Legislative Council: Wednesday, June 17, 2020

Contents

Bills

Controlled Substances (Confidentiality and Other Matters) Amendment Bill

Introduction and First Reading

The Hon. S.G. WADE (Minister for Health and Wellbeing) (18:35): Obtained leave and introduced a bill for an act to amend the Controlled Substances Act 1984. Read a first time.

Second Reading

The Hon. S.G. WADE (Minister for Health and Wellbeing) (18:36): I move:

That this bill be now read a second time.

I seek leave to insert the second reading explanation and the explanation of clauses in Hansard without my reading them.

Leave granted.

Today, I rise to introduce the Controlled Substances (Confidentiality and Other Matters) Amendment Bill 2020 into Parliament.

The Marshall Government made an election commitment to implement a Real Time Prescription Monitoring system for Schedule 8 medicines in South Australia.

This Bill is an important step in delivering on that commitment, and more importantly, it is a critical step towards reducing the misuse of controlled medicines in our community.

Sadly, the misuse of controlled medicines, which includes pain medications such oxycodone, morphine and fentanyl, has become increasingly prevalent.

The Real-Time Prescription Monitoring software will integrate with existing prescriber and pharmacist software to provide access to real-time prescribing and dispensing information and to enable real-time detection and alerts for regulators and prescribers. The built-in alert functionality will help health practitioners identify patients with a history of problematic access to high-risk prescription medicines and enable them to make more informed clinical decisions that minimise the risk of overdose, addiction and death.

The South Australian Real-Time Prescription Monitoring system will link with other jurisdictions’ Real-Time Prescription Monitoring systems through the Commonwealth-managed National Data Exchange to provide real-time access to prescribing and dispensing data nationally.

Amendments to the Controlled Substances Act 1984 are limited to those required to effectively implement Real-Time Prescription Monitoring, and these amendments will not change the broader intent or objectives of the Act, or the role of the government regulator. The proposed changes include:

Sanctions for inappropriate use of data collected under the Real-Time Prescription system.

Additional regulation making powers so that the current general confidentiality provisions can be clarified and tightened under the Controlled Substance (Poisons) Regulations 2011.

Increasing penalties for offences under the Controlled Substances (Poisons) Regulations 2011, along with the ability to expiate offences.

Allowing information under section 18A to be provided electronically including via the new system.

The changes to the confidentiality provisions will ensure that only relevant patient information is collected, can only be accessed by relevant health professionals and regulators, and is only used for the explicit purpose of the system, which is to minimise the risk of harm from the legitimate use of high-risk prescription medicines.

Patients can be assured that Real-Time Prescription Monitoring will not prevent them from receiving treatment with the medicines they require, whilst the families, friends and carers of patients who are drug dependent can be more confident that there will be less risk of inadvertent harm and overdose.

There will be minimal day-to-day impact on prescribers and pharmacists as the system will be integrated into existing practice software.

The changes proposed will impose only minor additional record keeping or reporting obligations on prescribers and pharmacists who are not using integrated software. The administrative burden for most pharmacists will be reduced as the existing obligation to submit monthly reports of dispensing data to the government regulator will be automated with an integrated Real-Time Prescription Monitoring system.

Stakeholders strongly support the implementation of this system in South Australia and have been actively engaged in determining the specific elements of the system, including the high-risk medicines to be monitored, the staged rollout, the training and support required for end users, and the information and education required for the wider community. Many of these elements will be captured in amendments to the Controlled Substances (Poisons) Regulations 2011 which will be amended in a concurrent process.

Victoria implemented a Real-Time Prescription Monitoring system, SafeScript, in April 2019, and in April 2020 it became mandatory for prescribers and pharmacists to use the system. Other jurisdictions are at variable stages of their development and implementation processes. As more jurisdictions implement Real-Time Prescription Monitoring and link with the National Data Exchange, more information will be available to health practitioners, further reducing the risk of harm to patients who may be doctor-shopping across borders.

The Bill before the House will enable the implementation of a Real-Time Prescription Monitoring system in South Australia to provide a national source of information about the prescribing and dispensing of high-risk medicines in real-time to address the growing problem of addiction, overdose and death associated with legal use of these medicines.

I commend the Bill to Members.

EXPLANATION OF CLAUSES

Part 1—Preliminary

1—Short title

2—Amendment provisions

These clauses are formal.

Part 2—Amendment of Controlled Substances Act 1984

3—Amendment of section 18A—Restriction of prescription or supply of drug of dependence in certain circumstances

Section 18A of the Act empowers the Minister to give a registered health practitioner an authority to prescribe or supply a drug of dependence in certain circumstances.

This clause amends section 18A to provide that an application for such an authority be made in a manner and form approved by the Minister (rather than in writing), and for such an authority, or the variation or revocation of such an authority, also to be given in a manner and form approved by the Minister (rather than in writing).

4—Substitution of section 60A

This clause substitutes section 60A of the Act.

60A—Confidentiality

Proposed new section 60A makes it an offence for a person to disclose confidential information obtained (whether by that person or any other person) in the administration or enforcement of the Act except—

(a) as required or authorised by or under the Act or any other Act or law; or

(b) with the consent of the person from whom the information was obtained or to whom the information relates; or

(c) in connection with the administration or enforcement of the Act; or

(d) for the purposes of any legal proceedings arising out of the administration or enforcement of the Act; or

(e) in accordance with the regulations. The maximum penalty is $10,000.

The proposed new section also makes it an offence for information disclosed for a particular purpose to be used for any other purpose by—

(a) the person to whom the information was disclosed; or

(b) any other person who gains access to the information (whether properly or improperly and whether directly or indirectly) as a result of a disclosure.

The maximum penalty is $10,000.

However, the proposed section does not prevent the disclosure of statistical and other information that could not be reasonably expected to lead to the identification of any person to whom it relates.

Confidential information is defined to mean—

(a) information relating to trade processes;

(b) medical information relating to any person;

(c) any other information that—

(i) is of a personal nature; or

(ii) is by its nature confidential; or

(iii) was specified as confidential by the person from whom the information was obtained;

(d) information of a prescribed class.

5—Amendment of section 63—Regulations and fee notices

This clause amends section 63 so that fines up to $10,000 can be prescribed for offences against the regulations and expiation fees of up to $2,000 can be prescribed for alleged offences against the regulations. It also amends the section to provide for fees to be prescribed by the Minister by fee notices (under the Legislation (Fees) Act 2019.

Debate adjourned on motion of Hon. I.K. Hunter.