Wednesday, 18 March 2026

 Georgie CROZIER (Southern Metropolitan) (10:42): I rise to speak to the motion in my name. I move:

That this house:

(1)   notes:

(a) the announcement by the Premier of the expansion of the Chemist Care Now program from July 2026 to allow participating pharmacists to provide the oral contraceptive pill to women without a prescription;

(b) the concerns raised by the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian Medical Association that this practice undermines established clinical safety standards and is contrary to determinations from the Therapeutic Goods Administration that the pill should only be prescribed by medical practitioners; and

(2)   in accordance with standing order 10.01, requires the Leader of the Government to table in the Council, within three weeks of the house agreeing to this resolution, all briefings, correspondence and other documents provided to the Premier by the Department of Health and the Minister for Health, or her office, relating to the expert medical advice sought and received on the safety of pharmacists initiating supply of the oral contraceptive pill.

What the motion essentially is asking for is the health advice that the Premier received when she made this announcement just a couple of weeks ago. In my motion I talk about the TGA and the various concerns that they had. It is on the record that the TGA undertook a review about five years ago looking at this very issue. When they did look at it – they took advice and they looked at this in great detail – they made a decision not to change the scheduling of any oral contraceptive substances. They said there was an increased risk of thromboembolism, especially with age, smoking, obesity or migraines with aura; cardiovascular risks – for example, having a stroke; possible increased cervical cancer risk; and side effects that change over time and require medical oversight. They also stated that safe use and eligibility criteria and risk factors are numerous and complex, requiring ongoing medical assessment. I think that is very important in the context of this debate. Oral contraceptives may mask conditions like endometriosis, and we know the Premier has been out on that, but she has disregarded this advice in relation to that very specific issue. There have been some other areas that the TGA did raise around the existing mechanisms through telehealth or continued dispensing rules, which already support access without fully removing the need for a prescription. The annual GP visits ensure women review contraceptive choices, including safer and more effective options.

The AMA has come back, and they strongly oppose the proposals, as we know. When they went to Family Planning NSW, they broadly supported improved access, according to the TGA, but highlighted many safety, training and implementation issues. That really was the whole point of that review. The risks of downscheduling outweigh the benefits. Current scheduling should be retained to protect women’s health – that is critical – and regular GP oversight remains essential for safe use of oral contraceptives and broader reproductive health care. When the Premier made this announcement there seemed to be some tension with the Minister for Health, who clearly did not agree with the Premier’s announcement. She went off and liked the Royal Australian College of General Practitioners’ social media post. There were some tensions between the Premier and the health minister, it is understood. But the president of the RACGP Dr Muñoz said she was:

… blindsided by the announcement as the government had recently told the college that allowing pharmacists to initiate the pill was not a policy it would pursue.

Their own Labor members of Parliament have also raised concern. Federal member for Bruce Julian Hill criticised the contraceptive pill announcement. He said:

I was also surprised, to say the least, to see this announcement by a state government, against the advice of the relevant medical colleges …

I think this was fair enough. He has got firsthand experience, I understand, from his own daughter who had a DVT linked to an off-label prescription of a contraceptive pill, so he was concerned about those safety issues. But what I am concerned about is the Premier’s language. She said:

I’m not going to let vested interests and old-fashioned ways of thinking – and middle-aged white men – decide when and where women should get the healthcare they need.

I think we are all sick of this language from this Premier. We are sick of it. It is divisive, it is unnecessary and it is quite frankly out of order. She needs to stop dividing the community and labelling people who are concerned about an issue ‘middle-aged white men’. It is offensive.

David Limbrick interjected.

Georgie CROZIER: Mr Limbrick interjects – racist and sexist. It is a reverse form of misogyny, and I am sick of the Premier doing this. It is extraordinary that she has disregarded medical expert advice on this very important issue around women’s safety measures. I say the Premier has gone alone on this decision, because the minister does not even agree with her. It seems like they are at odds, just like they were at odds with the ADHD virtual ED announcement. This is a Premier who is desperate. She is clinging at everything she can, and it is critical that we understand the advice that was provided to her and her office on this very important issue that goes to women’s safety. I am going to stress it again: this issue goes to women’s safety. I am going to stand up for women in this place against the Premier, who is trying to grab votes. All this is is a vote-grabbing exercise. It is a dangerous vote-grabbing exercise. We need to see the documents, and they need to be released within the specific timeframe. It is not a big ask. I would urge all members in this place to make sure the Premier desists with her ridiculous language and releases the documents.

 Sarah MANSFIELD (Western Victoria) (10:48): I rise to speak in support of this documents motion brought by Ms Crozier. I am also quite curious to see what advice and evidence has informed this decision and led to this announcement by the Premier. I have to say I was also quite surprised when this announcement was made. I am actually very supportive of reducing the barriers to access to contraception for women and gender-diverse people everywhere. There are barriers that exist, and there are lots of ways we need to be looking at reducing those.

In my electorate of Western Victoria there is a particular issue in parts of the central part of western Victoria with accessing a whole range of things, including abortion, contraception and just general cervical screening. All of those things are difficult to access. It is complex. It is not just the doctors that are the barrier. It is actually also, from evidence we have looked into, the pharmacists in some cases, so this is a complex issue. Increasing the scope of practice of other health professionals is also something I am not fundamentally against. I actually think we need to be looking at that. I think there is a lot of ability to increase the roles that different health professionals undertake in our health system. That is a sentiment that is not always shared by some of my doctor colleagues, but I fundamentally believe that.

It is not really about who is prescribing in this instance – I think there are very good pharmacists out there who may be quite capable, with the right training, of doing a pretty good job of this – but I think about where and how this prescribing is taking place. A retail pharmacy setting I do not believe is a great setting in most instances to be doing this kind of work, and I say that as someone who has done so many of these consultations. This is not a 5-minute consultation that you can do at the desk of a pharmacy. It is quite different to something like emergency contraception. I will even accept that a repeat prescription of the pill is a lot more straightforward. Initiating contraceptives is actually quite a complex thing, and it is the bread and butter of general practice; it is what you train for. The comments that were made that this somehow frees up GP time – to do what? This is the stuff we want to be doing. This is the good stuff. There is a bunch of stuff I can tell you we do not want to be doing – give that to someone else – but this is the core business of general practitioners.

There are some things that I think need to be worked through. When someone comes in asking for the pill, it is often not just the pill. What do they want the pill for? The pill is used for a whole lot of different reasons. Contraception is one of them, but it is not the only one. Sometimes it is menstrual management or menstrual migraines, or it might be for dealing with acne or for some of those issues that exist for that person, so you are going to tailor the particular pill or advice that you give to someone around that. We have a huge problem in this country with an underutilisation of long-acting reversible contraceptives – Implanon and IUDs. While I hear that they will be able to raise these other options, they are not actually able to provide that for someone when they come in.

You also need to take a detailed family and personal history from someone to identify their risk factors. It is usually an ideal time to have a broader conversation about general health and wellbeing and do things like check someone’s cervical screening, check whether they need an STI check-up and give them sexual health advice – the fact that you are on a contraceptive does not mean you are protected from STIs, and you still need to use condoms. Do you want to be having that conversation at the desk of a pharmacy? I am just not quite sure that that is the right setting. I will grant that some pharmacists have a separate room, but I also question whether any retail pharmacist wants to be off the floor for 20 minutes having this conversation in a room. It is just not the environment that you typically expect these kinds of consultations to occur in.

I think, crucially, the other thing that is really important when you initiate contraception is the follow-up. I cannot tell you the number of times when you start something and it needs to be tweaked. You might need to change the type of pill that they use, you might need to give them advice about taking it in a different way, running packets together – there are all sorts of bits of advice you might give to someone. And checking people’s blood pressure: there is a decent proportion of people – about one in 20, possibly even up to one in 10 – who get high blood pressure as a result of being on the pill, and that is something that needs to be monitored. You need to bring someone back for a check-up to check on those things. Again, I am not saying that you cannot manage all of these things in a retail pharmacy setting, but it is not really a place that is set up for that. I think it is instructive that entities like the TGA recommend against this approach and a number of the other peak bodies are quite concerned about it.

I am really looking forward to what comes out of this documents motion, if we get anything. I am very open to being persuaded on it, but there are certainly a lot of alarm bells based on the public statements that have been made by the Premier.

 Sheena WATT (Northern Metropolitan) (10:53): I rise to speak on the short-form documents motion brought forward by Ms Crozier regarding the expansion of the Chemist Care Now program. While the government will not oppose this motion, as per parliamentary convention, as is familiar to all in this place, it is essential to place on the record exactly why we are expanding access to the oral contraceptive pill and how this initiative supports the needs of Victorian women.

The Allan Labor government is making it easier to get the pill at the chemist without a prescription, and from July 2026 women over 18 will be able to access the oral contraceptive pill at one of 850 participating Chemist Care Now pharmacists. This change will save women time and provide them with more options to get the care they need. It will also expand access for women in rural and remote areas, where access to a GP is more challenging. By utilising our network of participating pharmacists we are ensuring that location and wait times are no longer a barrier to basic health care. Our expanded access to the pill will bring Victoria in line with Queensland and Tasmania as well as other countries around the world, including the United Kingdom, Canada and New Zealand. This is also, it is important to note, a change supported by organisations, including Women’s Health Victoria, who have welcomed initiatives that make it easier for women to safely access their preferred contraception, including directly from their local chemist, which gives them more options.

Safety and extra training are at the very heart of this program. Pharmacists who want to deliver this service will be required to complete a postgraduate training module. They must undertake a thorough consultation and outline any risks before dispensing to keep women safe. They must also provide comprehensive advice on other options, including long-acting reversible contraception. And if there are any concerns, our pharmacists will refer the woman to a GP, as per normal practice for a range of health care. The expansion of the program to include the initiation of the oral contraceptive pill will be guided by a clinical prescribing and management protocol. The TGA has classified the oral contraceptive pill as a schedule 4 medicine, and states and territories are responsible for the laws that regulate health practitioners that can supply, prescribe and administer scheduled medicines. In Victoria that includes pharmacists that are part of the Chemist Care Now program. Through this program Victorians can already receive resupply of oral hormonal contraception; treatment for shingles, uncomplicated urinary tract infections and psoriasis; and some travel vaccines.

The success of this program is already evident in the data that we are seeing. Victorians have accessed more than 77,000 occasions of care from over 870 approved pharmacists across the state, and this includes over 35,000 consultations for uncomplicated UTIs. There have been over 17,000 consultations for resupply of contraception and over 23,000 consultations for travel health vaccination services. Over a quarter of the 870 approved pharmacists are in rural or regional Victoria, improving access to health care for rural and regional Victorians. The program is overwhelmingly used by Victorian women, it is important to note, with 68 per cent of the consultations provided to women seeking resupply of hormonal contraception or treatment for uncomplicated UTIs. This program will be expanded to include 23 common health conditions and wellbeing services, including resupply of menopause replacement hormones, planned for implementation in late 2026. As I said earlier, we will not oppose the production of these documents. We are confident in the expert medical advice that underpins this program, which prioritises the health, safety and time of Victorian women.

 Nick McGOWAN (North-Eastern Metropolitan) (10:57): I will make my comments very brief to allow for other speakers, but I want to support Ms Crozier in this motion. It is a very important motion. I also want to add my support to the comments from Dr Mansfield. No-one here wants to make it harder for any woman to receive the contraceptive pill, or any other pill for that matter, and to put it in such a way as the government have done and pit people against each other is not only part of their form but unfortunately a very sad reflection upon this government. There are very genuine concerns held by men and women right across this state, including medical professionals and the AMA, who put that on the record, and other colleges, who have also expressed a very serious concern for the welfare of women and the unintended consequences of the Premier’s actions. I lend my support wholeheartedly to Ms Crozier’s motion today and hope that it does, as has been said by other members, actually result in the release of documents, because this government is notorious for not doing so.

 Rachel PAYNE (South-Eastern Metropolitan) (10:58): I rise to make a brief contribution on the docs motion in Ms Crozier’s name. Contraceptives should be as cheap and as widely available as possible – I think all of us in the chamber agree to that. For one in four women in Victoria the pill is their contraceptive of choice, so no doubt the Premier’s recent announcement to expand access to the pill was welcome news for that group. From July 2026 participating pharmacists who have gone through additional training will be able to provide the pill to Victorians without a prescription, who will now have increased access to their preferred form of contraception without the need for or the potential cost of a GP appointment.

We know that this builds upon existing policies where pharmacists can resupply an existing prescription. However, as identified in this motion, there are a number of stakeholders that have expressed serious concerns about this announcement. These include the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian Medical Association. They say this change undermines established clinical safety standards, raises concerns relating to risk factor screening and is contrary to determinations by the Therapeutic Goods Administration that the pill should only be prescribed by medical practitioners. They rightly note that the initial appointment with a GP to get a prescription presents an opportunity for conversations about sexual health, side effects and safe relationships, something that may be lost in a pharmacy environment that lacks privacy, as Dr Mansfield has indicated. This is particularly important as it gives the opportunity to talk about more effective long-lasting reversible contraceptives, which Australia has a low uptake of compared to other similar countries. When it comes to side effects, they should not be underestimated. They include nausea, weight gain, mood changes, depression, bloating and loss of libido. While they are not as common, more serious health problems are also possible. There is still a lot of stigma about sexual health in the health system, which has historically failed to take women’s pain seriously. If you are going to train pharmacists to do the prescribing, then additional training must be comprehensive.

Interestingly, despite a huge gap in the market, we still do not have a commercially viable alternative for men. The closest we have ever seen was in 2011, with an international study on hormonal birth control methods that was eventually stopped because the risks apparently outweighed the potential benefits. Despite 75 per cent of participants being satisfied with the results, some reported mood changes, depression and pain – enough to end that trial. Now, don’t those side effects sound familiar?

We understand that there is more likely to happen in this space, with the federal government’s recent announcement that from January 2027, concession card holders will be able to access pharmacy-prescribed contraceptives across Australia under a 12-month trial. There will also be advice on national standards for prescribing contraceptives, which is expected to be finalised midyear. Whether it is at a national level or here in Victoria, these kinds of changes work best when everyone is on board. With that in mind, increased transparency is a good step to building that trust, including the briefings, correspondence and documents detailed in this motion relating to expert medical advice.

Motion agreed to.