HANSARD
SITTING CALENDAR
SEARCH
LIVE BROADCAST
Hansard Dynamic Member Index
House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2022-12-01 Daily Xml
Contents
Xml

Motions

Urinary Tract Infection Treatment

Ms STINSON (Badcoe) (11:02): I move:

That this house establish a select committee to inquire and report into—

(a) barriers facing sufferers of urinary tract infections (UTIs) in gaining timely access to treatment;

(b) the applicability of implementing Queensland’s Urinary Tract Infection Community Pharmacy Service in South Australia; and

(c) any other related matter.

I am seeking the support of this house to establish a select committee into access to urinary tract infection treatment for the hundreds of thousands of South Australian women—and some men—who endure the excruciating and sudden pain of an uncomplicated urinary tract infection, better known to sufferers as a UTI.

This is for women like my mum, women like my friends, women like my colleagues even right here and women like me. Imagine that you are lying in bed, fast asleep and it is 2am. Suddenly you wake up and you can feel that you simply must race to the loo. When you get there you experience a sharp pain shooting through your lower body. It is like a thin metal pin has been shot into you and the more you try to relax, the more it hurts. It is so painful that you find yourself screaming out loud.

Imagine that you are at work. You are in a very important meeting with very important people. The discussion is getting complicated and you are trying to follow the points that are being made. You cannot concentrate. You cannot sit still. You cannot get comfortable. All you want to do is leave, go to the bathroom or maybe just lie down. You are getting stressed that you might just have an accident, but you struggle on, knowing that this is as much a mind game as it is a physical taunt.

Imagine that you are caring for children. You are bouncing on the trampoline in the backyard, you are playing chasey and you are having a great time, but suddenly you feel a familiar discomfort and you know what is coming. You know that pretty soon you are not going to be running around or playing on a trampoline, or even moving much at all.

Imagine that you are on a plane. Everyone has taken their seat and settled in, and you grab your book and try to get comfortable for the three-hour flight ahead. The plane takes off and you find yourself watching for that seatbelt light to flash off so you can get up and go to the toilet. It is that feeling again: this is going to hurt and it is going to be a tough few hours and maybe even a tough few days.

Maybe you are lucky enough to be travelling in a remote part of Australia, and this is what you live for. You are in the back of a four-wheel drive and you are on a rocky road. It should be a beautiful experience, soaking up the wilds of the Flinders. Instead, it is the most painful experience of your life as every bump shoots pain through your body. Miles from a doctor, you know you will be enduring this for many days to come. So much for that adventure.

Experiences like this are shared by so many women and some men too. These particular experiences that I have just shared are my own. I used to be terribly embarrassed and ashamed about this and, honestly, standing here in front of you all I am just a tiny bit embarrassed again. Let's face it, talking about wee is not the most elegant thing that you can talk about. I have found in recent years, when I have spoken about it with close friends and family, that so many other women endure exactly the same thing as I do and have for many years.

There is, of course, comfort in sharing such experiences, and other sufferers are very supportive, but so many of those conversations I have had end up in a discussion about the long wait for medication and how unnecessary it feels to have to endure such sharp and sudden yet entirely familiar pain as we wait to be able to see a doctor, get a script and go to a pharmacy to get medication.

In this place, we are essentially shiftworkers and the hours can be unpredictable. We have jobs that involve obligation and responsibility and being places when we need to be. We have busy personal lives, too, and that is no different from many other South Australians. This modern lifestyle can make it hard to get to a doctor, and there is no denying that getting a GP can take days or, for some, weeks. In country areas the wait can be long.

Like many others, I have sought detailed medical advice and tried to find a more permanent fix. I have followed the medical advice about how to avoid a UTI, and I have drunk more cranberry juice than anyone should have to in their entire lifetime. When the pain strikes, there is one solution for me and for hundreds of thousands of others, and that is a short course of antibiotics.

Half of all South Australian women will face a UTI at some point in their lives, and one in 20 men will be struck by the painful condition too. A UTI is caused by bacteria in the urethra, bladder and/or the kidneys and is often difficult to predict or prevent. The infection causes intense pain during urination, the constant sensation of needing to urinate and discomfort throughout the period of infection. While alkalising drinks may relieve symptoms for some people, for most sufferers antibiotics are required to address the infection.

Currently, sufferers must book an appointment with a GP to obtain a script for medication and then have that filled at the pharmacy. For many people, this can mean days of pain and discomfort before securing an appointment and the effective treatment. For those in country and remote areas, as I said, the wait can be much longer. If left untreated, or if treatment is delayed too long, the condition can result in admission to hospital for kidney infection or other complications, and that is not unusual.

Queensland has recently allowed specially trained pharmacists to assess patients and provide UTI medication following a successful pilot program that that state ran. The New South Wales government recently announced similar moves to be able to allow pharmacists to provide a wider range of medications, including UTI medication. In Victoria, only last week state Labor made an election commitment, which I expect they will fulfil given their re-election to government, in relation to UTI medication through pharmacies.

While some of these interstate approaches include additional medications other than UTI treatments, it is important to note that what I am proposing with this South Australian select committee is intended to focus only on UTI medication. Many people have said to me, 'Why don't you just legislate the change straightaway and why even hold an inquiry?' That is a fair question. It is an understandable question from sufferers who would like to have access to medication through their pharmacist as quickly as possible.

But the reason for an inquiry is this: I take women's health seriously, Labor takes women's health seriously and I am quite confident that this parliament takes women's health seriously. We owe it to women to carefully and thoroughly examine models of care and treatment that meet their needs in a safe and timely way.

I am well aware that there are divergent opinions between different medical disciplines and indeed differences of opinion between professionals who share the same discipline. There are also valid questions from consumers and practical considerations about the best type of scheme to suit South Australia. This is the purpose of the inquiry I am proposing—to tease out those questions, seek out answers and the most appropriate arrangements to suit patient needs.

I am unashamed that this inquiry is about putting UTI sufferers first, putting the health needs of women first. Of course we must rely on medical evidence to ensure that any scheme is as safe as it can possibly be, but I am really not interested in a turf war. I am interested in what is best for sufferers.

The point has been made and will continue to be made, I am sure, that there is a need for more GPs in order for patients to be able to see a doctor faster. I agree. Just last week the AMA released its report into the GP workforce. I will quote from their own media release:

Australia is facing a shortage of more than 10,600 GPs by 2031-32, with the supply of GPs not keeping pace with growing community demand.

In the decade to 2019 demand for doctors' services increased by 58 per cent, that's equivalent to the workload of 10,200 full time GPs.

In the 5 years to 2021, only the equivalent of 4,200 full time GPs were added to the workforce.

On average both male and female GPs have been trending towards fewer hours per worker. The combined effect has been a lowering of average hours worked across the GP workforce.

That is worrying. Those are very worrying numbers, and action is absolutely needed. This government is doing what it needs to do to act on those needs.

In reality, in the real world in which we are living, there is not going to be a new flood of GPs within weeks or months. In those weeks and months and years, more women are suffering an uncomplicated UTI that could possibly be treated faster in consultation with their pharmacist. I am interested in their needs in the reality of this world right now.

As I said, the purpose of this inquiry is to investigate—to ask questions, to seek answers and to arrive at useful recommendations to the parliament. Areas the committee may choose to traverse but are not limited to are:

regional and remote access to UTI treatments and the question of providing access where both pharmacists and doctors are scarce;

affordability of treatment;

privacy and confidentiality;

the training already provided to university-qualified pharmacists and what that training equips them to be able to do currently;

additional training in relation to any future scheme that might be established;

the actual model of care itself, with particular reference to the Queensland approach and how that might be improved upon or tailored to suit South Australian needs;

follow-up contact and collection of data so that we can track outcomes for patients; and

the periodic review of such a scheme.

I am sure that committee members would also want to look at the usefulness of trials or pilot periods for South Australia and the design of any such scheme. The use of antibiotic resistance will certainly, I think, come up if this committee is established. It is a serious concern, and I am sure the committee would like to have a look at whether that is an issue in relation to pharmacy-based provision of UTI medication.

Current alternatives to GP appointments, including online-based prescription services like InstantScripts, have been raised with me as well in relation to accessing UTI medication. I am sure that there are also many other areas for investigation that will arise in the course of written and verbal submissions, if this parliament agrees to establish the committee.

Although I do not wish to traverse the ins and outs of the Queensland model in detail at this juncture, because I firmly believe in the inquiry process and its capacity to delve deeply into that model in due course, I might just pause to point out an important factor: what we are talking about here is the assessment of uncomplicated UTIs. Under the Queensland model, if a pharmacist identified complicating factors, such as a pre-existing complex medical condition, or the pharmacist was not convinced that a patient was likely to be suffering a UTI, under the model of care they refer that patient to a GP. I feel that is an important point to make to the parliament and something that I am sure a committee would investigate further.

With the establishment of this committee, I look forward to hearing from all interested parties in the medical professions as well as advocacy groups, but most importantly from UTI sufferers, about their views on how we can make access to timely, effective and safe treatments for UTIs a reality for them. I strongly urge members of this house to support the establishment of this committee. We owe it to sufferers of this very common affliction to investigate any ways that we can make life easier and less painful for them.

Ms PRATT (Frome) (11:16): I rise today on behalf of the opposition to speak on the private member's motion moved by the member for Badcoe, and I thank her for turning her mind to this significant health issue that impacts not just women but men. As the shadow minister for regional health services and aging, I see a natural contribution that I can make to this space.

I think that in her speech the member for Badcoe has laid out for the future select committee a thorough and comprehensive understanding of why this is a significant health issue that seems to have some practical solutions available to us through clinicians, health practitioners and medical experts. It would not be lost on anyone in the chamber who is listening that cranberry juice seems to be the go-to option for most people at the moment.

Again, I reflect on the nursing homes and aged-care facilities I have been visiting and also on family members. I am sure that many in the chamber will know of someone, if not themselves, having a lived experience, if you like, of urinary tract infections. I am optimistic that a select committee can provide some alternatives or add some value to the cranberry juice option.

I note that when the member reflects on a turf war, I would like to think that perhaps she is reflecting on the medical experts and the differing views that we are coming across, particularly out of the Queensland trial, noting that the Australian Medical Association and the Pharmacy Guild are coming at this from different angles. I think the committee is the right course to take to ventilate and tease out some of those expert views. I have certainly been interacting with these groups naturally, from a regional health and aging point of view, and I think that the committee is going to learn a lot from taking evidence from all of these groups.

I would also take an opportunity to introduce a group that I hope the committee may take evidence from. It stems back to funding allocated by the former federal Liberal Coalition government to Flinders University based at Tonsley, to Aged Care Research and Industry Innovation Australia (ARIIA). They were allocated $34 million to explore research and innovation in aged care, and I suspect there are already projects that are being submitted that touch on innovation in this space. This is signalling to the member for Badcoe that the research and the experts are already ahead of the committee and it will be an opportunity for the committee to entice them to report back.

It is expected that this committee will hear varying views on the proposal relating to the provision of treatment for self-declared UTIs from a pharmacy and any other related matters determined by the committee. I want to touch on perhaps this turf war concept that the committee may uncover between warring professions or clinical experts with different views. The member mentioned the challenges that the general practice workforce is experiencing at the moment, and I note that the Pharmacy Guild of Australia have a view that they are, if nothing else, offering solutions to support a workforce and a frontline already under pressure.

I predict that the committee will hear differing views about service delivery from the Australian Medical Association, the Royal Australian College of General Practitioners and the Pharmacy Guild of South Australia. As lawmakers, of course, it is for us to investigate and implement sound policy decisions, particularly in the area of medicine, with the aim to protect and safeguard patients. We are obliged to lift our heads up beyond the walls of this chamber to seek best practice, wherever that may lie, and that may be in our state, interstate or even overseas.

The terms of the committee will review the analysis and outcomes reported from the Queensland trial and reflect on efficacy for both industry and patients and I think that balance is going to be important. The Liberal opposition supports the motion and, along with the member for Unley, I look forward to the work of the committee ahead. I support the motion.

Ms STINSON (Badcoe) (11:21): I want to wholeheartedly thank the opposition for their support and in particular the shadow minister, given her wealth of knowledge in this area. I am very much looking forward to working with her—and also Mr Pisoni—given the relationships she already has across the medical professions and also her focus and experience in regional health and aged care. Already the member has offered a possible line of inquiry in terms of the Tonsley-based Aged Care Research and Industry Innovation centre, which, of course, I will pursue. I would love to hear what they could contribute to the debate and the work they are currently doing. I thank the member very much for contributing so eagerly at this early stage and also overall for the committee's support.

I think that probably brings me to the conclusion of my remarks, other than to say that I am very much looking forward to getting stuck into work on something that I think is an important policy issue and also obviously something that is so incredibly close to my heart and the hearts of many in this place.

Motion carried.

Ms STINSON: I move:

That a committee be appointed consisting of Ms Pratt, the Hon. D.G. Pisoni, S.E. Andrews, Ms Hutchesson and the mover.

Motion carried.

Ms STINSON: I move:

That the committee have power to send for persons, papers and records and to adjourn from place to place and that it report on 8 December 2022.

Motion carried.

Ms STINSON: I move:

That standing order 339 be and remain so far suspended as to enable the select committee to authorise the disclosure or publication as it sees fit of any evidence presented to the committee prior to such evidence being reported to the house.

The SPEAKER: An absolute majority is required. With my careful count of the house and an absolute majority not being present, ring the bells.

An absolute majority of the whole number of members being present:

Motion carried.

Ms STINSON: By leave, I move:

That the committee have leave to sit during the sitting of the house today.

Motion carried.

PARLIAMENTARY BUSINESS
MEMBERS
GET INVOLVED
ABOUT PARLIAMENT
VISIT
LEGISLATIVE COUNCIL
HOUSE OF ASSEMBLY
CONTACT