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House of Assembly - Fifty-Fourth Parliament, Second Session (54-2)
2021-10-26 Daily Xml
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Health Practitioner Regulation National Law (South Australia) (Telepharmacy) Amendment Bill

Second Reading

Mr PICTON (Kaurna) (11:07): I think the minister has done his second reading already on this.

The Hon. D.C. van Holst Pellekaan: Yes.

Mr PICTON: Thank you. I speak in relation to the telepharmacy legislation. I indicate that I am the lead speaker for the opposition. Our community pharmacy sector is a vital part of our healthcare system. These pharmacies have done a particularly incredible job over the past two years as we have confronted the COVID-19 pandemic. While over the past two years, at various stages of lockdown, there have been various businesses that have been able to move online, close—

The SPEAKER: Member for Kaurna, I hesitate to interrupt. I am advised by the Clerk that the second reading has not been moved.

Mr PICTON: I did ask the government and they said they had.

The SPEAKER: You are quite right, member for Kaurna, you did in fact inquire of the government; I now inquire of the government. Leader of Government Business?

The Hon. D.C. VAN HOLST PELLEKAAN: I apologise to the member for Kaurna and to the house. I was of the expectation that the second reading explanation had been provided to the house, whether written or tabled, and apologise for accidentally providing the wrong information.

The SPEAKER: No matter, minister. We can continue to proceed, except to say that of course somebody must move that the bill be read a second time.

The Hon. D.C. VAN HOLST PELLEKAAN: I draw your attention to the state of the house.

A quorum having been formed:

The Hon. D.C. VAN HOLST PELLEKAAN: I take this opportunity on behalf of the people of Stuart to speak on the Health Practitioner Regulation National Law (South Australia) (Telepharmacy) Amendment Bill.

Mr PICTON: Point of order, Mr Speaker: somebody needs to move that the bill be read a second time.

The SPEAKER: Thank you, member for Kaurna; I accept that point of order. Minister, I do draw your attention to that point of order. Perhaps you or the Minister for Education will so move.

The Hon. J.A.W. GARDNER (Morialta—Minister for Education) (11:11): I am really pleased to move:

That this bill be now read a second time.

This is an important bill that seeks to effect the enactment of a number of measures that were brought as a result of the COVID situation. For the house's benefit, I was not aware that we were going to move so quickly through the first bill. Replete with knowledge about the bill as I am fortunate to be, I am very enthusiastic about this bill.

Mr Picton: What does it do?

The Hon. J.A.W. GARDNER: It serves a number of things. It serves communities in regional and rural South Australia, particularly in circumstances where a pharmacist may well have a number of outlets but they might not be able to be present at each of them for the entire opening hours. Rather than a community member who needs medicine urgently having to wait until the pharmacist is able to be on site to dispense the medicine, this bill will provide the opportunity for those community members to receive the medicine they need urgently through this telepharmacy practice. It will give certain security to the community to know that it is being done safely, but indeed the pharmacist does not need to be on site at the moment when things are being dispensed.

In introducing the Health Practitioner Regulation National Law (South Australia) (Telepharmacy) Amendment Bill, can I advise the house, as I think I have just enunciated pretty clearly, the purpose of the bill is to make permanent the legal provisions for the authorising of telepharmacy in South Australia—spot on so far. Similar temporary provisions were supported by members as a part of the COVID-19 Emergency Response (Further Measures) (No 2) Amendment Bill. I am not sure I need the notes. These provisions were extended with the passage of the COVID-19 Emergency Response (Expiry) (No 3) Amendment Act and are set to expire on 1 December 2021. That aspect is why I needed the notes.

Telepharmacy, as I said before, is the provision of pharmaceutical care and products to a patient through the use of video and audio telecommunication where the pharmacist is not physically present in a pharmacy. This also includes the provision of medicines where the pharmacist is not able to receive and/or provide the medicine to the patient personally, and therefore the provision of medicines is achieved through the use of telecommunications and information technologies to the patient at a distance.

I am very pleased to introduce further new information without any further repetition. In 2004, telepharmacy was provided in South Australia as part of the national trial to enable provision of care to rural and remote communities. More recently, telepharmacy has been provided on the understanding that it is not prohibited under the Health Practitioner Regulation National Law (South Australia) Act 2010.

This bill will consolidate the legislative base and provide the Pharmacy Regulation Authority of South Australia with clear and express powers to authorise telepharmacy arrangements under strict conditions. Clarifying the powers of the regulatory authority will also provide assurance to the communities that rely on these services. Telepharmacy services have been provided successfully in limited regional locations, which include Cleve, Cowell, Kimba, Crystal Brook, Laura and Gladstone.

Under the provisions of the national law, the Pharmacy Regulation Authority of South Australia, or PRASA as I am told it is called, is responsible for the administration of part 4 of the national law, which concerns pharmacy. PRASA is established under section 27 of the national law and has a number of functions, including the registration of pharmacy premises, depots and pharmacy services providers, ensuring compliance with the national law and preparing, endorsing and publishing codes of conduct, which also have to be approved by the minister.

The bill will clarify the law in regard to the authorisation of the remote attendance of a pharmacist by PRASA. Since the national law came into operation, telepharmacy has continued on the understanding that it is not prohibited by that act. This bill will provide PRASA with clear and express powers to authorise telepharmacy arrangements under strict conditions. There has been ongoing consultation with key stakeholders, in particular PRASA and the Pharmacy Guild of Australia (SA), in relation to the bill, which has led to further amendments and the inclusion of additional safeguards.

The bill builds upon the provisions included in the temporary COVID acts to ensure that the provisions allowing for telepharmacy are not misused to promote a new business model and to require compliance with PRASA's code of conduct. The bill provides that PRASA may only authorise the provision of telepharmacy services where the authorisation is necessary to ensure that pharmacy services are available to people who otherwise would not have direct and timely access to these services. This addresses any perceived potential for new business models for routine delivery of pharmacy services.

PRASA recognise that the best practice is for a pharmacist to provide professional pharmacy services in person to a patient. However, in the event that a pharmacy is unable to open and maintain essential pharmacy services—for example, due to an outbreak of COVID-19 from within their staff cohort—telepharmacy services may provide a safe and appropriate option and allow isolated South Australian populations to continue to access pharmacy services without the physical presence of a pharmacist. Community pharmacists play an important role in the delivery of medication and other services to customers and continuity of service is imperative.

The bill also requires that PRASA may only grant an authorisation where it is satisfied that the pharmacy services provider has taken all reasonable steps to ensure that it will comply with the relevant code of conduct when providing services remotely. The Pharmacy Regulation Authority of South Australia has developed a code of conduct for this purpose. In addition, PRASA may only authorise the provision of telepharmacy services to a pharmacy located within an area prescribed by the government. This requirement was inserted as part of further amendments to the bill in the Legislative Council.

As a result of consultation with the Pharmacy Guild of South Australia, the bill has also been amended to include that conditions on any authorisation for telepharmacy may be prescribed by regulation as well as by PRASA. This amendment provides another layer of oversight around the provision of telepharmacy in South Australia. The bill has been amended to include a penalty of up to $50,000 for providers who fail to comply with conditions of authorisation.

The commonwealth government has moved to enable provision of medication review services through telehealth systems during the COVID-19 pandemic to ensure vulnerable patients can receive pharmacist-delivered support while remaining isolated from COVID-19. This supports the safety of patients and pharmacists and ensures continuity of care. Technology is enabling the enhancement of the safety and quality of health care for the community through access to pharmacy services where they would otherwise be unavailable.

It is important that this framework is established permanently, and I commend this bill to all members. I seek leave to insert the explanation of clauses without my reading it.

Leave granted.

Explanation of Clauses

Part 1—Preliminary

1—Short title

2—Commencement

3—Amendment provisions

These clauses are formal.

Part 2—Amendment of Health Practitioner Regulation National Law (South Australia) Act 2010

4—Amendment of section 43—Supervision of pharmacies by pharmacists

This clause amends section 43 of the Act to provide that the requirement under section 43(1) that a pharmacist is in attendance and available for consultation while the pharmacy is open to the public does not apply in circumstances where—

(a) the person is authorised by the Authority to operate the pharmacy business without a pharmacist being physically in attendance at the pharmacy; and

(b) a pharmacist is, by means of Internet or other electronic communication (other than communication of a kind specified by the Authority), in attendance during any period the pharmacy business is operating and is available for consultation by members of the public.

The amendment provides that the Authority may only grant an authorisation for the exemption to apply if—

(a) the pharmacy is located within a prescribed area (however this requirement will not apply in circumstances determined by the Authority to be circumstances of an emergency); and

(b) the authorisation is reasonably necessary to ensure that pharmacy services are available to persons who would not otherwise have direct and timely access to such services; and

(c) the Authority is satisfied that a pharmacy services provider, who is proposed to provide pharmacy services as part of the operation of the pharmacy business without a pharmacist being physically in attendance at the pharmacy, has taken all reasonable steps to ensure that the provider will comply with a code of conduct applying to the provider under this Act in respect of such operation.

The amendment also provides that an authorisation granted by the Authority will be subject to any conditions prescribed by the regulations and any conditions imposed by the Authority. It will be an offence to contravene or fail to comply with a condition applying in relation to an authorisation granted by the Authority with a maximum penalty of $50 000 applying.

5—Amendment of section 46—Conditions

This clause amends section 46 of the Act to provide that a condition of the registration of a pharmacy that is inconsistent with section 43(1a) (as proposed to be inserted by clause 4) will, to the extent of the inconsistency, be taken to be modified to give effect to that section.

Mr PICTON (Kaurna) (11:19): Who says that parliament does not deliver some hilarity given what has gone on this morning on the other side of the house, with not being able to understand their own agenda that was set for this morning's events? I indicate that I am the lead speaker for the opposition in relation to this bill and that the opposition will be supporting the bill. I had my folder prepared already, unlike the Minister for Education.

As I was saying before the confusion on the other side, very clearly pharmacists and community pharmacies have provided a vital role during the course of the COVID-19 pandemic. They are an absolutely essential part of our healthcare system: very well-trained professionals who provide both administration and advice in relation to drugs and pharmaceuticals right across our community. While there have been many other types of services—officers, even other healthcare provision that has been able to go online and virtual—this is not possible when it comes to operating community pharmacies. They have been open and available.

Obviously, we are talking about a specific type of telepharmacy in relation to this legislation, but by and large pharmacy services need to have a physical presence. Hence, the staff who have worked in pharmacies have worked through what were some of the scariest days of the beginning of last year when most other organisations and businesses were closed, but people who had symptoms obviously went to chemists, pharmacies, and those staff—pharmacists and pharmacy assistants—had to confront the dangers that were apparent to them by turning up to work. On behalf of the opposition, I pay my thanks to all staff, all the pharmacists and all the people who work in our community pharmacy sector, for the support they have provided our state over the past two years.

This legislation will make permanent some measures in relation to how telepharmacy works. Through the initial stages of COVID-19, certain pharmacies were temporarily granted the ability to deliver telepharmacy or remote pharmacy in regional areas of South Australia. This bill serves to make permanent those temporary COVID measures but ensures that those powers are limited to certain rural and remote areas.

This legislation was introduced into the parliament one year ago, back in October 2020, in the other place. It shows the glacial movement of this legislation from this government and the passage of it through the houses. But it is not just tardiness: essentially, what happened was they introduced this legislation without actually properly working and consulting with people in community pharmacy about what the legislation provided. Very quickly, after it was introduced without that proper consultation, the phone was running hot from people in community pharmacy extremely concerned about what the government introduced and the potential unintended consequences that could flow from allowing telepharmacy, with very limited restrictions around it.

Very clearly, a principle we would agree with is that telepharmacy needs to be in place in certain limited areas, but it is not as good as seeing a pharmacist in real life. It is not as good as being able to speak to that person one on one and get that advice at your local community pharmacy. We do not want to see a situation where we see our local community pharmacy network replaced by a remote service, unless it is absolutely necessary, and there are examples of this.

You only have to look at the United States, where a huge component of their mail system involves the delivery of drugs. We do not have that in Australia. People have access to a good network of local pharmacies where they can get that advice. Clearly, it is a more unsafe situation that they have in the United States, where the delivery of drugs via internet and then courier or mail services occurs very regularly.

This sat on the Notice Paper for six long months after it was introduced—just sat there, no progress, no speeches, no discussion—and clearly this was because of the lack of consultation. The government then had to go through another round of consultation to address all the flaws they had in their legislation. They then filed amendments back in June this year, some nine months after the bill was originally introduced into the other place, and it then passed back in August. It has now been sitting here for a few months before this discussion this morning.

Much detail was left to the regulations in relation to the pharmacy regulation. There was great concern that there needed to be more specification. In particular, I pay credit to the Pharmacy Guild for their advocacy in this area: that we saw more definitions, more protections put in this legislation via amendment to make sure that people have the protection that this should only be available in certain areas and have a number of protections around it.

We continue to have concerns in relation to what will be left to the regulations, because a large amount of this will be left to the regulations. I appreciate the government eventually gave me a briefing on this legislation. I think, off the top of my head, I waited between six and nine months to get a briefing from the government in relation to this legislation, clearly because they were in this mad panic trying to rewrite it after they introduced it into the parliament.

Very clearly, for a lot of the detail we are going to have to wait to see what the regulations say. The government have given commitments to the Pharmacy Guild and other stakeholder groups—the Pharmaceutical Society of Australia and others—in relation to how many of these provisions will be replicated in regulations, but they will be, obviously, up to regulation rather than in the legislation.

Matters left to regulation include minimum time requirements for telepharmacists to check in with a physical pharmacy, the exclusion of schedule 8 drugs of dependence and compound medicines from telepharmacy, the level of pharmacy technicians who perform certain roles, mandatory specifications surrounding the telepharmacy consult itself and that prescribed areas for telepharmacy will likely be Monash level 5 and above. All those requirements are very important in terms of making sure that this is a limited scheme.

The Monash model is, as members may know, a model that determines how remote particular locations are. There are a whole range of different health service requirements that flow from that, probably the most famous being in terms of regional doctors, their payments and attraction bonuses, etc. But clearly this is now going to say, 'You have to be a level 5 area under the Monash model to be able to undertake this,' so that leaves it to relatively remote areas of South Australia. We certainly would not want to see this in metropolitan areas or in large regional centres, etc.

The opposition has consulted—we did what the government did not do initially—with the Pharmacy Guild and with the Pharmaceutical Society. The guild have made clear that they do want to see comprehensive engagement and consultation regarding the regulation development, and we will be watching very closely the practical implementation of this. However, we do support the legislation. It is important that we put some structure around this, particularly for those areas where we struggle to find a workforce. This can be a solution to making sure that people can get services, but they need to have the protection around them to ensure that they are safe and that people get the right services to make sure they can adequately have their drugs administered in a very safe and responsible manner.

This is, of course, just one of many issues affecting pharmacists at the moment. I was privileged to speak to the Pharmacy Guild at their members' dinner and conference recently, along with the Minister for Health, and very clearly there are concerns from community pharmacies in relation to the fact that in South Australia we used to be a leader. We used to be a leader in terms of making sure that pharmacists could operate at their full scope of practice and could make sure that they provided the services needed to the community in their local areas.

However, what has happened over the past 3½ years is that other states have caught up. Not only have they caught up but they have often now exceeded us in terms of the additional services that people are able to access from their local pharmacy. So we have really seen a big leapfrogging in terms of our legislation in South Australia.

One of those areas that is very striking is in relation to the administration of vaccines. When we were in government, we changed the law to make sure that pharmacists could provide a whole range of different vaccines. What we have seen is other states leapfrogging us now in terms of what their legislation allows, in particular in relation to the administration of the National Immunisation Program vaccines for influenza.

As people may be aware, you can go to a pharmacy at the moment to get your flu shot, but that is not the same vaccine that you can get through the National Immunisation Program. People who are seniors, people who are in particular vulnerable groups, are able, under the National Immunisation Program, to get access to a particular type of flu vaccine—quad flu vaccine—which provides a greater level of immunity, particularly for vulnerable groups.

In various other states and territories the government have now allowed pharmacies to provide that vaccine, but not here in South Australia. The South Australian government prohibit those pharmacies from being involved in that program providing their quad National Immunisation Program flu vaccination to South Australians, and there does not seem to be any reason for that whatsoever. It seems to be basically on the basis of too much administration for SA Health to have to worry about, whereas other states and territories have been able to do that.

It shows how ridiculous this situation has become when you see that the pharmacies are now playing a fantastic role in relation to the rollout of the COVID-19 vaccination program. On the one hand we are saying to pharmacies, 'You can now be involved in providing the rollout of the COVID-19 vaccine.' I believe, in fact, that they are the only places rolling out the Moderna vaccine across Australia, but with this flu vaccine that we have had for decades in this very long part of our health system, 'You can't be involved in administering that. You're skilled enough to do COVID, but you're not skilled enough to do flu.' It is a totally ridiculous scenario.

I thank all those pharmacies that are involved in the rollout of the Moderna vaccine. I know that in my electorate there are a number involved in the rollout. Certainly, across South Australia many have put up their hands to do it. I think it is unfortunate that it took so long for pharmacies to be involved in that rollout, and not only too long on a national basis but too long in terms of South Australia compared with other states. I think it was weeks, I believe even maybe up to two months, later than we saw in Queensland that a significant number of pharmacies in South Australia became involved in the rollout of the vaccine.

Where that really affects people is in regional South Australia because there are many areas of the state where there has not been enough access. Obviously, we are not going to have a Wayville-style mass vaccination clinic in every small regional town across South Australia, but we do have pharmacies and we do have the ability for them to provide support. An earlier rollout of that vaccine certainly would have ensured that the number of vaccinated people in some of those regional areas would be higher now.

It is unfortunate that it has taken so long. It is good that we have finally got there. It is not that long before the start of the flu rollout again at the start of next year and now the government are saying, 'We are going to have a task force to look at whether this should happen or not.' Give me a break! This does not need to be some long, drawn-out consultative process in relation to whether pharmacists are going to be allowed to be involved in the National Immunisation Program for flu vaccines when they are doing a great job at the moment with COVID. They have done a great job with other flu vaccines. It actually needs a decision that this minister has been delaying for the last 3½ years as to whether he wants to go ahead with this or not.

We are very supportive of the role community pharmacies play in this state. I believe that pharmacies have been raising with government a number of different ways in which they want to provide additional support for people in their communities. They have been putting these ideas to the government. They have said repeatedly that they believe they can play a great role in terms of addressing the ramping crisis we are currently in, in terms of supporting people's medication management, making sure that we do not have people ending up in emergency departments because of errors in terms of drugs.

To be honest, there are so many South Australians who have a very complex regimen of drugs they need to take and they all have different effects. They all have interactions that can cause damage to those people if the wrong drugs are taken in combination with others. That is where pharmacies can play a great role. They are keen to do that, but their calls to the government have been falling on deaf ears. We encourage the government to actually speak to those frontline pharmacies who have felt left out in the cold.

Look at what is happening in other states, in terms of how supportive other states are now being in the role of their pharmacies, and make sure that we can use all those hardworking pharmacists to the best of their abilities to ensure we can keep people healthy here in South Australia. I support the legislation.

Mr WHETSTONE (Chaffey) (11:37): I, too, rise to make a contribution to a very important part of the health system through the Health Practitioner Regulation National Law (South Australia) (Telepharmacy) Amendment Bill 2020. There have been some inaccuracies by the opposition in their contribution to date about the lack of consultation by the government and having an understanding and having those conversations with pharmacies in the regions in particular.

I know that I have been briefed to within an inch of my life, and I thank the Pharmacy Guild—Nick Panayiaris, the president—and also all the pharmacies I have spoken to in Chaffey for giving me a better understanding of how important it is that we have video and audio telecommunications that are being used and have been used to provide important pharmaceutical care and products to all South Australians.

For those living in our regions and remote areas, such as the Riverland, the ability to provide an alternative means of service via telecommunication is extremely convenient. It makes care and products more available and accessible to those in need of them most. Although telepharmacy has been employed by many regional pharmacies for years, the lack of clarification regarding the powers of the Pharmacy Regulation Authority of South Australia has caused some confusion.

The telepharmacy services have proven to be successful throughout the state and in some cases have become the main way of distributing pharmaceutical services to customers particularly, as I said, in rural and remote areas. For this reason, many South Australian pharmacies rely on the use of the telecommunication services and without them could end up permanently closing their doors. The bill will see the clarification of the regulatory authority's powers and make legal provisions for authorising telepharmacy permanent, ensuring South Australian pharmacies can continue to employ fantastic services to those in our regional and remote areas.

I must say I want to thank the Pharmacy Guild not only for the briefings that I have received from them and their members but also for the guild coming in and making presentations to standing committees here in the parliament. I think it is critically important that we continue to engage with them and better understand the challenges with the modern-day health services and what they mean to every South Australian.

Obviously, being a representative in one of the great regions in South Australia and having the ability to have satisfactory health services, in Chaffey we have a number of hospitals and healthcare providers, with none more important than the Riverland General Hospital, which is the main base in the Riverland and potentially some of the Mallee. There is a hub-and-spoke approach to some of those healthcare services, namely, Renmark hospital, Loxton Hospital, Barmera hospital, and Karoonda hospital, which services some of the Chaffey constituents.

Karoonda is in Hammond, and of course the Waikerie hospital cannot be understated, as well as Lameroo and Pinnaroo currently, as I said, also in the electorate of Hammond. They also provide an outreach service to some of those constituents in Chaffey, and when they are looking for health services or health care they go to their nearest point of contact. I think we also need to pay respect to the Royal Flying Doctor Service. For many regional people needing health care, if we do need people to be either flown to hospital or have services or supplies provided to them, we occasionally look to the skies and to the Royal Flying Doctor Service.

It is always a concern when we see the plane go overhead and land in a nearby airstrip, but it is there to provide a service—and a vital service it is. I did pick up on the opposition talking about providing services in the COVID pandemic. I think we need to understand that the pandemic is something that has changed the world's thinking about health care, and particularly pharmaceutical care, but what we need to understand is that potentially the health system and health care might be changed forever with the pandemic.

My view is the pandemic will pass, as other pandemics have. It will leave its legacy on today's society for health care, and my heart goes out to those families who have been impacted by the pandemic. I also want to say a very loud thankyou and give a big shout-out to those who are responding to what the pandemic has presented to all South Australians, but particularly in the regions, with people getting vaccinated.

It is critically important that we all play our role and, for those who are sitting on the fence, I say, 'Look on the other side of the fence. Look to the eastern seaboard: it has not been good.' Their vaccination rates are higher than ours, but for very good reason. As I understand it, in New South Wales there are over 30,000 active cases of COVID-19, with an increase every day. We look to Victoria, with the sad stats that are presented every morning by the Chief Health Officer or the health professionals who are there to give us a daily brief. Here in South Australia, I think the government should be commended.

The Transition Committee has performed extremely well in keeping the pandemic and the number of cases at bay. Yes, we will now go through a transition with borders opening, with relaxing some of those levels of restrictions, and we will see numbers start to increase potentially and we will have to deal with that the best way we can. While we are dealing with that, using the science and the health professionals' advice, I think South Australia is poised to be one of the great destinations globally with the way that this government has handled it.

Of course, in the day-to-day operations of providing a satisfactory health service via telepharmacy, I want to thank all the frontline professionals, all those frontline service providers, for their dedication and providing us what I consider a first-class professional healthcare service. If they are providing telepharmacy services, which many people living in the regions would only understand, they need to be commended for keeping us as safe as they can, keeping us in the best of health possible.

We know that when we are sick, when we have an accident, when we have needs through natural causes or natural needs or ongoing treatment, we all look to the health system to provide that level of comfort, to provide that level of care and to save lives. For far too long, people have very much had an expectation on the health system. I just want to make sure that those frontline service professionals are given the accolades they deserve, particularly coming out of this pandemic. I think they have put their services and their health on the line to provide an outstanding level of care not only in country South Australia, remote South Australia, but of course here in metropolitan South Australia.

We know that without good levels of health care, without good levels of professional dedication, the health system would not be what it is today. Without further ado, I support the bill and I hope that it has a very swift passage through the parliament.

The Hon. J.A.W. GARDNER (Morialta—Minister for Education) (11:46): I thank the member for Chaffey for his strong advocacy on behalf of his constituents, and other people living in regional South Australia, and his support for the bill. I thank the opposition for supporting the bill. I commend it to the house.

Bill read a second time.

Committee Stage

In committee.

Clause 1.

The Hon. A. PICCOLO: I would just like to make a few comments in support of this bill. I think it is a very important bill, but it probably does not go far enough and probably does not provide enough protections, which I would anticipate. However, there are two things that I would like to point out.

First—and I do not have to tell you, sir, the importance of this because you live in the country areas—is to ensure that people get access to various services, particularly where they do not have doctors in place, where there is a shortage of health practitioners, and that is important. Secondly, the bill is actually designed to keep our pharmacies viable in country places as well. That is a very important element of this because if we do not have pharmacies, do not have doctors, then there are actually very few primary healthcare opportunities for people in regional areas.

For those reasons, even with its limitations, I would support the bill. I think we should come to a point sometime in the future where we actually get a better understanding of the important role that pharmacies do and could play in our rural communities to support the services and also to keep them viable.

Mr PICTON: I am wondering whether the minister can outline the current status of the draft regulations: have they been drafted and have drafts been circulated to key stakeholder groups, such as the Pharmacy Guild and the Pharmaceutical Society of Australia?

The Hon. J.A.W. GARDNER: There have been ongoing discussions with key stakeholders in relation to the regulations. The minister has written to PRASA and the guild, outlining the key matters proposed to be included in the regulations: prescribed areas where telepharmacy can be provided; that a telepharmacy service, where authorised by PRASA, may only be used when/if in the pharmacists' professional judgement there is a need for immediate supply to the service of a person; and that the locations at which tele pharmacy can be provided be limited to locations with a rating of the Modified Monash Model (which is a measure of remoteness in Australia) of no less than MM5 or small rural towns.

Note, this provision is not proposed to apply in the case where the authorities are authorising telepharmacy to ensure maintenance of pharmacy services during an emergency, as defined by the authority. Further, schedule 8 drugs cannot be dispensed by remote attendance and compounded medicines cannot be dispensed by remote attendance. A requirement is that a pharmacist must physically attend each pharmacy that is undertaking remote dispensing each day it is open and dispensing drugs to the public and that staff working at a pharmacy providing a telepharmacy service are qualified in accordance with the requirement specified by PRASA.

Those items were certainly included in the examples of matters proposed to be included in the regulations. The regulations, as drafted by parliamentary counsel, will be provided to the key stakeholders and a consultation period of two weeks provided for feedback. Following consultation, it is proposed that the regulations will be finalised and gazetted. If I can take the risk of abbreviating the advice provided, the detail of everything that is to be in the regulations has been socialised and circulated and is being consulted on. The legal drafting of the regulations will be further provided upon the passage of the bill.

Mr PICTON: Presuming that we pass this legislation today, which we probably will before midday, what are the government's intentions in terms of timing for when this will come into effect?

The Hon. J.A.W. GARDNER: As soon as possible.

Mr PICTON: The last question, which did answer a number of questions I had in the first one, which was very helpful: in the regulations is there a level of pharmacy technician who will be authorised to deliver pharmacy services?

The Hon. J.A.W. GARDNER: That is among the things that will be the subject of consultation being considered.

Clause passed.

Remaining clauses (2 to 5) and title passed.

Bill reported without amendment.

Third Reading

The Hon. J.A.W. GARDNER (Morialta—Minister for Education) (11:54): I move:

That this bill be now read a third time.

In moving that the bill be read a third time, I offer my thanks to the officers of the Minister for Health, who have provided me with outstanding support through the lengthy passage of this debate, in particular our Chief Pharmacist, Naomi Burgess, who serves the people of South Australia so well. I commend the bill to the house.

Bill read a third time and passed.

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