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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2023-08-31 Daily Xml
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Bills

Advance Care Directives (Review) Amendment Bill

Committee Stage

In committee.

(Continued from 21 February 2023.)

New clause 5A.

The Hon. C.J. PICTON: I move:

Amendment No 1 [HealthWellbeing–1]—

Page 4, after line 8—Insert:

5A—Amendment of section 19—Binding and non-binding provisions

Section 19—after subsection (1) insert:

(1a) Despite any other provision of this Act, a provision of an advance care directive that purports to be a refusal of health care arising out of, or directly related to, the attempted suicide or self-harm of the person who gave the advance care directive will be taken to be a non-binding provision.

I move to amend sections 19 and 36 of the principal act to clarify the effects of an advance care directive on the provision of health care when a health practitioner reasonably suspects that a person has attempted suicide or self-harm.

During the 2019 review of the Advance Care Directives Act, Professor Wendy Lacey was made aware of a small number of cases where advance care directives were applied to prevent the delivery of life-saving medical treatment following an attempted suicide. Professor Lacey recommended the act be amended to ensure that an advance care directive cannot be used as the basis for refusing life-saving treatment following an attempt of suicide or self-harm.

The former Marshall Liberal government, in particular the then minister, the Hon. Stephen Wade, made a regulation to address this matter and, realising that they had not undertaken broad community consultation, committed to further consultation in response to Professor Lacey's review. The Malinauskas government has committed to bringing this matter to parliament for debate and we have worked closely with clinicians and the community to get the form of this amendment right.

The government is treating this matter as a conscience issue, to highlight the fact that the amendment was not included in the tabled bill. I am therefore moving it as an amendment to the government bill as a private member. In 2021 the Hon. Stephen Wade moved a similar amendment to include section 36A into the principal act, with the intent to address Professor Lacey's recommendation. Members will recall that bill to amend the act did not pass before parliament was dissolved for the 2022 state election.

The amendment that I bring to you today improves upon previous iterations of legislation by ensuring additional safeguards are in place against misuse. I stress that there has been a significant amount of work done to try to resolve differences between some of the key stakeholders in addressing this issue. These additional safeguards include:

1. That provisions written into an advance care directive that explicitly refuse health care arising out of or directly related to an attempt of suicide or self-harm will no longer be binding provisions;

2. That a healthcare practitioner will need to have reasonable grounds for believing that a suicide or self-harm attempt has been made and the provision of health care is necessary to save the life of that person;

3. That healthcare providers will be required to record and report health care provided in contravention to a binding provision of an advance care directive;

4. That these amendments will not compel healthcare providers to provide treatment, nor force them to disregard binding provisions; and

5. That there will be further clarifying notes and examples on the effect of the amendments for the avoidance of doubt.

There are various ways in which a binding provision and advance care directive might relate to an attempt of suicide or self-harm. For example, an advance care directive might be explicit in expressly stating that the person does not want to be resuscitated following a suicide attempt. This is addressed by the proposed amendment to section 19. Alternatively, a binding provision in an advance care directive might be a series of wishes expressed by the person regarding outcomes that should apply in all health care. This is addressed by the proposed amendment to section 36.

These amendments do not authorise a health practitioner to provide health care. If a health practitioner wants to provide health care they still need consent, either by obtaining it under the Consent to Medical Treatment and Palliative Care Act 1995 or by some other statutory authorisation. Nor do these amendments compel a health practitioner to disregard a binding provision. A health practitioner may choose to comply with a person's refusal of health care and not provide health care to that person following an attempt of suicide or self-harm. Such a decision would be subject to the usual professional standards of that health practitioner.

I believe that the overwhelming majority of South Australians support suicide prevention. This was shown in the broad support of the community of the Suicide Prevention Act. Supporting this amendment accords with the views of the community to prevent suicide but also balances the other concerns in this area.

I acknowledge the concern of some members of the community that the amendment will, in limited instances and scenarios envisaged by this amendment, remove the autonomy of the person to make their future decisions binding through an advance care directive. However, on balance I am confident the amendment supports health practitioners to provide the best care for our community.

I again reiterate that I want to thank all the key stakeholders for their work in working with the department to try to reach what we hope is at least a consensus position. It was not necessarily everyone's initial view, but I thank people for working constructively on this matter. Hopefully this can be endorsed by the house.

In particular I would like to thank former minister of this place the Hon. Martyn Evans for his work and his passionate advocacy in relation to advance care directives for many, many years. I thank the Australian Medical Association and their officials who have been part of this process for a long period of time as well. I also thank the Chief Psychiatrist, Dr John Brayley, who has been a passionate advocate in relation to this matter as well. Everybody has worked constructively to try to reach this outcome, and I am hoping that this compromise will be considered favourably by the house.

Mr TEAGUE: I am grateful to the minister for that introduction and perhaps putting into some context the history of this going back at least, anyway, to Professor Lacey's review in 2019. I just take the chance at the outset, as the minister has, to recognise the work of the Hon. Stephen Wade, then Minister for Health and Wellbeing, as he led, navigating through the early days of the legislation and then the significant moment of the Lacey review, identifying as it did a whole range of different recommendations back then.

I was fortunate to be asked by Minister Wade to review the Lacey recommendations, consider the report and come back and think about it at the time, so I have had some engagement with the process that Professor Lacey undertook and had the opportunity to speak with her about it. I expressed my gratitude for her work at that time.

As the minister has indicated, the response from Minister Wade was expressed in two ways, firstly by regulation to respond to the relevant recommendation and then what we saw introduced into the other place and passing the other place in the last parliament, an amendment bill that was very substantively in the form of the amendment bill that is before the house now. So we are in familiar territory as we navigate this in the Fifty-Fifth Parliament.

What, as I heard it, the minister might have perhaps skipped through and what might assist the committee at the outset is a recognition or indication that the amendment bill as it was introduced by the minister omitted to incorporate a provision of any kind dealing with this and that the amendment that we have then seen moved by the member for Frome is what was included in that amendment bill.

There has clearly been some conscious deliberation about what was brought to the parliament initially and then, as the minister said at the outset of his remarks, some considerable amount of time passed since the introduction and the commencement of the process in relation to the debate on this bill before the minister has now come to the committee with a form of amendment on this subject matter.

I would be interested if the minister might perhaps put on the record some indication as to how the bill came to be presented absent treatment of this particular aspect and how come we are now seeing—and we will get to the merits of it in a moment—this subject matter being put forward. Of course, that is in no way to characterise the merits of it one way or another, just to understand the steps in the process and to be clear about how we had in the first place an omission by reference to legislation that the parliament had previously seen and now something that is reintroducing the topic and may be covering it in even more slightly comprehensive terms.

The Hon. C.J. PICTON: I thank the member for Heysen for his question. Essentially, if my recollection serves me correctly, what Minister Wade did was introduce the bill in the same way that we introduced the bill, then he introduced an amendment that became the functional conscience vote issue in the Legislative Council. I do not think it ever actually came to our house in the end before the election.

We sought to do the same thing: introduce it without that clause but with the expectation that there would be a debate. Obviously, the member for Frome moved the amendments in a similar if not identical form to that which Minister Wade did, and that became therefore the substantive conscience vote issue.

We have obviously continued to consult and discuss this. We had a forum for all members of the house to hear various people's views on this matter, which brought out some of the complexities and also the differences of opinion on this issue. I have encouraged the department to keep working with those relevant stakeholders, Chris Moy from the AMA, Martyn Evans and Dr John Brayley, to work together to see if there is some way that could find an improvement that could lead to more consensus in relation to this matter. That is now where we have brought this to the parliament and I am hoping it will get more consensus than where we were previously.

Ms PRATT: I wish to thank the minister for the efforts he has taken to work with those stakeholders in improving on the amendment that I filed last year in good faith in that we were all striving for a similar outcome. While I think it is unfortunate that much time has passed, because there are so many people dependent on the conclusion and the passing of this bill, if the silver lining is the amendment we currently have before us—and hopefully today we see a positive outcome—I will accept that the delay was worth it. I genuinely thank the minister, public servants and staff who have been working in the background on this to find some common ground.

Minister, I am taking my focus straight through to (1b), so I am looking at the amendment of section 36, 'Health practitioners to give effect to advance care directives', where the insertion of (1b) directs that—

An honourable member interjecting:

Ms PRATT: I do not have any questions for the new one.

New clause inserted.

Clause 6.

The CHAIR: Member for Frome, you have an amendment at clause 6. Do you want to speak to that? It is schedule No. 34(1) and amendment No. 2. It deals with clause 6, page 4, after line 14; is that correct?

Ms PRATT: That is not how I read it.

The CHAIR: That is what I am advised. So 34(2) and 34(3) relate to later clauses. We are now at clause 6, which is actually 34(1). That is what I am advised. We are now going back to clause 6, which is the amendment put by the member for Frome—that is, 34(1), amendment No. 2.

Ms PRATT: I would like to ask some clarifying questions because it has been a long time. My amendments were filed a long time ago. There were two amendments, and the minister has filed his amendment, which I understood he was speaking to. If we are not now addressing his amendment in committee and that was just an introduction—

The CHAIR: No, we dealt with amendment No. 1 because that was dealing with clause 5.

Ms PRATT: So we are going back to the amendment I filed on requirements for witnessing advance care directives—amendment No. 2, clause 6, page 4, after line 14.

The CHAIR: Yes, we are doing that now.

Ms PRATT: Which is where the committee was interrupted at that point.

The CHAIR: That is correct, but because this clause dealt with the previous clause, we finished that one off.

Ms PRATT: Yes. It was messy, Chair, but we are back on track. Those clauses and that amendment, or the two parts of those amendments, obviously were addressing the order of signing. It is unfortunate that it was interrupted part way through, so I am looking to the Chair now for guidance or instruction on this amendment. From memory, I spoke to the purpose of my introducing it. I assume I am not asking questions of the minister about my own amendment.

The CHAIR: All you need to do is move your amendment.

Ms PRATT: This is part 2 and this committee was stopped after part 1 with not a lot of notice. I move:

Amendment No 2 [Pratt–1]—

Page 4, after line 14—Insert:

(2) Section 21—after subsection (3) insert:

(3a) Without otherwise limiting the requirements that may be set out in regulations made under this section relating to the appointment of substitute decision-makers, the regulations—

(a) cannot require an advance care directive to be signed or witnessed in a particular order; and

(b) cannot require a substitute decision-maker to complete a part of an advance care directive form before the advance care directive can be witnessed.

The Hon. C.J. PICTON: To be clear for the committee, this is not in the conscience vote discussion; this is the order of signing issue, as I understand it, which we had previously discussed. Certainly, the government's position is that we are opposed to this amendment. We will be opposing this amendment for the reasons that we previously articulated in the previous amendment during the committee stage.

Amendment negatived; clause passed.

Clause 7 passed.

Clause 8.

The CHAIR: I understand there are two amendments to clause 8. We will proceed with the minister's amendment first, but I am also advised that if the minister's amendment is passed it does not stop you from moving your amendment.

Ms PRATT: I am seeking clarification from you, Chair. Separate to clause 8, my amendment looks to insert a clause at 8A, which was filed first, and so before we address the minister's amendment—

The CHAIR: I am advised that because the minister's amendment, even though it is 8A, deals with an earlier part of the bill it takes precedence. Even if the minister's amendment is passed, it does not preclude you from putting yours. They are two separate matters and it does not stop you from moving yours. My understanding is that the minister's amendment is amending section 36. Your amendment seeks to introduce a new 36A and that is why it takes precedence.

Clause passed.

Clause 8 passed.

New clause 8A.

The Hon. C.J. PICTON: I move:

Amendment No 2 [HealthWellbeing–1]—

Page 5, after line 17—Insert:

8A—Amendment of section 36—Health practitioners to give effect to advance care directives

(1) Section 36—after subsection (1) insert:

(1a) Subsection (1)(a) does not apply in relation to a binding provision of an advance care directive to the extent that—

(a) the health practitioner reasonably suspects that the person has attempted suicide or self-harmed; and

(b) the health practitioner is of the opinion that the provision of health care is reasonably necessary to save the life of the person.

(1b) A health practitioner who, pursuant to subsection (1a), provides health care in contravention of a binding provision of an advance care directive must, as soon as reasonably practicable after doing so—

(a) make a written record setting out the information required by the regulations in relation to the provision of the health care; and

(b) provide a report in relation to the provision of the health care in accordance with the requirements set out in the regulations.

(1c) Subsection (1)(b) does not apply in relation to a non-binding provision of a kind referred to in section 19(1a).

(1d) Subsection (1)(c) and (d) do not apply in relation to a binding provision of a kind referred to in subsection (1a), a non-binding provision of a kind referred to in section 19(1a), or to health care of a kind referred to in subsection (1a)(b).

(1e) Without limiting subsections (1a), (1c) or (1d), but to avoid doubt, the effect of those subsections is as follows:

(a) a health practitioner may disregard a provision of a person's advance care directive that is a refusal of health care if—

(i) the need for the health care arises out of the attempted suicide or self-harm of the person; and

(ii) the health care is reasonably necessary to save the life of the person;

(b) in such a case, the health practitioner—

(i) may nevertheless decide to comply with the person's refusal of health care in their advance care directive and not provide such health care to the person; or

Note—

Such a decision would be subject to the health practitioner's usual professional standards.

(ii) may, if authorised to do so under another Act or law, provide health care to the person despite the person's refusal of the health care in their advance care directive if, and only if, the health care arises out of the attempted suicide or self-harm and is reasonably necessary to save the life of the person;

Note—

Such Acts would include the Consent to Medical Treatment and Palliative Care Act 1995 and the Mental Health Act 2009.

(c) nothing in those subsections operates to authorise the health practitioner to provide health care without being authorised to do so under the Consent to Medical Treatment and Palliative Care Act 1995 or the Mental Health Act 2009 or any other Act or law;

Note—

Those Acts operate to deem consent to have been given, or to dispense with the need for consent, in specified circumstances.

(d) the person's refusal of health care in their advance care directive (for example, in the case of a general 'do not resuscitate' provision) would continue to apply in relation to any health care that does not arise out of the attempted suicide or self-harm, or that is not reasonably necessary to save the life of the person.

Example—

If the person were to need stitches for a non-life threatening laceration, the person's refusal of treatment would, even in the case of self-harm, continue to apply.

(2) Section 36(5)—delete 'subsection (1)' and substitute 'this section'

I would love to take credit for the tricky parliamentary manoeuvre that has occurred, but certainly it was not intentional.

We have previously articulated, and as the member for Heysen outlined, the comments that I made in relation to my previous amendment essentially covered the two amendments together and obviously the comments in relation to the work that has been done to try to reach a consensus position applies to this amendment as well as to the previous one.

I would like to put on the record, following the member for Frome's previous comments, my thanks to her in terms of the constructive way in which she has worked on this matter. It is certainly not, in my view, a party political matter and it is certainly something on which there has been broad bipartisan agreement in terms of this area of policy for some time, and long may that continue. Hopefully, through the work that has happened over the past few months in reaching some level of consensus, this can broadly get consensus across both houses.

Mr TEAGUE: This is just an indication of my attitude to the amendment before there might be more particular questions about the provisions that have been presented and, as it turns out, first for that numbering reason. I want to indicate to the committee the reasons for my support for this amendment, and I want to recognise also, with particular gratitude, the work the member for Frome has undertaken in making sure that this is attended to. It has been a significant and dedicated commitment to this particular aspect of the legislation.

Of course, when we are talking about advance care directives we are in a space as a matter of principle which is concerned with an engagement between an individual and a healthcare provider in circumstances where a directive is able to be given by someone who is capable to do so in advance of circumstances that might befall them down the track in terms of their health and later life.

It is not, in my view, an occasion by which the parliament ought to find itself legislating in such a way as provides or in any way regulates a pathway towards the taking of one's life. We have focused as a parliament over a sustained period of time on an understanding of how to prevent suicide. We have indeed legislated specifically in that regard in what is a particularly difficult, mysterious, unknown and still one of those few remaining taboo areas of life and wellbeing; nonetheless, we have grappled with it with a view to understanding how it can be prevented.

It ought to be, I think, a matter of straightforward understanding that every suicide is an unmitigated disaster, and there is no occasion that, through a legislative instrument that is designed to facilitate the engagement of an individual with the health system, ought to be in any way distracted by those particular circumstances. Without traversing further into the area of the voluntary assisted dying legislation, which passed the parliament in recent years, there are a number of ways through statute, public policy intervention and other public engagement, where we can grapple with end of life, we can grapple with autonomy of individuals in their engagement with the healthcare system and indeed with we can engage proactively in better understanding and working towards suicide prevention.

It is my view as a matter of clear principle that advance care directives have no role to play in those circumstances, and it is right that the legislation provide a robust pathway for health practitioners to navigate when dealing with those particular and unfortunate circumstances. I commend the amendment, and I think there are some questions more particularly directed to those aspects of it that expand upon the version that has previously been elucidated, and I might take the opportunity in due course, but I otherwise commend the inclusion of it in the amendment bill.

Ms PRATT: Minister, the clause that got my attention with most interest was the insertion and addition of requiring a doctor or a health practitioner providing that life-saving treatment where the health practitioner must, at (1b), make a written record or provide a report. I am looking for an explanation of the origins of this clause and further details around whether it will be a digital record. Who is this report for? Who is it reporting to? What oversight will there be? What necessitates this report? While I am mindful of the details in this question, my interest goes to the data that is going to be recorded, captured, and the purpose behind the origins of that clause. I think I will reserve a follow-up question.

The Hon. C.J. PICTON: As I mentioned earlier, this is one of the additional safeguards that has been added. This came out of the consultation that I discussed earlier. I am advised that this particular one was a suggestion from the Hon. Martyn Evans, who is someone who has been significantly involved in advance care directives work for many years. The idea is for this not to be an onerous requirement. The provision sets out that the specific requirements will be set by regulation, but it is envisaged that this could be in electronic form, i.e., it could be added to in SA Health way through the Sunrise electronic patient record system that we have and operate across our hospitals, and that would be duly noted within that electronic record system.

Ms PRATT: Following on from that, can the minister speak to who will have access to this record and report once it is created? Does it allow for the substitute decision-maker or a family member to understand the decisions made by that health practitioner? Who will receive this report?

The Hon. C.J. PICTON: In relation to the report, it is envisaged that that it will be a statistical report, not going into the particular clinical details about individual people. Essentially, there is a safeguard to detect if this issue is becoming abused, for lack of a better word, in the sense of numbers more than would be expected as a safeguard to be able to track the statistical data of it.

On the other hand, the information that we put in somebody's electronic health record is obviously subject to the standard procedures required under the Health Care Act in relation to a patient's data, and medical information would be subject to their personal privacy provisions or their permissions or the next of kin's permission for that information to be accessed or as authorised in another way under the Health Care Act.

Mr TEAGUE: This goes to the same subsection (1b). To be clear, there are a number of aspects that are not spelled out within the subsection. It is a matter of interest as to exactly what purpose these obligations upon the health practitioner are intended; they are just not spelled out on the face of the record. The thrust of my interest goes to the practical burden upon the health practitioner in terms of complying with these two requirements and, as the member for Frome has commenced to inquire upon, the place that these reports and written records will be recorded and the purpose for which they will be applied. To be clear, (1b) provides:

(1b) A health practitioner who, pursuant to subsection (1a), provides health care in contravention of a binding provision of an advance care directive—

again, we have already deemed it to be non-binding, so I will perhaps move on from that. If I am understanding it correctly, it might have been expressed as a non-binding provision by operation of the new section 19(1a) of that advance care directive—

must, as soon as reasonably practicable after doing so—

(a) make a written record setting out the information required by the regulations in relation to the provision of the health care; and

(b) provide a report in relation to the provision of the health care in accordance with the requirements set out in the regulations.

We have requirements that are to be set out in the regulations, but we don't have anywhere there to whom the written record is to be provided for the purposes of (a) nor to whom the report is to be provided for the purposes of (b).

The minister has given an indication about the kinds of places where one might expect to find such a written record or such a report, and it may be that the regulations are capable of encapsulating both the contents of each of those documents and their destination, but we do not see anywhere on the face of the provision that it is a kind of report or written record that fits within a certain category, therefore it is always understood to be headed in a particular direction, nor do we see anything indicating the purpose for which that written record or report is to be provided.

It is a question about the capacity of the new provision and an opportunity to put on the record where those documents are to be directed. I realise there is a bit of a catalogue in working through that, but the minister might care to address whether or not there is a need to address the fact that this is presumably not a binding provision; it is an otherwise binding provision but deemed to be non-binding by virtue of section 19. I apologise for ending up wrapping all that up in one combination of questions.

The Hon. C.J. PICTON: Some of that was commentary, which I will accept as commentary. In relation to the reporting requirements, as the section says, that will be set in the regulations. Our thinking in putting it as part of the regulation is to enable that obviously to be as less burdensome as possible to make sure that we are reducing the burden on clinical staff. For instance, what is envisaged is that in SA Health it would be something that would be part of the Sunrise electronic health system, it would be something that could be easily entered within there, and then there would be no separate reporting requirements because it would be within that system; it could be pooled centrally.

If it were to be outside that system, then there would be—in the regulations that we are envisaging—a way in which that information could be provided to the Chief Executive of SA Health so that that statistical information can be compiled and can be reported against to ensure, as we said, there is no overuse or abuse of these sections that are being legislated.

Mr TEAGUE: That answer from the minister just now helps in terms of the body of information that might be available to anybody who is seeking to interpret the provision. I guess to look at it from the other end of the spectrum, in terms of what it actually requires as a minimum, as opposed to what might be expected as a form of compliance against quite a straightforward proposition, if you are a health practitioner and you consult the regulations in each case as to the contents of the written record and the report respectively then, on the face of the provision, you are complying if you make for yourself a form of written record and you make for yourself a form of report.

I just emphasise that the regulations do not contemplate indication as to the required destination of each of those two documents. The regulations are only going to be concerned, on the face of it, with the contents of the written record and the report respectively. I wonder if the minister has anything further to say about that and whether or not it may be necessary to provide for further regulation as to the required destination of those two documents.

The Hon. C.J. PICTON: I think in the vast majority of these cases—to the extent that there is a significant number of these cases, which I think remains to be seen—the requirements in terms of record keeping will be essentially what a clinician will be doing in any case in terms of recording the care and the decision-making that were provided, and there are numerous professional or statutory requirements on clinicians in terms of their record keeping requirements.

To the extent that there is, through paragraph (b), a report in accordance with the requirements and the regulations, this has enabled that information—particularly the statistical side of that information, not the direct care and clinical notes but the statistical information—to be provided ultimately to the department so that that can be kept track of as a safeguard measure to ensure that there is no overuse of this section.

Mr TEAGUE: This is a third one, but it is giving you another go to answer what was in the first one. I realise that that came along as part of the narrative. I will just come back for a clear answer, if I may, about the point that I raised in the first question: (1b) sets out to say that you have a health practitioner who provides health care in contravention of a binding provision of an advance care directive. Is it consciously set out that way so, therefore, it provides for not only the circumstances of this particular amendment that we are here talking about but is applicable more broadly, or is it necessarily addressing itself and should be read as an otherwise binding or a non-binding provision by virtue of section 19(1a)?

The Hon. C.J. PICTON: The member has raised a good question. It is complicated and I will try my best to answer it. In relation to the amendment we have just passed in relation to new clause 5A, amendment of section 19, that is about a specific provision within the advance care directive that relates to a suicide outcome—so saying, 'If I do this, don't resuscitate me'—whereas section 36 is broader than that.

Mr TEAGUE: Do not stop there. It is a supplementary, if you like. Do not stop there; it is important. The point is that if it is intended to apply across the board—that is, every time a health practitioner provides healthcare treatment in contravention, therefore, of a binding provision, and there might be any number of them—then are they by virtue of this provision now having to provide the written record and the report in terms that we have talked about?

The Hon. C.J. PICTON: I just draw your attention to the starting of new subsection (1b), which is 'pursuant to subsection (1a)', so it is only in relation to those binding provisions that are discussed within (1a) where the practitioner reasonably suspects that the person has attempted suicide or self-harmed and the health professional is of the opinion that the provision of health care is reasonably necessary to save the life of the person. It has to be seen in that context. It is broader than section 19, but is narrower than everything under the sun because it is limited to subsection (1a) as well.

Ms PRATT: My questions were about the origin of this clause and the purpose for collecting that data, and you have certainly been addressing them in a fulsome fashion. Given the engagement that has occurred with stakeholders, I wondered whether the Office of the Chief Psychiatrist was engaged with the creation of or gave feedback on these clauses in regard to making a written record or providing a report, and whether—to the member for Heysen's questioning in terms of the destination—there is any action or connection to the Office of the Chief Psychiatrist where these records are given, noting that I do not think South Australia has a suicide register, but—we do?

The Hon. C.J. PICTON: Yes.

Ms PRATT: We are talking about collecting information or creating reports that will document those attempts. The question is about the interaction with the Office of the Chief Psychiatrist contributing to the clause or feedback back to the OCP.

The Hon. C.J. PICTON: Firstly, the Office of the Chief Psychiatrist has been very much involved in all the discussions around this clause over the past few months, so that is certainly in relation to number one. Secondly, in relation to whether they are supportive, that consensus provision has been arrived at, so there is support.

Thirdly, in relation to whether they will receive the reporting, it is envisaged that we will put it in the regulations that will go to the chief executive of the department, but certainly via that mechanism it may well be that that information is provided through to the Office of the Chief Psychiatrist as well as part of their statutory role.

I will quickly sum up and thank all members for their contributions and work on this clause over a long period of time and thank all the stakeholders who have been involved in the discussion. I think it is good that we have reached this consensus provision. No matter what side people were coming to, there was a lot of passion for making sure that this was a good outcome, and I think we have achieved that.

New clause inserted.

The CHAIR: It is my humbling duty to advise the committee that something that was said earlier has been proven incorrect—I was wrong, simple as that. As a consequence, the member for Frome cannot proceed with her amendment to 8A, as that would be in contradiction of the two amendments already passed. Having said that, I will give the member for Frome an opportunity to speak about what she intended to do if she wishes so that we have it on the record.

Ms PRATT: Thank you, Chair. The minister knows my views based on previous discussions and comments today in committee. I again thank parliamentary counsel for the work in drafting both amendments, colleagues on both sides for their consideration of both amendments and the opportunity to reflect on former Minister Wade's original amendment in a previous iteration.

The intention of the original bill was, in my words, not to facilitate or be a vehicle for suicide. This current amendment that has just passed is indeed an improvement on the amendment bill introduced by the minister, and I thank the Chair for his recognition of due process for the amendment that I filed. I thank him for that opportunity to address that oversight. I thank again all members of the house who have considered this amendment.

Remaining clause (9), schedule and title passed.

Bill reported with amendment.

Third Reading

The Hon. C.J. PICTON (Kaurna—Minister for Health and Wellbeing) (16:38): I move:

That this bill be now read a third time.

Bill read a third time and passed.

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