Alcohol and other drug services
David ETTERSHANK (Western Metropolitan) (12:41): (1363) My question is to the Minister for Mental Health on alcohol and other drugs. Back in 2020 the health complaints commissioner tabled the report of its investigation into private alcohol and other drug rehab services. It found that the largely unregulated sector had a detrimental effect on the health and wellbeing and financial situation of clients and their families. Then commissioner Karen Cusack warned that overwhelming demand, the high vulnerability of clients and a profit-driven model created ‘the space where poor consumer outcomes seem most likely occur’, and that is a significant understatement. Recommendations included mandatory licensing of private AOD providers, registration of AOD workers and protection of professional titles to reduce the greatest immediate beneficial effect on safety and quality. Minister, given this was a government-commissioned investigation, what has the government done to forward the recommendations of the commissioner to advance basic safety and accountability in the private AOD rehab sector?
Ingrid STITT: Two, that is right. But back to Mr Ettershank’s important question. I know that from the data that I see from the department that many of those beds are actually taken up by people who have an alcohol addiction. This is important work, and it forms a key part of our AOD service system in Victoria. In answering your question, I think I would take you to the work of the statewide action plan to reduce drug and alcohol harm in the community, including the AOD strategy, the 10-year strategy which the government released late last year, and the establishment of an expert AOD ministerial advisory committee, which has many experts from the alcohol and drug sector. I am grateful for their expertise, and I know that they are going to give me lots of frank and fearless advice about what the priorities need to be. One of the areas that I know is in their work plan is to look at the private providers in the rehab space to make sure that there is strong regulation but also looking at what the most up-to-date treatment options are. Maybe it is time to look at some of the newer treatment options that are not being taken up across the health system to the extent that they might be able to.
I would also point to the work of Dr Paul MacCartney, who is the chief addiction officer, which was another initiative out of the statewide action plan to reduce drug harm across the state. He has been very closely engaged with a number of really important health service providers and peak bodies, including VACCHO and including some of our community health providers, particularly around some alternative treatments when it comes to drugs and alcohol. But the regulation of private services is certainly something that I have been in conversations with my department about, and I am happy to engage further with you about that work.
David ETTERSHANK (Western Metropolitan) (12:45): Thank you for that response, Minister. I guess after five years to have a committee and an addiction officer is perhaps small change. But the Royal Commission into Victoria’s Mental Health System and the government’s 2022 integrated treatment, care and support guidance spoke of the importance of service-level integration across the mental health and AOD systems to provide people with co-occurring mental illness and substance dependence safe, integrated and appropriate care. The government has embedded these principles across the public system in response to the royal commission’s recommendations. These integrated care reforms only apply to the public system. Private AOD services do not have any equivalent safeguards, minimum standards or requirements for qualified staff despite the clear risks identified specifically by the health complaints commissioner. Given the government’s strong commitment to service integration in the public system, how will it extend these protections to the private AOD sector to afford the same level of safety, quality and accountability to their clients?
Ingrid STITT (Western Metropolitan – Minister for Government Services, Special Minister of State, Minister for Ageing, Minister for Mental Health, Minister for Multicultural and Multifaith Victoria) (12:46): I thank Mr Ettershank for that question. It is quite a complex one, and I have only got 1 minute, but I will do my best. I do want to take issue slightly with what you said about the progress in relation to these matters. Since 2014 and coming to government, our government has invested more than $3 billion – $3.6 billion to be exact – in drug treatment supports and harm minimisation services for those who need them. That is in publicly provided services of course. It is not the role of the state government to fund private providers, but it is certainly the role to regulate appropriate services, and I absolutely take that very seriously. It is something that the department and also Safer Care Victoria have been doing work with, and I have been engaging closely with them around that work. We need to really strengthen the regulatory arrangements for private providers in the AOD sector, and I am not taking issue with that with you.