Tuesday, 1 August 2023

Bills

Mental Health and Wellbeing Amendment Bill 2023

Second reading

Debate resumed on motion of Ingrid Stitt:

That the bill be now read a second time.

Georgie CROZIER (Southern Metropolitan) (15:24): I rise to speak to the Mental Health and Wellbeing Amendment Bill 2023, and I do so because it is an important bill that we are debating this afternoon that has come to the house. Obviously, members in this place know the government’s intention in relation to the mental health crisis that is gripping Victoria. This bill has a number of purposes. It makes minor amendments to the Mental Health and Wellbeing Act 2022 and makes consequential amendments to the Judicial Proceedings Reports Act 1958, and it is looking at partly fixing up some areas with the implementation of the recommendations from the royal commission.

The final report of that very important royal commission was handed down in early 2021. It was an important report for the state, because it did highlight a range of issues around the mental health system here in Victoria. Of course there was an interim report, which was handed down in 2019, where five of the nine recommendations highlighted the desperate need to build the mental health workforce so that we have capacity in the system that can support those with mental health problems and so that those practitioners supporting people can also have the resources available.

What we know, though, is that that just has not transpired, and there are some real concerns around the implementation of the royal commission’s recommendations and just where the government is at on it. They might talk about putting money into the system, but really where it is being delivered and how it is being delivered I think is of concern, because we know that mental health bed waiting times are blowing out yet again. I am waiting on the last quarter’s Victorian Agency for Health Information data on health. Last time I looked, earlier today, it had not been released. We are still waiting on that. That is now overdue yet again. In the latest data that we know about, it was showing that, again, targets have been missed and that 60 per cent of patients were forced to wait longer than 8 hours for a mental health bed in Victoria’s emergency departments. That data from VAHI shows that the government continues to fail to meet the 80 per cent target of admissions within the clinically recommended 8-hour time frame.

The reason I raise these issues around workforce is because the government has spoken about it; it is a major cornerstone of the royal commission’s findings and recommendations. They said that the workforce was critical to have the ability, as I said, to deliver the services to Victorians. In doing so, again the government made some pretty big announcements around a workforce reform task force – that it would have responsibility for directing workforce reform activities and considering how models of care and the introduction of new roles in workforces and systems planning would improve opportunities for Victoria’s mental health and wellbeing workforce to work across the full breadth and depth of their trained scopes of practice to improve consumer outcomes.

The mental health and wellbeing workforce strategy 2021–24 was released in December 2021 by the then minister, Minister Merlino. In his foreword, he speaks about this issue:

… providing better care requires people. People who are skilled and trained to do the jobs that will deliver that care, and who approach their work with compassion, empathy and dedication.

I think there are so many people that actually do that. They do do that when they are working in this space. They provide amazing empathy and care and support in sometimes very challenging circumstances, and it is just heartbreaking to know that so many people are falling through the gaps, and so many children are falling through the gaps. We saw what happened in the extended lockdowns, with kids not being able to go to school and have that social interaction, and what was happening behind closed doors – the number of GPs that spoke to me about children with self-harm and tragically those that took their own lives. That will have a massive impact for years and years to come – the shadow pandemic, as it was described by so many who were seeing their children suffer in such a very detrimental way through that very dark period here in Victoria.

I was at lunch on Sunday – Mr Davis and a number of us were there – and a woman came up to me with tears in her eyes. She was a middle-aged woman, and she said, ‘Georgie, you have got to do something about the mental health system; four of my friends have suicided in recent months’ – four of her friends. That is the extent of I think the heartbreak that is going on in the community. It is sometimes forgotten because it is not immediate and it is such a private grief. We all know, I am sure, people who have suffered or seen those that are close to them that have suffered from a mental illness. So it is an important reform, and we understand that. We understand the royal commission and what the government is trying to do. This workforce strategy that I refer to has got lots of statements in it – motherhood statements – about what the government is doing, with the government patting themselves on the back. But they are actually failing to deliver – that is the point – because of how many people who are not being able to get the services that they so desperately need. For many people that are working within this system – within the acute health system but also within the mental health system ‍– their frustrations are increasing because they also know that the personnel and the resources are just not being applied.

It is interesting to note, and I want to refer to, this report. As my colleague Ms Kealy in the other place so eloquently pointed out in her contribution, we fully understand that through the implementation there are going to be some errors, and what this bill does is fix up some of those errors. But it also actually is pushing back on some areas where we believe the government is not taking responsibility in an appropriate manner. What I am talking about is clauses 13 and 14, around removing paramedics from being part of that response. What these clauses do – and I will be moving in committee to omit these two clauses – is take paramedics away from that. To leave police and PSOs to be the first responders that have to deal with these patients and not have paramedics as part of that team is actually counterproductive to the whole health-led response that the government continues to tell Victorians this is all about, because it is actually not when you are taking away that part of the workforce. Again I refer to this strategy of December 2021, where it is noted there is a new workforce cohort. I will quote from page 26 of the report:

Action area 1c: Building emergent and new workforces

…

New workforce cohorts are also needed to deliver consumer-centred care and new service models …

They talk about that it should:

… include new professions, potentially including mental health-trained paramedics, counsellors and wellbeing roles delivered across tertiary and community settings …

The report goes on to talk extensively about that health-led response and the new and emerging workforces, as I said. I quote from page 49:

New and emerging workforces – including paramedics, consumer wellbeing support officers and counsellors, who have the skills that will support new models of care – need to be built to help stabilise the workforce.

That is the main point of why we will be moving a reasoned amendment. I am wondering if I can have that circulated. I move:

That all the words after ‘That’ be omitted and replaced with the words ‘this bill be withdrawn and redrafted to enable the delivery of a health-led response to mental health related emergencies.’.

The reason I am moving this amendment is because that is what the government has said, and that is what this task force talks about. It talks about a health-led response. It talks about having new and emerging workforces, including paramedics. So why then is the government taking away that option through this bill – through the changes in the clauses? We do believe that the bill does not capture what the government has told Victorians or what the government has told the sector. Ms Kealy has done extensive consultation with the sector. They are not happy that the health-led response has been ditched for having no paramedics as part of the transfer that clauses 13 and 14 go to.

I just referenced clause 12. Clause 12 supports the health-led response principle and allows 000 call takers to provide a health-led response wherever possible. But clause 13 removes the express reference to paramedics employed under the Ambulance Services Act 1986 in relation to ‘Taking a person into care and control in a mental health crisis’. Clause 14 provides for an authorised person to transfer care and control to a police officer, a PSO or a member of a class of authorised health professionals to be prescribed by regulation at a later date.

So that is why we are moving this reasoned amendment – to say to government, ‘Well, your clause 12 points out that’s what you want to do, but in actual fact clauses 13 and 14 negate that.’ So in committee I will be moving to omit clauses 13 and 14 in the bill so that it can be a true health-led response.

I wanted to just state that there are the stakeholders that, as I said, Ms Kealy has spoken to, and they are very much concerned about the government’s approach.

Melina Bath interjected.

Georgie CROZIER: It does recall, as Ms Bath just said, the Police Association Victoria. The police association have spoken out, and we understand that they have got concerns around their resources and the number of police that will be required to undertake the work that the government is now doing. The Victorian Mental Illness Awareness Council (VMIAC), those with lived experience, provided enormous information to the royal commission and gave such extraordinary evidence through those hearings and through the submission process, and the royal commission looked at those lived experiences. They are not supportive of the actions of government. The RANZCP, or the Royal Australian and New Zealand College of Psychiatrists, are also very concerned about this approach by government. The Victorian Alcohol and Drug Association – the alcohol and drug sector – have been very outspoken in terms of what is required and, again, provided significant information to the royal commission and provide enormous support to so many who suffer with drug and alcohol addiction and of course then may have mental health issues as a result.

So these very important stakeholders who have been providing information to the royal commission, who have been at the forefront of talking about why we need reform in this state, do not support the intentions of the government. As I said, Ms Kealy has spoken with them at length, and they have spoken about concerns that paramedics are now taken out of that response.

I think, as we have said, the recommendations from the royal commission’s report really highlight the importance of treating mental health like any other health emergency and in that situation that health professionals be there to assist in those emergencies – that certainly paramedics should be among those first responders and part of that health response. A key recommendation focused on the 000 responses to ensure that paramedics rather than police, in instances where appropriate and where able, were the first responders. That really is, I think, very important – that paramedics are not cut out of this response.

I will be asking in committee: what is the government’s reasoning for this? It makes no sense – it makes absolutely no sense. What have the union provided to government in relation to what they want about not assisting with these patients who are needing emergency care? Removing the ability of 000 call takers to refer a matter to Ambulance Victoria leaves police or PSOs to be the legislated first responders, and we do not believe that is right. We do not believe that that is the right course of action. We think this is a step backwards from the important reforms from the Royal Commission into Victoria’s Mental Health System and the recommendations and findings from that important work that was undertaken. It is very much inconsistent with the findings and recommendations those commissioners provided to government. Whilst I note that it is aiming to provide flexibility, taking out a huge number of first responders in a health emergency crisis makes no sense.

I hope that those in the chamber understand the reasons for us to be proposing and moving this reasoned amendment. We do believe that it should be withdrawn and that we have that health-led response at the front and centre to ensure that those with a mental illness who are requiring emergency care get the care from a range of first responders, including paramedics.

John BERGER (Southern Metropolitan) (15:42): Today I rise to contribute to discussion on the bill before the Parliament today, the Mental Health and Wellbeing Amendment Bill 2023. This bill was born out of an urgency for Victoria to correct issues in our system and support those who need to be supported. The Royal Commission into Victoria’s Mental Health System, from which the bill takes many cues, delivered many enlightening insights that all culminated in one key understanding: something needed to change. In delving into the bill and exploring just what it will do to improve the lives of Victorians navigating the mental health system, I would like to take a moment to touch on the Royal Commission into Victoria’s Mental Health System, which delivered the final report on the royal commission’s findings in February 2019. This report outlined extensively what needed to change in Victoria’s mental health system to improve the delivery of meaningful and life-saving care for the Victorians that need it the most. The Andrews Labor government has taken this on and committed to following every single one of the royal commission’s recommendations.

There were many findings of the royal commission, the root cause of many of which are to be swiftly and effectively and decisively addressed in this legislation, the Mental Health and Wellbeing Amendment Bill 2023, just as they were in the Mental Health and Wellbeing Act 2022. The commission also noted the urgency in these reforms, as a long-deteriorating mental health system will continue to cause damage to individuals requiring care. To this effect, many reforms in this bill are inspired by or directly adapted from the royal commission. The royal commission came to these findings and recommendations through a variety of methodologies that focused on exploring as many stories and experiences as possible to gain an understanding of the diverse group of Victorians within our state’s mental health system. This side of the chamber does not stand for a system that leaves vulnerable Victorians high and dry. Mental health is a serious issue, and it needs to be taken seriously. Victorians need and deserve a system that is fit for purpose. They have a right to seek help when help is needed, and they have a right to be aided and respected when they seek help. This is why the Andrews Labor government and the Minister for Health have proposed a bill that will introduce several measures to ensure that Victorians of all ages requiring mental health and wellbeing support can access networks to support them. It is as simple as that.

Mental health is just as important as any other forms of health care ensuring that individuals are healthy and happy. Unfortunately, the system has not always been functioning to its full potential, as outlined by the royal commission. Part of this was rectified last year with the Mental Health and Wellbeing Act 2022, but the work is not done yet. We are not the kind of government that just does half a job. In fields that really matter, like the mental health and wellbeing of every single Victorian, we make sure we get it right. This is a rapidly changing sector in Victoria, and we are trying to build a mental health system that truly supports those in it, a system that does not leave people worse off or worse for wear but, rather, improves their lives.

As these rapid changes take place, we must be ready to jump on expert advice and amend sections of the act that need to be amended, which brings us to the Mental Health and Wellbeing Amendment Bill 2023. It goes to a couple of the measures to improve our state’s health system and ensures that the delivery of reforms within the Mental Health and Wellbeing Act 2022 causes the best possible outcomes, which I will now read over. Many of these amendments only exist to clarify or correct technical passages, but it is essential that this act be effective when it comes into effect later this year.

An additional key reform within the Mental Health and Wellbeing Act 2022 that this amendment bill highlights and strengthens shifts the current law enforcement focus that our legislation currently has towards those experiencing mental health issues that may present harm to themselves, the community and others to a focus on how these individuals may be assisted through avenues of health care. The science has shown time and time again that when an individual presents a threat to themselves and others due to their mental state, they need help. This is not to discredit the importance of our law enforcement officers or their ability to protect the community but rather to explore ways to see the harm decrease in the long term. This would ultimately be achieved by allowing paramedics the ability to exercise their work more flexibly in situations that could constitute a crisis if those circumstances ever arise. However, it is important to clarify that systemic reforms must be made to ensure that an appropriate statutory framework exists for such flexibility. When these reforms take place and a person obviously needs to be detained, it will be done.

Ambulance Victoria responds to over 60,000 calls a year in which the patient is in some way affected by mental health issues. It is important that these cases all be treated as effectively as possible, and in some cases that means reducing police engagement. These amendments will in no way alter the way in which paramedics and other healthcare professionals are able to treat these patients. This ensures that before powers are to be awarded to paramedics, the necessary systemic supports are in place and that other healthcare workers are equipped to support paramedics in such situations. This will ultimately lead to a much more effectively functioning system for our emergency services. It also means that we will have a health-focused approach to situations of potential harm that it is as fit for purpose as possible.

These mental health reforms will change the nature of mental health care in Victoria as we know it. The royal commission showed the changes were essential. Whist it is shifting to a health-focused approach to dealing with a public mental health crisis, if a mental health crisis team is unable to respond as quickly as needed, police will remain with the powers to address the crisis. This is only in extreme circumstances.

To summarise that specific amendment, it will provide clarity to the reforms that we are hoping to introduce to create a health-led mental health crisis response standard. The protection of every Victorian is at the heart of this amendment. We believe in supporting Ambulance Victoria, hence not rushing these reforms. We are very passionate about Ambulance Victoria over here. In fact funding for Ambulance Victoria has more than doubled since the Andrews Labor government was elected: that is right, 140 per cent on ambulance spending, which adds up to somewhere around $2 billion. This is because we know that it is important that money be spent on our essential services. We have even got more paramedics on the road, an increase of 50 per cent, which adds up to around 2200 more paramedics. This is nothing but a net positive for the Victorian people. Everybody knows that if you want a decent ambulance service, the Andrews Labor government will be the ones to deliver it.

This of course is not the only amendment being made to support the reforms being made in mental health. Clarity is made to several definitions within the act to ensure that there is absolutely no confusion when delivering these important reforms. One of those definitions being clarified is the definition of ‘parent’. This obviously relates to the issue of youth mental health, which was a large component of the royal commission. Due to this there are many reforms within the act that interact directly with how youth mental health is approached and what treatment for youth mental health would look like. Naturally, as with any other health-related consultation or interaction, if the patient is under 16, then there is a possibility that a parent must be consulted or notified.

The amendment bill clarifies that the Mental Health and Wellbeing Act will use the definition of ‘parent’ outlined in the Mental Health Act 2014. That is for all purposes of supporting all the big reforms we are making in mental health, like the introduction of carer-designed and led clinics across Melbourne and greater Victoria. There are a couple of those in Southern Metro, and I am excited to see the results and how they deliver for families and carers of individuals. It is important that every single Victorian is healthy and supported, even those who do the supporting.

The Mental Health and Wellbeing Act has also seen the introduction of the board of the Victorian Collaborative Centre for Mental Health and Wellbeing commencing its operations last September. It has proven already to be successful and competent in its purpose – that being the creation of a centralised voice and a reference point for the design of our new, overhauled mental health system by bringing together individuals who hold lived experiences and interactions with the mental health system, as the Mental Health and Wellbeing Amendment Bill 2023 seeks to pull back overly restrictive requirements to assist in creating an easier route to recruiting key leadership roles. This is an acknowledgement of the importance of the design recommendations and contributions being made by the collaborative centre. With these amendments the board will become even more an integral asset to the development of a positive and effective mental health system.

On the topic of the many entities established by the Mental Health and Wellbeing Act 2022, the bill also addresses the commencement of a regional board, with the interim regional bodies established and filled in February of this year. They have hit the ground running, building relationships and connections with the community and stakeholders. This is all with the intent of transitioning these interim regional bodies into the statutory regional board, a body that will inform the development and delivery of the services within regional Victoria. This amendment bill seeks to delay the establishment of the statutory regional board to make the most of the capabilities of the interim bodies in establishing the connections needed for the board to have with regional communities.

The bill also seeks to amend for clarification the specifics of which organisations may be eligible to receive state funding and therefore the exact nature of the statutory obligations these organisations are beholden to. This pertains to the opening of the 60 mental health and wellbeing locals across Victoria, an essential reform recommended by the commission. Mental health and wellbeing locals deliver important services and support close to the individuals requiring them. This is in recognition that one of the most common barriers to seeking support and treatment is simply distance. In 2023 this is not okay. To that effect these locals will ensure that mental health and wellbeing support is not systemically inaccessible. Six of these locals have been delivered, with an additional seven in the advanced stages of development. Due to the size of this program much of the cooperation with subcontractors and partners has been integrated with its delivery. The amendments made with this bill will clarify the organisations assisting in the opening of these locals and with funding from the Andrews Labor government will take the Mental Health and Wellbeing Act’s definition of ‘mental health and wellbeing services provided’ and therefore sit under the same statutory oversight mechanisms and obligations that all mental health and wellbeing services answer to.

Ultimately most of the bill is to ensure clarification. It in no way alters or deviates from the recommendations made by the royal commission. To do so naturally would lead to a less satisfactory result for Victorians struggling with mental health issues, and what this bill does is clarify exactly how the legislation should be interpreted to achieve the best and safest results for Victorians navigating mental health systems.

The Mental Health and Wellbeing Act 2022 offered extensive change, an overhaul if you will, to the way that our state institutionally approaches mental health. As outlined in the royal commission, this is essential to the wellbeing of every single Victorian. It is a mammoth task, but it must be done. That is what the Andrews Labor government is about: taking big steps because we know it is the right thing to do, doing what matters.

It is clear that the original Mental Health and Wellbeing Act has so much potential to right the wrongs of the past and ensure that Victoria’s system and institutions will no longer hold flaws that run the risk of serious failings for some of the most vulnerable members of our community. It has been a long time coming, and the work is not yet done.

Before I go I would like to thank, and acknowledge the work done by, our health professionals. They are truly the backbone of our community, regardless of what role they take in the health world. Mental health workers are no exception to this, and they ought to be recognised for all the good work they do for us. This bill seeks to remedy difficulties for those who professionally interact with the health system and its mental health sector. After all, it is in everyone’s interest that we work to make their role easier. This amendment bill is sensible, it is straightforward and it is the right thing to do. I commend the bill to the house and look forward to following how the Mental Health and Wellbeing Bill will improve the wellbeing of my constituents in Southern Metro and all Victorians at large.

David LIMBRICK (South-Eastern Metropolitan) (15:55): I rise to speak on the Mental Health and Wellbeing Amendment Bill 2023. As with the Mental Health and Wellbeing Bill 2022, I will not be opposing the legislation before us today. But before I address some of the specifics of this legislation I think it is worth reflecting a little bit on the past three years and the impact that government decisions are continuing to have on the mental wellbeing of Victorians.

Many of my colleagues who are here in the chamber today were not present for the dark days of the pandemic, but for those who were, you will no doubt remember me frequently raising the issue of mental health harms when considering how the government responded to the COVID-19 pandemic. One of the first issues related to the mental health harm of the government response that was brought to my attention was the mask mandates and in particular the effect that they had on victims of family violence and sexual assault. But I could not even get the health minister, the Premier or the chief health officer to adjust their language to try and prevent people who could not wear a mask getting bullied or, even worse, verbally attacked on the street.

While I could recount many specific stories from the tidal wave of misery that was produced, I want to highlight one of the key harms that I maintain was a reckless and irresponsible trade-off. I am referring here to the closing of schools. During the Public Accounts and Estimates Committee COVID inquiry the government confirmed that they had not done any modelling to better understand the harms caused by the government response to the pandemic. We heard from experts in the health, mental health and social services sectors. Professor Patrick McGorry stated:

We already know that there is a 33 per cent rise in deliberate self-harm presenting to emergency departments, and it is actually really even more dramatic than that – the Royal Children’s and some suicide clusters – but probably there has been no significant rise yet in completed suicide.

The Commission for Children and Young People also did some great work over that period, producing regular snapshots surveying young people on how they were coping during the pandemic and particularly with school closures. While not all young people struggled, the stories from the ones who did are quite harrowing. I will not read out quotes from the various reports, but suffice to say they are heartbreaking expressions of loneliness, sadness and despair. It was with this suffering in mind that I introduced a motion in this chamber in 2020 calling on the government to reopen the schools. Whilst this motion was not successful, everything that occurred after that has only convinced me that it was the right thing to do and would likely have prevented some measure of harm to young people in this state.

It was common to hear people state, even in this place, that ‘The economy doesn’t matter’ when you are trying to save lives. This was always a naive claim. Indeed Professor McGorry in his testimony, just prior to the previous quote I read out, stated that:

As I said earlier, we could predict a rise in suicide, particularly because of the economic impacts. That is really one of the most potent drivers of suicide in these conditions.

Of course the economy matters. When people are struggling to pay their bills and feed their kids, this has an impact on mental health. We are only seeing the beginning of this now. We cannot spend our way into prosperity, and the ever-increasing taxes, fines and fees imposed on Victorians will continue to create harm.

In these circumstances people may more frequently have to deal with the frustration of government services and heartless bureaucracies. I do not mean to imply that people working in the public service are heartless – I am sure that many of them are well meaning and some of them even likely to be very hard working – but the system itself is heartless. The Victorian Ombudsman Deborah Glass did some excellent work during the pandemic, and while the inquiry into the public housing towers lockdown has received more media attention, the inquiry into the border closures provides a very clear demonstration of how heartlessly bureaucracy can manifest itself. Let us reflect on what this inquiry was all about. The government announced with almost no notice that they would be instigating a hard border closure with New South Wales. We essentially created a situation where many Victorians may have met the international definition of ‘internally displaced people’ – that is, we made internal refugees of our own citizens.

To better understand the full impact that a heartless bureaucracy can have on mental health, I want to read a couple of brief quotes from people that provided comment for the Ombudsman’s report. From page 7 of the Ombudsman’s report – this is from a contributor:

I had to constantly book online appointments with our doctors to get more and more paperwork vouching for the severity of our mental health. It was so dehumanising and humiliating … I had to call and threaten self-harm to feel like I was being taken seriously.

From page 8 of the Ombudsman’s report:

We just want an exemption to be with our dying daughter … She is terminal, palliative and end of life. We are being treated inhumanly … [by a person] making a decision taking weeks we don’t have …

As I stated at the beginning of my comments, I will not oppose this legislation, as I did not oppose the reforms in 2022. A large component of what the reforms seek to accomplish is more patient autonomy, improved consent processes and a framework for mental health that better meets the needs of consumers – and these are good things. But I simply cannot comment on legislation related to mental health without reflecting on the harm done by the government itself during the pandemic period. While improving the functioning of the mental health sector is certainly not the worst goal of a government, they could achieve some initial improvements by cancelling COVID fines immediately.

I will close by quoting the Victorian Ombudsman from the close of the foreword of the Investigation into Decision-making under the Victorian Border Crossing Permit Directions. She said:

I also encourage the government to publicly acknowledge the distress caused to so many people when discretion was exercised narrowly, or not at all.

If there is a next time – we cannot let this happen again.

And I agree. If we are to prevent these things from happening again, we need a royal commission into the COVID response in Victoria.

Melina BATH (Eastern Victoria) (16:01): I am pleased to rise this afternoon to speak on the Mental Health and Wellbeing Amendment Bill 2023, in doing so for the Nationals in concert with the Liberals. This bill is in some respects a tidy-up of the former bill from 2022, and it fixes some, I will say, inconsistencies that were in that bill, a very large bill, and some typos. That is the first point, and we certainly agree with that tidy-up. This bill also makes some minor amendments to the Mental Health and Wellbeing Act 2022 and consequential amendments to the Judicial Proceedings Reports Act 1958.

The bill really does stem, as we have heard this afternoon, from the Royal Commission into Victoria’s Mental Health System. The first report from that, the interim report, was handed down in 2019, and certainly five out of those nine recommendations in that interim report were on the need for a mental health workforce and to ensure that there are people working across the breadth of Victoria.

I had the opportunity and took the opportunity as part of that royal commission to join roundtable discussions with the commissioners, and there were a number of commissioners in regional Victoria. I remember attending one in Warragul one day, primarily to support some of my constituents who had come into my office. They were consistently frustrated. They were the carers or the parents of adult children, or adults, who had been suffering from prolonged mental ill health. Of course the pathways down to a mental health disorder, condition or illness can be many and varied. It can have its origins in the physical – in DNA – in substance abuse and in the pressures of life. There are multiple and concerning ways.

My particular constituents went there, and they needed to tell their stories, because despite my best efforts in raising their issues in here they were so frustrated that they felt they could not get their voices out. I do not know – it may have been temporarily cathartic. I still wonder whether or not they actually achieved what they needed to achieve. However, listening to their stories was so very challenging for us sitting there and listening to their heartfelt daily issues that they had to face on behalf of their adult children and their frustrations with the system. Also there were mental health practitioners at that roundtable for the royal commission. I remember that from a professional standpoint in regional Victoria and in Gippsland they were frustrated by the lack of other professionals and the fact that their waitlists were so, so long. They were concerned that they were not actually able to meet the needs of their potential patients, and there was frustration that surrounded that. Indeed one of the findings of the royal commission certainly was that families, carers and supporters felt that they were left out of the system. Sixty thousand Victorians care for someone with a mental illness. That was the report’s finding. Indeed they felt excluded from the system. They also felt a lack of access to information about treatment, care and support – and I can reflect that in my experience with people coming into my office in my Eastern Victoria electorate.

One of those key factors, in speaking with that mental health practitioner, is the backlog and waitlist. Certainly that particular hearing and the round tables by the commission were pre COVID, and then we had COVID. We have just heard from Mr Limbrick about the effect and the impact of our statewide lockdown system – which no other state in the world had – particularly in regional Victoria, where COVID had a light footprint by comparison. We had schools in Orbost locked down for weeks and months. That certainly had an impact on those young children and the way they interacted – their lack of social and educational interaction. But there was also deprivation of contact with the elderly and the concerns they had. That really put them back on their haunches in relation to the isolation effects. Also, for those members of the community who had substance abuse issues, certainly those consistent lockdowns through COVID pushed them off into a state of increased addiction, and then they could not have an appropriate response because the waitlist was so long.

These are just some of the things that I have experienced and seen. The Andrews government have known – they have been in government for eight years – for such a long time about the thousands of job vacancies across Victoria in the mental health area and the need to put skilled and qualified people in front of those vulnerable people and their families to support them in finding a pathway to better mental health.

I just want to acknowledge our shadow minister, my colleague Emma Kealy, who has done a power of work in this space. She has really led our discussions, other than those who have written to me and certainly those who I have come across in my Eastern Victoria electorate. She has really led this in terms of the stakeholder groups. Their concerns are about this bill sliding backwards and slipping away from the royal commission’s recommendations for a health-led response to a police-led response, and that is of course a disappointment. Quoting the royal commission:

Given that most people experiencing a mental health crisis have done nothing illegal, the involvement of police can be humiliating and traumatic.

They have done nothing illegal. They simply, and most complexly, have a mental health condition. The recommendation also states that police should be involved only where necessary to protect people’s safety. So we see that the royal commission really had a focus on the health professionals leading the medical support, with police and PSOs being brought in, shall we say, only as a last resort or where there was a safety issue at heart.

One of the key things that some of the constituents in my electorate have said is around the frustrations they have felt at the lack of opportunity they have had to make inroads into the initial triage and then into the support systems. These are recent case studies. A constituent’s son who was under the influence of drugs and behaving erratically stated that he was going to kill himself – so a very, very serious situation. The mother’s only and last port of call, in sheer desperation, was to call 000, and the police attended her property. She was really seeking an intervention in the form of a mental health professional, a lynchpin that would have provided her son with a pathway. But the police said that they felt very hamstrung and that the only pathway they could use to get him into the system was in effect to charge the young man in the hope that a magistrate would provide that pathway to mental health. The police said to this mother that they felt totally hamstrung in their attendance – and they had to do that of course, because he was potentially going to be a danger – and that they want that system better triaged.

Another constituent has a 50-year-old son who suffers from bipolar and has frequent manic episodes. To date he has been arrested several times by the police for his erratic behaviour. The concerned father stresses that mental health professionals are better placed to assist his son in bringing about suitable treatment options as an alternative to the police. Again, he is concerned that there is just this cycle of going in and coming out without that proper triage.

It is very, very clear that our police association have raised their concerns as well about a walk back from, or walk to or walk away from, a health-led to a police-led response. We saw the Andrews government spruik at election time that we were going to have 500 new police officers in our system to bolster those police lines and police support. Well, we also know that there are approximately 800 vacancies in Victoria where they cannot find police positions, and that is a concern – that is an absolute concern. I was at a function only recently where I spoke with a Victorian police officer, a dedicated officer, and he said, ‘We’re just under the pump.’ He was not going anywhere, but the pressure on their shoulders is more and more and more.

We also see that information has come to light only recently in the media. They state that alarming data released to this Parliament on Monday shows police were called to 10,310 mental health incidents last year that led to someone having to be taken to the emergency department. That is where a lot of police actually spend their time – they are unfortunately cooling their heels in emergency departments for extended hours on end.

I would like to put on record my thanks to all of our first responders, to Victoria Police officers and to Ambulance Victoria officers. Again I had the pleasure at another function to sit and talk with a very distinguished AV officer, just talking in generalities about their work and their dedication. They are the front line – they come to explosive and volatile situations – and it is their calm, professional compassion and stability that provide often the most intensive support from Ambulance Victoria. One of the key recommendations of the royal commission focuses on the 000 responses and ensures that paramedics, as I have just said, are the first respondents to these call-outs. Again this is really vital, the way that they are responded to, for the support and the recovery and the triaging of mental health patients.

My colleague Ms Crozier has spoken about clauses 13 and 14 and our concerns around clauses 13 and 14. We certainly support clause 12 because that provides that flexibility in dispatch, in ringing 000. Call takers can certainly then nuance and triage that and provide the appropriate police or paramedics as required. So clause 12 we certainly endorse, but clauses 13 and 14 remove a focus around that medical, health-led response and walk backwards to that police response. We have got both a reasoned amendment to take this bill away and to do some work, to speak to those stakeholders and to triage this bill, and also some house amendments from the Nationals and the Liberals around removing clauses 13 and 14 altogether.

Finally, we need to listen to those professionals. They are at the coalface of mental health support. The Police Association Victoria certainly have frustrations around this, and I know my colleague Emma Kealy has spoken with VAADA, the Victorian Alcohol and Drug Association, in depth, and they do a power of work. They have also been certainly supportive of the importance of first responders, but then also getting into the system and having that ongoing professional service and a clear pathway for those people to lead better lives. Our local hospitals and our medical centres and our emergency departments are really confronted quite often with challenging situations, and I would like to put on record here today my thanks for all of our Gippsland hospitals, our Eastern Victoria hospitals, for the work that they do. I call on the crossbench to support both our reasoned amendment and our house amendment. Otherwise, this bill has merit and needs to pass through this house.

Michael GALEA (South-Eastern Metropolitan) (16:16): I also rise today to speak on a bill which is of utmost importance, the Mental Health and Wellbeing Amendment Bill 2023. This bill does represent a significant leap forward in our collective journey towards better mental health outcomes for all Victorians. To provide some context, this state has been striving to reform our mental health system under the Andrews Labor government, and we have been following the path set out by the 74 recommendations made by the Royal Commission into Victoria’s Mental Health System. Our government has embraced these recommendations wholeheartedly and has already committed over $6 billion towards the implementation of these recommendations, a commitment which is unparalleled in this country’s history.

The relevance and importance of this bill that we are debating today cannot be overstated. We are addressing an urgent need, one that touches each and every Victorian: our friends, our family, our children, our colleagues and ourselves. Mental health is not an isolated issue; it threads through every aspect of our lives and shapes our society. So as we progress, let us remember why we are here today. We are here because every Victorian deserves easy and accessible high-quality mental health care. We are here because mental health matters and because it is time that our legislation reflects that reality. Mental health is about not just the individual but also the community. We all have a role to play in creating a supportive and inclusive environment. As elected officials, we have been entrusted by the community to prioritise and improve mental health services for our constituents.

Turning to the pivotal work of the royal commission, which many of the previous speakers have referenced, a significant turning point in our state’s history, this royal commission conducted an extensive and intensive study into the state of our existing mental health services and delivered a comprehensive report with those recommendations I mentioned. These recommendations encompass an array of interventions and reforms all designed to make these mental health services that we have more accessible, more inclusive, more responsive and more effective. A plan such as this is not simply a guide. It is a clear call to action, a demand for change that we as lawmakers and as public servants have a moral responsibility to heed. This government has pledged wholehearted support to the full implementation of these recommendations, and this bill stands as a testament to this commitment, as it forms a key component of our journey towards comprehensive mental health reform.

Commitment alone, though, of course is not enough. Action is the lifeblood of change. In the two years since the royal commission’s final report was released, we have been relentless in our pursuit of change. To date the Andrews Labor government has already successfully implemented 60 per cent of the recommendations, and work has begun on over 90 per cent of them. We are not just talking about change, we are driving it, we are living it and we are delivering it.

It is also important for us to examine the financial commitments that underline this tangible dedication to mental health reform. The government has shown an unprecedented level of commitment to mental health in Victoria. This is not just echoed in words or policy but, more importantly, shown through the investments made. To date we have allocated over $6 billion to fortify and revamp this state’s mental health system. The level of investment is unrivalled in the history of Victoria and indeed Australia. No other state government has so significantly invested in and put support into mental health. This assertion is not an exercise in self-congratulation or anything; rather it is an important signal of what has been a stark change in our collective approach to mental health.

The commitment also continues into this year’s state budget, with an allocation of $776.3 million earmarked to progress the implementation further of those recommendations. This fund is designed to bolster existing services, initiate new ones and ensure that we meet the urgent needs of those requiring mental health, alcohol and other drug treatment and rehabilitation and harm reduction services. It is also a clear and unequivocal message to all Victorians that their mental health is a priority to this government. We are dedicated to fostering a future where mental health services are readily available, are easily accessible and are catering to the needs of every Victorian.

An integral part of this bill and the broader mental health reform effort is the deliberate, strategic and effective implementation of those recommendations. One such initiative in this reform process has been the establishment of mental health and wellbeing locals. It is all very well and good for us to reinvest in world-class mental health services, but if they are all located in Parkville or Prahran, that is not doing much good to people in Cranbourne or Pakenham or Gippsland. These mental health and wellbeing locals are a really significant and important part of this reform agenda because they bring these services into people’s neighbourhoods. I am so excited that in this year’s state budget we saw a commitment towards the building of an additional three mental health locals, including one in the south-east – in Narre Warren – as well as planning commitments for future mental health and wellbeing locals right across the state, including in Cranbourne and in Officer as well in the outer south-east. These local services are a really important initiative. There has already been $263.8 million invested in these mental health and wellbeing locals, with the expectation of having 50 such locals operating across the state by 2026. It also ensures that people have less barriers to treatment not just in terms of actually getting there but in terms of social acceptance as well – being able to fit it into your schedule and not have to take the time out and then explain what you are doing to find solutions that work for you. Having those services close to home really is transformative.

Beyond those locals as well, we are undertaking the expansion and upgrade of other facilities across the state, from opening the Parkville youth prevention and recovery centre and an additional five new youth facilities to upgrading existing ones in various locations. We are ensuring that this high-quality mental health service is available in every part of the state. The expansion also includes the creation of a women’s prevention and recovery care centre, the first in Victoria to offer accommodation for accompanying dependants, further testifying to this comprehensive approach.

It is not just confined to physical infrastructure. It is equally focused on addressing different mental health conditions and the diverse needs of our communities – initiatives such as the hospital outreach post-suicidal engagement program, or HOPE; the $20 million investment to tackle eating disorders; and a $60 million investment to support the various and diverse mental health issues of our diverse communities. Our CALD and LGBTIQ+ communities are examples of this. Our approach is about recognising the unique experiences of different communities, of different Victorians, and tailoring interventions to meet those specific needs.

Moreover, we are also preparing for future mental health needs, investing in infant, child and family wellbeing hubs and in mental health and wellbeing services across the state as well. These investments will also ensure age-appropriate mental health support is available for all Victorians. The $801 million mental health beds expansion program is another step towards this by reducing waiting times, easing the burden on our emergency departments and providing immediate treatment for those who need it. This is all about bringing those royal commission recommendations to life and bringing them to action for all Victorians. It is about creating a future where mental health is treated with the urgency, the care and the respect that it deserves, meaning no-one is left behind.

There are also a number of reforms in terms of our workforce development. I would also like to join previous colleagues from both sides of the house who have acknowledged the work of those people who work tirelessly in our mental health sector, and I wish to add my voice to theirs in my admiration of the work that they do. Quite frankly, the work that they do is remarkable and an inspiration to many of us, and especially many of us in this chamber, and there is a need for further allocations of staffing. There is a need for more staffing, and that is why we have set ambitious targets. We set them last year to double the mental health workforce by 2031 from 8700 to 17,400 full-time equivalent workers. We are proud that this government has been at the forefront of workforce expansion in the mental health space, also investing over $600 million since 2020–21 in workforce initiatives. These efforts have already resulted in the creation of 2100 more jobs in this sector. This includes more than 400 mental health nurses, over 300 psychologists, more than 100 psychiatrists and over 900 additional allied health clinicians. These numbers are not just statistics; they are our frontline workers, our frontline soldiers in the battle against the mental health crisis.

Additionally, we also believe in the power and influence of lived experience in mental health care. In line with this we have invested $50 million to grow and develop the lived-experience workforce. This is the largest ever investment of its kind, showcasing our commitment to enhancing career pathways for this crucial part of the workforce, and as we look towards the future, our plans for workforce expansion continue unabated.

We have offered relocation incentives for returning international health and mental health workers, launched the Aboriginal mental health traineeship program, and we are also expanding the forensic community mental health workforce as part of the $81 million commitment to improve Victoria’s forensic mental health services. These efforts not only create more jobs but ensure that our workforce is skilled, equipped, diverse and culturally competent to meet the varied mental health needs of our community.

As I conclude I would like to, in commending this bill to the house, note that mental health is a real issue that has real-world effects on each and every Victorian in many different ways. This amendment bill is a very important step closer to achieving true mental health equity, and we must continue striving for that goal. Mental health is not a destination but a journey, and it is about taking significant steps, small or large, every day to improve our wellbeing. I do commend this bill to the house.

Sarah MANSFIELD (Western Victoria) (16:28): I rise today to speak on the Mental Health and Wellbeing Amendment Bill 2023. This bill amends the Mental Health and Wellbeing Act 2022, which comes into effect later this year. Just for the record, my partner is employed as a psychiatrist at a public health service and sits on the board of the Victorian Collaborative Centre for Mental Health and Wellbeing, and although this legislation impacts both roles, there is no personal gain for him and it does not present, I believe, any conflict of interest.

The Greens have long stood by the principle that people experiencing mental illness should live free from stigma and discrimination. They should have maximum opportunities for inclusion in society and contribution to their community. We stand firm that mental health services, our agencies and frontline responses should adopt trauma-informed approaches that uphold the dignity, culture, gender, lived experience and strengths of an individual, their family and carers. That is why, although we will be supporting this amendment bill, the Greens will continue to push the government to work towards implementation of more humane and health-led responses for people facing mental health challenges, and we do in fact agree with many of the concerns we have heard from across the chamber this afternoon.

Recommendation 10 of the Royal Commission into Victoria’s Mental Health System called for first responders to people experiencing mental health crises to be led by health professionals like paramedics rather than the police. While many police do a tremendous job in what are often very challenging circumstances, a justice-led response is not the right one for what is fundamentally an acute health issue. For various reasons many people and their families fear and mistrust the police, and a person’s past experiences of trauma can influence their response to an intervention. The reality is, as we heard throughout the royal commission and we all too frequently hear from our communities, far too many people have been subject to further harm and trauma from punitive responses when compassion and mental health expertise were what was needed.

We understand that from a practical perspective it is not possible for paramedics to take on this additional workload by the original proposed date of 1 September. They currently lack appropriate resources, support and capacity to take on this role to keep consumers and staff – keep themselves – safe, and safety for all must be paramount. We recognise that this is challenging work, and we are aware that our paramedics are already overloaded due to extraordinary demand. Chronic underinvestment in health prevention and primary care means more people are getting sick and requiring hospital-level care, and our paramedics are at the front line of all of this extra healthcare demand. But highly skilled health professionals like paramedics are well placed to lead health-related emergency responses, and the government needs to be doing everything it can to support them and other mental health workers and create capacity for them to undertake this important work. They may need more time, but the Greens want assurances from the government that removing references to a full health-led response in the legislation does not mean that these reforms will be swept quietly under the carpet.

Our mental health workers, as we have heard from many speakers already this afternoon, do such important work and deliver life-changing and very often life-saving care, but it is no secret that there has been a history of mistreatment and abuse of power in our mental health systems and associated institutions, and this has led to a legacy of neglect and broken trust which will take transformational change to heal and rebuild. The government has done well with the implementation of many of the recommendations from the mental health royal commission, and we want to see that good work continue because the number of people in our community experiencing mental illness only continues to increase. Nearly one-quarter of Victorian adults report being diagnosed with depression or anxiety by a doctor, and 45 per cent Victorians will experience a mental health condition in their lifetime – that is nearly half of us. In a 2012–13 survey 30 per cent of First Nations people surveyed reported high or very high psychological distress levels, which was nearly three times the rate of non-Aboriginal people. The impacts on young First Nations people are devastating, with rates of intentional self-harm among young Aboriginal people aged 15 to 24 years at 5.2 times the rate of non-Aboriginal young people. Other marginalised groups include our LGBTQIA+ community, who suffer mental health problems at four to six times higher rates than those of the general population, and it is particularly high among trans and gender-diverse young people.

As hard as these figures are to hear, we know the numbers are not likely to come down in the near future. The pressures and strains from the rising cost of food and essentials, skyrocketing house prices and increasing homelessness are taking their toll on the wellbeing and mental health of people right across our state. For people already living with a severe mental illness or caring for someone with a severe mental illness, who are already more likely to be living in poverty and experiencing homelessness in the first place, these additional pressures that they are facing currently can be devastating.

Initial responses to the Greens cost-of-living survey that is currently out have highlighted just how much current pressures are impacting people’s mental wellbeing and their ability to pay for medications and access health care. These are just some of the stories that have come in from Western Victoria when we asked people how they had been impacted by the rising costs of living:

Stress, fear of homelessness if our landlord should decide to put the rent up again, feeling like I cannot go to the doctor when I need to because it costs around 100 dollars now.

This is another person:

I have developed anxiety and depression as a result of worrying about paying bills.

And another:

… my entire payment is taken by rent & food & meds & bills. I feel so isolated especially since I am a high risk person for covid & unable to partake in many community activities or see family & friends much.

And another:

Have had to choose who gets dental or mental health care between myself and my partner.

Things are really tough for people, and they deserve better. What we need right now is the political courage to address the pervasive and mounting pressures of poverty and housing. If we are really serious about improving mental health outcomes for people in Victoria, these are the sorts of things we need to be prioritising. These issues are not disconnected. I know from my time working as a GP that it is virtually impossible to address the physical and mental health issues that people experience without secure and stable housing and enough food on the table.

So my challenge to this Labor government is to be bold and to do more to really give Victorians the best chance of living healthy lives, prevent mental illness in the first place and better support those who are already living with a mental illness. Our public mental health services must be fully funded so that they can provide timely, high-quality intervention for people experiencing mental illness – people of all ages and regardless of where they live. When people are given the right conditions and support to recover, they can and do thrive. The World Health Organization put it succinctly in 2004: when individuals are mentally healthy, they are able to realise their own abilities, cope with the normal stresses of life, work productively and make positive contributions to their community. These are things we should all have the right to do.

Ann-Marie HERMANS (South-Eastern Metropolitan) (16:36): I rise today to speak on the Mental Health and Wellbeing Amendment Bill 2023, which aims to make minor amendments to the Mental Health and Wellbeing Act 2022 and consequential amendments to the Judicial Proceedings Reports Act 1958. Importantly, I emphasise that the Liberals and Nationals are supportive of the recommendations of the Royal Commission into Victoria’s Mental Health System. Personally, with my background in education and social work – or more accurately youth work – I am fully cognisant of the importance of mental health and of the escalation of the mental health crisis we face in Victoria at this time.

I do at this point want to also acknowledge that there are a number of families who are dealing with family members who have either committed suicide or are contemplating suicide and people who are a risk themselves and to others, and I do offer my sincere condolences to anyone who has lost a loved one in this way. I know also from my portfolio that a number of our hardworking emergency services first responders, particularly in the fire services, have to deal with the effects of suicide on a regular basis. They are the ones that are called out to cut people down and to collect that which is left, and that is an incredibly difficult thing to have to do. So we do need to also make sure that we are providing for our emergency services workers and first responders the support that they need to protect their mental health.

I am very passionate in supporting services that will address the very real difficulties and challenges that we face in this state of Victoria at this time. I also want to acknowledge the comments made by my colleague Ms Georgie Crozier, as she mentioned the aspect of suicide. It is one that is really affected by the Mental Health and Wellbeing Amendment Bill, and we need to consider the issues that are predominant and that relate to this particular bill being passed.

I also at this point in time want to acknowledge that in my electorate I am hugely supportive of the work done in the mental health space. I want to acknowledge many of the health services that do exist in the South-Eastern Region: the mental health services of Community Support Frankston; the South Eastern Private Hospital’s mental health service in Noble Park; Early in Life Mental Health Service; Cornerstone centre in Dandenong, which is a contact centre and has a lot of people that are suffering with mental health that go there for food and support; Monash Health, which deals with a lot of mental health; the mental health services in Cranbourne; and there are many others that I may have left out.

I also had the opportunity on the weekend to attend a fundraiser for mental health, and I want to commend and support the work done in the mental health space. The Mental Health Foundation’s gala dinner was hosted in Rowville on the weekend, and I was there with a table, supporting this fundraising event and the initiatives that it works towards with the expansion of services for people in need. I want to commend the great work that this foundation does and others in their delivery of support – many of them offer it for free, from fundraising – and the counselling services that they provide also to the multicultural communities.

These services help people to have access to vital resources and group-supervised activities and contribute towards the establishment of a wellness hub for people to access whenever and as needs arise. I want to also say it was a great night, and I am really pleased to note that there are others that are coming up and I would like to commend them to the house. So there is the mental health forum, ‘Healthy minds’, which has been organised by the local Rotary clubs for the south-east. It is actually for the Australian Rotary Health mental health research. I want to thank local constituent Leanne Byron for raising my awareness of this mental health forum that is going to be taking place in Casey for surrounding areas and will be raising money for Australian Rotary Health, which is now one of the largest non-government funders of mental health research in Australia. They are also working towards improving mental health issues in Australia and have been since the year 2000.

It is a sad reflection to note that a number of Australians are currently diagnosed with a mental illness and that this is overwhelming, particularly among young people. Research is showing that half of mental illness begins by the age of 14, and we need to provide the support services that we can for these people. I also want to note that it is concerning in terms of my portfolio that over half of WorkCover claims are said to be mental health claims and related to mental health issues. So this is an important bill that is before the house, and I am really, really pleased to be able to rise to speak to it.

I want to note though that we have concerns, the Liberals and Nationals, about clauses 13 and 14, and we have proposed some amendments in this area. Clause 13 amends section 232 of the Mental Health and Wellbeing Act 2022, which currently permits certain classes of people, including registered paramedics employed by an ambulance service as defined in section 3(1) of the Ambulance Services Act 1986, to take a person into care and control during a mental health crisis. I could not help but take notes when some of my colleagues in this chamber were speaking. For instance, Mr Berger mentioned that he is passionate about Ambulance Victoria and that even more paramedics are now on the road. Of course we are all looking for best possible outcomes, but there are concerns with the clauses in terms of how we are looking at this particular bill in relation to whether we are going to have a health-led response or whether we are going to have a police-led response. I do want to explain how much we feel it is important to consider the issues and the impacts that this bill and these particular clauses are going to have.

At this point I do want to remind people, as a person who has worked in education in schools, that right now I know a number of my colleagues who are still working in education are having to deal with incredible rises in the number of mental health issues in classrooms. In fact I hear of children who are pacing in classrooms. It used to be that you would maybe have to take a few little fidget items into a classroom in years gone by, prior to COVID and prior to lockdowns, for the odd ADHD situation or the odd young person that might struggle to be able to focus. But now I can say that my daughter as a preservice teacher is going in with a bag full of these things, that young people are suffering from anxiety, that they are unable to focus, that this is a real concern and that we have an escalation in mental health issues. And so I do think that for a person in the police force to actually turn up to a situation of crisis in mental health as a first responder can often be incredibly intimidating. When we have children that are now starting to suffer from mental health issues at more escalated numbers than we have ever had before in this state as a result of what they experienced during the time of the lockdowns in Victoria, then I do think we need to really consider the impact that this particular clause is going to have on the lives of Victorians.

As my worthy colleague Melina Bath from the Nationals mentioned, there was a particular situation where the police felt hamstrung and had to come into the situation and then charge a son. The mother called the police, and they charged the son in order to protect him, because he was wanting to commit suicide. They were hamstrung – those were her words – in what they were able to do. So is this the best approach? Well, we would say it is not the best approach, and that is why we are looking at these amendments for clauses 13 and 14. We would really commend them to the crossbench to consider as we come to a time of actually considering the situation with this particular mental health and wellbeing bill that is before the house.

As we know, police, ambulance and fire services are struggling with a lack of resources. They are struggling with manpower, they are struggling with their budgetary constraints and they are struggling in terms of the number of increases that we have for WorkCover. In fact first responders have the highest rate of people who are on mental health cover through WorkCover. It has just increased, so we know that they are struggling in this area. I would say too that it is a real shame, and I will just throw this in there, that we still have a number of vaccine-injured first responders who would like to return to work to be able to support these forces and are yet not permitted to do so because they are struggling with draconian mandates that are still imposed on them. The government just continues to throw some of our more vital services under the bus. I think that to actually expect police, who are not fully equipped, to deal with the unreasonable additional pressure on their resources and personnel is not fair at this time. It is not as if they do not have enough to do with the increases that we see in family violence and the escalation that is taking place in our society. Police themselves are voicing their concerns with the Police Association Victoria and arguing that this is a backward step, using police personnel, and that it will only further hamper timely and necessary police responses to the public both for general situations and also in the mental health area.

As Melina Bath mentioned, it is humiliating for people who are requiring some form of mental health mediation to find themselves facing police. This is not the best approach. I myself know that I have friends that are dealing with mental ill health and the mental health space, and I am really pleased that we are looking at ways that we can improve in this area, but I do again commend to the house the amendments which we have put forward as a coalition.

I think it is really disappointing that with an issue as big as this one this government again did not consult effectively with everyone that is a stakeholder when they were preparing their bill. Victoria needs a unified mental health system, and the advice from people that are on the ground is that it is incredibly imperative to make sure that we have a system that works effectively. So I just want to say that we need to make sure that our mental health bills that we put forward and that we pass in this house are genuinely going to impact in a positive way the safety and wellbeing of Victorian lives.

Sheena WATT (Northern Metropolitan) (16:49): I rise today to speak on the Mental Health and Wellbeing Amendment Bill 2023, and in doing so I would like to acknowledge that not only is the Andrews Labor government committed to building a mental health system that works for all, we are actually getting it done. When I was growing up, I quickly came to understand that our mental health system was failing those experiencing mental ill health. I came to understand rather quickly, particularly from my mob and my Indigenous brothers and sisters, that our history of past and ongoing racism and discrimination has had a profound and enduring impact on our social and emotional wellbeing outcomes. I came to understand that, though we remain a strong and resilient people, the intergenerational trauma and the continued impacts of marginalisation which we experience each and every day have meant that for us we face higher rates of poor mental health than my non-Aboriginal friends and family. I watched as far too many members of my community tried to navigate a broken, underfunded, overburdened mental health system. I watched as mob sought mental health support through services that lacked any diversity or cultural understanding of what good health and wellbeing meant to Aboriginal peoples. I even watched as those in my community in need of mental health support avoided these services altogether, knowing that they would not get the help that they needed. The truth, in my eyes, was plain and simple: Victoria’s mental health and wellbeing system was inadequate not just for Aboriginal Victorians but for all of us.

Later, when I entered the community healthcare workforce at the National Aboriginal Community Controlled Health Organisation and later the Victorian Aboriginal Community Controlled Health Organisation, the respected state and national peak bodies for Aboriginal health, I came to understand that the impacts of mental ill health created lasting problems for our First Peoples, and I would like to share with you some facts that affected me so deeply that I have carried them with me since my days at NACCHO more than a decade ago. Did you know that poor mental health and substance-use disorders are estimated to account for as much as 14 per cent of the health gap between Aboriginal and non-Aboriginal peoples? Or that twice as many young Aboriginal people as young non-Aboriginal people experience mental ill health? Or that the national suicide rate for Aboriginal people is estimated to be twice that of the general population?

The last time we came here, in the sitting week before we broke for winter break, I had the deep joy actually of meeting with Thirrili CEO Annette Vickery. Annette is the CEO of an organisation that works around Aboriginal suicide prevention and postvention – a term that some may not be familiar with, but it is a growing and incredibly important piece of work for our mental health workforce and of course for our communities that need it. I was joined at that meeting by the Parliamentary Secretary for Mental Health and Suicide Prevention Tim Richardson, and in that meeting we really had an opportunity to hear from Annette, an expert in her field and a really profound and esteemed leader, about just what crisis we have in mental ill health here in our state and the numbers – the sheer and frighteningly large numbers – of Aboriginal people that have made attempts on their own lives. It was something that definitely spurred me to action, although it was not new to know.

It does not end there, with a single organisation doing all of the heavy lifting. There are so many others in our community that work on that, and I would like to take a moment to acknowledge the work of VACCHO, the Victorian Aboriginal Community Controlled Health Organisation, which I had the distinct pleasure of working in for a few years. One of the pieces of work that VACCHO did with such esteem and pride was really affect the way the Royal Commission into Victoria’s Mental Health System in the first place was thought to be. I recall with great affection actually representing VACCHO in the negotiations around the terms of reference for the mental health royal commission, which led to a really substantial look at the impacts of mental ill health on Aboriginal Victorians and the really disproportionate numbers that we can see, as I said earlier.

There are so many folks that will be needed to really effect the sort of large-scale change that this royal commission envisaged, and so to those that have chosen to make a life and a career in the mental health workforce, can I take a moment to acknowledge you and all that you do. It is a tough gig – there is no other word for it – but I hope in the work you do that you find it enormously rewarding, particularly when working with those most marginalised and most vulnerable. So thank you to particularly our Aboriginal health and mental health workforce.

There are long-term effects of a failing mental health support system for First Peoples. It means an ongoing cycle wherein the intergenerational challenges facing Aboriginal people combine with ongoing discrimination and a mental health support system that does not work to generate very, very poor outcomes for Aboriginal Victorians, not just in terms of our mental health but also our physical health.

My background is in Aboriginal community controlled health organisations, and I have risen in this chamber to talk of it a number of times. It does tell me that although as Aboriginal people we are more than capable of working within our communities and organisations to support better social and emotional wellbeing outcomes, our leadership can only take us so far when it is not matched and supported by government. In fact creating a fit-for-purpose mental health system also requires that governments have the courage to step up and make it happen, and that is what the Andrews Labor government has done. It was us who said enough is enough, it was us who decided that given the inadequate state of the mental health support system in this state we needed a royal commission to help shine a light on every nook and cranny of the system and it was us who listened to the wealth of evidence presented to the Royal Commission into Victoria’s Mental Health System by clinicians, experts and even those facing mental ill health themselves and accepted each and every one of the 74 recommendations that outlined that we needed to build a functional mental health and wellbeing system in this state.

Since the royal commission’s final report was handed down – and so many of us here in this place were there at the Royal Exhibition Building for it – we have not wasted a day in getting on with the job. We have delivered critical investments to fund the replacement of existing mental health services with a new 24/7 fit-for-purpose service, to place mental health practitioners in every Victorian secondary and specialist government school and to establish the Victorian Collaborative Centre for Mental Health and Wellbeing, and that is just the tip of the iceberg. I still remember getting the opportunity to open the 20-bed youth prevention and recovery care centre in Parkville with then Minister for Mental Health James Merlino. YPARC, as it is affectionately known, offers young people in my electorate who are at risk of suicide and self-harm the specialist mental health care and support they need through the provision of treatment and acute in-patient mental health services. At the time of opening, this was the fourth of eight hubs funded by a key investment from the Andrews Labor government in response to recommendation 21 of the royal commission. It is with investments like this and services like this that we rebuild our mental health system into the fit-for-purpose, responsive system it needs to be to work for all Victorians. I am proud to be part of a government that has begun the work to reform our mental health and wellbeing sector, and with this bill we are also continuing to gradually build up the institutional capacity, legal structures and people power we need for a strong and sustainable mental health system that will be able to support the social and emotional wellbeing of Victorians for generations to come.

As many of my colleagues have highlighted, this bill amends the Mental Health and Wellbeing Act 2022 to ensure that the act is operating as intended and ready to go when it commences on 1 September this year. Alongside our investments in services, additional mental health beds and other resourcing and capacity-building endeavours, we are making sure we have a strong legal framework in mental health and wellbeing because we are serious about creating robust and long-lasting change which each and every Victorian will benefit from for years to come. That is why we are proposing these amendments to the 2022 act to make sure that we take the time to get this absolutely right.

This bill will amend the act to ensure that there are clear powers to detain and transport security or forensic patients who are absent without leave from a designated mental health service, clarify the definition of ‘mental health and wellbeing service provider’ and, most significantly, make changes to the provisions establishing a health-led response to mental health crises in the community, which will enable paramedics and other authorised health professionals to be prescribed by regulation to exercise crisis response powers once they are appropriately supported by progressing system reform. These amendments will enable us to continue working towards the full implementation of all recommendations of the royal commission whilst also working together with Ambulance Victoria and other key stakeholders in the sector to ensure that reform, development of models of care, service investment and adoption by paramedics of care and control powers is done in a way that is safe and practical.

I want to focus for a minute on our move to a health-led response to mental health crises in the community – something that our government is committed to implementing. I think we can all agree that the best way to manage and handle a mental health crisis in the community is for responses to be led by healthcare professionals rather than law enforcement. Such an approach allows those experiencing a time-sensitive mental health crisis to receive the compassion, health care and referral to services that only health professionals can provide. This is instead of approaching situations where people need mental health and wellbeing support in a way that assumes criminality. This is a big and necessary change. With this bill we are ensuring that we can take the time to get this right and make sure that our mental health system is responsive to the needs of patients while also ensuring workers right across the sector are safe and supported when on the job.

I know that ensuring this legislation is as strong as possible will put us on the path to a fulsome, quality mental health and wellbeing system that will support, change and save lives across the state, and I know that only a Labor government is able and willing to get on with the job and get this done. I commend this bill to the house.

Rachel PAYNE (South-Eastern Metropolitan) (17:02): I rise to speak to the Mental Health and Wellbeing Amendment Bill 2023 on behalf of Legalise Cannabis Victoria. This bill amends the Mental Health and Wellbeing Act 2022, which comes into effect in September this year. It provides several clarifying amendments, including the scope of service providers regulated under the act, the health-led response to mental health crises and powers for transportation of patients.

Legalise Cannabis Victoria will lend its support to this bill, but we would like to preface this support by acknowledging that we do have some reservations about aspects of this bill. In doing this, we would first like to highlight the circumstances that gave rise to the existing act. The Mental Health and Wellbeing Act drew on the recommendations of the Royal Commission into Victoria’s Mental Health System – most notably to ensure that, wherever possible, emergency services responses to people experiencing time-critical mental health crises are led by health professionals rather than police. This new health-led approach to mental health and wellbeing is progressive policy that recognises the need to transition away from a law enforcement approach to mental health crises, and it was widely welcomed by the community and stakeholders.

Although this bill does include technical amendments necessary for the proper functioning of the act, we fear other amendments may result in a backsliding on our important work on mental health and wellbeing. Specifically, we had concerns about clauses 13 and 14 in this bill. Clause 13 removes paramedics as an authorised class of persons that may take a person into care and control in a mental health crisis – but for a reason. Clause 14 prescribes police officers and PSOs as authorised persons for the transfer of a person to the care of another authorised person in this same context. As the explanatory memorandum notes, this delay is required principally to allow Ambulance Victoria time to train paramedics and ancillary staff in care and control powers – all 4000-plus of them – and we thank the minister’s office for their time and extensive explanations on this front.

Ambulance Victoria does incredible work every single day, and their involvement will be central to our transition to a health-led response to mental health and wellbeing. We are not ignorant of the demands on our state’s ambulance service. They are under the pump and unfortunately often under strain to meet response times. Legislating their role in addressing mental ill health requires a fine balance to ensure that we do not undermine their role in emergency response. If the need to delay their assumption of care and control powers has been identified and justified, we will not protest. Rather, what we will do is highlight the need for government transparency and accountability. Vague commitments do little to reassure the public that these amendments will not erode the recommendations of the royal commission. So to ensure this does not occur, we have pressed the government to provide a fulsome explanation and to commit to a time line to confirm the extent and nature of upskilling required and to clarify the number of personnel to be upskilled. We thank the government for the explanation that they have undertaken to provide in this chamber today, because in the meantime police continue to be one of the primary responders to mental health crisis situations and that it is not what they or the royal commission want. Although this is and will continue to be important where there is a community safety risk to paramedics, we know it is not the way to lead our response to mental ill health.

As was highlighted in the royal commission and as I expect we are all well aware, having police as first responders to mental health crises is highly problematic. Despite their best efforts, police lack the expertise and extensive training to deal with mental health patients. Often their presence can be incredibly traumatic and escalate the risk of violence for someone going through a mental health crisis. These people have done nothing illegal and deserve to be treated as such; we know this. Many stakeholders are dismayed at the growing involvement of police in situations where people are experiencing a mental health crisis, including Victoria Police. This is why a health-led response is so important. We need to get health professionals at the forefront and allow people with mental health issues to be responded to in accordance with mental health principles in the very least restrictive way possible. We understand that this is a major transition requiring the implementation of many difficult changes. We understand that Ambulance Victoria will simply not be ready to assume this role on 1 September, and we believe it is imperative to reassure those affected by these amendments of our continued commitment to mental health and wellbeing.

Gaelle BROAD (Northern Victoria) (17:08): I rise to speak on the Mental Health and Wellbeing Amendment Bill 2023, as I believe any spotlight we can shine on the importance of mental health care in this state is worthwhile. It is particularly important in regional areas at the moment as our communities are grappling with issues, including floods, COVID-19 and extreme cost-of-living pressures. This bill makes minor amendments to the Mental Health and Wellbeing Act 2022 and also makes consequential amendments to the Judicial Proceedings Reports Act 1958. I do want to thank my Nationals colleague Emma Kealy for her leadership on this bill and the extensive consultation that has been done.

The Mental Health and Wellbeing Act 2022 was brought in after the recommendations of the Royal Commission into Victoria’s Mental Health System. The commission’s interim report was handed down in 2019. Five of the nine recommendations focused on the overwhelming need to create a strong mental health workforce. The final report was released in early 2021, and it is important to note that the Nationals support all recommendations of the royal commission.

This bill aims to fix several errors in the act and also changes the time frames on a number of recommendations made by the royal commission. I am concerned, however, that it also suggests major changes to the police response to people suffering a mental health crisis. This would potentially take the focus away from a health-led response in the first instance. There is a quote on page 515, chapter 9.2, from the royal commission’s report, which says:

Given that most people experiencing a mental health crisis have done nothing illegal, the involvement of police can be humiliating and traumatic.

Clearly, it is far better to have health professionals trained in mental health first aid as first responders. It is also clear that we have grave shortages of workers right across our emergency services team in this state. The Police Association Victoria are concerned that this legislation will add extra pressure on their limited resources. I think most of us would like to see people with a mental health issue being treated as they would be for any other health issue where immediate emergency support is required.

I thank my colleagues Ms Crozier and Ms Bath, who have also spoken on the need to omit clauses 13 and 14 through our amendments. As I mentioned, the issue of mental health is particularly important in regional areas, and as I travel throughout Northern Victoria I regularly meet people who are facing a wide range of mental health issues. Recently I had the privilege of spending time with some residents of Rochester who had lost their homes during last year’s disastrous floods. They were very generous with their time and in sharing their stories of heartbreak and devastation as well as the strong community response in the town. I thank them for that. We will soon be marking a year since the floods devastated many communities across Northern Victoria Region. This anniversary will be a tough time for many people who are still struggling with basic issues such as accommodation, finding builders and tradesmen and working through the minefield of insurance claims. In Benjeroop recently I met with local residents who are very stressed because our water storages are now at capacity and many levee banks have not yet been repaired after last year. They fear just a few days of heavy rain could easily spark another flood.

Yet another major mental health impact has come from the rising cost of living under this government. Everything is costing more. The government’s raft of new and increased taxes has added to this considerably. Steep increases in the cost of basic items such as groceries, gas and electricity are hurting our communities, and all of this takes a massive toll on people’s mental health. It is clear that the mental health of Victorians has suffered greatly because of the decisions made by this government.

I think back to the lockdowns during the COVID pandemic. I spoke with residents in regional towns without a single case that were struggling as they were told not to leave their homes. I recall the decision made by Jacinta Allan to close Victoria’s borders in 2021 on New Year’s Day and force families to drive over 10 hours and wait for hours in the car with young children and elderly members of the family to get back before the borders closed. I know people that have moved interstate because of decisions made by this government. I know paramedics, kinder teachers, engineers and gardeners that were unable to work because they did not get the COVID vaccine, and despite workforce shortages some of these restrictions still apply today. I know of a friend’s father who would visit his local men’s shed on a regular basis who during the lockdowns committed suicide. I received some correspondence just recently from Loddon Mallee Lifeline. It is incredible the work they do. They took over 15,000 calls in 2022, and they state that in the Loddon Mallee region, which covers Mildura, Bendigo and Swan Hill, last year there were 84 deaths by suicide. That is almost two per fortnight. They say there has also been a significant increase in hospitalisations for intentional self-harm in the region in the past year, increasing to a worrying 184 admissions. The demand for their support services and their crisis support locally has increased by 36 per cent since the start of the pandemic.

I think of the families that had to mourn alone as funerals were watched by family and friends online. A friend of mine attended his mother’s funeral in Sydney and then had to spend two weeks in quarantine in a Melbourne hotel room, with no access to fresh air, before he could return home to be with his family.

I think of the mental pressure that decisions of this government are having on people in local businesses. I spoke with a business owner just last week who employs a few people and now has to pay $11,000 for his WorkCover insurance premium but has never made a claim.

I think of the government’s lack of detail in the announcement of the payroll tax on independent schools and the pressure this put principals and families under as they struggled to find out more detail and wondered how they would pay for it when families were already struggling.

I think of people I have met in Charlton and Wedderburn who are concerned about the planned transmission line project, known as VNI West, and the minister’s constant changes to the route and the lack of a proper consultation process. I think of the towers that are going to dominate the skyline and cross over productive agricultural land. Just today I heard of a young farmer whose property has been devalued by $1.5 million by the bank due to the powerlines crossing that property.

I think of the families I met visiting Powelltown last week and meeting the owner of a timber mill who wonders about the future of their 40 workers, many of whom would struggle to find employment elsewhere, and the mental stress this government has caused by closing down Victoria’s sustainable native timber industry – going from seven years to seven months and offering free TAFE courses for people to retrain and telling them to seek mental health support from their local community health services, which are already under pressure.

I think of the Commonwealth Games and how much our local communities were looking forward to it, the athletes in training, the kids inspired to play sport, the business owners that had already made significant investments to expand their business and our emergency services, which were already meeting together to make plans. Local business groups had been hosting sessions for hundreds of local businesses and providing regular updates, and local councils in Bendigo and Shepparton had already invested lots of time and energy with local sporting groups preparing for the games. Then, just like that, this state government cancelled it, and the Premier said it was an easy decision. Well, it is clear that the decisions made by this government and their lack of care, lack of planning and constant desire to raise taxes to cover up their financial mistakes are contributing to the increased demand for mental health support services in this state.

Jacinta ERMACORA (Western Victoria) (17:16): I am pleased to speak on the Mental Health and Wellbeing Amendment Bill 2023. Most in this chamber would know that in a former life I worked as a counsellor for the South Western Centre Against Sexual Assault. In this role I had direct contact with clients who were impacted by traumatic events that led to adverse effects on their mental health. At the time the majority of South Western CASA clients not only had experienced sexual assault but were also living with diagnostic and statistical manual diagnosed major mental illness. Acknowledging the impact of major mental illness on survivors of sexual assault was central to the care and support that we provided our clients.

The Royal Commission into Victoria’s Mental Health System was a pivotal investigation into a system that was not fit for purpose. Victorians suffering from waning mental health often found themselves struggling to find access to treatment long after the first signs presented themselves. Unable to access community supports, family members regularly felt the added strain of being the only support system, despite no formal training. Compounding this was a judicial and policing response to mental illness rather than a health-led response. The experience and preferences of people with mental illness were not reflected in the way the culture or structure of the mental health system worked, and in outer regional and rural Victorian communities the service system was even smaller. I remember being devastated to deliver a teenage survivor of sexual assault with a high suicide ideation score to the local hospital emergency department because there was no service able to monitor her overnight. I welcome the findings of the royal commission and, in the final report, the 65 recommendations to overhaul the mental health treatment space. The government’s commitment for each and every recommendation to be fulfilled swiftly, deftly and within the recommended time frame makes me proud to stand here today as a member of the Andrews Labor government.

The bill before us today is an extension of the government’s commitment to rectifying the mental health system, particularly for those who identify as LGBTIQ+, refugees, asylum seekers, people living with disabilities and people from culturally diverse backgrounds. This bill amends the act passed by the last Parliament in August 2022 to make sure it operates as intended. Before the act comes into effect on 1 September 2023 these minor but technical amendments are necessary to prevent any unintended consequences or misinterpretation.

Some key features of the Mental Health and Wellbeing Act 2022 are the establishment of the Mental Health and Wellbeing Commission and Youth Mental Health and Wellbeing Victoria. The Mental Health and Wellbeing Commission, among other things, will hold government to account for the performance, quality and safety of Victoria’s mental health and wellbeing system. The act also establishes Youth Mental Health and Wellbeing Victoria, which will address the emerging evidence of the youth mental health crisis. This initiative goes beyond the recommendations of the royal commission and reflects recognition of the need to do more to address the unique experiences of mental health and wellbeing issues for young people in Victoria. The Mental Health and Wellbeing Act 2022 also introduced new service delivery frameworks underpinned by a set of rights and principles. I will address some of these principles, which are close to my experience as a social worker in the past.

Dignity and autonomy – not everyone responds to the same treatments in the same way. Practitioners can use different models of therapy for different people with the same condition. Some respond to the psychotherapy model, whilst others response to a cognitive behaviour therapy model. So the principle of dignity and individuality is important in the act.

Family and carers also are important. Inclusion of the needs of families and carers and supporters, including children, is very important. It is not uncommon to have a parent with a mental illness being cared for by a teenager or even a young child. These wonderful young people are often studying and living their own childhood whilst fully responsible for the care of a mentally unwell parent. The lived experience of persons with mental illness and their families should be respected. This is about believing the lived experience of people with mental illness, not what the books say but how the individuals describe their experience.

As with the rest of the community, people living with mental illness often live with other medical and health conditions. This is about the unique interaction of comorbidities and how they impact on mental illness. Many people have more than one condition to contend with. The mental health system should provide a holistic approach to care rather than a condition-by-condition approach.

The dignity of risk is another principle which is really important. We all have a right to take reasonable risks, and so should people living with mental illness. For some people, living in the community is a risk in itself, but it may for some be far more satisfying than institutional living. This is an expression of the right to participate in the good, the bad and the ugly of our ordinary society, whether that is playing sport, going out for dinner or even simply going for a walk. Acknowledging the unique characteristics of people experiencing mental illness is important. We all know how it feels to be demeaned because of a particular characteristic we have or who we are. Suffering from a mental illness does not justify derogatory treatment because of any diversity characteristic.

Gender safety is also addressed in the act. Services must be responsive to any current experience of family violence and trauma or history of violence and trauma. This is very important, because when you have comorbidities your vulnerability is multiplied. At CASA our figures showed that once you had been assaulted for the first time you were more likely than those in the average population to be subsequently assaulted. If you layer this with other comorbidities, like disability, for example, the figures go up exponentially. So it is important that the act explicitly expresses expectations around the safety of people with mental illness.

Today’s bill came about during preparations for implementation of the 2022 legislation. In doing so the government recognised some omissions that would impact on the intent of the last Parliament to overhaul the mental health system. This is a proactive approach by the Andrews government, ensuring the implementation is effective and free from misunderstanding. The government is prioritising these amendments to ensure that the intention and spirit of the 2022 act are preserved. The bill aims to amend minor but key implementation hurdles. It is important to note that none of the amendments in this bill deviate from the royal commission’s time line recommendations.

In conclusion, respect is an important core value of mental health service delivery. After all, we are all on the same spectrum; we are all variations of ‘normal’. Some of us are mentally healthy most of the time and occasionally experience a touch of mental illness. Others have major mental illness and occasionally feel well. In the end we are all different and unique human beings who deserve a strong and caring mental health support system.

Council divided on amendment:

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

Noes (23): 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, Gayle Tierney, Sheena Watt

Amendment negatived.

Motion agreed to.

Read second time.

Committed.

Committee

Clause 1 (17:34)

Georgie CROZIER: Attorney-General, I am just wondering if you could provide to the committee how many recommendations from the royal commission have been fully implemented and just the progress of the implementation of those recommendations.

Jaclyn SYMES: As you would appreciate, Ms Crozier, that is not specifically connected to the bill. But I reckon that if I ask the people in the box, they will have a good response for you in relation to that.

Georgie CROZIER: It is clause 1.

Jaclyn SYMES: Yes, but it is a big one. I am advised that there are 74 recommendations, as you would be aware, and 90 per cent are underway.

Georgie CROZIER: Ninety per cent are underway – that was in a media release on 2 March 2023. Is the 90 per cent still underway? I want to understand how many have been fully implemented.

Jaclyn SYMES: We have implemented 60 per cent, which leaves the remaining underway with a commitment to implement all recommendations of the royal commission.

Georgie CROZIER: Thank you, Attorney, for that clarification. Is that public? Are those 60 per cent recommendations publicly reported anywhere?

Jaclyn SYMES: I am advised that the Department of Health website has regular updates in relation to this, as I have indicated. I am more than happy to try and provide you with information, but this is of a very general nature in relation to the questioning that you are undertaking. I am here to facilitate the passage of the bill. Perhaps if there is any further information of that specific nature that is not forthcoming, I can endeavour to ask the office to get back to you in relation to some of those unrelated matters to the bill – acknowledging that it is all in some way connected – but I understand that the department’s website should be useful as well.

Georgie CROZIER: Thank you, Attorney. The reason I ask this is because, as you say, it was a large body of work, and the government has put in place a bill around the royal commission and specifically some of the recommendations, the work that you are undertaking. This bill is to correct some of those errors that have occurred through the implementation, as we all know, and there are concerns that have been raised. I think it is entirely reasonable for the house to understand exactly how many recommendations have been implemented in full and what the latest information on the department website is, because that changes. And I think all I am asking is that we have an update with that accurate reporting of the 60 per cent of the 74 recommendations that have been implemented and have a list of which ones have been implemented.

Jaclyn SYMES: Yes, thanks, Ms Crozier. I certainly understand your interest in this matter. We can say that it is a significant reform program, an agenda that will take several years to implement. I think 10 years is the forecast of the implementation plan. There are regular updates on the website of the recommendations that have been implemented, and that is where you will get the information about the 60 per cent. If that is not adequate, then perhaps we can find another mechanism to get you that information.

Georgie CROZIER: Thank you very much, Attorney, for that clarification. Could the Attorney provide to me an update – and you may have done it; you possibly have – of Victoria’s Mental Health and Wellbeing Workforce Strategy 2021–2024, which was handed down in December of 2021? I referred to it in my second-reading speech. In it the then minister spoke about:

… we will review and update the strategy every two years, so it reflects the needs of the mental health and wellbeing workforce as we build the new system from the ground up.

I am wondering if there has been a review as yet. Obviously this is not quite the two years – it was December 2021 that this was handed down, so we are not in December 2023, I understand – but in terms of that, is that underway? Is that review on track to be delivered by December 2023? That is really the question I am asking.

Jaclyn SYMES: Planning is underway for the next strategy, yes.

Melina BATH: This actually relates to clause 19, but it is probably just as easy to ask this particular one now, because by the time we get to the other clauses it will be keeping on going. In relation to the Governor in Council orders for regional mental health boards, I am interested to know why the government has extended – moved out – the date by which an order must be made until the end of December next year. What has been the philosophy behind that?

Jaclyn SYMES: I understand that through consultation there has been overwhelming support for an agreement to delay it by one year to allow sufficient time for further community engagement, and this is a proposal that has been supported by those chairs.

Melina BATH: Thank you, Attorney. In terms of the community engagement, could the Attorney provide a bit of context about how that has occurred – the type of feedback? Also, how will that be presented? Is that going to be presented in a public way for those boards?

Jaclyn SYMES: Ms Bath, you have hit the nail on the head. They want further community engagement, which is one of the rationales for the delay or the pushing it back for another year. In relation to how that will be communicated, I will see if I can get an answer to that.

Ms Bath, I am advised that, as I am sure you would appreciate – and it sounds appropriate to me – interim chairs will be very much in control of what is appropriate for their local community and will form the basis of how the community engagement will be best placed in those communities as well as how they would communicate that.

Georgie CROZIER: Minister, it is my understanding that the mental health sector did not see a full exposure draft of the original bill until – well, the first time they saw it was when it was first tabled in this place. Was there a reason why they did not receive a full exposure draft of the original bill?

Jaclyn SYMES: The original original bill or this bill?

Georgie CROZIER: No, the original bill, because this is correcting the errors of the original bill.

Jaclyn SYMES: The amendment bill. Well, I am only here today to talk about this bill, not the original bill, but consultation with agencies since the original bill has led to many of the amendments in relation to this bill.

Georgie CROZIER: I understand you are talking about this bill, but the reason I am asking is because the original bill had errors in it, and this bill is partly correcting those errors. That is why I am saying if the sector had been exposed to the original draft, then perhaps some of those errors would not have occurred. I am just wondering: was there a reason why they did not receive an exposure draft?

Jaclyn SYMES: Exposure drafts are not necessarily that common. We have not had many in the last little while. Sometimes they are a good idea. Sometimes you can get a similar outcome through appropriate consultation. My memory of that legislation, from when the former minister brought it forward, was there was an acknowledgement that we expected to come back after it was enacted and fix some of the implementation issues. It was something that we wanted to get underway. So I think we have been pretty honest with the sector that we knew that we would be returning to this bill to amend, and a lot of the agencies have fed into the amendments that are before us today. We were very keen to progress the original bill to be true to our commitment to implementation of the royal commission’s recommendations, so I think we have been very up-front with the community and the sector in relation to wanting to get underway, acknowledging that we would need to come back and fix some things up, and that is hopefully what we are doing today.

Clause agreed to; clauses 2 to 11 agreed to.

Clause 12 (17:45)

Sarah MANSFIELD: The change in clause 12 is to essentially remove the requirement for the response to be led by an authorised health professional, and it has been changed so that that only has to occur insofar as it is reasonably practicable in the circumstances to be informed by an authorised person or health professional. Essentially, this is a watering down of the health-led response that was recommended by the royal commission. We are just wondering why this change has been made.

Jaclyn SYMES: Thank you, Dr Mansfield, for your question. I would not articulate it as a watering down of recommendations. Recommendations in relation to these matters are still under development and under consideration and have involved a lot of operational consideration before coming to proper fruition. This clause actually puts beyond doubt that police officers and protective services officers are not prevented from exercising care and control powers if they are unable to base the exercise of those powers on the advice of a health professional. The rationale is that the health-led principle requires that to the extent reasonably practicable in the circumstance the exercise of care and control powers be health-led or, if that is not possible, be health-informed. It is our view that unless there is amendment, there is a possible interpretation that police or protective services officers cannot act in circumstances where they are unable to be informed by health advice. ‘Reasonably practicable’ was already in the original act, and this amendment is all about providing clarity for that original act.

Clause agreed to.

Clause 13 (17:48)

Jeff BOURMAN: I have some questions, if I could. My apologies if this has been covered off already, but I just want to make sure I am right before I make a vote. Clauses 13 and 14 effectively, as far as I can tell, remove an ambulance or a paramedic from taking a person into care and control in a mental health crisis. Now, my understanding of it is that at the moment they can. This will remove them. Am I correct in that? Just reading it verbatim, it says:

… omit “, a registered paramedic employed by an ambulance service as defined in section 3(1) of the Ambulance Services Act …

The way I read that – and this is obviously the crux of Ms Crozier’s amendment – is that this will end up being a police- or PSO-led response; it has to be by law.

Jaclyn SYMES: Paramedics will be prescribed in regulations, but, Mr Bourman, what this clause does is remove ambulance paramedics from the provisions conferring powers to take a person into care and control from the community and allow registered paramedics and others to be prescribed by regulation at a later date. This does not mean that they are not involved in the process. The status quo will remain. At the moment there are 90,000 calls a year that involve ambulance turnouts to mental health patients or people that are displaying mental health issues. The reason that we are ensuring that we are acting appropriately here is that it has not been possible for necessary training and service reforms to be rolled out in time for ambulance paramedics to take on these powers from the commencement – that is, on their own. That is the concern that we have.

I think some of these questions could perhaps be directed to Ms Crozier in relation to the intention of her amendments, because what we are wanting to do at the moment is to ensure that both agencies can respond to issues. But we know that removing the ability for police and PSOs to assist, in many instances, whether they jump in the ambulance with the paramedics or they follow the ambulance in relation to getting to the hospital to respond to some serious behaviours or community safety concerns ‍– we are wanting to move to a health-led model but we are not in a position to do that at this time. The royal commission made recommendations to do that by 2024 and it remains the position that the government would like to advance. You would appreciate that these recommendations were made in 2019, before we had the unprecedented impact on our health system. So this is about making sure that we are in a position to move to a health-led model at a later time when we think it is safer to do so. But I can reiterate that the practice of dual call-outs, for example, would be expected to continue, as they do each and every day.

Jeff BOURMAN: Thank you, Minister. I guess I am just confused. I understand what you are saying. Talking about a mental health crisis, obviously police have powers under section 351 of the Mental Health Act to take someone into custody or protective custody – whatever you want to call it. I understand what you are saying, but I am still not sure why this made it in here. If the status quo is going to stay, wouldn’t it have been easier just to leave the status quo and deal with it otherwise, rather than removing the ambulance from the legislation itself?

Jaclyn SYMES: This enables us to keep the commitment and to implement it in a safe, responsible way when it can practically come into effect. Our concern is that if we were not to make this amendment, if we were to move too early to a health-led response and effectively, in many instances, discourage the police or the PSOs from having that role before paramedics are appropriately trained or more are recruited in relation to the current demands that they are facing, it would be premature to move to what we would ultimately like. But the regs will do that.

Jeff BOURMAN: Yes. I get that. Thank you, Attorney-General. I guess my concern is always that in the end using a police-led response can, in the eyes of people that are not there, lead to unfortunate circumstances. It was put that police do not have the training to deal with mental health issues. I can tell you from experience they certainly get the experience really quickly, but I want to put it on record. I guess this was probably not ideal from the government’s point of view either, but I just really do not like the fact that it leaves police at the front of something that they probably would rather not deal with at all, if they could.

Jaclyn SYMES: Mr Bourman, I acknowledge that, and that is why we want to move to a health-led model. These amendments do not change the current role for police or PSOs. The original amendments, if they had been enacted, would have made changes. The original bill, if enacted earlier than what we are now proposing – if it had been brought forward – would have taken away more police presence. I reiterate: there are 90,000 calls a year for paramedics to respond to mental health issues. Many, many of those involve police attendance as well. The police have specific powers, particularly in relation to assisting paramedics with patient transport arrangements and the like when there is no consent. A paramedic is not in a position to force somebody into the back of an ambulance, regardless of how much health attention that person needs. They do not have the training and they do not have the power to do that. That is what we want to move to potentially in the future as part of the recommendations in relation to that health model, but we are not quite there yet, which is why the status quo has effectively been maintained through this legislation.

I think you asked specifically in relation to why we have to make these amendments. In addition to the concerns about significant safety risks were ambulance paramedics to take on the roles ahead of the appropriate training and support, my advice is that if the powers remain in the act and are not exercised there is a legal risk to Ambulance Victoria (AV) for failing to meet obligations under the act, so it is not as though we can just leave them there and say that we will fix it up later. That is why we have to address this.

But there will be a continued focus on police’s response to mental health issues. They are still always going to respond. You have articulated that in your experience they get training on the ground pretty quickly in response to this, but it is also part of their formal training. They have a two-day mandatory training in mental health focusing on communication, de-escalation, stigma and bias, and what we are wanting to do in the future is have the least restrictive means to respond to instances as possible.

Some police have been doing a great job – we acknowledge that – but moving to a health-led model is all about only using care and control powers as a last resort. It is really about making sure that our wonderful health professionals are best equipped, best trained and best supported to continue to de-escalate and continue to provide care and hopefully be in a situation where they are not needing the additional presence of police and PSOs, because it is all about the person’s health condition, responding appropriately to that and leaving police to respond to community safety concerns or offending behaviour.

Sarah MANSFIELD: You indicated that government is working to progress to the full health-led model ideally by the recommended time of 2024. Can you commit to a time line for implementing the full health-led response, and will it at least be in this term of Parliament?

Jaclyn SYMES: I thank Dr Mansfield for her question seeking information in relation to the government’s commitment to this matter. Just to put it on the record, the royal commission recommended that responses to people experiencing a mental health crisis should be led, wherever possible, by health professionals rather than police. We have been exploring that this afternoon. The establishment of the health-led response was recommended by the end of 2024. We have committed as a government to implementing every recommendation from the royal commission, and this includes the commitment to establish the health-led response. However, as we have explored a little bit this afternoon as well, rising demands on Ambulance Victoria and the ongoing impact of the pandemic have put great pressure on the health system, and it would be irresponsible to proceed with introducing new care and control powers for Ambulance Victoria paramedics when the act commences on 1 September without being sure that the necessary supports are in place for the safety of our healthcare workers and of course the broader community.

The amendments in the bill will allow time to ensure the necessary system reforms are in place to support paramedics to take on these roles, including the delivery of training to the more than 4000 Ambulance Victoria paramedics that we are effectively attracting and onboarding.

I think I might have heard you say in your contribution that you were concerned about a set-and-forget-type mentality. That is certainly not the case. This is a commitment that we are fully behind. There are project teams in Ambulance Victoria, ESTA and VicPol, and all are currently undertaking planning and design work to move towards the health-led response. Options to support the implementation of new care and control powers for paramedics are also being currently considered by government. So all of the agencies that are currently on the ground dealing with these issues are indeed providing direct feedback and direct suggestions to government about how we can get this right in order to deliver it before the recommended time.

We expect that Ambulance Victoria will commence the rollout of training to paramedics next year, in 2024, and this is in addition to the significant amount of work already undertaken to deliver a health-based response, including planning and design activities to implement the royal commission’s other recommendations to reform existing mental health triage services, develop a range of new safe spaces for adults and young people and develop new crisis outreach teams that will be available 24/7 for people to receive immediate support in their home environment. That is all about better treatment, de-escalation and getting to matters before they come to that pointy end where there is a first responder approach. When fully implemented, the health-led model will ensure that people are better connected with services that are responsive to their needs, and the intention is to reduce unnecessary transports to emergency departments (EDs) and reduce demand on ambulance crews and certainly the police.

Sarah MANSFIELD: Just a follow-up to that: do you plan on legislating this fully health-led response, perhaps returning paramedics into the legislation at some point in the future when you are ready to do so?

Jaclyn SYMES: My understanding is that the way we have set up this bill enables that to be done by way of regulation. So we are asking for support of the bill, which has along with it a commitment to implementing this change through regulations rather than relegislating.

Georgie CROZIER: Attorney, could you please clarify – when you were answering one of Mr Bourman’s questions I could not quite hear you – the number of transfers that you indicated? How many were there that were done?

Jaclyn SYMES: No, I was indicating that my information is that there were 90,000 call-outs from AV for mental health related incidents. Many of those involve dual dispatch in relation to both AV and police.

Georgie CROZIER: Thanks, Attorney, for that clarification. Yes, I understand that there sometimes needs to be a dual response, but now that paramedics have been taken out of the response until you commit to that health-led response, which is due next year – but as you said, the training will have to take place – it is the intention, but it is not clear, I do not think, from the response, that there is a set deadline about when that health-led response will take place and paramedics will be a part of that process. The reason I ask is because of that 90,000, which is going to put a big burden back on the police. Will paramedics be paid more to respond to these call-outs?

Jaclyn SYMES: Ms Crozier, let us explore this a bit. We might go around in circles a little bit, but your claim that paramedics will be taken out of this response is not what is happening here. On the 90,000 calls that were received in 2021 for mental health issues that paramedics were dispatched to, those figures are not anticipated to change much. The only thing that is happening here is that paramedics cannot undertake the care and control aspect, but they can still support mental health patients.

As I was articulating to Mr Bourman, when I was making inquiries about what happens in practice if a person is experiencing or is perceived to be experiencing a mental health issue that paramedics want to respond to, police are required if there is a community safety aspect, if there are weapons involved or if there is a crime being committed but also if the patient does not consent to being transported. There are many instances where the police merely support the paramedic response and the paramedics have the additional support for transport where a police officer might say, ‘Well, I’ll jump in,’ or they may just follow the ambulance in the car and be at the hospital for those handovers before the care and control can be transferred to a psychiatrist, for example. So there is not a massive difference. There is no removing of paramedics’ response to health issues that have a mental health element; it is just that care and control issue in relation to those concerning behaviours. We want to make sure that we have a workforce that is well equipped to be able to deal with those either by themselves or only in instances where there are community safety offences and other areas where police would ordinarily be the first responders. AV have never had the care and control powers, so this amendment is not taking them away. This is not changing that. It is just delaying the commencement of the health-led model, which will actually remove more of the police from these instances, to a later date so we can get the training right, the support right and further recruitment and the like.

There is not a lot of change happening here at this point in time. The change for the health-led model is due, in line with the recommendations, by the end of 2024, and the commitment, as I outlined to Dr Mansfield in relation to all of the first responder agencies giving us advice in relation to how best to do that, is occurring now.

Georgie CROZIER: Thanks, Attorney. Clause 13, as is my understanding, removes the express reference to paramedics employed under the Ambulance Services Act 1986 in relation to taking a person into care and control in a mental health crisis that you just explained.

Jaclyn SYMES: As I said, I reckon we are going to go around in circles a bit. Can I jump in?

The DEPUTY PRESIDENT: Attorney.

Jaclyn SYMES: That is what the bill was doing. It has not happened yet. That is what the bill was proposing to do on 1 September. That is what is being removed. What is happening right now stays the same. It is just not changing on 1 September.

Georgie CROZIER: Well, there is concern. Why is there so much consternation from stakeholders?

Jaclyn SYMES: I do not know. There is a misunderstanding, which I think people have been trying to articulate.

Georgie CROZIER: I do not think you have actually consulted with them. Because when you speak to the Victorian Mental Illness Awareness Council, the Victorian Alcohol and Drug Association, the Police Association Victoria – the police association say that you are backtracking on the original legislation, that you are not actually undertaking what the royal commission expressly is requesting you to do. I have been listening to your answers: you are talking about a health-led response, you are going to start the training for paramedics at some point in 2024. I would like to ask: when will that training start so that it can be a health-led response? And my question is: does that apply to every paramedic coming through as well? Will every paramedic be trained in this? What is the time frame for that to be completed? If you would not mind answering those questions and then I will come back to my concerns that have been raised around the police force and what the impacts will mean for them.

Jaclyn SYMES: I am going to start where you finished. There is no change to Victoria Police right now. VicPol will have less involvement once the paramedics come online through the regulations for being the –

Georgie CROZIER: But when?

Jaclyn SYMES: By the end of 2024 is the royal commission’s recommendation, which is what we remain committed to.

Georgie CROZIER: By the end of 2024 all paramedics will be trained and they will all be ready to go?

Jaclyn SYMES: I do not want to put a definitive date on this. What I want to come back to is the recommendations of the royal commission, which is that by the end of 2024 we want a health-led model, which means we want less cops, more paramedics, in its simplest form. That is a recommendation of the royal commission we support. With the legislation that we introduced, we wanted to do it on 1 September. For a range of reasons, predominantly pandemic issues, because of the current unprecedented impact and pressures on AV, we are wanting to push that out to make sure that we are ready to make that transition in line with the royal commission’s recommendations. I understand that stakeholders support the royal commission recommendation of a health-led model. We remain committed to that recommendation. Training will be for all paramedics. We have got 4000 new paramedics that need to be trained. So we are wanting to make sure that we have adequate time to train new paramedics without pulling everyone off the road that wants to have a group training session. You have to stagger these.

Georgie CROZIER: So it is not going to be met by 2024, is it? It is pie in the sky.

Jaclyn SYMES: Well, your amendments do it on 1 September. I would like you to move your amendments, because I am actually really concerned your amendments mean that paramedics will be forced to do it on 1 September and police will not. That is the effect of your amendments.

Georgie CROZIER: Attorney, the concerns from police who say that they are spending 60 per cent of their time in terms of transport and 4 to 6 hours on average staying with these patients in an emergency department – that is not a health-led response.

Jaclyn SYMES: No, that is why we are moving away from it. That is the commitment.

Georgie CROZIER: Yes, but you are taking paramedics out of that situation. You are leaving it in the hand –

Jaclyn SYMES: No, we are not.

Georgie CROZIER: Well, no, this is the understanding –

Jaclyn SYMES: Well, you are wrong. That is the problem.

Georgie CROZIER: Well, I think the government has got this way wrong, because that is what the stakeholders all believe. That is what their impressions are. You have done a shocking job of consulting on this, if that is what they are saying. There are 900 officers who are on sick leave or on long-term WorkCover leave – 900 police officers – as of today. How many more police officers are going to be able to do this work, because we just do not have enough paramedics in the system to be able to support these patients? You are saying that it removes the express reference to paramedics employed under the Ambulance Services Act 1986 taking a person into care and control. So that is going to be left with the police.

Jaclyn SYMES: It already is, right now.

Georgie CROZIER: Yes, but it is going to be more pressure on them –

Jaclyn SYMES: No, it is not.

Georgie CROZIER: Well, convince me why it is not, because that is what the bill says.

Jaclyn SYMES: I do not understand how you have formed this view. I was listening to the debate going, ‘Do they honestly believe this, or are they deliberately trying to mislead the public?’ And you have convinced me that you genuinely believe this – but you are wrong. We are not taking powers away from paramedics – they do not currently have them. We are not putting more pressure on police, because they are already currently doing this. We acknowledge that that is not the right approach. We want to change it. We wanted to do it by 1 September – the pandemic hit. We are not ready to do it by 1 September. We wanted to go back to the royal commission’s recommendations, which were to introduce a health-led model by the end of 2024. We are committed to doing that, and that is all the amendment does – it does not change anything that is currently happening now. No powers are being taken away from anyone – it remains the same. I get that you are a little bit confused about the amendment, because the amendment is amending a bill that has not come into effect yet. If the bill had come into effect and we were amending it, then we would be taking something away. We are amending this bill before the enactment, which is 1 September, which means we ain’t taking away anything, because it does not exist yet. I am trying to help.

Georgie CROZIER: No, well, I am here to put it on the record, because there –

Jaclyn SYMES: I am trying to help, but I am going to make the comment: the misinformation that the opposition are peddling has been very unhelpful, and as I said, I am going to give you the benefit of the doubt that you are genuinely just confused and not deliberately trying to tell people that we are changing something that we are not. That is the effect of your amendments; that is the effect of your language.

Georgie CROZIER: No.

Jaclyn SYMES: It is.

Georgie CROZIER: Clause 12 enables that flexibility, so it is already there.

Jaclyn SYMES: The bill has not been enacted yet.

Georgie CROZIER: Yes, but what I am saying is your clause 12, the 000 response allows police, PSOs or ambulance, depending on the appropriate response, for available resources. So it is there. It is there in clause 12, but clause 13 takes away the paramedics.

Jaclyn SYMES: Ambulances can already respond. This is about the specific care and control power, which is different to providing health care, responding to someone who needs an emergency response. The care and control order is about physical restraint, non-consensual transport – those powers. There is nothing to stop someone, right now or any time in the future, calling 000 and going, ‘There is someone that is experiencing a very significant health issue. I’m concerned that they are going to commit suicide.’ They will still deploy ambulances now and into the future. Nothing changes there. But if that person is violent –

Georgie CROZIER: You just said there were not enough paramedics.

Jaclyn SYMES: That there is not what?

Georgie CROZIER: You said in answer to a question that there were not enough paramedics.

The DEPUTY PRESIDENT: Ms Crozier, the minister has the floor.

Jaclyn SYMES: Well, we want more paramedics. That is why we have committed to recruiting more. There are unprecedented health demands, but we want more paramedics too. What I just want to really clarify is that if you call 000, a health response will be dispatched now. The only thing that we are talking about here is what powers that paramedic has at that point in time in relation to dealing with somebody through the mental health lens. At this point in time, it is only police and PSOs that have that power in relation to some of those issues we want to move to paramedics once they are trained and once we have recruited.

Georgie CROZIER: Why then when a patient ends up in an emergency department does a police officer have to sit with them for 4 to 6 hours? Why is that an appropriate response? Why is that allowed to occur? And I would like to understand what consultation you have had with the police, as they have got these concerns about what is happening out there in the Victorian community now and what happened throughout the pandemic. There were no ambulance officers, so they were leading the whole thing. They were transporting them. The patients would leave. They would come back and back. It was a complete and utter debacle. I have raised it in this house numerous times. That is not a health-led response. That is the police undertaking the work of paramedics where they should have been in place and where healthcare workers should be taking their place in an emergency department. That is not happening. A police officer is having to stay there for hours and hours and hours on end, and we have got a shortage of police officers – 800. How on earth are they expected to pick up the slack until you get everybody trained to undertake this work?

Jaclyn SYMES: We acknowledge that we want a health-led response. We want less police doing the coercive power element of responding to people with mental illness and mental health issues. We are only talking about the coercive element here. A better way of describing that, I think, would be that it only relates to someone who needs to be taken into care and control to prevent imminent or serious harm to that person or to another person. So we are talking about really significant incidents that are of most concern in relation to what might happen to that person or somebody else. You make reference to picking up the slack and why should they. This is what police are already doing. This is why we have committed to a health-led model, because we acknowledge that we would like to move away from that. But your narrative that we are by virtue of this bill making it harder for police tomorrow or on 1 September is an inaccurate characterisation of what we are doing. What we are doing is being true to the recommendations of the royal commission, which will move some of those care and control issues, the coercive powers, away from police to appropriately trained paramedics.

As Mr Bourman has reflected, police have been dealing with these types of behaviour for a long time, and a lot of people, when they see somebody having a mental health issue in the street, go, ‘Oh, I don’t know if I ring the police or if I ring an ambulance.’ It is really confronting, and they do not want that person to harm themselves, so often both are dispatched. At the moment, police are trained in mental health response, in de-escalation et cetera, but they are the ones that currently have the powers to force somebody to stay at a hospital, for example, to ensure that they do not go out then and do something terrible.

We want to move away from that and make it more of just health people doing this job. There will always be a role for police in some way, shape or form when it comes to community safety, but we do want to get the balance a little better, and that is why we are doing this – because we acknowledge that VicPol are like, ‘We think more health people could do a really good job here. We think our skills are better placed over here.’ And they are working with us on this model because it will benefit them in the work they do whilst we make sure that AV are well placed to do this appropriately for their own safety and for the benefit of the community and patients that will benefit from it.

Georgie CROZIER: Thank you, Attorney. You just said the police are working with you on this model. Could you provide to the house who was consulted, when they were consulted on it and what input they had around this model?

Jaclyn SYMES: Well, I can assure you that AV, ESTA and VicPol have been consulted and we continue to do so. There are consultative groups right now.

Georgie CROZIER: You are saying they are continually being consulted?

Jaclyn SYMES: Conversations are happening right now.

Georgie CROZIER: With police?

Jaclyn SYMES: Probably not at 6 o’clock at night, but right now, yes.

Georgie CROZIER: So with police they are ongoing?

Jaclyn SYMES: Yes, absolutely.

Georgie CROZIER: And at what level is that, just to provide a context in terms of who is responding on behalf of the police?

Jaclyn SYMES: There is a working group with representatives from all agencies.

Melina BATH: Minister, I want to just ask a couple of questions or make a point about regional Victoria. You have said that when 000 are called sometimes both are dispatched – VicPol and ambulance. In regional Victoria there is sometimes a very thin line and there may not be the dispatch ability of police and ambulance. So if the ambulance is the first responder due to lack of resources, what is the government’s read on this? How is it being informed by regional Victoria, and what is it doing? Under this bill it is putting the ambulance officers, the paramedics, in an invidious position.

Jaclyn SYMES: You two have different views on this. In one sense Ms Crozier is saying ambulance should do everything; you are acknowledging –

Members interjecting.

Jaclyn SYMES: You are acknowledging the challenges of responding to emergencies, which is why we have a lot of people that can be trained to be dispatched to different emergencies as it is – fire trucks can go to car accidents and the like. So there are already inbuilt in our emergency response many situations where first responders from different agencies can respond to particular issues. What you are referring to is that ambulances can still respond to mental health issues. If there is somebody that is at risk and they need police assistance, they can still, in the confines of their own safety, ensure that they are providing assistance. If they need police, then that can be an additional dispatch. Often you will not know until you are there as an ambulance paramedic the situation that you are in. For instance, ESTA take calls and they are blind; they can only go on the information that they are provided. I do not want there to be too many hypotheticals here, but you could be deployed to what is requested as an ambulance and you get there and you are really concerned because another person in the house has a weapon. It is not advised that ambulance paramedics, whatever they are responding to, would put themselves in a position where they would enter a home where somebody has a gun, for instance. So there are numerous arrangements for dispatch to respond to different issues, but what you are specifically asking about is –

Melina Bath interjected.

Jaclyn SYMES: Ambulances can be dispatched to mental health issues now, and whether police presence is required as well is often determined through ESTA’s information call and the dispatch information or indeed informed by paramedics once they arrive at the incident.

Melina BATH: Minister, you have mentioned recruits. Then you mentioned new paramedics – 4000 new paramedics – that need to be trained by the end of 2024. Did you mean new paramedics that are currently in service – that are currently employed by Ambulance Victoria – or did you mean 4000 new paramedics that you are about to and yet to employ into the service?

Jaclyn SYMES: Yes, sorry. For clarification, 4000 paramedics will need to be trained in total.

Melina BATH: Thank you, Minister. Now, a couple of years ago, I understand, you put $6 million into training new paramedics, so I am seeking to understand: where has that money gone, why hasn’t it gone into training and why do we still need 4000 new paramedics in this particular system?

Jaclyn SYMES: I am little confused by your question. I am also confused how it relates specifically to the bill. We do not need 4000 new paramedics. There are 4000 paramedics that need to be trained to transition to a health-led model. I am not the relevant minister, as you would appreciate, but this is not the only area that paramedics need training in. Presumably there are many other training programs for paramedics, new and existing, that are underway. As it is not relevant to the bill, there might be another way for you to seek information about the level of training that goes to paramedics.

Georgie CROZIER: Well, Minister, it is relevant to the bill, for heaven’s sake. On 4 March in 2021 ‘Emergency workers at the heart of mental health response’ was your government’s media release. It talks about a $6 million investment, which includes:

… changes to responding to 000 calls, with our ambulance services to become first responders to calls for mental health support.

So Ms Bath’s question was entirely appropriate for this bill. What she was asking is: since that time two years ago, how many people have been trained with that investment that was put in place by the government?

Jaclyn SYMES: Well, Ms Crozier, I do not want to be too cute here, but we are on clause 13, and I am not really sure how this relates to that clause. It was not asked in clause 1, but in any event, in order to be helpful, this is training that is work that is already underway and will continue to be delivered.

Georgie CROZIER: I am not going to go back and forth on this, Attorney, but we have been talking about training. You have just mentioned that in relation to this clause.

Jaclyn SYMES: I have not. I am trying to respond to your questions.

Georgie CROZIER: I understand that, but in terms of the responses it is all very much related because, as you are saying, it has got to be a health-led response around the paramedics that need training. So we are just trying to understand: of that investment that was put through the system by you two years ago, how many people have been trained? It sounds like none have.

Jaclyn SYMES: Ms Crozier, since 2014 this government has spent an additional $2 billion on ambulance services.

Georgie CROZIER: And look at the number of Victorians that have died.

Jaclyn SYMES: Imagine what the system would be like under you guys. There has been 140 per cent more spent on ambulance services by our government than the former government.

Georgie CROZIER: It is not about money, it is about where it goes.

Jaclyn SYMES: The training is underway and it will continue to be so. As I think I said before, you cannot pull paramedics off the road responding to increases in health demands. You have to make sure that you get the staggered approach and that the design work is right. It has been informed by the other agencies, and we will continue to deliver it. I would appreciate it if we could get back to the bill.

Georgie CROZIER: I am not going to debate it further. I do not know if Ms Bath has got further questions. I will move the amendment. But I do have to say, Attorney, about your contribution just then in terms of the investment, you spoke about the investment and carried on about what we would have done in opposition. I am not going to go off on a tangent about that, but you have actually put $6 million into training on this very issue, and I have not had a response from you about how many paramedics have actually been trained for this very reason. Because you have not gone and sought information from the advisers box, clearly none have been trained with that $6 million. That is taxpayers money. When you put out a media release and make an announcement about money that is going into a system to do this – as you say, to better prepare – then we should be able to have an understanding about where that money has gone.

Jaclyn SYMES: Funding, planning and design activities for the training package are underway, and the media release relates to recommendations 8, 9 and 10, I am advised. I can assure you, Ms Crozier, that we want to make sure that this reform works. We are genuinely behind the royal commission’s recommendation. We acknowledge that it is better for health professionals to respond to people in times of crisis that are underpinned by mental health. We want to make sure that they are well equipped to do that. We want to get the training right, as I have said. The funding is available to ensure that it can be delivered.

Georgie CROZIER: You still have not answered my question.

Jaclyn SYMES: I did. I started with –

Georgie CROZIER: How many?

Business interrupted pursuant to standing orders.

Lee TARLAMIS: I move:

That the meal break scheduled for 6:30 be for half an hour.

Motion agreed to.

Sitting suspended 6:31 pm until 7:03 pm.

Georgie CROZIER: Before the break I was speaking about a health-led response and the need for that to continue. I want to just go back to the legislation that you are talking about, Minister, which comes into effect in September and what this amendment that we are talking about refers to. Part 5.2 of the Mental Health and Wellbeing Act 2022, ‘Power to take a person into care and control in a mental health crisis’:

232 Taking a person into care and control in a mental health crisis

(1) An authorised person who is a police officer, a protective services officer, a registered paramedic employed by an ambulance service as defined in section 3(1) of the Ambulance Services Act 1986 or a member of a prescribed class of persons may take a person into care and control under this section if the authorised person is satisfied that –

(a) the person appears to have mental illness; and

(b) because of the person’s apparent mental illness, it is necessary to take the person into care and control to prevent imminent and serious harm to the person or to another person.

(2) A person remains in an authorised person’s care and control under this section until the person’s care and control ends in accordance with section 239.

That is the bill that is coming into effect in September, as we both understand. I would like to understand this issue: this bill that we are debating today takes out the reference to a registered paramedic employed by an ambulance service as defined in section 3(1) of the Ambulance Services Act. I would like to understand whether the government’s intention is that the non-emergency patient transport, which is under review by the government, will take on this aspect when that review is completed and when the NEPT service could come under the control of AV. Is it the intention that they would be providing this backup and providing care for those patients with a mental illness that need transfer?

Jaclyn SYMES: That review is independent of this act, so I cannot comment on a review that is yet to report. Its findings are not informing this act at this time.

Georgie CROZIER: Thank you, but there is concern from a number of people about that review, as I have indicated in previous weeks. The reason I am moving the amendment to clause 13 is for this very reason that I have just spoken about – that:

An authorised person who is a police officer, a protective services officer, a registered paramedic employed by an ambulance service as defined in section 3(1) of the Ambulance Services Act 1986 …

remains in the legislation, the bill that we are debating today. That is the reason for my amendment, and I would request that the chamber support the reasons for doing so.

Jaclyn SYMES: Ms Crozier, with your amendment the advice I have is that it would put paramedics in a position where they have coercive powers – they have the ability to do what police have now – and they have not undertaken the training to do that yet. Are you not concerned about the impact that your amendment will have on our hardworking paramedics? Because I think you are putting them in a very precarious position.

Georgie CROZIER: Well, Attorney, as I previously said, as per the media release there has been $6 million provided by your government – taxpayers money – on this very issue back in 2021. Here is a media release, as I have referred to, from the Premier and the acting Minister for Police and Emergency Services Danny Pearson. They were talking about the training for the paramedics to undertake this response. So you are telling me that none have been trained, even though you have told Victorians they have been and you have put investment into it – $6 million. Is that what has happened here, because I think somebody –

Jaclyn SYMES: I asked the question.

Georgie CROZIER: Well, this is what I am referring to. It talks about exactly what this is, so I want to know. It is not me that is putting anyone in danger. I think that the government has misled Victorians in the most extraordinary way again. You have said that this money was going towards this very training, and you have not answered it properly. It has not happened. I do not want to put anyone in danger; I just want the truth here, and I want to understand exactly what is going on.

Jaclyn SYMES: At the risk of going around in circles again, Ms Crozier, the media release was referring to the training that we are still delivering. We are delivering that training. It is incomplete, and my question remains. Your amendment will have the effect of, on 1 September, putting paramedics in the very difficult position of not being ready for the health-led model, which is why we are changing it to push it out in line with the royal commission’s recommendations for 2024.

Georgie CROZIER: But you are never going to meet it.

Jaclyn SYMES: My question remains: do you accept that your amendment is putting paramedics in a very precarious, dangerous and unsafe position as of 1 September?

Georgie CROZIER: Clause 12, Attorney, talks about authorised health professionals ‘so far as is reasonably practicable in the circumstances’ –

Jaclyn Symes: On a point of order, Deputy President, I sit here regularly, and I acknowledge that it is not often that I ask questions, but I am interested in some direction from the Chair. When an amendment is proposed by a member of this chamber, it is my understanding that we are entitled to ask questions about the impact of that amendment, and I am not receiving any answers, I am just getting further questions. We are talking about an opposition amendment at the moment, we are not actually talking about the bill.

Georgie CROZIER: I actually think –

The DEPUTY PRESIDENT: Order! Ms Crozier, sorry, the Attorney has raised a point of order. Yes, Attorney, you are entitled to ask a question. Just like in question time, I cannot control if you do not like the answer. So you are entitled to ask the question, but the member answers in the way that she sees fit.

Georgie CROZIER: Thank you, Deputy President. I think we are having this debate because there is a lack of clarity in this bill – so much lack of clarity. I have referred to the media release of 2021, where you promised it was happening. You are talking about meeting the royal commission guidelines, which you say are going to be delivered in 2024 but we may not get there. We have no certainty.

Jaclyn SYMES: You are verballing me. I did not say that.

Georgie CROZIER: Well, can you guarantee that every paramedic will be trained – I have already asked this question – by 2024 to meet the time lines that you are insisting will be met?

Jaclyn SYMES: I can confirm that we have got a better chance of –

Georgie CROZIER: No, no.

Jaclyn SYMES: I am allowed to answer in the way I see fit. We have got a much better chance of training 4000 paramedics by 2024 than by 1 September, which your amendment is forcing people to try and do.

Georgie CROZIER: Clause 12 allows for the flexibility. If there is not a paramedic in place to be able to care for a patient, it allows for the flexibility to have a trained police officer or PSO undertake that work. Your own bill states it. So if you do not have a paramedic to be able to do this, then this bill, in clause 12, allows that to occur, Attorney. What I am saying is that we say this should be a health-led response as per the recommendations of the royal commission. Right?

Jaclyn SYMES: We agree.

Georgie CROZIER: Clause 12 already has the flexibility to meet the demands if there is not a trained paramedic available. Your media release from 2021 says you are investing in that. You have not answered the question of how many people have been trained, which I am very concerned about, that clearly –

Jaclyn SYMES: So concerned that you want to put them into the field without training.

Georgie CROZIER: No.

The DEPUTY PRESIDENT: Order! Attorney, Ms Crozier has the floor.

Georgie CROZIER: I am actually concerned about the process undertaken by you as the government bringing legislation into this place, the lack of consultation that has occurred. And what you promise, what you say and what you spend – taxpayers money – you do not deliver on. That is what I am really concerned about. I do not want any patient to be put at risk, but equally I have listened to the police association and others who tell me what is happening inside emergency departments. So you have failed on every level. I stand by this amendment to be carried today so that paramedics are included in this legislation. Clause 12 is still there to support a careful transition if required if there is no-one, as clause 12 says, ‘so far as is reasonably practicable in the circumstances’. That is what it is referring to. If they are not available, then of course they will be transferred appropriately.

Jaclyn SYMES: Ms Crozier, the flaw in your argument is that clause 12 does not provide any legal protections for AV, so it does not stand up, the logic that you are trying to articulate. I understand; I actually think we are on the same page here. We all want health responses for people that deserve health responses, and people who are experiencing mental health issues should get a health-led response. I think all of us in this chamber agree with that. What we are saying is that we want it to be appropriate, we want that to be safe. What we are doing right now is maintaining what happens at the moment, with an acknowledgement that we would like to do better and have more of a health-led model and less reliance on police. We are saying that the original bill proposed to do that on 1 September. We are not ready for that.

You can criticise us on that, and you have done that – okay. But my concern is that we are discussing your amendment, which will have the impact of doing what we want to do after everyone has been trained, everything is in place and we have consulted broadly with first responders before the regulations are made. You are wanting to do that on 1 September. That is what your amendment does. Clause 12 does not help you as you have articulated, because it does not do what you think it does. I actually think we are in agreement here, and it is a misunderstanding. It is complicated, I get it. We are amending a bill that has not been enacted yet, and I am trying my best to articulate to you why your amendment is bad. I would like you to withdraw it, because it is going to have a big impact on the people that you purport to support. You purport to be an advocate for paramedics. You are literally saying, ‘I don’t want police to do the job they are currently doing; I want paramedics to sit next to a violent patient who is suffering a mental health illness because we want them to have coercive powers tomorrow,’ when I am acknowledging that we need to do more work to enable those workers to be able to do that job.

Georgie CROZIER: The minister is verballing me. That is not what I want. That is just ridiculous to say that.

Jaclyn SYMES: I know you do not, but that is the impact. I am trying to explain it to you.

The DEPUTY PRESIDENT: Attorney, Ms Crozier has the call.

Georgie CROZIER: Clause 12 gives that flexibility. It is there. It gives that flexibility for authorised persons to be able to transfer and care and have that if there is a patient that requires it. It is what is happening now. But we are saying that a registered paramedic, who has been trained using the $6 million that was provided in 2021, should be there if available. That is why we say it should stay in the legislation. It can roll on. Goodness knows when they will all be trained – goodness knows. That is on the never-never. But it should be there. According to your media releases you are doing this: paramedics are being trained. You have put $6 million in for them to be trained. You have been doing that for two years. If they are being trained, then they should be in the act. That is why I am moving my amendment, so that they are recognised in the act. If they cannot, then clause 12 will step in so that PSOs or police officers will be there to safely care for those patients.

David LIMBRICK: I do not have a question; I would just like to state my position on this amendment for the record. We must be very careful when enacting any sort of coercive powers, and that is exactly what this is doing. It is handing coercive powers to paramedics. I would like to thank the government’s advisers for working with my team on giving us advice around this. I accept what the government has said – that their initial intention with their previous bill was to have things ready by September. It is clear that is not going to be the case; therefore the idea that in September paramedics are suddenly going to get coercive powers without training is dangerous, in my mind. Therefore the Libertarian Party will not be supporting these amendments. If I was going to offer some constructive criticism to the government, I would say that they seem to have a pattern of being rather optimistic with their time lines for implementation of these sorts of things and that maybe they should be more conservative with how long it will take to do these things, because they clearly take a lot longer than what is anticipated in the first place.

The DEPUTY PRESIDENT: Ms Crozier, do you want to explain your amendments?

Georgie CROZIER: I have. I have explained it. I have just explained many times why I am moving my amendments.

Jeff BOURMAN: I just have a couple of quick questions. Attorney-General, what mental health training do the ambos get now?

Jaclyn SYMES: Mr Bourman, the question relates to the training that is informed by clinical practices for health workers. We do not have to hand a summary of everything that that covers. It is similar to other health worker provided training in relation to dealing with mental health and mental illness matters. I am more than happy to get you more information on what that looks like as part of a training module for paramedics, and obviously the existing package of training will inform how we want to expand the additional training for paramedics as they obtain greater control over those powers and the ability to respond to people in the absence of other authorised officers.

Jeff BOURMAN: Thank you, Attorney-General. If you could just get me the highlights – I do not need the whole package. Will the ambos in the future, before this gets enforced, be trained in physical control? Control of someone can sometimes be verbal, and sometimes it goes beyond that.

Jaclyn SYMES: Thank you for your question, Mr Bourman. In relation to the finalisation of what will be provided in training, it is still under development. There are working groups that are coming together, including representatives from our agencies, which are going through real-life situations and what may be required. I think what is important to note is that paramedics would not be expected to step into the role of community safety or responding to violent situations that police would ordinarily.

There is sometimes a fine line between an episode that someone is having with a mental health issue and how dangerous they can be to themselves or to others and where it is appropriate for police assistance. But we are wanting to counter that balance from now overwhelmingly relying on police to respond to that to try and get more of that health-led model in, and it will be an evolving practice over time. Even when paramedics become enabled under the regulations to have care and control order powers, that will not take away powers from police. They will still have the ability to play that role. We are just wanting to have more training, a health-led model and trauma-informed practices that start to ensure that that practice of police and PSOs stepping into that role can be more appropriately picked up by health professionals when the health-led model is an appropriate response to that individual circumstance.

Jeff BOURMAN: Thank you, Attorney-General. This is probably more of a statement. Obviously, the police will still have a role to play, but these things can go from really quiet to extremely violent in a moment, and I think it would be fairly unfair to any of the ambulance people if they were there on their own whilst it went south, with no training. As I said, I guess it is more of a statement than anything.

Jaclyn SYMES: Yes, I appreciate that, and I guess you have articulated why we want to take more time to ensure that the enactment does not put that pressure and that legal uncertainty on paramedics right now. Part of the training package for paramedics will also include de-escalation of incidents and the like. But returning to my comments about the fact that police will retain the ability to step in, in the event that a care and control order power is enacted by a paramedic, they could reverse that decision and say, ‘No, no, we need to hand this particular individual over to police or another health body,’ for example, in relation to responding to that person. So just because they have enacted the powers, when they come into effect, that does not mean that there is no ability to step back if the risk profile changes, for example.

Jeff BOURMAN: Thank you, Attorney-General. Obviously, the police will still have the ability and will be needed in some cases. I just think, without knowing what actual training and powers they have – I guess, just to put it on record – if the paramedics are going to be trained in hands-on control, there will probably be a need to change the recruitment standards. Because there are a lot of people that have been hired by the ambulance people over the years that were not expecting to be in this sort of situation, and now they will be facing it. As I said, if the police do not go there and it goes off, it does take the police time to get there, and if they are already there in every instance, it is kind of defeating the purpose of what we are doing.

Jaclyn SYMES: You make good observations, but also these were considerations of the royal commission. We know that there are instances where a health-led model is more appropriate to deal with individual circumstances. This is not designed to take the place of the appropriate role that police play in relation to community safety; it is going to be about balancing. And you are right, there will be situations – they are happening now – where paramedics are deployed and the situation becomes dangerous for them and they have to step away. Even though they are wanting to help someone that is injured, for example, if it is too dangerous to do so, it is their policy to ensure –

Jeff BOURMAN: As they should.

Jaclyn SYMES: Yes, as they should. We want a safe work environment for our emergency services personnel, and police are more appropriately trained for those instances. That push and pull will continue to happen as the reforms play out, and there will be a role for everyone. Everyone is on board that we can do better to respond to people with mental illness through better health response and less reliance on coercive powers that are predominantly held by police.

The DEPUTY PRESIDENT: Ms Crozier’s amendment proposes to omit this clause. If you are supporting Ms Crozier’s amendment, you should vote no.

Council divided on clause:

Ayes (24): 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, Gayle Tierney, Rikkie-Lee Tyrrell, Sheena Watt

Noes (13): Matthew Bach, Melina Bath, Gaelle Broad, Georgie Crozier, David Davis, Renee Heath, Ann-Marie Hermans, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland

Clause agreed to.

Clause 14 (19:33)

Georgie CROZIER: I think we have prosecuted the argument throughout the course of the evening. I am inviting members to vote against the clause.

The DEPUTY PRESIDENT: If you are supporting Ms Crozier’s amendment to omit the clause, you should vote no.

Council divided on clause:

Ayes (24): 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, Gayle Tierney, Rikkie-Lee Tyrrell, Sheena Watt

Noes (13): Matthew Bach, Melina Bath, Gaelle Broad, Georgie Crozier, David Davis, Renee Heath, Ann-Marie Hermans, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland

Clause agreed to.

Clauses 15 to 53 agreed to.

Reported to house without amendment.

Jaclyn SYMES (Northern Victoria – Attorney-General, Minister for Emergency Services) (19:37): I move:

That the report be now adopted.

Motion agreed to.

Report adopted.

Third reading

Jaclyn SYMES (Northern Victoria – Attorney-General, Minister for Emergency Services) (19:38): I move:

That the bill be now read a third time.

Motion 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.