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Legislative Council - Fifty-Third Parliament, Second Session (53-2)
2015-10-28 Daily Xml
Contents
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Motions

Medical Cannabis

Adjourned debate on motion of Hon. T.A. Franks:

That this council—

1. Notes the release of the Victorian Law Reform Commission's landmark report recommending a controlled licensing scheme to produce medical cannabis and congratulates the Andrews government in Victoria for indicating they will take steps to legalise cannabis cultivation for medicinal use;

2. Recognises the significant body of research supporting the benefits of medical cannabis to treat serious medical conditions including cancer, Multiple Sclerosis, HIV/AIDS, epilepsy and chronic pain;

3. Notes that more than a dozen countries, including Canada, Israel, Italy, Portugal, Spain and parts of the United States already permit the use of medicinal cannabis;

4. Notes the cross-party work led by Greens leader Richard di Natale, via the Regulator of Medicinal Cannabis Bill, which could become operational as early as next year; and

5. Calls on the Weatherill government in South Australia to follow the lead of the premiers of Victoria, New South Wales and Queensland by acting on medical cannabis reform to ensure that South Australians do not continue to suffer needlessly.

(Continued from 14 October 2015.)

The Hon. T.T. NGO (16:29): I rise to respond to the motion on behalf of the government. Before I outline my reasons I move to amend the motion as printed on the sheet that I handed out as follows:

1. Delete the words following 'medicinal cannabis'.

2. Delete the words, 'Recognises the significant body of research' and insert the words, 'There is some evidence'.

5. Delete the words, 'Calls on the Weatherill government in South Australia to follow the lead of the premiers of Victoria, New South Wales and Queensland by acting on medicinal cannabis reform to ensure that South Australians do not continue to suffer needlessly' And insert the words, 'Note the South Australian Government will continue to collaborate with the other jurisdictions to progress the evidence to inform best policy and approach for the safe and effective medicinal use of cannabis'.

In proposing these amendments to the motion as it currently stands, I make the following observations. Cannabis is a controlled drug under the Controlled Substances Act 1984. Possession, supply or use of cannabis is illegal in South Australia. The government takes the view that cannabis is not a harmless drug. The long-term harmful effects of cannabis include increased risk of respiratory disease associated with smoking, including cancer, dependence, decreased memory and learning abilities, mental health effects and decreased motivation in areas of study, work or concentration.

The government recognises the need for South Australians to have access to the optimal range of treatments and services to promote the best health outcomes. This includes the availability of medicines that are shown to be safe and effective.

Medicinal use of cannabis is subject to ongoing debate among health professionals and more research is needed into its safety and efficacy. On present evidence, medicinal cannabis would only be appropriate for a very restricted group of patients in specific circumstances. These patients would generally be people with severe and distressing symptoms not able to be relieved by existing medications.

The evidence for the efficacy of cannabis in the treatment of particular conditions varies in its vigour and there are gaps in the evidence, particularly in relation to the long-term safety of use of medicinal cannabis. The evidence is often anecdotal; studies are often small and the medicinal cannabis products are not tested against the accepted standards of care. For most conditions the current evidence would fail to meet the standards required by the Therapeutic Goods Administration for registration of medicines in Australia. Cannabis may potentially have value in treating the following:

severe muscle spasms or pain resulting from multiple sclerosis;

severe pain resulting from cancer, HIV or AIDS;

severe nausea, vomiting or wasting resulting from cancer, HIV or AIDS;

severe seizures resulting from epileptic conditions where other treatment options have not proven effective or have resulted in side-effects that are intolerable for the patient; and

severe chronic pain.

The government notes that the Victorian Law Reform Commission Medicinal Cannabis Report, August 2015 was tabled in the Victorian parliament on 6 October 2015. The report proposes the following:

1. Access to medicinal cannabis in exceptional circumstances according to defined eligibility criteria and a licensing scheme for cultivation and manufacture of medicinal cannabis in Victoria.

2. Dosage forms would include tinctures, capsules, oils, sprays and vaporisable liquids.

3. The use of medicinal cannabis products would only be permitted under medical supervision, with supply via pharmacies. The Victorian Premier, the Hon. Daniel Andrews MP, said that, as a priority, the government will provide access to medicinal cannabis for children with severe epilepsy in early 2017.

Considerable resources will be needed to establish and maintain the regulatory framework for the Victorian medicinal cannabis scheme. There would need to be amendments to the Victorian and commonwealth legislation before the Victorian medicinal cannabis scheme could be implemented. The government notes that under the Victorian medicinal cannabis scheme, the medicinal cannabis products used by patients would be assessed for quality, but not for safety and efficacy.

The government will work collaboratively with the other jurisdictions to develop and share knowledge about the appropriate use of medicinal cannabis products. The New South Wales government has announced a program of clinical trials with funding of up to $9 million over the next five years. The program aims to build the evidence on cannabis and cannabis products in providing relief for patients suffering a range of difficult to treat and debilitating or terminal illnesses.

South Australia supports the New South Wales led clinical trials of medicinal cannabis and has observer status on the expert panel. Victoria and Queensland have said they want to collaborate in the New South Wales led trials. The New South Wales Ministry of Health will administer clinical trials in the areas of (1) adults with terminal illness, focusing on improving quality of life and symptoms, such as pain, nausea and vomiting and (2) adults with chemotherapy-induced nausea and vomiting where standard treatment is ineffective.

The optimum number of trial participants and study sites will be determined by the trial design. If there is a research benefit, New South Wales is willing to recruit participants for the trials from other states and territories. It is not likely the trial in adults will start before 2016. The government is open to facilitate participation of South Australians in the trials if that is possible.

There have been difficulties assessing international supplies of legal medicinal cannabis crops and products for use in clinical trials and to develop therapeutic products due to limited supplies and export barriers in other countries. The commonwealth Minister for Health, the Hon. Sussan Ley MP, announced on 17 October 2015 that the Australian government will create a commonwealth licensing scheme for controlled cultivation of cannabis for medicinal and scientific purposes in Australia.

Providing a safe, legal and sustainable Australian supply of cannabis is a key first step in providing medicinal cannabis products that have been subject to strict manufacturing processes and assessed for standardised dose, quality and efficacy. A commonwealth licensing scheme within the Department of Health would ensure that cultivation meets Australia's international obligation. In summary, it is the position of the South Australian government that it will continue to collaborate with other jurisdictions to:

1. progress the evidence to inform best policy and approach for the safe and effective medicinal use of cannabis; and

2. formulate a national approach to the regulation of medicinal use of cannabis.

The Hon. S.G. WADE (16:39): The use of cannabis for medical or other purposes is currently prohibited in all Australian states and territories. There is a growing body of national and international research highlighting the benefits of medical cannabis. The New South Wales Premier Mike Baird and his government have initiated medical cannabis trials with the support of commonwealth-state agreements. These trials are expected to commence in early 2016, with results being available in two to five years.

The Victorian government is moving to legalise medical cannabis as early as the end of 2015, with a view to it being available to Victorian patients by 2017. The federal government has given in-principle support for a federal cross-party bill which deals with licensing arrangements by creating a regulator for medical cannabis and has announced that they will legislate to allow for cultivation of cannabis for medicinal purposes. The South Australian Liberal Party position is to support the New South Wales clinical trials. In a press release on 28 April 2015, my leader Steven Marshall made the following comments:

The State Liberals are urging the Weatherill Government to join the national research effort to better understand the evidence relating to the medicinal use of cannabis to relieve symptoms for a range of debilitating conditions.

South Australia is the only…State not engaged in clinical trials being conducted in New South Wales to explore the medicinal use of cannabis…The tardiness of the Weatherill Government in joining this national effort to improve the lives of people suffering a range of afflictions is disappointing.

Later in the release he noted that:

South Australian medical researchers need to assess the best way that South Australia can enhance the trial and support South Australians suffering from these conditions.

He noted that:

The [New South Wales] Government is leading the clinical trial with the support of the Commonwealth. They meet national and international standards for clinical trials. The outcomes of the trial will inform the Parliament's consideration of any legislative change.

Since the release, the Weatherill government has dipped its toe in the water. It has appointed an observer to the expert panel. The minister's so-called cautious approach, in my view, was that of what I have called passive opposition. A genuinely cautious approach would be to fully engage with these trials so that the parliament and the community would have the best information available as possible legislative reform is considered.

I am pleased to hear the comments of the Hon. Tung Ngo today in relation to the first statements that I have seen that the South Australian government is open to South Australians participating in the New South Wales trials. There is yet another opportunity for the government to engage, and that is to look at whether South Australian researchers could complement the trials with South Australian-led trials.

The state Liberals, as I have said, are taking a positive yet cautious approach. We support the New South Wales trials. We look forward to the results informing possible legislative changes. We are certainly more cautious than the Victorian approach, as I understand it, in the sense that they are not waiting for the outcomes of clinical trials. If the clinical trials indicate that there is benefit, the state Liberals' approach to legislative reform would be cautious.

We would want strict protocols for the cultivation and processing of medicinal cannabis and for its use to be managed under medical supervision. We certainly agree with the spirit of the motion in that South Australians who are suffering from a range of debilitating conditions should have access to the medical use of cannabis if trials show that that can be done responsibly. I support the motion.

The Hon. J.A. DARLEY (16:44): I rise to indicate my support for this motion and to commend the Hon. Tammy Franks for raising this very important issue in this place. There is no question that the debate over the use of medicinal cannabis is one that has gained significant momentum across Australia in recent times. We now have trials taking place involving three Australian jurisdictions, namely, New South Wales, Victoria and Queensland.

Earlier this month the Victorian government became the first state in Australia to announce that it would push to legalise cannabis cultivation for medical use. Then in mid-October the federal government announced it would legalise the growing of cannabis for medicinal purposes. As recently as yesterday, New South Wales Premier Mike Baird announced world-first trials of a cannabis-derived drug, being used for children with severe epilepsy, to begin in early 2016. These changes are about delivering compassionate care and improving quality of life for people, including children with chronic, debilitating and sometimes fatal illnesses and health conditions.

In previous debates I have given examples of families who have risked it all in an effort to treat their children with cannabis-derived products, such as cannabis oil. I think this is also an opportune time to recognise the continuing efforts of Lucy Haslam, the mother of Dan Haslam, who has advocated fiercely on this issue. Those familiar with Dan's story would know that his own experience, involving using cannabis to relieve the pain of terminal bowel cancer, played an instrumental role in changing Premier Mike Baird's position on the medicinal use of the drug. Sadly Dan lost his fight with cancer in February this year, but his mother Lucy and his father Lou continue to play a pivotal role in political discussions over medicinal marijuana. Their son's story and their fight is widely recognised as the driving force behind the changes to cannabis laws that are taking place in Australia.

I appreciate that this issue raises all sorts of concerns over the misuse of marijuana and the risks that poses, as well as issues in relation to its illegal supply. However, my view is that this motion, and this debate more generally, is not intended to take anything away from those concerns. I think we need to separate any views we may have on the use of marijuana as an illicit or recreational drug from those concerning the potential health benefits that poses in a medical context. We need to concentrate on the positive benefits for those people who are suffering from medical conditions—in many cases, needlessly.

This point seems to be supported by a recent Roy Morgan survey, the results of which were published in The Advertiser two days ago. The survey found that 89 per cent of South Australian residents and 91 per cent of Australians believed that medicinal use of marijuana should be legal, with Australians aged 50-plus being strong supporters, as this group is most susceptible to several of the conditions that medicinal marijuana can provide relief from. According to Roy Morgan's chief executive, Michelle Levine, the results of the survey demonstrate that 'Australians understand that smoking and consuming marijuana for medicinal purposes are two very separate issues.'

Until now the South Australian government has chosen to sit on the sidelines on this debate. As recently as a few days ago minister Snelling made comments in the media to the effect that we should wait for the results of scientific data before proceeding any further. I think this response is out of step with other jurisdictions, and it is time we took a proactive approach on this debate. At the very least we should be exploring every possible avenue of including our own community members in the New South Wales trials. I support the motion.

The Hon. K.L. VINCENT (16:48): I will speak very briefly to lend my support to this motion. I would like to say that over the years I have been in this parliament I have been advocating for many individuals and alongside several groups on behalf of people with severe and chronic pain who find it very difficult to get adequate access to the already legal medications that would, if provided to the appropriate level, go a long way to alleviate the suffering they experience day in and day out.

The suffering is often so great that they are not able to get out of bed, yet they have to because if they require these already legal medications to a certain level they have to go and pick up that medication. Sometimes it is a week's supply and sometimes they can be given only a day's supply at a time because of the level of the medication they require.

These people with severe, debilitating chronic pain are forced every day or every week to go and pick up that medication, that medication that is already legal. I am incredulous, I have to say, that I went many years before I could even get a meeting with the health minister in this state about this issue, let alone getting the health minister to actually meet with those people and not just dismiss them outright as addicts; yet in a situation where people are already going without medication, particularly the level of medication that they need, the level of legal medication that they need to live a dignified life, there is still so much panic about denying people access to a medical substance that could alleviate their suffering in some way.

I am not a doctor, I am not an expert in these matters, but I do know that I have dealt with several constituents, particularly over the last year, who have found no relief available to them through other substances and who have found relief through the use of medical cannabis. The Hon. Mr Darley has rightly pointed out that we need to separate the use of cannabis for recreational purposes and the use for medical purposes, because they are very different, so I will not go into that in any detail. The point I am trying to make is that it is hard enough for people to get an adequate level of legal medication where the benefits of that medication are already understood and accepted widely in society, yet there is still so much panic in a situation where someone is telling you, 'I get relief from this medication.'

I have to say as well that I am bemused by the fact that we can still, under law, legally in this country perform a hysterectomy on a young person with a disability because they might experience heavy periods or they might have trouble with parenting or childbirth due to their disability. Under law we can perform a hysterectomy on young women and girls in certain circumstances because of perceived hardship because of disability. We can do that just in case these situations arise, yet it is so difficult to provide people with adequate access to a substance that they are saying does definitely alleviate their suffering right now—not perceived but right here and right now.

There is a real need for this substance. I am bemused by the disparity between these two situations. I would certainly like to see South Australia fully participate in a trial and I am pleased to see the government is open to that, especially where people have already exhausted their current legal options. As a society we need to take a strong stance and to have a mature debate on how we can put aside the moral panic and put aside the fact that yes, some drugs can be misused—and many drugs with an existing medical property are already misused.

I think we need to put aside the moral panic and have a mature, objective, responsible debate on how we can provide comfort and some dignity to those people who have, in many cases, as I have already said, exhausted their current options. With those few words, I will support the motion.

The Hon. D.G.E. HOOD (16:54): Very briefly, I indicate that Family First will support the motion as amended by the Hon. Mr Ngo but oppose it without the amendments.

The Hon. R.I. LUCAS (16:54): I rise to speak briefly. I support the comments my colleague the Hon. Mr Wade has broadly made on behalf of the party. He has indicated the party room position and he has indicated some of the caveats between the position that the Liberal leader Steven Marshall has put on behalf of the party and others who might advocate in this particular area.

I just indicate that certainly in relation to the current drafting of the motion, the Liberal Party room, of course, was not aware of the amendments being moved by the Hon. Tung Ngo on behalf of the government; they were only circulated this afternoon. Clearly, we have not had the opportunity to discuss and debate those, and therefore our position remains the position that the Hon. Stephen Wade has put. It is not always possible, and certainly I accept that, so it is no criticism. I am just saying that with some of these difficult areas, the earliest advice possible would allow members and other parties to at least canvass the views to see whether or not they might be in a position to support them.

I just indicate while supporting the party's position on this that, having read some of the aspects of the government amendments, if they had arrived earlier I would have been sympathetic to some aspects of them, in particular the re-crafting, I think, into a slightly different balance in terms of the current drafting in relation to the evidence that exists at the moment in relation to the medical benefits of cannabis in this particular area. The government, I assume driven by the Minister for Health and the government, is proposing adding the words, 'However, medicinal use of cannabis is subject to ongoing debate among health professionals and more research is needed into its safety and efficacy.'

I suspect most people on all sides of this particular debate would accept that there are differing views on this particular issue in terms of the medical aspects of the debate as opposed to anything else. Certainly, the medical and expert opinion is not all one way or indeed the other. As to the words that are proposed to be inserted, as I said, if there had been earlier notice of those, the Liberal parliamentary party room would have obviously have had an opportunity to debate whether or not we were in a position to support some of those amendments.

The only final point I would make is that, whilst acknowledging that the party room has supported the motion as it stands, with the caveats that the Hon. Stephen Wade has put, I just add to those caveats, from a personal viewpoint, that our current position as enunciated by Steven Marshall is to urge support for participation in the trials that are being conducted. Certainly, on my understanding we fall short of supporting the Andrews government's decision to legalise cannabis cultivation for medicinal use in the state of Victoria. That would be a separate step to what I understand the position Liberal leader Steven Marshall has put on behalf of the Liberal Party, which is urging participation in the current trials.

I just add to the caveats that my colleague the Hon. Stephen Wade has put in terms of the party's position on this particular motion, and also indicate that there were aspects of the Hon. Mr Ngo's amendments that, should they have been able to be debated by the Liberal Party room, they may well have had some support from some people—whether it was a majority or not, only time would have told.

The Hon. T.A. FRANKS (16:58): I would like to thank those members who made a contribution today: the Hon. Tung Ngo representing the government's position, the Hon. Rob Lucas and the Hon. Stephen Wade representing the opposition, the Hon. Kelly Vincent from Dignity for Disability, the Hon. John Darley from the Xenophon Group and the Hon. Dennis Hood from Family First.

I would like to start by addressing some of the amendments that the government has proposed. I note that they seek to remove the words 'and congratulates the Andrews government in Victoria for indicating that they will take steps to legalise cannabis cultivation for medical use'. I indicate that the Greens will oppose this attempt to amend the motion, and I point out to both the opposition and the government that they are not understanding that the federal Liberal government has this week announced that they are to introduce a bill to cultivate cannabis for medical use, or perhaps the state Liberal Party has a difference of opinion with health minister Sussan Ley, who said that the federal government is finalising their draft amendments to the Narcotics Drug Act 1967 to allow controlled farming of cannabis for medicinal and scientific purposes.

I also point out to the Labor members of the government benches that perhaps they meant to amend the motion simply to refer to the landmark report, which has suggested a controlled licensing system, but if they are taking steps to amend this motion to take out congratulating the Andrews government for indicating they will take steps to legalise cannabis cultivation, that is, growing of the product, then how do they expect the medicines for the trials to be produced, other than by expensive importation? So, I leave both the opposition and the government with that question to ponder to start with.

I will certainly on behalf of the Greens be opposing the other amendments to the motion. There may have been some scope for wordsmithing around the nature of the research; however, I think it was simply getting into pedantic point scoring in the way that No. 2 of my motion has been amended. I am incredibly disappointed that the government seeks to amend point 5 of my motion, which states:

5. Calls on the Weatherill government in South Australia to follow the lead of the Premiers of Victoria, New South Wales and Queensland by acting on medical cannabis reform to ensure that South Australians do not continue to suffer needlessly.

I do not understand which part of point 5 the Weatherill government seems to have a problem with. But I note that in the government's contribution (and I thank them for this) they have started to consider this issue and they have now made some public statements indicating that the health minister will indeed work collaboratively, not just with the New South Wales trials (and I welcome that we are an observer in that), but we need to be an active participant and we need to let suffering South Australians take place in these medical trials.

Sick children with epilepsy will be able to be medicated from 2016 through the New South Wales trials. Those children do not have to live in New South Wales. We know, because of the action and the leadership of the premiers of Queensland and Victoria, as well as, of course, Premier Mike Baird, that sick children with epilepsy, who have been resistant to treatments so far, will be able to access medicinal cannabis legally as part of the New South Wales trials from 2016. Those state premiers will be standing up for those sick children. I hope the Weatherill government will also stand up for sick South Australian children, like young Charlotte, whose father would dearly love her to be able to take place in those trials.

I note that minister Pru Goward of the New South Wales state Liberal government made an announcement yesterday that those trials will start in 2016, and they have secured and undertaken a partnership with a British company to ensure that the appropriate medicinal cannabis will be able to been administered to those sick children with epilepsy. She said that it was the proudest day of her political life.

I have heard those words before: they were the same words that Premier Daniel Andrews, the Premier of Victoria, said when he announced in his landmark report into medicinal cannabis that it would be supported and that that state would seek urgently to legalise medicinal cannabis and to cultivate it to ensure that not only was there a supply but also a safe crop to use, that production could be made and sick people would not have to play pharmacist to themselves, that they would be able to secure a medicine—yes, a medicine is a drug—safely and without falling foul of the law.

So, yes, I would say that that is rightly both minister Pru Goward's and Premier Daniel Andrews' proudest day of their political lives. I would love to hear such words from a Labor leader in this state. What I do draw to the attention of Labor members again is their federal leader's words, Bill Shorten MP, who I note has posted on the Labor Party website a picture of his meeting with young Abbey Dell and Abbey's parents. Abbey suffers from a rare genetic disorder which sees her suffer seizures, which are relieved only by small injections of medicinal cannabis. Labor leader Bill Shorten visited the Dells in their family home to hear their heartbreaking story. He says in his post on the Labor Herald of 18 October:

I had the honour of visiting three year old Abbey to hear her and her family's story. No one can imagine how horrific it must be for someone to see their child, partner or parent in immense pain, knowing relief is available but illegal. Labor firmly believes the time has come for a national scheme for medicinal cannabis. Share if you agree too.

I note that they even have a Facebook square saying:

Labor will ensure people suffering from terminal and serious medical conditions can access medicinal cannabis. Share and stand for a compassionate plan.

Where is that compassionate plan in South Australia? Seriously, Labor in South Australia is out of step with Labor across the rest of this nation. The article goes on to note, in fact, that the Labor National Conference voted in support of federal action on medical cannabis. So, it is very disappointing to finally hear from the government speaker on this motion, tinkering at the edges of my motion.

There has been a lack of leadership from the Weatherill government on this issue, but I do warmly welcome the announcement made in the speech today, if I heard correctly, that we will see South Australians who are sick and suffering able to participate in the New South Wales medicinal cannabis trials. I certainly have a list of people who would be very keen to take part in that, particularly children with epilepsy but also those, of course, suffering in other ways who fit into those categories.

The Labor leadership in this state should know that the people will be behind them. As the Hon. John Darley mentioned, there was a survey done this week by Roy Morgan which showed that, of a survey of 644 Australians, 91 per cent and 89 per cent of South Australians believe medicinal use of marijuana should be legal and, indeed, the 50-plus age range were the strongest supporters. So, there is nothing to fear from showing leadership on this issue, and there must be further leadership, otherwise we will be standing by the sidelines while sick and suffering South Australians go on suffering needlessly.

I ask the Weatherill government to step up on this issue to help the Fulton family come back from Canada. Tabetha and Georgia-Grace, those two little girls with the lung condition, have responded to medicinal cannabis in Canada and have gone through a system where they have a prescription for treatment. They deserve to come back home and live here in their state of South Australia, in their home town of Victor Harbor, with the rest of their family, with their father and their older brother and with his family. That family has been torn apart by the lack of compassion shown in this state to help those two little girls with their medical condition.

I have written to the minister, and I am now pushing for him to meet not only the Fulton family but other constituents. I do welcome the minister's words today and, indeed, more recent indications that he would be willing to have those conversations. The minister has previously corresponded with me saying that there is nothing he can do to help the Fulton family. Well, there is something he can do. I will be bringing back legislation that will amend the act to ensure that we have ministerial discretion under compassionate grounds, as Pennsylvania and California do, and as many other places across the world can and have done. South Australia can do that too.

It is not rocket science: it is simply helping the sick. To buy into the hysteria of saying that this is a dangerous drug, while ignoring the many dangerous drugs we prescribe to people in this country every day, is simply not standing up for suffering South Australians. As I have said, the Greens will continue to show leadership. I commend not only the Liberal state leadership on this issue, who have long advocated that South Australians be able to participate in the trials, but also the federal cross-party leadership of the Labor Party, the Liberal Party and the Liberal Democrats—

The Hon. D.W. Ridgway: Of the Greens.

The Hon. T.A. FRANKS: Of the Greens, of course—take some credit. Of course, Senator Richard di Natale has that bill to establish a regulator of medicinal cannabis but, in particular, minister Sussan Ley deserves great congratulations for her leadership on this issue in recent times, and the fact that the federal government has indicated that it will ensure that medicinal cannabis can be grown in this country. That we will soon see a bill debated on the regulator means that South Australia has no more excuses and nowhere to hide, and it needs to step up and lead the way and support sick and suffering South Australians.

Motion carried.

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