Friday, 14 November 2025

Michael GALEA: I seek leave to circulate a replacement set of amendments to replace the amendments MGA01C that I circulated on Tuesday.

Leave granted.

Michael GALEA: Just for the benefit of the chamber, I have identified a technical wording of part of amendment 9 to clause 7 that may have unintended consequences, and to clarify for the chamber, my intention is to only define who can initiate conversations about that and in what circumstances they may do so for the context of patient safety. The way my original amendment for new section 8B(3) was drafted had the potential to impact the usual discussions that should occur between patients and their care team when a person raises VAD themselves or is in the course of already accessing VAD. Importantly, this could have the potential to include the role of workers at the statewide care navigator service and statewide pharmacy service who are working with patients seeking to or already accessing VAD.

Clauses 2 and 3 agreed to.

Clause 4 (10:05)

Sarah MANSFIELD: I move:

1.   Clause 4, line 8, omit “medical”.

2.   Clause 4, line 13, omit “medical”.

3.   Clause 4, page 5, after line 6 insert –

‘(ca) in the definition of consulting assessment omit “medical”;’.

4.   Clause 4, page 5, after line 11 insert –

‘(da) for the definition of consulting medical practitioner substitute –

“consulting practitioner for a person means –

(a)   a registered medical practitioner who accepts a referral to conduct a consulting assessment of the person; or

(b)   a nurse practitioner who accepts a referral to conduct a consulting assessment of the person;”;’.

5.   Clause 4, page 5, after line 20 insert –

‘(fa) for the definition of co-ordinating medical practitioner substitute –

“co-ordinating practitioner for a person means –

(a)   a registered medical practitioner who accepts the person’s first request; or

(b)   a nurse practitioner who accepts the person’s first request; or

(c)   a consulting practitioner for the person who accepts a transfer of the role of co-ordinating practitioner under section 33;”;’.

6.   Clause 4, page 5, after line 23 insert –

‘(ga) in the definition of final request omit “medical”;

(gb) in the definition of final review omit “medical”;’.

7.   Clause 4, page 5, after line 28 insert –

‘(ha) in the definition of first assessment omit “medical”;’.

8.   Clause 4, page 5, after line 33 insert –

‘(ia) in the definition of first request, after “practitioner” insert “or a nurse practitioner”;’.

9.   Clause 4, page 6, line 17, omit “medical”.

This set of amendments, while it looks complicated, essentially would enable nurse practitioners to act as coordinating or consulting practitioners – they cannot undertake both roles for an individual, but they would be able to undertake one of those roles. The amendment reflects that access to voluntary assisted dying practitioners is currently very limited. It is a problem that has been highlighted not just in Victoria but in other jurisdictions, and I think it is something we have to be really mindful of. If we are wanting to create a scheme where people have equitable access to voluntary assisted dying, there needs to be the workforce who can provide it.

This is of particular concern in rural and regional Victoria. As I mentioned in my second-reading speech, rural and regional Victorians already face significant barriers to accessing health providers. They face even more significant barriers to accessing specialists, let alone specialists who are able to provide voluntary assisted dying and are willing to provide voluntary assisted dying. As everyone in here would know, you are unable to access voluntary assisted dying via telehealth under the federal laws. It is still illegal under federal law to have a telehealth appointment, which means rural and regional Victorians typically have to travel typically to either large regional centres or metro Melbourne, often at a time when they are very frail and very unwell.

Nurse practitioners currently play a significant role in voluntary assisted dying. There are many excellent nurse practitioners involved in the process. We think they are well placed to be able to take on more formal roles if they are so wish, provided they have appropriate qualifications and training. We believe that, similarly to the provisions required for doctors to be able to provide voluntary assisted dying, they need to be at least one year post their final qualifications to be able to do that. That year of relevant experience post endorsement is something that is allowed in the ACT under their laws. I feel this is something that we could comfortably accommodate in Victoria. I will note that the government has expanded the role of nurse practitioners in the administration of voluntary assisted dying. I think this is really welcome and reflects this very issue that nurse practitioners are well placed. We need more people who are able to do that. They are often very involved in supporting people through the process already, so that is the essence of why we are putting forward this amendment today.

Ingrid STITT: Firstly, I thank Dr Mansfield for her amendments and for the conversations that have been held between her and the minister’s office. We do not support this amendment. The proposed changes in the bill are ones where we can look at safety, effectiveness and implementation evidence from other Australian jurisdictions. The ACT will be allowing nurse practitioners to be assessing practitioners. However, as this role has not yet been implemented, we cannot really draw on any operational evidence, so we will not be supporting this amendment.

Georgie CROZIER: I also will not be supporting the Greens’ amendment on this point that Dr Mansfield has put through. I understand the intent, but I do agree with the minister. We do need to ensure that we have got those safeguards in place, and I am not convinced that this will provide that.

Evan MULHOLLAND: I thank Dr Mansfield for moving her amendment and for the contributions, but while nurse practitioners have many skills, they do not have the training or qualifications to do all of that. Two such qualified practitioners are required to be involved to attempt to provide a safeguard and check against errors and ignorance. Requiring one such practitioner to be involved removes that safeguard. The bill is already reducing standards by reducing the post-qualification experience of five years to one year, and this amendment would mean the risk of misdiagnosis, deficient prognosis, and inadequate advice about palliative care options and what palliative care could achieve would be increased even more by this amendment than they are already increased by the bill itself. These risks are bad enough as it is, and they should not be made any worse in my view. So I will be opposing this amendment.

David LIMBRICK: I thank Dr Mansfield for moving this amendment. I understand the motivation behind it. However, I accept the minister’s position on this and agree with the minister and therefore the Libertarian Party will not be supporting this amendment.

Michael GALEA: I will keep my remarks short. I appreciate Dr Mansfield’s intent in raising this matter, but I will not be supporting this either.

Ann-Marie HERMANS: I thank Dr Mansfield for putting forward these amendments. I will not be supporting them on the same grounds, that I do feel that we are taking away those checks and balances. I think we are putting undue pressure on our nursing staff, and I feel that we are removing too many checks and balances as it is with this amendment bill.

Council divided on amendments:

The DEPUTY PRESIDENT: We now move to identical amendments from Mr Galea and Mrs Broad. When there are identical amendments, people just need to stand and I will give someone the call. Mr Galea.

Michael GALEA: I move:

1.   Clause 4, page 4, lines 4 to 6, omit all words and expressions on these lines.

Deputy President, as you have indicated, both Mrs Broad and I are moving the same amendment here. However, I do note that they are consequential tests for different sets of amendments that we are differing on. From my perspective, whilst this particular amendment is relatively straightforward and functional – this is obviously the definitions clause of the bill – the effect of this particular amendment is to remove the definition of ‘health service provider’. And that is because, consequentially, in clause 6 I will be moving my amendments 4 and 5. They go to the conscientious objection of registered health practitioners. Specifically, that is clarifying that the provisions of this bill as they stand will apply not to health practitioners but to medical and nurse practitioners. I am moving my amendments here in the definitions phase, in the hope that they will be supported and I can move my amendments 4 and 5 shortly.

Gaelle BROAD: Just to speak briefly to my amendments, I am supportive of that move to define it a little bit more, because I guess my position has been to retain the existing act because the review found that it was working well. I think that we need to be asking ourselves today: do we want to expand everything? Because these are fairly significant changes that are being put to the chamber today. I know that there is a bit of a flow-on effect of these things, but I am supportive of that defining. I had it defined more to medical practitioners, defined to doctors and specialists, to take away the sort of bigger conversation as well.

Georgie CROZIER: Thank you, Mr Galea, for your discussions and providing the information you have to me regarding your amendments that you intend to move. I just ask in relation to your amendments around the health practitioners: the Australian Health Practitioner Regulation Agency (AHPRA) has a number that are listed on their site. They are Aboriginal and Torres Strait Islander health practice, Chinese medicine, chiropractic, dental practice, medical practice, doctors, medical radiation practice, nursing, midwifery, occupational therapy, optometry, osteopathy, paramedicine, pharmacy, physiotherapy, podiatry and psychology. You have only listed health practitioners, medical practitioners, registered nurses, registered psychologists or registered Aboriginal and Torres Strait Islander health practitioners? Why are they not all listed?

Michael GALEA: I believe you are referring to my amendments 2 and 3, which are slightly later in this clause, but I am happy to come to this this now. Yes, you have correctly read, as far as I am aware, from the same list that I have of AHPRA practitioners. It was my view coming into this debate that whilst I do support the lifting of the gag clause, particularly for those who it is most relevant to – and my initial view came to be that medical and nurse practitioners should be able to initiate conversations. I understand from the AHPRA list that there is a wide range within that list, and I know you have identified psychologists as well, in particular, in your second-reading speech. I share those sympathies. My intent of moving just the first two initially was based on equivalent legislation in other states and trying to make that as straightforward as possible. However, I am of the view that psychologists, registered nurses and Aboriginal and Torres Strait Islander health practitioners should be able to initiate these conversations. I appreciate the work that I have had with the minister’s office and with colleagues across the chamber in reformulating the amendments that led to the amendments that I put forward for the chamber on Tuesday. That is why I have settled on these five roles within that AHPRA list.

Sarah MANSFIELD: I thank Mr Galea for putting forward these amendments, and I understand the context of them. I do actually have a clarifying question. This relates to the provision of information by these health practitioners. By narrowing the scope of who is required to provide it, what are all of the other registered health practitioners that Ms Crozier referred to supposed to do if they have a conscientious objection? I am trying to understand what rules apply to them.

Michael GALEA: As this pertains to clause 6, the intent of this is that it would be the same as in the current act.

Ingrid STITT: I just want to indicate, as I did in my summing-up contribution on Tuesday, that we are supporting the amendments proposed by Mr Galea. I understand that Mr Galea has slightly altered them, as he has tabled this morning. We are supportive of the changed amendment.

Evan MULHOLLAND: I would like to put on record my thanks to Mr Galea for the way he has gone about negotiating diligently and courteously with all members across the chamber on this particular amendment. I would also like to recognise my colleague the member for Kew Jess Wilson and Daniela De Martino in the lower house, who I understand had a lot to do with this amendment in the lower house. There was obvious disagreement in the lower house, but when colleagues across the political aisle can come together and work through an amendment that has such serious consequences, I think that is a very, very good thing. Throughout this debate on all sides we have seen the best of the parliamentary process. I would like to put on record my thanks to those colleagues for getting an outcome on this amendment.

David LIMBRICK: I would like to indicate that I also will be supporting this amendment. I would like to thank Mr Galea for his engagement on the amendments that he is putting forward. I am glad to see that the government has agreed, or that the minister has agreed, to this amendment, and I will be supportive of it as well.

Sarah MANSFIELD: I too want to thank all the members who were involved in discussions around this. I understand that there are a number of concerns about this particular clause, and this is a pathway through. In that spirit we will be supporting it. But I want to register that I do have concerns about this amendment. I think effectively what it does is it retains the gag clause for the whole range of registered health practitioners that Ms Crozier outlined, apart from the ones that have been provided here. They will not have the obligation to provide information in the same way, from my understanding of the explanation. I suspect down the track we will be revisiting this provision. But I appreciate that this is the path forward, and it is an improvement on the existing act that we have.

Ann-Marie HERMANS: I would like to put on record that I want to thank Mr Galea and a number of others from different sides of the chamber who have been willing to have discussions and negotiate. Whilst I still share concerns for all people in situations where they may have to go against their conscience, I feel very strongly about not making a number of health practitioners for whom this is completely outside their scope of experience have to talk about voluntary assisted dying. To me this is at least a balance, and it allows some clarification of who can and who cannot have those discussions based on their medical experience and understanding. I want to thank Mr Galea for his collaborative approach in being able to work on these amendments.

Lizzie BLANDTHORN: I, in a somewhat untimely way, have very limited voice today, but I just want to indicate that I will, of course, given what I outlined in my second-reading speech, be supporting Mr Galea’s amendment and thank him, as others have, for the collegiate way in which he has engaged across the chamber in relation to his amendment. As I outlined in my speech, I do not support the extension to health practitioners more broadly. I think end-of-life care should be reserved for those who are specially trained in it, and the extension as it stands in the bill does not provide for that. But I do think that Mr Galea’s amendment is an improvement on the bill as it currently stands, and I will be supporting that amendment.

Amendment agreed to.

The DEPUTY PRESIDENT: That means that Mrs Broad’s identical amendment will not be moved, because they are identical, and that is how we will deal with other identical amendments during the course of the day.

Mrs Hermans, I invite you to move your amendment 1, which tests your amendments 12, 13, 17, 19, 22 and 23 on sheet AH01C.

Ann-Marie HERMANS: I move:

1.   Clause 4, page 4, lines 11 to 14, omit all words and expressions on these lines.

I am just trying to return to some of the original bill that had the checks and balances and provided the opportunity for people to be protected. I feel that many of the amendments that are in this bill are removing so many safeguards that they actually prevent people from having that opportunity to be protected, which is why I have put forward ‘to omit all words and expressions on these lines’. I have a substitute here, which is very similar. We are looking at clause 6 as well, lines 15 to 33 – is that accurate?

The DEPUTY PRESIDENT: We are dealing with clause 4 at the moment.

Ann-Marie HERMANS: Okay. All right. That is why I put it forward. We are just going to do clause 4. That is simply what this is about: me attempting to bring us back to the original bill, which provided those checks and balances that this does not provide.

Ingrid STITT: I do not support this amendment to narrow the range of health practitioners who can be administering practitioners to exclude registered nurses and nurse practitioners. Including registered nurses and nurse practitioners acknowledges that the skills required for administering the VAD substance fall within their normal scope of practice. The administering practitioner role will support patient choice of administration method and the choice of some coordinating and consulting medical practitioners not to deliver this as part of the service.

Additionally, this will enable the administration function to be transferred to another practitioner, including an experienced nurse practitioner or registered nurse, where the coordinating or consulting practitioner is unavailable. For those reasons I do not support Mrs Hermans’s amendment.

Georgie CROZIER: I also will not be supporting Mrs Hermans’s amendment. This legislation has been in place for a number of years now. Nurse practitioners have been assisting in this process. As I said in my second-reading speech, no-one has come to me in my role as Shadow Minister for Health with any complaints, so I will not be supporting this amendment.

Sarah MANSFIELD: We will not be supporting this amendment either. I think following on from our previous amendment, where we tried to expand the role of nurse practitioners, we are really supportive of nurse practitioners being involved in voluntary assisted dying, and the addition is really welcome – them being able to be administration practitioners. As we have said, people already face a lot of hurdles in trying to find health providers who have the capacity and are willing and able to participate in VAD. This is particularly the case in rural and regional Victoria, but right across the board. I think nurse practitioners are already very involved in providing a range of end-of-life care and in voluntary assisted dying. I think they are really well placed. There are excellent safeguards around their role in terms of administration. So we are very supportive of these changes.

Michael GALEA: I acknowledge Mrs Hermans for bringing these amendments to the chamber. In line with the comments of the minister and Dr Mansfield, I will not be supporting these amendments. I think nurse practitioners play a very important role, and I support the amendments in this bill as they stand.

Ann-Marie HERMANS: The way these amendments are coming forward – and we have not yet got to the point where we are looking at the conscientious objection, which is part of the difficulty and why I was not expecting to get to this quite so soon – I guess I have a question of the minister, because the way this is worded, not only are we putting doctors in this position where they have to engage against their conscience but what concerns me is that nurses may be put into a situation which goes against their conscience of having to participate in this. Yes, they already administer morphine. Yes, there are already ways that people end up, through medication, where eventually these drugs take their lives. But I think it is a very different thing when it is voluntary assisted dying because it is very purposeful, very intentional, very timely, in the sense that there is less of a time span from the time that the person receives the poison or the drug to the time that their life is taken, or at least we would hope to think that would be the case. But in the case of nurses being put into a situation where they too could have to leave a hospital or leave a workplace, there will be nowhere left for many nurses to be able to engage and work. If they are working in this field, I guess my concern is that they will be forced to do things against their conscience by us passing this particular section in the bill and that this has not been really considered because we have not yet thrashed it out when we get to those other amendments. The question I have for the minister is: what safeguards do we have for nursing practitioners? Should they not want to be intentionally and deliberately and wilfully taking the life of a patient, what safeguards are in place if this goes ahead?

Ingrid STITT: That would never happen under the existing legislation. With the bill before the house today, no-one would ever be forced to administer against their will. Practitioners must agree to be an administration practitioner. I hope that clarifies it.

Evan MULHOLLAND: I thank Mrs Hermans for putting through this amendment. I see this as an improvement to the bill so it is something I would support, but I understand this is something that the chamber does not support, so I will seek to voice my opposition but not divide.

The DEPUTY PRESIDENT: Just before we vote on this amendment I might explain a couple of things about this committee stage. Where people have identical amendments – and we did deal with Mrs Broad’s and Mr Galea’s before, but there are some more to come – it will just be the first person who stands, because there is no seniority for parties when we have a free vote on a bill. So if you have got an identical amendment you need to just stand, and I will give the call to whoever catches my eye first.

The other thing is if you are moving amendments, can you be in the chamber and be very aware of where we are on the running sheet. It is going to be a long day. It is moving a little bit quicker than we thought, so people need to be aware of when they are going to be called on to move their amendments. Just be ready to go, please.

The question is: that Mrs Hermans’s amendment 1, which tests her amendments 12, 13, 17, 19, 22 and 23 on her sheet AHO1C, be agreed to.

Council divided on amendment:

The DEPUTY PRESIDENT: Mr Galea, I advise you to move your amendments 2 and 3, which tests your amendments 6 to 12 on sheet MGA01C.

Michael GALEA: I move:

2.   Clause 4, page 4, after line 19 insert –

“registered Aboriginal and Torres Strait Islander health practitionermeans a person registered under the Health Practitioner Regulation National Law to practise in the Aboriginal and Torres Strait Islander health practice profession (other than as a student);”.

3.   Clause 4, page 4, after line 27 insert –

“registered psychologist means a person who is registered under the Health Practitioner Regulation National Law to practice in the psychology profession (other than as a student);”.

This has been touched on briefly already, but I will for the benefit of the chamber outline what these amendments will seek to do. In lifting the gag clause for a number of health practitioners, which is something that I do support, I am mindful of where we draw the line between what health practitioners may and may not initiate voluntary assisted dying. I note that this has been a topic of conversation from a number of members in the chamber that have also raised this in their contributions. Because I am looking at Dr Heath, I know that she acknowledged that she is not comfortable with chiropractors, noting that she is one. I have attempted to strike the right balance here between which health practitioners may actually initiate those conversations. As indicated in my earlier answer to Ms Crozier, the five health practitioner groups that I would seek to be included as being able to initiate VAD discussions are medical practitioners, nurse practitioners, registered nurses, psychologists and Aboriginal and Torres Strait Islander health practitioners.

I do just want to note that I will raise this when it comes up in the appropriate clause, but there are a few clauses which refer to four definitions of medical practitioners, registered nurses, Aboriginal or Torres Strait Islander health practitioners and psychologists. In those clauses the advice I have received – very clearly, as is logically the case – is that ‘registered nurses’ also incorporates nurse practitioners in those definitions. In specific relation to the inclusion of Aboriginal and Torres Strait Islander health practitioners, I know this has been the source of some discussion, and I am happy to provide some added context. The registered Aboriginal and Torres Strait Islander health practitioners are registered under the Health Practitioner National Regulation Law in the same way that medical practitioners, nurse practitioners and all other health practitioners who are registered are. The Aboriginal and Torres Strait Islander Health Practice Board of Australia provides regulatory standards, codes, guidelines and other resources for Aboriginal and Torres Strait Islander health practitioners. These practitioners are trained and experienced health professionals providing culturally safe care to Victoria’s Aboriginal community.

I do note that as part of the five-year review there was a specifically independent evaluation conducted by a First Nations consultant, which highlighted that more culturally respectful and inclusive approaches to end-of-life care generally and VAD specifically were needed, and I draw members attention to the ‘Long-term Actions (3 to 5 years)’ component and specifically recommendation 1 of that review. That review also advocated for an Aboriginal-led VAD process to ensure appropriate practices and to build trust. Permitting Aboriginal and Torres Strait Islander health practitioners to raise VAD contributes to supporting self-determination and autonomy in end-of-life decisions. Victoria has 49 practising Aboriginal and Torres Strait Islander health practitioners, and this bill will require them, if raising VAD as part of an end-of-life discussion, to tell their patient that a medical practitioner is the most appropriate person to talk to about VAD, palliative care and treatment. I understand from the minister’s office that the Victorian Aboriginal Community Controlled Health Organisation, during consultation, were supportive of providing these health practitioners with these rights to initiate conversations as well.

Ann-Marie HERMANS: I thank Mr Galea for the spirit in which he has put this together. However, whether Aboriginal or not Aboriginal, we are all human beings. At the end of the day, I do not believe in dividing people up and having one standard for Aboriginal people and a different standard for everybody else. I think that if we are saying that doctors and nurse practitioners are the ones who are going to be doing VAD, that they are going to be the specialists that are going to be working with patients, I think that Aboriginal people deserve the same care as every other Australian and Victorian. I 100 per cent support interpretation for Aboriginal people. I 100 per cent support people being able to be there, but I do not support having different standards for Aboriginal people, and I feel very strongly about that. Whilst I am sure the intention is to try to be inclusive, to me this is exclusive, and it actually divides our state and our nation by saying, ‘We are going to divide you up by race and give different standards and different health care to Aboriginal people,’ which is exactly what this amendment does. So I will not be supporting it.

Evan MULHOLLAND: I would like to thank Mr Galea again for his amendment and the way in which he has gone about communicating it to the chamber. I would like to say that I will be supporting the amendment very strongly.

Georgie CROZIER: I also will be supporting Mr Galea’s amendment. Thank you for providing the information and for the discussions that we have had. I had some concerns in relation to some of these aspects that we have discussed in the chamber and outside the chamber, and I thank you for bringing and putting this amendment forward.

David LIMBRICK: I also would like to thank Mr Galea again for his engagement on this amendment. I note that it has changed significantly since he had discussions with the health minister, I believe. The scope that has been landed on is narrower than the scope of the original bill, and I think that it is an appropriate safeguard. Therefore I will be supporting this amendment.

Sarah MANSFIELD: I too would like to thank Mr Galea for his engagement on this issue. I think my comments in relation to the previous amendment are probably more applicable to this amendment, but the sentiment is the same in that I understand the importance of this amendment in gaining broader support in order to ensure that this bill and these particular provisions in some form have a pathway to passage through the chamber. In that sense we will be supporting the amendment.

But I do have concerns about what this in effect does for a range of registered health practitioners. They are registered with AHPRA. There are a whole range of professional codes of conduct that apply to those health professionals. The conversations were only ever intended to be initiated around VAD in the context of end-of-life discussions. In the bill proposed by the government I think there are sufficient parameters to ensure that those discussions are appropriate. I can see instances where registered health practitioners who do not fit into this prescribed list may be in a position where it would be appropriate to initiate a discussion around voluntary assisted dying, but they will be unable to. The irony is that any layperson down the street could initiate a discussion around voluntary assisted dying – you know, you go down to your newsagency or the baker could start the conversation with you or your neighbour could start a conversation with you. But there are a group of registered health practitioners who, under this amendment, will not be able to initiate that conversation with you. In effect it is retaining the gag clause for a certain group of registered health practitioners.

I am also concerned about the confusion this could create. I think it was simpler in the government’s proposal. But I accept that this is an improvement on the existing act. It is very welcome. This has been a huge barrier for people. I think the gag clause has caused significant problems for people and confusion within the medical profession, because I think there is uncertainty about what even constitutes a patient raising the subject and how specific they have to be in order for a health practitioner to then be able to engage in that discussion. This is an improvement, so we will be supporting it.

I think Mr Galea made a very good point about registered Aboriginal and Torres Strait Islander health practitioners. They play an extraordinarily important role. Particularly if you are talking about a conversation like VAD, that trust and the relationships that those health practitioners can develop with First Nations people are critical. These are very difficult discussions for people, very difficult subjects, so I think they are very well placed to have those discussions. I thank him for including that category of health practitioner.

In essence we will support this. I do not particularly like it. I think we will find we will be revisiting some of this again in five years. It will be really important that we monitor how this plays out in practice through the various reviews that will take place. We will see where we are at in five years time.

Lizzie BLANDTHORN: Further to my earlier comments, I wish to indicate that I support this amendment because it does further narrow this extension to health practitioners. In response to some of Dr Mansfield’s points just now, I want to particularly draw out, as I did in my second-reading speech, that despite the fact that any person in the street could raise the opportunity to access the voluntary assisted dying scheme with somebody, those who are on an approved list would hold a particular standing with their patient, with their customer or with their client. When those provisions are then extended to professions that are not trained in end-of-life care, to professions such as podiatry, chiropractor, indeed Chinese medicine and dentists – there are a range of professions on the AHPRA list that the bill, in its initial form, proposed to extend the provisions to who are not trained in end-of-life care but who do have a particular standing with their patient, with their customer or with their client. That builds a level of trust that would put more weight on that information than perhaps if it was raised with them by the ordinary person in the street.

I do think this is an important area in which we need to maintain safeguard provisions. I think Mr Galea’s amendment is a good amendment that improves the bill.

Melina BATH: Just briefly, I will be supporting these amendments as well in ensuring that it is not only the medical practitioners and the nurse practitioners in discussions but also that limitation on psychologists and including Aboriginal health practitioners. I think there is very much an important element about people feeling comfortable, and that is certainly one element that would benefit from that in that sector, so I appreciate these amendments.

Ingrid STITT: As indicated earlier, I will be supporting Mr Galea’s amendment. Just on the issue of registered Aboriginal and Torres Strait Islander health practitioners, this is about the health workers who will be supporting Aboriginal people at the end of life, often in the community, and I welcome their inclusion.

Michael GALEA: I want to briefly acknowledge and thank all members for their contributions on this. I just want to pick up on a couple of minor points. Firstly, Minister Blandthorn addressed the point I was going to raise in relation to Dr Mansfield’s issue with regard to health practitioners beyond the scope of my amendment. I am of the view that these are people in many cases who members of the public may have that different level of respect for as a figure of authority in the community, and that is why I think that this balance is appropriate.

I do also wish to acknowledge Dr Mansfield’s contribution in relation to Aboriginal and Torres Strait Islander health practitioners. I am certainly not an expert in this space, but it is fair to say that from what I understand there are significant cultural barriers and significant trust barriers there, particularly with the Indigenous community. In speaking with the Dandenong and Districts Aborigines Co-operative Limited in my electorate, I have heard similar things from them about that, and that is why I believe that there is a need for that.

I do just wish to clarify that though I did focus a large part of the discussion on that particular part in my opening remarks before, the effect of this amendment, just for clarity, or the amendments that this amendment will test, is that medical practitioners, nurse practitioners, registered nurses, psychologists and Aboriginal and Torres Strait Islander health practitioners will be able to initiate VAD conversations, but other health practitioners will not be able to as was originally proposed in this bill.

The DEPUTY PRESIDENT: The question is that Mr Galea’s amendments 2 and 3, which test his amendments 6 to 12 on his sheet 01C, be agreed to.

Ann-Marie Hermans: On a point of order, Deputy President, in terms of the way this is going to impact clause 6 and onwards – and I guess this is to the minister, if I could just ask a point of clarification – will this only increase that definition to make that exception for the Aboriginal people, or is that ruling out –

The DEPUTY PRESIDENT: Sorry. This is not a point of order. You are asking a question about the clause. The point of clarification is that this is just dealing with his amendments 2 and 3, which insert two new definitions into the definitions and do not make any change to the bill other than to insert a definition of what a registered Aboriginal and Torres Strait Islander health practitioner means and what a registered psychologist means. The bits that would actually make a change to the legislation will come later.

Council divided on amendments:

Clause 6 (11:12)

Michael GALEA: I move:

4.   Clause 6, line 19, omit “registered health practitioner” and insert “registered medical practitioner or nurse practitioner”.

5.   Clause 6, lines 27 and 28, omit “registered health practitioner or a health service provider” and insert “registered medical practitioner or nurse practitioner”.

This was canvassed in earlier debate today, but amendments 4 and 5 will vary clause 6 in relation to conscientious objectors by providing that definition as outlined.

Jeff BOURMAN: I will be supporting this. I will also be opposing the clause because the one thing that is really strange about a bill that is entirely about the choice of the person is removing someone else’s choice.

Ingrid STITT: I would like to indicate that I will be supporting the amendment.

Enver ERDOGAN: I think I will be supporting this amendment. Obviously I have my own amendments that I feel are a lot stronger, because I think the point that Mr Bourman made, and it is really my principal concern with this bill, is about what I would describe as a move away from compassion to compulsion, particularly in terms of people’s choices, especially because we do have a world-class health system that does rely on people from different traditions, different backgrounds, from all over the world that are so crucial to providing that service.

In many of our legislative instruments put before this Parliament, in fact even in this session of Parliament, we have moved to make sure people are protected, such as with our anti-vilification legislation which has the focus of protecting people from being discriminated against based on their beliefs. But that is not a belief that should be a protection afforded just to people of faith. It is one for everyone, for even people that are Ephesus, a secular Ephesus and, in the context of global conflict, people that have a conscience not to bear arms. That is an important human right that is recognised in many United Nations charters. I feel like moving away from those broader principles in this legislation is very unfair to those health practitioners that have those concerns, to have to choose between their conscience and their profession. That is why I have circulated two amendments that I believe are a lot firmer and a lot stronger in protecting people in those situations. I will support Mr Galea’s amendments, but I still intend to move my amendments.

David LIMBRICK: I also will be supporting Mr Galea’s amendments here. However, I concur with Mr Erdogan that this is also my biggest problem with this bill. Therefore I will also be supporting Mr Erdogan’s amendments, which I agree place a far stronger emphasis on this. However, I will support Mr Galea’s amendments regardless.

Georgie CROZIER: I too will be supporting Mr Galea’s amendments.

Sarah MANSFIELD: Just building on comments I made earlier about this, I will be supporting this. I know that this was a way of finding some broad agreement and giving some comfort to people who had a lot of concerns about this clause. I appreciate the concerns about this clause and the tensions that exist within it. In my second-reading contribution I acknowledged that people do have a right to hold conscientious objections and not participate in the provision of health care that goes against their conscience. I think that protection has been retained in this bill in that health practitioners who do not want to administer VAD and do not want to actually be part of the active process do not have to be. There is also a very real situation for patients who are trying to find information out about VAD. They are incredibly vulnerable. It takes a lot of courage a lot of the time to bring up a conversation like this. There is a huge power imbalance and information asymmetry. The health provider holds all the information. For people to raise that subject and then be told no and for them to have to then go and find someone else that they can talk to about it but not know where to start is a very real experience. I think that was something that a number of members in this chamber shared was their experience. You are not talking about people who maybe lack some health literacy or ability to navigate a difficult system. I have talked to countless families where that has been the case, where they have just been told no and that is the end of the story. It is very difficult if, say, your local GP is not willing to provide you any information and your specialist will not. Where do you go to get a referral to a new specialist? How do you know where they stand?

This is a very basic information requirement to provide some basic information. ‘Here’s a phone number you can call to find out a little bit more’ I think is completely reasonable. I understand there still exists a tension for people who hold very strong conscientious objection to this – I certainly appreciate that. But I think we have to recognise it is legal to access voluntary assisted dying, and health practitioners, I think, at a bare minimum have an obligation to provide some basic information to people about things that they are asking for. It does not mean they are participating any further in the voluntary assisted dying process. They do not have to speak any further about it. Providing an information sheet is literally all that that would be doing.

Touching on Mr Galea’s amendments, similar to being able to initiate a discussion, I just think limiting the range of health practitioners who this applies to has the potential to create some confusion. I think it is unlikely that people are going to raise this with certain types of health practitioners. I think that it is just a very unlikely thing that that situation would come up. But there are types of health practitioners who fall outside this prescribed list who you could conceivably see someone has developed a trusting relationship with and that they do initiate that discussion. For example, I think Ms Crozier talked about a situation in her second-reading contribution about a physio who was working closely with someone. They have developed a really trusted relationship. Someone asks them, ‘I want to know a bit more about VAD.’ They have no obligation to provide any further information. For that person that might be the last time they feel that they are confident to raise the subject again. They might just feel so shut down by that.

We have got to recognise the power structures that exist in health care. It is very confusing for people. I think one of the things that really stands out for me is so many people felt like they were doing the wrong thing. They were made to feel like they were doing the wrong thing when they brought up the subject of VAD because of the way that they were responded to. They felt like they were trying to do something illegal, which is absolutely not the case. This is legal – it is 100 per cent legal. It has been that way in Victoria for a long time.

Anything we can do to just make sure that they can access that information that they should be entitled to from the people who they are naturally going to be seeking that information from and who are well placed to give them reliable information I think is a very basic requirement, and I am very comfortable with the amendment that the government has put forward. I think restricting the number of health practitioners to which that applies is unnecessary. I do not think it adds any meaningful safeguards. I think it has the potential to add confusion and create some further barriers for people. But as I said, if it means that this provision remains within the bill, I am willing to support Mr Galea’s amendment if that gives some comfort to other members of this place.

Evan MULHOLLAND: I want to thank Mr Galea for this amendment. I think it is quite important, and it represents an improvement to the bill. Again, I put on the record the work of our colleagues in the lower house as well. Yes, this bill is about choice, but we are also, in a sense, removing choice by medical practitioners. As Dr Stephen Parnis said last week in a lecture, doctors are not a vending machine. We are removing their conscientious objections. While I am supporting this amendment, I want to say I will be supporting Mr Erdogan’s amendment.

I want to just quickly use this opportunity to go through and say that you probably would not hear this from me normally in the course of upper house events, but I really want to credit the work of the member for Broadmeadows, the member for Greenvale and the member for Preston, because if you go to those communities in the north – and particularly to those Labor colleagues and others who I overheard in the parliamentary bar that were threatening the careers of their colleagues because of the way they acted –

Harriet Shing: A point of order, Deputy President. Mr Mulholland, that is a very serious accusation that you have just levelled. I would suggest that if you wish to make that accusation you move it by way of substantive motion.

Ingrid Stitt: Deputy President, just further to the point of order, I think that the debate so far has been conducted in a respectful manner. We have got a lot of work ahead of us to conclude the committee stage, and I would ask Mr Mulholland to think about the way that he conducts himself and not detract from what has been a good debate and a respectful conversation so far.

The DEPUTY PRESIDENT: The comments made were not technically unparliamentary, but they were bordering on it. Mr Mulholland, I ask you to keep your comments to the contents of the bill.

Evan MULHOLLAND: If I could get to my substantive point, I invite people that might have a different view on conscientious objection – and I am happy to take them – to come out to medical centres and GP clinics in Roxburgh Park, in Broadmeadows or in Mickleham, like Aitken Grove, which I officially opened a few weekends ago. You will not find a single medical practitioner who does not have a conscientious objection, because that is just the make-up of those communities in the north, where 80 per cent of those electorates profess a faith, which is double the statewide average of any other electorate. What you are doing to my community is making it very difficult by removing not just the choice of a few but the choice of all.

I again reiterate that particularly for communities like those in the outer northern suburbs this is a very, very difficult issue. But I would also say, at least based on the suburbs in the petition that I tabled, there is very strong opposition to removing conscientious objection in the outer northern suburbs. By doing what other colleagues did in the lower house in representing those communities I want to say that they were representing their electorates. They were not representing a deep ideological view. They were doing what their community would expect them to do and what my community expects me to do as well.

Lizzie BLANDTHORN: My fundamental proposition in relation to this bill is not that it is a question of whether or not someone does or does not support the system of voluntary assisted dying. At the end of the day what we are being asked to consider here is the diminution of safeguards, and I am fundamentally opposed to any restriction on conscientious objection. I think that it is a fundamental human right. Indeed the Victorian charter of human rights provides that every person has the right to freedom of thought, conscience, religion and belief, including the freedom to demonstrate his or her religion or belief in observance, practice and teaching, either individually or as part of a community, in public or in private.

This bill does restrict that right. This bill does compel practitioners to provide information via an information sheet, a website or otherwise. It compels practitioners to provide information about how to access the scheme against their own free will. I 100 per cent agree with Mr Bourman, who makes the point that if this bill is, as many in this place argue, about providing individual freedom and individual choice, in the very same bill we are denying that individual freedom and that individual choice to the practitioners themselves. In restricting conscientious objection the bill would compel practitioners who conscientiously object to act contrary to the right of their own freedom of thought, their own conscience and their own beliefs, which, as I said, are outlined in the Victorian charter and which are consistent with core principles of a democracy.

On that basis I do not support the clause, but I will support Mr Galea’s amendment and I will support Mr Erdogan’s amendment that seeks to improve that situation.

Ann-Marie HERMANS: I applaud Minister Blandthorn for what she has just shared and share her sentiments exactly. I would have read out the charter of human rights as well. I feel very strongly that we are moving in such an extreme way with this amendment bill to take away the freedom of doctors and of practitioners in the medical field to have that conscientious objection, and it concerns me deeply. This is the particular clause that is most distressing for most of us – to see medical professional people being put into a situation where they will have to discuss, potentially at length because of the lack of restrictions within the amendments, the information.

It has not yet been consigned and restricted. We have not yet got to what the secretary will be making a doctor provide. For instance, a referral is one thing. I take the point that has been raised by Dr Mansfield, but the issue is right now if somebody asks for voluntary assisted dying and their doctor does not feel comfortable to speak about it, there are others that will be. It simply has to be initiated by the patient in the bill. The bill allows the patient to initiate the conversation, not the doctor, but this amendment mandates the doctor to have to initiate that conversation, to provide someone to be able to do that and provide information. One of my amendments, depending on how things go, is very clear. Depending on how we end up defining what the secretary forces the doctor to provide, my amendment is simply to provide an and/or, which if everything else fails will at least provide some level of choice for a doctor.

The way this is prescribed, it takes away all choice from a medical professional. We do not, for instance, ask a doctor to have to go into the depths and lengths and breadths of describing or explaining what an abortion looks like and how that will take place. But in voluntary assisted dying, we have not yet defined what it is that the secretary will be preparing and giving to the doctor. That is just open slather at the moment. It is not defined and we are clearly putting medical professional people in a situation where they will have to go against their conscience, not simply to talk about or provide the referral, but also to have to provide the information. That clearly takes away from that conscientious objection. I feel very strongly that we need to protect the rights of individuals, not just the rights of patients, but also of the medical profession, to have their own conscience and to be able to work in that space where they can maintain their own personal integrity according to their own beliefs.

I will be supporting Mr Galea’s amendments. I will also be supporting Mr Erdogan’s amendments in the interest of trying to improve the – I hope I said your name correctly, sorry, Mr Erdogan’s amendments – in the interest of trying to improve this amendment bill, but I do feel very strongly that we are taking away from Victorian doctors the opportunity to have their conscience. I think we will lose doctors if we mandate that they have to speak about things that go against what they actually believe in and why they got into the profession in the first place.

The last thing I want to say is that we have to remember that doctors take the Hippocratic oath. It is about health and healing, and many doctors take that very seriously, and the way they have interpreted that is not about actually bringing end of life to people intentionally. That is why it goes against their conscience, and to even have to entertain the thought of providing that is very difficult for many doctors.

Ingrid STITT: I just want to add a couple of comments, given some of the contributions. I think that, with respect Mrs Hermans, you have not understood some aspects of the bill, so I just want to make my position clear on this matter. The freedom to hold a belief, such as a conscientious objection to VAD, is absolute. However, the freedom to act on that belief may be subject to reasonable limitations. In other words, the requirement that is imposed on practitioners who conscientiously object to provide minimum information is a reasonable limitation on their freedom to manifest their objection to VAD. Patients also have a right to freedom of thought, conscience, religion and belief, as well as the right to personal autonomy, dignity and protection from inhumane treatment. In relation to your reference to other laws where conscience is exercised, I do want to point out that the Voluntary Assisted Dying Amendment Bill does not go as far as some other legislation in the state.

Melina BATH: Just consistent with my second-reading speech, I am quite comfortable with these amendments.

The DEPUTY PRESIDENT: Are there any further comments or questions? No. If not, the question is that Mr Galea’s amendment 4 and 5, which have been tested by his amendment 1 on his sheet, MGA01C and GB01C, be agreed to.

Amendments agreed to.

The DEPUTY PRESIDENT: Mrs Broad, I invite you to move your amendment 2 on your sheet, GB01C.

Gaelle BROAD: I move:

2.   Clause 6, lines 15 to 33, omit all words and expressions on these lines and insert –

‘At the end of section 7 of the Principal Act insert –

“(2) A registered health practitioner who has a conscientious objection to voluntary assisted dying has the right to communicate that conscientious objection in the course of practising the registered health practitioner’s profession.

Example

A registered health practitioner may communicate their conscientious objection by displaying a notice at the practitioner’s health practice or by publishing the conscientious objection on the health practice’s Internet site.”.’.

This speaks to the conscientious objection. I support any move to give doctors the ability to have that conscience, because we are getting a conscience vote today. I think it is not basic information, as Dr Mansfield talked about earlier; this is significant information. I think our GPs and doctors and specialists have a variety of views on a variety of issues – you know, some agree with HRT, some do not. It is to require all to provide information. I would rather see that minimum information go back to the initial act. I would like to see it excluded. I have got the further amendments specifying the information required, if need be. I think that the ability of the conscience to be able to communicate views to patients is really important. That speaks to my amendments that I am putting forward.

Ann-Marie HERMANS: I will be supporting Mrs Broad’s amendments. I agree with her entirely, and I feel that we need to do whatever we can to protect the ability for everybody to be able to act according to their conscience.

Michael GALEA: I would like to take the opportunity to thank and acknowledge Mrs Broad for the way in which she has engaged on these and other amendments. I understand that if this amendment is successful, it will prohibit Mr Batchelor from moving an amendment very shortly. On that basis, I will not be supporting this amendment.

Ingrid STITT: Just for the record, I will not be supporting Mrs Broad’s amendment.

Georgie CROZIER: I understand Mrs Broad’s intent and concerns, but I will not be supporting her amendments on this occasion.

Enver ERDOGAN: I am just going to thank Mrs Broad for bringing this amendment. It is very consistent with mine, so I will be supporting it. But obviously if it is not successful, I still intend on moving mine. I particularly want to focus on my second amendment after this one. I will be supporting this amendment.

David LIMBRICK: I thank Mrs Broad for bringing this amendment. I am actually sympathetic to the intent behind it. However, I have decided to support the alternative mechanism proposed by Mr Erdogan, so I will not be supporting this amendment but rather supporting Mr Erdogan’s amendment.

Melina BATH: This is democracy at its best, when we can all delve into our innermost thoughts and concepts around this and drill down, and I appreciate Mrs Broad’s amendment very much. At this point I prefer to support a further amendment on this topic.

Sarah MANSFIELD: Again, I appreciate the reasons that this amendment has been brought forward, but I do not support this amendment, largely based on many of the comments I have already made around conscientious objection. I think there is a further risk if you are displaying that information at the outset. People should be able to come to their health practitioners to discuss the range of issues that they wish to, and to be saying that there are certain things you are not allowed to come and talk to a health practitioner about, or to indicate that or to communicate that, I think puts patients in a very difficult position. I think they should have the right to be able to ask a health practitioner about the things that they want to, and as I said, receive some very basic information.

Just to provide some further context, I know that there will be further amendments that will be moved to provide greater clarity on the information the secretary is to provide, but the explanatory memorandum and the minister’s second-reading speech do actually provide significant context about what that information is. It is very basic information about the care navigator service. It could be as simple as a pamphlet, a phone number or a website. We are not talking about having to have in-depth discussions with people about the ins and outs of voluntary assisted dying. I think this provision protects against that. It means that there is just some very basic information. It is not a referral – I would actually support I think a referral, because it is very hard to find practitioners. But this basic requirement I think is a minimal one. People should have the right to ask about it. They should have the right to receive just some basic information so that they can go on their way and find a provider who is then able to assist them further.

I think it is well within the obligations of healthcare professionals and the code of ethics and standards that we sign up to that they should be required to provide basic information for people about things. We have that, as Minister Stitt indicated, in other areas of law. I just think it is completely reasonable when you take into account where patients are going to get their information from and that relationship that they have and the expectation that they have of healthcare practitioners.

Evan MULHOLLAND: I support Mrs Broad on this, and as I have mentioned before – I have gone into it – I will also be supporting Mr Erdogan’s amendment. The conflict I have here is that this would knock my amendment out, which is now Mr Batchelor’s amendment, and I am very, very keen to support that one, but I understand that on a division it might not succeed. So I just want to express my support for Mrs Broad’s amendment and thank Mrs Broad for the way in which she has conducted herself.

Amendment negatived.

The DEPUTY PRESIDENT: We will move to Mr Mulholland’s amendment number 1 on his sheet EM39C.

Evan MULHOLLAND: I had circulated this amendment, and I want to thank all the colleagues that I have spoken to from all sides of the chamber about this particular amendment. I want to flag that I will be withdrawing this amendment but also speaking to it. This is quite important. Almost every stakeholder I spoke to and every doctor and healthcare professional that I spoke to flagged this as an issue, and it is an important one, because the way the bill was drafted it limited information as approved by the secretary. ‘Information’ could mean absolutely anything. What ‘information’ is, we now understand from the explanatory memorandum, is a website and a VAD navigator service. But there was nothing in this bill stopping the Department of Health secretary from coming back in 12 months without coming back to the Parliament and forcing that information to be a physical copy of a very glossy, positive brochure about voluntary assisted dying and nothing about palliative care, for example, and not giving people a full picture. This is something that was raised with me particularly by people that would normally conscientiously object in my electorate that were really concerned about what this might mean into the future.

I want to thank members opposite. I want to thank members on my side of the chamber. I want to thank Ms Crozier in particular, who might speak to this as well, because it is something that a lot of stakeholders did raise and did bring up. I want to thank Mr Batchelor. I want to thank also Minister Stitt for recognising that she is endorsing Mr Batchelor’s amendment. I want to thank the health minister, who I have had a handshake with about this amendment in agreement that I will withdraw my amendment to endorse Mr Batchelor’s amendment, which he will move after this.

Harriet Shing: Yes. There have been lots of handshakes and trust.

Evan MULHOLLAND: Yes. And again, if I can repeat what I said before, that is the best of this Parliament – when we can come together and work out a middle ground. This is something where it is in the explanatory memorandum and let us just put in the bill, and that is what has been agreed to. I want to thank everyone involved with this and withdraw my amendment.

The DEPUTY PRESIDENT: I will now move to Mr Batchelor’s amendment number 1 on his sheet RB01C.

Ryan BATCHELOR: I move:

1.   Clause 6, lines 32 and 33, omit all words and expressions on these lines and insert –

‘(b) give the person the following information –

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

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

The amendment is pretty straightforward. It seeks to put into the bill those matters identified in the explanatory memorandum that were intended for the secretary to approve for the provision of information to those who seek information about voluntary assisted dying. It was clear during the course of the second-reading debate that members are seeking greater clarity about the scope of this provision. Personally, as someone who wants this clause to pass, I was very pleased to be able to find an amendment, working with the minister and others, that would allay the concerns that some people have. That is what this amendment is designed to do – to allay those concerns and be very, very clear about the minimum amount of information that will be provided to people who seek to access voluntary assisted dying by the health practitioner, the registered medical practitioner or the doctor that they are talking to about the fact that they are dying.

I just want to reflect a little bit on some of the debate that has just occurred about this clause. My second-reading debate speech I think pretty comprehensively and carefully stepped through why this matters to me so much. Two years and six months ago I sat in a room with a dying woman who asked a doctor for information about voluntary assisted dying and was given nothing. If this amendment to this bill prevents that occurring for others in the future, I think it is really important.

I want to address this issue about choice. When you are bundled into an ambulance and taken to an emergency department because you are sick, you get taken through emergency and you get released from emergency into the care of a specialist. For many patients that is how they encounter discussions about the fact that they are going to die. There is no choice for a lot of people about who they see and who the medical specialist is, the practitioner, that passes that information onto them – no choice at all – because that is the way our health system often works.

People who choose to do medicine take a lot of time and a lot of care in learning how to best treat their patients. All we are trying to do with this piece of legislation is ensure that for procedures that are lawful in the state of Victoria we allow those patients to be at least informed about where they can get more information about lawful medical procedures and lawful courses of action that they can choose to take. If this amendment, for people who have been given the most confronting information they are likely to receive, makes that process a little easier and a little better and does not leave them bewildered, confused or uncertain, I think it is really the least we can do. I commend the amendment and the clause.

Georgie CROZIER: I will be supporting Mr Batchelor’s amendments, and I thank him for bringing them to the house. I also want to thank Mr Mulholland for the discussion on the issues that I have been raising both with Mr Mulholland and also the government.

The government are very aware of my concerns around this issue. I made that clear in my second-reading speech. I made it clear through the very productive discussions that I have had with the minister’s office and the minister around this issue. I do want to thank all involved for getting to this point so that it is clear. I think it does allay some of that anxiety in relation to potentially what this would have meant. It has made it very clear now. I do want to thank Mr Batchelor again for making this amendment that provides that assurity and again, to Mr Mulholland for his ability to see the benefit of this too, and how he has worked constructively on this.

Lizzie BLANDTHORN: I too want to thank Mr Mulholland for his efforts in relation to this clause in particular. I do want to thank the government through Mr Batchelor who has provided an amendment. I do this with the greatest of respect, but I do want to put a counterargument to that which Mr Batchelor just put.

I think across this debate, both in 2017 and now again in 2025, many people have taken the opportunity to share individual experiences about their own family, their own friends, their loved ones, people they know who have either faced or are facing end-of-life decisions, discussions and choices. I did not do this in my second-reading contribution in 2025, but in the 2017 debate I spoke about my grandfather. My grandfather when he was in his early 30s was a father of then five children, a sixth on the way. He was a very active man. He played football for Williamstown, he was a rower with Xavier. He was someone who loved to be out and about, but he dived into the Middle Park baths and broke his neck and became a quadriplegic for the rest of his life. It was an accident at the time that people told him he would not live with, that he would not recover from. My grandmother, who was a nurse at St Vincent’s, gave up her work as a paid nurse at the time, because her view was that she had the skills and the wherewithal to be able to care for my grandfather at home. My grandfather’s movement was extremely limited. He could not move from basically the neck down. He could do nothing other than take a phone call. He could not move his hands, he could not move his arms, his legs – nothing. At one stage, my grandfather was told that he should not proceed with bladder surgery because he was going to die anyway. My grandfather said that he wanted to have the bladder surgery, because if it gave him one more day with his wife, with his children, then he wanted that opportunity. My grandfather lived for 14 years as a quadriplegic. He saw all but the last of his children – who died in a tragic accident in a pram – grow to become young adults. Despite not being able to move from the neck down, he had a particularly productive life raising funds for Mother Teresa. Indeed when Pope Paul came to Australia, he was wheeled in to see him at the racecourse.

My point being, end-of-life care goes both ways, and end-of-life care should be provided for in a way that recognises, without abandonment, the inherent worth and dignity of every life from its beginning until its end-of-life position. I think that in providing information or compelling people to provide information, we need to do that in a very careful way. I thank Mr Mulholland and I thank Mr Batchelor, because I think despite the fact that these arguments can be put from a very respectful place and indeed in many senses from the same philosophical place, but leading to an absolutely different conclusion, that what we have is a meeting of a sensible approach to how this amendment should go forward that recognises not either side of the debate, but both sides of the debate, and I thank both Mr Mulholland and Mr Batchelor for that.

Ann-Marie HERMANS: I will be supporting Mr Batchelor’s amendments. They are in actual fact very similar to Mrs Broad’s amendments in terms of providing and specifying contact details as part of the referral process and address what we are looking at. I will be voting against the clause anyway because I prefer the original bill, but I will be voting for this amendment because I feel that it does strengthen and clarify what will be expected of those in the medical profession. It takes away that ambiguity and some of the pressure, which I feel is a good thing. As I said, it is very similar to the work that Mrs Broad has done, but perhaps it has gone a little bit further in clarification. I thank all those involved for the congenial way in which this has come about so that we can have greater clarity and protection of people in the workplace, particularly those who take that Hippocratic oath and feel strongly that they are there to value life and protect life, not take it away.

Evan MULHOLLAND: Again I want to put on record my thanks to all those in the chamber who have worked through a pragmatic solution to this issue. To basically run you through a practical example: many of our Catholic hospitals and aged care facilities – all of which we would know and have had some sort of interaction with across our time – already do what Mr Batchelor’s amendment now specifies, which is to provide details for the VAD navigator service. It really sets the objection at an institutional level rather than an individual level, which is where I was trying to get to. I know that the Catholic services, after 2017, had extensive discussions with the department of health and formed part of their 2018 and 2019 care guidance agreements to do this particular process. I think there are sometimes a lot of boogiemen created in terms of some of the services that we have here in Victoria and some of the healthcare services that we have in Victoria. But in reality we see services working cooperatively with government, and this amendment really sets in stone what is already the case. I am very pleased that we have been able to see this amendment become a reality, and I want to thank particularly all the stakeholders that got in touch regarding this amendment. This is a very, very good outcome.

Ingrid STITT: As I indicated yesterday, I do support this amendment. I do want to acknowledge that there have been concerns raised regarding the specifics of the minimum information to be provided. This amendment certainly does clarify those concerns. It strikes the right balance and therefore is supported.

Michael GALEA: I also wish to indicate my support for this amendment, and I would like to thank Mr Batchelor for bringing it to the chamber today. I would also like to acknowledge Mr Mulholland for his efforts on this clause and the similar amendment, which he has now withdrawn. In indicating that I will be supporting this amendment I would also like to acknowledge the contributions made by both Mr Batchelor and Minister Blandthorn.

Melina BATH: Very briefly, this is about getting the balance I think, and this house is achieving that on the floor after some detailed work. We thank everybody, including all the contributors, certainly, here today. It is about the very sickest of patients having their own autonomy, having that access to information, but also respecting the medical profession that is so vital in our lives and in our deaths, and respecting that conscientious objection. I think this has got the balance right.

Sarah MANSFIELD: We will be supporting this amendment. While it perhaps was not necessary, I did have some concerns about what could happen with a future government that perhaps watered down what was required to be provided by the secretary, so in this sense it provides at least a minimum standard and it legislates that – it protects that minimum standard of information being provided. In that sense I think this is quite a positive thing. We have seen it in other areas of health where governments have required some questionable information to be provided about access to certain health services and in effect restricted information. I think in leaving that to regulation there was that risk.

I also just want to highlight again the importance of having this clause. All it is about is that basic information provision for people who seek it, and I think that is a really important point. There were a number of stories shared that indicated that someone else might force that information upon someone who is perhaps not seeking VAD. This is for people who ask about VAD, who want to know more about it, where the provider does not feel they are in a position to speak about it because they have got a conscientious objection or otherwise. This is a basic amount of information that they are obliged to provide to that person who is seeking that information. It is not forcing anyone to receive information they have not asked for. This is provision of information that they are asking for. I think that is a very reasonable thing to expect.

Business interrupted pursuant to standing orders.