think in response to one of the questions from Mr Puglielli, if it is needed to be a broader set of offerings to health and social services, then those options might be available, but the site itself is the site for the purpose of the injecting centre.

Clause agreed to; clauses 10 to 12 agreed to.

Clause 13 (21:25)

Georgie CROZIER: Minister, is the government liable for any compensation payable to the licensee in the event of a breach or termination of the agreement?

Harriet SHING: That would be the subject of the agreement that exists at the point at which it is made, so that will be set out in the terms of the contract as negotiated and agreed.

Georgie CROZIER: Thank you for the response, Minister. I presume that any annual payment from the government to the facility will also be set out in the terms at the same time – or is there an annual payment that you are aware of?

Harriet SHING: There is a bit of hypothetical in that question. I do not actually yet know about the terms that have been negotiated, and that will be the subject of discussion between the parties as to what is ultimately set out in a contract and agreement.

Georgie CROZIER: Minister, what metrics and KPIs does the licensee provide to the department to measure outcomes of the facility? Are there any? I am happy for you to take that on notice too.

Harriet SHING: Do you mean the facility as contemplated in its permanent status? I will have to take that one on notice on the basis that it is yet to be determined as to how it will operate and upon what basis those objects are met following the Ryan review and the recommendations that it has made about how that should be delivered.

Georgie CROZIER: Minister, given the current facility failed to meet six objectives of section 55 of the principal act, why didn’t the government consider this a breach of the agreement?

Harriet SHING: Ms Crozier, it comes down to the terms of the agreement itself as to whether a breach has occurred, so I do not have that information for you based on the fact that a contract will in and of itself determine what constitutes a breach and the way in which that is established.

Georgie CROZIER: I did not want to go down this rabbit hole, but I will for a minute. Clearly there has been a failure in maintaining amenity around the injecting room. Everybody is in agreement with that. The Ryan report says that; Hamilton has made reference to it. We know that. So what is the government therefore considering is appropriate for the amenity to be maintained in the new agreement? How would that look?

Harriet SHING: The objects, again, of the act are the basis upon which those standards are established, and they would then inform the parameters of the tender and of the contract and of the agreement and of the benchmarks that apply around satisfaction of those objects. They are built, as we have talked about before, based around the recommendations of the Ryan review. It is also then about the work that we do as government to approve amenity and how that sits alongside the operation of the facility and how that delivers on those objects.

Georgie CROZIER: Looking at the Ryan review terms of reference, they go to this very point about amenity and syringes:

To reduce the number of discarded needles and syringes in neighbouring public places

To improve neighbourhood amenity for residents and local businesses …

apart from the other things that are also listed about reducing ambulance attendances and reducing the spread of bloodborne diseases et cetera.

Again, because the residents have quite correctly outlined their concerns about what is happening to the local area and the number of discarded syringes, which has increased from 6000 a month to 12,000 to 18,000 a month, are you saying then that it is the responsibility of the government to be able to clean that up because that will not be part of the tender process, those aspects around amenity – syringes, the discarding of needles and improving the neighbourhood amenity for residents – will not be a part of the tender process?

Harriet SHING: The way in which the service will be delivered will be subject to the terms of the contract and the agreement, which will be predicated on the tender process itself. The findings of the Ryan review are based in the achievement of the injecting centre of core objectives around harm reduction and the saving of lives that we have talked about at length. The further impact is around reduced ambulance attendances; a reduction in overdose-related hospital presentations, as you have said; reducing the spread of bloodborne viruses; and those pathways around access to general health, social and wellbeing support and housing services. There is further work, though, to go on around community safety and amenity, and this is part of the work that government will do around working alongside council, working alongside the community and working alongside the service to understand what the impact and consequence is of the injecting centre as it continues in this location, determined with passage of this bill, on a permanent basis.

Georgie CROZIER: Thank you for that response, Minister. I take it then amenity does not come into that and will be the work of government. It will not be a part of that tender process for that to be maintained.

Clause agreed to; clause 14 agreed to.

Clause 15 (21:33)

Georgie CROZIER: Clause 15 allows the secretary to be able to take disciplinary action against the licensee. What was the rationale to include this new section, especially as we have been discussing fit and proper persons to hold a licence? How will that agreement be entered into and how will that be managed?

Harriet SHING: We are seeking some further information about the detail of what you are after, Ms Crozier. If you would like to continue in the interests of time, we can then come back to it.

Georgie CROZIER: You might need to take these on notice too, Minister. What I am interested in is: how many reports of disciplinary action have been reported to the department, how many have been investigated, what were the outcomes of those investigations and what were the changes in process and policy as a result? I am particularly interested in any investigations that may have been undertaken.

Harriet SHING: There have been no investigations, I am advised, in relation to the matters that you have raised.

Clause agreed to.

Clause 16 (21:36)

Georgie CROZIER: Minister, is compensation payable by the state if a licence is revoked by the secretary?

Harriet SHING: That will be determined by the terms of the agreement, Ms Crozier, as negotiated and agreed between the parties.

Georgie CROZIER: Minister, will there be an appeal process available, or will that also be determined by the tender process?

Harriet SHING: The tender and document refinement and agreement process will be the subject of discussion between the parties. It is then a negotiation, which involves the parties agreeing to submit to the terms of that agreement. So the short answer to that is: I do not know, because the terms have not been established, because that is what this process is for recommissioning.

Just to go back to something you asked about earlier around the department ensuring that licence conditions and legal requirements are being met, the secretary can in fact already impose immediate and effective sanctions if a licence fails to comply with the licence conditions or internal management protocols, a number of which I have touched on this evening, from new conditions in the licence right through to the suspension, amendment or revocation of the licence. As part of the service agreement, the licensee is required to maintain records within the relevant legislative obligations to understand client needs, drug trends et cetera, and the licensee, as we referred to earlier, has that biannual audit process built in as well to ensure that the service is meeting appropriate standards. So that is then how the department can ensure that those conditions are being met.

Georgie CROZIER: Minister, you again spoke about the audit process. What happens to the data? How much of that data is made public?

Harriet SHING: Data is the subject of reference in annual reports or otherwise available in the course of the review, which is set out from this bill. There is one built in, Ms Crozier, to the bill, and audit data itself is from the Department of Health.

Clause agreed to; clauses 17 to 23 agreed to.

Clause 24 (21:40)

David LIMBRICK: Clause 24 changes the requirements of a ‘director’ or ‘supervisor’ from ‘a registered medical practitioner’ and also adds the extra ability – ‘or a registered nurse’. I am informed that registered nurses should be perfectly capable of overseeing and supervising overdose; however, the facility provides other types of medicine – for example, hepatitis C treatments – and it is quite unusual, in my understanding, for a nurse to be in a position to supervise a doctor in clinical practice. Could the minister please outline how this will work.

Harriet SHING: How a medical practitioner will supervise a nurse? Sorry, could you just say it without –

David LIMBRICK: Yes. A nurse can become a supervisor in this case, and they would potentially be supervising doctors giving clinical treatments such as hepatitis C treatments, for example – I believe they conduct other treatments there. My understanding is that that is a fairly unusual arrangement.

Harriet SHING: Thank you, Mr Limbrick, for that clarification. The nature of the medical supervisor status is to ensure that operationally there will always be somebody there at the service who can prescribe. So that might be a nurse or indeed a medical practitioner as otherwise defined.

Clause agreed to; clauses 25 to 28 agreed to.

Clause 29 (21:43)

Georgie CROZIER: This is in relation to the second review of this part on the licensing of a medically supervised injecting room – the minister must arrange for a review to be conducted. Why did the government decide to set the date of the review to commence a year after the four-year term of the licence? Why didn’t it conclude just after the four years instead of a year after that four-year period?

Harriet SHING: The terms of the review are based on the negotiations between the parties. That is done by an outside parameter, so there is a capacity for that to take place earlier depending on what the duration is.

Georgie CROZIER: Minister, the legislation outlines that the minister must cause a copy of the review to be tabled before each house of the Parliament as soon as practicable after the review is completed. What is the minister’s definition of ‘as soon as practicable’?

Harriet SHING: This is about doing something as soon as possible in the circumstances that apply. So the idea is that there is primacy around doing the tabling and laying that report at the earliest opportunity in the circumstances.

Georgie CROZIER: I ask that because of the Lay report, which has been delayed for years. There seem to have been excuses by the government for various reasons for the iterations of the report that have been delayed. When was the first Lay report delivered to the department? When was it first delivered to the department, and on what date was the minister briefed on each version of the report?

Harriet SHING: It has been indicated on a number of occasions by a number of people that the Lay report will be provided at the end of May. I am not aware that there is anything other than the Lay report, so –

Georgie CROZIER: But when was it first delivered to the department? I mean the first Lay report delivered to the department.

Harriet SHING: The first Lay report? The Lay report is a report that will be provided at the end of May. I am not sure why there is a reference to ‘the first Lay report’.

Georgie CROZIER: So the Lay report I think you said earlier will be delivered at the end of May, and there are no other interim reports that have been provided to government.

Clause agreed to; clauses 30 to 33 agreed to.

Clause 34 (21:48)

Georgie CROZIER: Minister, how many staff are currently employed by the injecting facility?

Harriet SHING: I am very happy to take that one on notice.

Georgie CROZIER: Thank you very much, Minister, for that undertaking. I am just wondering – and I should have asked this with the previous question: would you also be able to provide the breakdown of salary ranges? I am happy for that to be taken on notice as well.

Harriet SHING: Subject to the relevant privacy considerations around the way in which bands are expressed – as occurs in annual reports, for example – I am very happy to take that one on notice for you too.

Clause agreed to; clauses 35 to 37 agreed to.

Reported to house without amendment.

Harriet SHING (Eastern Victoria – Minister for Water, Minister for Regional Development, Minister for Commonwealth Games Legacy, Minister for Equality) (21:50): I move:

That the report be now adopted.

Motion agreed to.

Report adopted.

Third reading

Harriet SHING (Eastern Victoria – Minister for Water, Minister for Regional Development, Minister for Commonwealth Games Legacy, Minister for Equality) (21:50): I move:

That the bill be now read a third time.

In saying so, I want to thank everybody in this chamber who as part of this debate has been so respectful and given this process the time and the space that it has needed in such a complex area of policy and of law. I thank everyone who has participated in sharing a range of different views as we have tackled this issue, and I hope that from here we can continue the work of collaboration and discussion and respect.

The DEPUTY PRESIDENT: The question is:

That the bill be now read a third time and do pass.

Council divided on question:

Ayes (22): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, David Limbrick, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Sheena Watt

Noes (14): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Renee Heath, Ann-Marie Hermans, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Rikkie-Lee Tyrrell

Question agreed to.

Read third time.

The PRESIDENT: Pursuant to standing order 14.28, the bill will be returned to the Assembly with a message informing them that the Council have agreed to the bill without amendment.