Wednesday, 22 March 2023

Bills

Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023

Second reading

Debate resumed.

Will FOWLES (Ringwood) (18:02): As I was saying before the break, dealing with drug addiction in the community is a complex task, and it is a complex task that requires people with complex needs to interact with a complex web of support systems. These are not straightforward matters, and there is a very, very strong link between trauma and addiction. This complex web of circumstances that brings people to the position where they are using drugs and/or using the services of a safe injecting centre means that you have got to have a properly resourced response. Importantly, you have got to have that response in the right place, and that is where the drug use is habitually happening and where the drug transactions are happening. That is the appropriate siting for it. This safe injecting centre has delivered safer streets for North Richmond. As I said prior to the break, I used to live around the corner. I have seen people overdosing in the streets. That was in the pre medically supervised injecting centre era, and I am very glad that that era is behind us. We are now dealing with this maturely and sensibly. Despite the shrill moral panic from those opposite, we are dealing with it maturely and sensibly and using an evidence-led policy in relation to these issues.

In the final 47 seconds available to me, I do want to pay particular tribute to my friend, the former member for Richmond Dick Wynne. Dick was an absolute icon of his community for so many years, and he championed this policy even though it certainly was not government policy at the time that he was championing it. I do not know that it was a policy that was widely embraced necessarily by a large number of his parliamentary colleagues. But by dint of his passion and his good work and by dint of the evidence that was carefully and sensibly amassed over the journey, he persuaded his colleagues of the merits of the policy, and it is to his great credit that those 63 lives have been saved.

Tim READ (Brunswick) (18:04): It is a pleasure to rise to speak on this bill, which will make the medically supervised injecting room a permanent healthcare institution in Melbourne. It is important to just quickly recap why this exists. Heroin and other opiates stop people breathing if they have too much of them. It is just as simple as that. You just stop breathing. The black market opiate trade does not come with accurate dosing information, and so it is inevitable that people will periodically stop breathing.

Back in 1990s we had an epidemic of heroin overdoses with, from memory, around 500 deaths a year. That was followed by a heroin shortage, a drought, so the death rate fell. But somehow the drought has been resolved and we are seeing an increase again in heroin overdoses. The epicentre of a lot of the trade has remained in the Richmond area, and particularly around the site of the current medically supervised injecting room. I am grateful to the staff there for taking a number of us on a tour of the supervised injecting room on Friday, where we learned that they deal with an average of six or so overdoses per day, but only one every couple of days is severe enough to require the opiate receptor blocker medication naloxone, otherwise known as Narcan. The rest are treated by positioning the patient correctly and ensuring that their airway is open and maybe giving them some oxygen. The success rate of treating those overdoses is 100 per cent. The medication, if it is required, is very effective and the patients leave after a period of time. So preventing death by heroin overdose is technically quite straightforward, using either the medication or attention to airway and oxygenation. Essentially what is done in the supervised injecting room is resuscitation. It is a simple form of resuscitation, but the fact that it is technically simple does not take anything away from the significance of what is done. Without it, they will die. With it, they live and walk away. So what we have is a resuscitation service that is applied to an average of six people a day.

Opposition to this really should take into account the significance of the service that is offered. We should also ask why it is not offered in other locations, but the issue I want to turn to this evening is why several groups of people are not allowed to use this service. Under existing legislation and regulations, pregnant women, individuals aged under 18, people who are subject to certain court orders and individuals who would like someone else to inject the heroin are not allowed to go into the service, so they are effectively denied the resuscitation. If you find someone who has stopped breathing or is blue in the face after a heroin overdose, you call an ambulance. The ambulance will turn up and administer the same treatment, regardless of whether that person is pregnant, under 18, requiring a friend to inject them or is subject to a court order, but those four groups are not allowed into the service to have the benefit of the resuscitation.

I am not blaming anyone for this. This was probably the political price to pay, I guess, for getting the legislation for the trial through in the first place, but now that we are establishing a permanent resuscitation service at the epicentre of Melbourne’s heroin use, we should allow those groups of people to have access to resuscitation. We would not deny resuscitation to any group of people for any reason that I can think of, and so the remaining legislative and regulatory barriers to those groups entering this service should go.

The Greens have these concerns, and we will raise them further – potentially with amendments to the legislation – in the other place. Another aspect of this service that I would like to raise is the important array of additional healthcare services that are offered. I understand that at this site more prescriptions for hepatitis C treatment are written than in any other treatment location. In other words, the medically supervised injecting room in North Richmond treats more hepatitis C than anywhere else in Melbourne. Hepatitis C treatment is remarkably effective these days. It typically takes about three months. It is typically tablets dosed about once a day. Even with this group, with often chaotic lifestyles, the success rate is above 80 per cent. That is a cure rate for hepatitis C. Twenty years or so ago we had a cure rate of 25 per cent in the best treatment institutions. Hepatitis C treatment has advanced, but it is now being directed to the group in Melbourne who need it the most, and that is happening at this service. That means we are preventing cirrhosis of the liver, liver failure, liver cancer, and we are keeping a whole bunch of people out of hospital. We are not just resuscitating people, we are keeping a large group of people out of hospital and stopping them from infecting others by treating the hepatitis C.

They have also got some really high-quality dental treatment there which has pioneered a silver fluoride treatment, which is a kind of black paste that is put on dental cavities. Opiate users have really bad teeth, and there is a range of reasons related to reduced saliva production which means that they get shocking tooth decay. Instead of time-consuming, invasive treatment with drills and fillings and so on, you can just paint this paint on their fillings and it lasts for six months to two years. It can cause some black staining – that is the effect of the silver – but it kills the bacteria dead and stops the cavities from progressing. For people who may not want to commit a lot of time or subject themselves to pain and whatever else, you can achieve enormous improvements in their dental health with this simple treatment.

Another treatment they offer there is opioid replacement therapy. You have all heard of methadone, which is usually a daily drink, but there is now a once-a-month injection of a long-acting drug called buprenorphine, which is highly effective and will probably replace methadone in most but not all cases. Getting more people onto opioid replacement therapy will be an enormous cost saver, particularly in the criminal justice system. Providing these additional services to the population in Melbourne who needs them the most is not just saving the health system a lot of money but it is taking a big load off our overstretched hospital system and it may be taking a big load off our criminal justice system. If we have more prescribers for opioid replacement therapy – we have a shortage of prescribers in Victoria – we will be able to achieve even more.

There are other services there, and I do not have time to go into the details of the employment services, the legal services and the housing and homeless services they offer, but they all save one of our most vulnerable groups from further pain and suffering and they are all a good long-term investment for this state. We should have more of these supervised injecting rooms. They do not all have to be large multidisciplinary clinics like the one in North Richmond. Some of them perhaps should be pop-up clinics until we establish whether they are really needed or not. But the thing I like best about this supervised injecting room is that it represents a fundamental challenge to the cold-heartedness that underlies the value system promoting prohibition, the value system that says, ‘You use an illegal drug, you should suffer and take the consequences.’

Daniela DE MARTINO (Monbulk) (18:15): I rise to support the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. As the member for Wendouree so poignantly put it, ‘Hope lives in this bill and trajectories will be changed’ – how very true. I too share in her pride and the pride expressed by other members here today amongst my colleagues, the pride and admiration for the members of government who had the courage of their convictions and voted for the safe injecting rooms in the first place – notably against much opposition from those who were across the chamber at the time.

In late 2017 the Andrews Labor government announced the first trial of a medically supervised injecting room in this state’s history. It was a bold initiative. It took a safety-first, medical approach to addressing decades of harm caused by high drug use in the City of Yarra. Every single life lost to drugs is a terrible tragedy for the families and the friends affected and for the wider community. This government remains unwavering in its work to reduce drug harms in the City of Yarra. We in this place must take a step back and remember it is our responsibility, it is our mandate, to care for the most vulnerable in our community. We provide ways and means for those in the battle of their lives to get back up on their feet and for those in the depths of their despair to be under the close watch of medical professionals when they need them the most.

Time and time again experts tell us that safe injecting rooms save lives. Two independent reviews since the trial commenced in June 2018 have demonstrated that this safe injecting room has saved approximately 63 lives – that is 63 daughters, 63 sons, 63 parents, siblings, friends, all thanks to this essential service. The member for Melton, former paramedic and former secretary of Ambulance Employees Australia, also described in poignant detail what it is like for paramedics to attend a fatal overdose and the problems in North Richmond prior to the opening of this safe injecting room. The sheer volume of those who were using and overdosing and dying in the streets and the alleyways was the reason for the location of this room in the first instance. The member for Melton quoted Danny Hill, the secretary of the Victorian Ambulance Union, who said that 6000 overdoses have been managed by the safe injecting room since its inception. That means 6000 less ambulance call-outs. It means no fatalities. People are alive today who would not be otherwise.

These 6000 overdose events – I just want to say it again – resulted in zero fatalities. Let us let the numbers sink in for a moment. To put it into perspective, because sometimes large numbers sound big and fancy but it is hard to conceptualise what they mean: St Vincent’s public hospital, if anyone has ever been there, has 780 beds, probably almost always occupied. It is 7.7 times that hospital that comes close to that 6000 number. That is a significant, huge number of people who ended up overdosing in a safe space – not on the streets, not in the schoolyard but in the injecting rooms – and that is an extraordinary figure and achievement. It has taken pressure off local hospitals, reduced ambulance call-outs and led to a reduction in the spread of bloodborne viruses such as hepatitis C within the City of Yarra.

The establishment of the trial followed growing concern about the number of heroin-related deaths, two parliamentary inquiries and coronial findings that an injecting room would reduce the risk of death from heroin overdose – and it has. These reviews have provided solid evidence that the service is doing exactly what it is designed to do. There have also been more than 3200 referrals to health and social services, including general practitioners, oral health, housing, drug treatment and bloodborne virus testing and treatment. It has been vehemently endorsed as an ongoing service by the Ryan review, and we have introduced the amendment bill to ensure its ongoing nature. This legislation will pave the way for immediate measures to be taken to further boost safety and amenity in the North Richmond precinct and increase wraparound supports for the clients of the service. These changes will strengthen it, ensuring it continues to do what it is designed to do, which is save and change lives. It is not about doing what is popular sometimes, it is about doing what is right, it is about doing what matters – it is about saving lives.

Contained within the Ryan report is a paraphrased client interview transcript published on the North Richmond Community Health website. It gives a firsthand account of the immense value of this service, stating:

The addicts go to the injecting room because they think their life is worth saving. They should be treated as people who want to live their life so let’s help them. No-one is out to hurt anyone. All an addict wants to do when they go to use the injecting room is walk out alive. And by going to the injecting room, there is an avenue to get some help.

It’s ground-breaking, I would be dead without the injecting room. Or I’d probably still be using.

These are powerful words from someone with incredible firsthand experience. It is only a Labor government which can be trusted to reduce drug harm and support those who are struggling with addiction to get the support they need to live a better life.

Hundreds of stakeholders, including people living and working in the local area and those directly involved in the safe injecting room, have been involved in almost a year of research and consultation as part of the Ryan review. It developed a really deep understanding of people’s experiences, perspectives and suggestions. In determining where the location should be, the government was guided by where drug use was happening. For decades the City of Yarra had experienced trauma and tragedy of high levels of drug use and deaths. In 2015, before the safe injecting room was established, there were 25 fatal overdoses alone. In 2017, when this program was announced, a woman tragically passed away not 50 metres from the press conference. Since the trial’s commencement the Andrews Labor government has invested more than $200 million across the North Richmond precinct. It has included new and upgraded public housing and improvements to the housing estate grounds and communal buildings, including new playgrounds, a sportsground, lighting, landscaping and community room upgrades, all with a focus on improving amenity and safety in this precinct.

Much has been said about the primary school by those opposite. I would like to state that Richmond West Primary School is a great primary school with a strong academic record and a wonderfully diverse student population from culturally, linguistically and socio-economically diverse backgrounds. The school has been a strong supporter of the safe injecting room since its inception, understanding the imperative purpose that it serves in taking drug use off the streets and reducing deaths. I would like to thank them for their ongoing cooperation and understanding of the importance of this centre.

The truth is we have all been affected, touched and impacted by drug addiction in some way. Whether it is family, friends or constituents, we all recognise how unforgiving this disease is. Thirty years ago the sister of a friend was struggling with a heroin addiction. She worked really hard to overcome her dependency, and her family and her friends were thrilled. They were happy because she had got clean. A year later life got pretty difficult for her again, and she turned back to her heroin use. Within two months she had died. I cannot help but think that maybe, just maybe, if this had been around, she would still be here with us.

The former member for Richmond, the Honourable Richard Wynne, wrote an article five years ago which put the case so clearly for these injecting rooms. It painted a clear picture of what the situation was in North Richmond prior to the opening. It makes it very apparent as to why this area was selected in the first place. He asked:

What do we say to a community so scared it has resorted to taking heads off front garden taps to prevent providing water for the next overdose …

… how do we explain to children why they’ve faced the unforgettable trauma of stumbling across an overdose victim at the park …

And what can we possibly say to console a grieving parent whose child could not beat the demons of drug addiction? There was a grassroots campaign that a local of North Richmond Judy Ryan led at the time. She had found a young man slumped at her gate. He was one of her regulars who often injected drugs in or around her property. She wrote a book about her campaign for these rooms. She described how things were in her community before the facility, and they were concerning at best. She said:

I regularly walked south along Lennox Street to Richmond station. It was common to see people injecting, “on the nod”, or overdosed in the playground of Richmond West Primary School or next door in the carpark of North Richmond Community Health. As these incidents had been common place in this area for decades, both establishments had well-honed drills.

So there is a reason why it is there near the school. It is because that is where people were dying. That is where people were overdosing. You cannot place a centre kilometres away in the hope that people will go there simply because that is where it is. You need to bring the centre to where the issue was at its core, and that is why this place has worked. I have to say some have used it as a political football, this issue, which is really disappointing to all of us here. Even during last November’s election they made it abundantly clear that they wanted to move it to some magical alternate place. There was nowhere listed, which basically means, ‘Let’s just shut it down.’

I just would like to commend this bill to the house. It is incredibly important. It saves lives, and it is worth all the effort here.

Gary MAAS (Narre Warren South) (18:25): I too rise to make a contribution on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. I note as I make my contribution over the next 9½ minutes or so that I am doing this without my spectacles, which I left in my office, so please bear with me. In all seriousness, though, in supporting the passage of this bill I think something has to be said about the reasoned amendment which has been put by the member for Lowan. So the opposition is seeking that after the word ‘That’ the bill be omitted and replaced with the words:

… this bill be withdrawn and redrafted to prevent a medically supervised injecting centre from operating in … proximity to schools, childcare centres and community centres.

Of course we are opposed to this reasoned amendment, and the reason we are opposed to this reasoned amendment is because on this side of the house we ultimately support community. We know that community is made up of all of us, of every one of us. It might be inconvenient that drug users have a public health problem where harm needs to be minimised, but taking a zero-tolerance approach to that does not make our community stronger. Drug users are a part of and are included in our community, and can I just say at this point, just as members of our LGBTIQ+ community are part of our community. They are a valid part of our community. Just like the multicultural parts to our community – and I am talking about Narre Warren South here, but I know I am speaking about all communities. I have African people in my community, and I love them dearly. They know they are part of our community. They are not excluded and they are never called out – never called out by us. People on Centrelink as well are never called out by us or excluded. They are a part of our community. I say the same to drug-addicted people: you are a part of our community, and you should feel safe as you are working through that public health issue.

Education is absolutely key in all of this. As a parent – gosh, it must have been about 11 years ago now – taking my eldest daughter to primary school for the first time, I was confronted when dropping my daughter off at school with being told by the school principal, ‘There’s been a drug overdose in the grounds of the school today, but we’re letting you know that we have this situation under control. We have protocols in place. We know that our local medical services are here to help. We have a direct line to police if they are needed, and we have our protocols that we enact when something like this does happen. And when it does happen we have an educational process that we go through with the children not only who might’ve witnessed it but who were there in the school.’ It becomes a bit of lesson, a learning if you like, to kids in the school. But the whole school community understands that it is a public health issue, and the issue is tackled by way of a community solution. It is not a zero-tolerance approach. It might be simple to cut certain layers of our society out. It is not done like that. It is done through a community mechanism, and I am very, very proud to be supporting this bill and to support its passage through the house.

The objectives of the bill are very clear: to establish that the North Richmond medically supervised injecting centre is an ongoing service at its current location and to remove limitations to medically supervised injecting room (MSIR) models of care. The key changes in the bill include making North Richmond medically supervised injecting centre an ongoing service at its current location, the ability to transfer or reissue an MSIC licence to another provider, the ability to extend a licence and the ability for a service to have clinical nursing oversight as an alternative to supervision by a medical professional.

It was in late 2017 that the government announced the first trial of a medically supervised injecting room in this state’s history to address the decades of harm that had been caused by drugs. The establishment of the trial followed growing concern about the number of heroin-related deaths. There were two parliamentary inquiries and coronial findings that an injecting room would reduce the risk of death from heroin overdose. In 2015, before the MSIC was established, there were 35 people who died from overdoses that related to heroin purchased or that was used in the City of Yarra, and this demonstrated a clear need for the development of an MSIC to reduce death and drug-related harm.

Since then two independent reviews have been conducted over the trial period. In June 2020 an independent panel chaired by Professor Margaret Hamilton delivered the first review of the trial, and in February 2023 an independent panel chaired by Mr John Ryan delivered the second review. One of the most significant recommendations that the Ryan review made was to keep North Richmond as an ongoing service. The Ryan review panel’s report tells us that the trial has saved lives and provided access to general health, housing support, GPs and social and wellbeing assistance. It has performed as it was intended to, and it continues to provide beyond its original scope. The operating model guided by the Ryan review will include coordinated care to support clients to access key health and social services. It will also deliver specialised services for vulnerable cohorts, including women and Aboriginal and Torres Strait Islander peoples.

It is anticipated that the decision to make the North Richmond service ongoing at its current location will elicit some criticism from the community. However, since its opening in 2018 the facility has safely managed more than 6750 overdoses and has indeed saved 63 lives. Saving lives is a priority of this government, and this facility is clearly achieving its intended purpose. In the 3½ years before the centre opened there were 818 ambulance attendances involving naloxone administration within 1 kilometre of the service, compared to 459 ambulance attendances in the 3½ years after the MSIR opened, and that is a 55 per cent reduction. It has also led to a decrease in ambulance call-outs and reductions in heroin overdose related presentations in local emergency departments and the spread of bloodborne viruses, easing significant pressure on our healthcare system.

The government is improving governance of the precinct by introducing an interdepartmental committee, which will also oversee safety and amenity issues across North Richmond to increase safety and address community concerns and criticisms. The government, however, does remain unwavering in its work to reduce drug harms in the North Richmond community, and these changes will strengthen the service. This is an excellent bill, and I really commend the hard work of the minister to ensure its passage through both houses of Parliament. I commend the bill to the house.

Jordan CRUGNALE (Bass) (18:35): I rise to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. Life throws all sorts of slings and arrows in our paths, and we may or may not have the support structures, social and familial networks, programs and services easily and readily accessible or even close by to reach out to. Trauma, stress, genetic predisposition, depression, anxiety, pain, wanting to self-medicate, mental ill health – it can all be too hard to even scratch the surface of the underlying causes, so drugs in their myriad forms kind of sweep in to quieten and dull that pain, that noise, the stress and the trauma. Whatever the reason, it is complex and it is fibrous and it is difficult. It is not easy, as many think, just to stop.

Our Australia-first Royal Commission into Victoria’s Mental Health System had findings about and also mentioned in its final report the strong links between drug addiction and poor mental health. It said that in Victoria a substantial number of people are living with both mental illness and substance abuse or addiction, but many are not getting the comprehensive treatment, care and support they need to recover and lead contributing lives. It goes back to that health response, which many have spoken to today in this chamber, with the care and compassion and the supports and services in place – why this bill is before us.

One of the most significant recommendations to come out of the Ryan review, which we have also heard about today, is to keep the North Richmond medically supervised injecting room as an ongoing service. This is why we have introduced this bill. Key changes include the ability to transfer or reissue the licence to another provider, the ability to extend a licence and the ability for a service to have clinical nursing oversight as an alternative to supervision by a medical professional.

But there is always more to do, and this is why you have a review: what is working well, where we need to improve and what we can do better. This legislation will also pave the way for immediate measures to be taken to further improve safety and amenity in the North Richmond precinct and increase wraparound supports for clients and services, whether that is better access to integrated treatment, better access to health and social supports for our vulnerable community members or women-centric services outreach. These are all areas that will be addressed and actioned working alongside the local community. By making sure we can deliver more integrated health and social services we will be aligning with the recommendations of the Royal Commission into Victoria’s Mental Health System and better meeting the long-term needs of both clients and the broader North Richmond community. These measures and improved supports will strengthen the service, ensuring it continues to do what it is designed to do: saving lives and changing lives. We have heard a lot about that in this debate as well.

At about the same time as Sydney was opening Australia’s first medically supervised safe injecting room in Kings Cross the conversation here in Melbourne was beginning and was not without controversy. It was just over 20 years ago. I remember that time, and I was very supportive of the Kings Cross facility. Before it opened, one in 10 overdoses was happening in the Cross. The conversation here in Victoria – and it is really interesting – over that sort of 20-year period has shifted. Then it was about whether people using illegal substances should be in a safe and supportive environment. Now it is more about a conversation, disagreement, whatever you want to call it, around, and I will quote from the Ryan review:

… which policies and practices will lead to the best health outcomes for all Melburnians.

It is a great indicator over time of how we have changed as a community and a society around the use of drugs and also a public health approach to treatment as opposed to the criminal aspect. The Ryan report was a year of research and hundreds of consultations with residents, business people, people using drugs, police and service providers. Alongside was the Centre for Evaluation and Research Evidence bringing in the dataset and analysis, and it culminated in the findings and recommendations in the Ryan review.

Preceding this of course was the Hamilton review in 2020, and both provided evidence that the service is doing what it is meant to do – saving lives and changing lives. The panel have spent hundreds of hours consulting with people, as I mentioned just now, including police and ambulance services and representatives, to develop a really deep understanding of people’s experiences, perspectives and suggestions, and speaking with local residents, people who inject drugs and the workers at the North Richmond facility. They also had four round tables with health practitioners, human service providers and alcohol and other drug harm reduction experts; commissioned research; and sought advice from Australian and overseas experts on models of care, community engagement, approaches to improve amenity and opportunities for service system improvement.

Since its opening in June 2018 the facility has safely managed more than 6750 overdoses and saved 63 lives. We have heard people talking about their own experiences and the member for Melton’s experience of being on the front line itself. We have all got experience of people around us using – well, maybe not all. But I used to live in an area where there was really high drug use, and I was constantly called because someone had OD’d and I knew how to do CPR. I tended to be the first person on the scene and then was able to get the ambulance to come along as well. A lot of the time people did not want ambulances to come at all for fear of retribution – but this is going back to the last century. Also, through my work in mental health and working in the St Kilda precinct, it was a common thing to see people that had OD’d on the street, and that is not what you want. You want someone to be in a safe, supported environment using clean needles. It is all about harm minimisation.

We have heard about managing the over 6000 overdoses, but it has also saved 63 lives. As the member for Eltham said, that is 63 children of someone – 63 people that now have the opportunity, the networks and the supports to take a more positive life path and 63 people that are still with us today because of this service. Those around them have been spared the lifelong grief of sorrow, pain and guilt – everything that is attached to losing a loved one to drugs.

It has taken the pressure off our hospitals, St Vinnies being the main one, which has actually seen a decline in presentations – a trend not seen in our other hospitals like the Alfred or Royal Melbourne – and it has led to a reduction in ambulance call-outs and a reduction in the spread of bloodborne viruses within the City of Yarra. Importantly, there are also all the referrals – I think there are over 100,000 – that have happened from the centre to GPs, dentists, housing and drug treatment facilities and a number of health and social services that are provided on site around mental health, dental, addiction support and treatment. Ambulance attendance has decreased, and even the number of instances of support that have had to be given out around health promotion and management of injecting-related injuries has decreased significantly. The services that I was talking about, like St Vinnies and Launch Housing, and all the referrals – it is all about those wraparound services in our community.

As the member for Narre Warren South was saying, we are all community members. We are all here, we are all on the planet and we are all trying to do our best. We are hit with all sorts of things that life throws at us and some of us can cope a bit better than others, but it is about providing a safe, supported environment around harm minimisation and doing things safely. I absolutely commend this bill to the house, and I want to thank everyone that has been advocating for such a long time to have a safe injecting room here in Victoria.

Meng Heang TAK (Clarinda) (18:45): I am delighted to rise today to speak on the Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2023. It is such a great honour to stand here and also to join the member for Bass, the member for Narre Warren South and all the colleagues on this side of the house that support this bill. I would like to say that perhaps we have all had friends or family or have known of people who have suffered from drug addictions and OD. I certainly did during high school back in my days in Springvale, and I know that the member for Narre Warren South also grew up in that suburb, and we saw many times our classmates in the morning and asked, ‘Is he coming back?’ if it was one of those days. During uni time, many times at Springvale train station we saw the police attend or ambulance, and it was to do with OD.

That was about two decades ago, and it is such a privilege to be here contributing to this bill today. It is a very important objective and it is a very important bill, one that will save lives and change lives and one that is deeply rooted in compassion and care for some of our most vulnerable Victorians. I am very proud to speak in support of this bill and very proud of what the North Richmond medically supervised injecting room has achieved since its inception some five years ago. Time has flown. It really is hard to believe that it has been five years since the initial trial period commenced in North Richmond, but also much has happened in that time – so many life-changing events and many life-changing interventions, and we can see many of those details in the recent review of the MSIR.

In fact two independent reviews of the MSIR have been conducted over the trial period. In June 2020 an independent panel chaired by Professor Margaret Hamilton AO delivered the very first review of the trial, and in February 2023 an independent panel chaired by Mr John Ryan delivered the second review. Mr Ryan, with members Chris Kotur and the Honourable Robert Knowles, outlined 10 recommendations to the Minister for Mental Health. Most importantly the Ryan review found that since its establishment in 2018 the MSIR trial in North Richmond has succeeded in achieving the trial’s central objective, which is to save lives. Saving lives is what this facility and this piece of legislation are all about. Amazingly there have been almost 6000 overdose events safely managed in the MSIR trial, and we have heard time and time again that 63 lives have been saved. That is 63 lives, and you can imagine the families and the friends and loved ones that also contributed to these 63 lives. So it is truly amazing. It is a rare occasion that we have a piece of legislation before us that is so significant and that can have such profound consequences and can make such a meaningful difference in somebody’s life – and what is more meaningful than saving lives? I am extremely proud and honoured to be able to stand here today as a member of the Andrews Labor government to support this piece of legislation and to support the continuation of that life-saving work taking place at the MSIR.

The results of the MSIR as detailed in the most recent review are astounding. As some context, the MSIR was some 20 years in the making. Twenty years ago the conversation started on a medically supervised injecting room to combat heroin-related deaths in Melbourne. At the time it was very much a controversial idea, but fast forward to 2023 and that debate has shifted. The community agree that drug addiction is a health issue and requires a health response. Drug addiction is an extremely complex issue, but the community agree that those suffering from drug addictions need and deserve care and support. The debate has moved on, and it has shifted. We are not stuck 20 years ago, stuck in the old ways of thinking. We are here working on the trial and delivering a health response to this health issue – and a very effective response at that.

Certainly the trial commenced in North Richmond in June 2018. Its establishment by the Victorian government followed a high number of fatal heroin ODs in the area in the years preceding the trial. In 2015 there were 20 fatal ODs in Richmond, with a further 15 occurring elsewhere but using drugs that had been bought in North Richmond. Absolutely tragic – 35 lives lost, 35 families and 35 communities deeply touched and affected. We had to act, and we did. The MSIR contains 20 injecting booths, and it is coordinated with an on-site needle and syringe program which provides sterilised injecting equipment and health-related information and referrals. This is what we do, and that is why it is important. The MSIR is housed within a purpose-built facility adjacent to the North Richmond public housing estate and next to North Richmond Community Health, which also operates the MSIR. NRCH is a small organisation originally established to support public housing residents in the area. It is connected to other health and social care community services, including a GP clinic, a dental service, nutritionists and occupational health therapy as well as health services for people identifying as Aboriginal or Torres Strait Islander.

What has the facility delivered? As previously stated, and as we have heard from many of the previous speakers here on this side of the house, since its establishment in 2018 the medically supervised injecting room has been successful in achieving the trial’s central objective – to save lives, and we have to say it again, it is saving lives. There have been almost 6000 overdose events at the place during the trial period, and none have been fatal. The modelling suggests that during its time in operation the MSIR has prevented up to 63 deaths. It is unbelievable, and what is more important is that over the 42-month period before the MSIR opened there were 818 ambulance attendances involving the use of reverse heroin overdoses within 1 kilometre of the MSIR compared to 459 ambulance attendances during a comparable 42-month period. The review also noted a declining trend of opioid overdose presentations at St Vincent’s, the nearest public hospital emergency department. Since the MSIR began operating they have peaked at around 250 presentations a quarter in 2019 compared to around 150 presentations in the second quarter of 2022, which is a very low number and a very positive one. Lastly, there have also been some positive improvements regarding public injecting and discards of injecting equipment. There is so much more to add here, but given the time that I have got left I would just like to say that overall it is a really positive achievement.

I would like to finish by thanking all the staff at North Richmond Community Health and the staff of the medically supervised injecting room, as well as the various clinicians, service providers and academic and community organisations that have worked together to make the MSIR what it is. You are amazing, and Victorians as a whole are grateful for your work and expertise. You all ought to be commended, and I commend the bill to the house.

Katie HALL (Footscray) (18:55): I am very pleased to be able to make a contribution, in the time we have remaining prior to the adjournment today, to this bill and express my strong support for it, but I would like to make a few comments about the position of the Liberal Party on this matter and the amendment from the other side. A couple of years ago in Footscray a member from the other place Ms Crozier joined with her former colleague Bernie Finn to hold a protest in my community of Footscray – in the heart of Footscray, in the mall – against the establishment of a medically supervised injecting facility in my community. It was literally a protest against nothing, because there was no proposal for such a facility; there was no proposed location for such a facility. But this did not stop them distributing petitions in my community, especially to Vietnamese businesses, where many of those business owners remember all too well what it was like to live with an out-of-control heroin problem in Footscray in the 1990s and the early 2000s. So this idea that there is concern about the location of this facility I think is completely disingenuous, because the Liberal Party was all too happy to come to my community to hold a protest about a facility that was neither proposed nor backed by any research. It was just scurrilous, and what it was about was politics. It was about scaring one cohort of my community and demonising another.

I am strongly supportive of this bill, because living in Footscray I have seen firsthand what it is like as a resident to fish syringes out of your backyard on an almost daily basis, to see terrible situations on the streets of Footscray – an open drug trade – and also to see the horror of overdoses in my community. Thank God we had people like the member for Melton working in my community. Thank goodness we had people like him who were willing to go in there and help members of my community who had a health problem, who were profoundly vulnerable people with complex and challenging issues in their lives.

What we have seen opposite is basically a distraction, a moral panic. We have a facility that is working. It is saving lives. You know, there are 63 people who still have their loved one, and there are 63 families who are not going through the grief and devastation and lifelong trauma of thinking ‘What if we had intervened earlier? Could we have done more?’ and living with that tragedy every day. That is what this is about. This is about saving lives. This facility is saving lives.

I would like to thank a nurse from my community of Footscray Elwyn Davies, who I spoke to today. He has been working in the centre in North Richmond, and he spoke to me about the complexity of the clients there and the wraparound services that they receive – and these are people who would be out on the streets of Richmond. Those opposite spoke a lot about amenity. Well, there is nothing more devastating – and I can speak to this from experience in Footscray – there is nothing worse than having people dying on your streets. I am very pleased to have been able to make a short contribution to this. This is an issue that is very important in my community. It is recognised as a health issue in Footscray, but it is also recognised as an issue that we have dealt with before. We have seen it before.

Business interrupted under sessional orders.