I join today with my colleagues on the committee and thank all the people who contributed to the discussion of this issue: to Mr Rattenbury in the first instance for his draft bill, to the specialist adviser, Professor Arnold, to all the submitters and witnesses, to my colleagues on the committee, and, of course, as Dr Bourke outlined, to Nicola Kosseck for her fine work in pulling together what I think is a comprehensive and very thoughtful report for the committee.
I valued the opportunity for the committee to inquire into this issue. It is important that we ensure people who are suffering and in pain, especially those nearing the ends of their lives, have access to the services and products they need to ease pain and ease suffering.
I joined this committee at its halfway point, but I was able to be part of all of its hearings and deliberations. I started out very open to this issue and very open to the idea that medicinal cannabis should be accessible to people suffering ongoing and severe pain from their medical conditions, especially those nearing the end of their lives. But I also took into this committee a serious intent, and it is one that I will do throughout my time in this Assembly—that is, to seriously weigh up the issue, to examine its opportunities and risks, to take the wide view and understand what it means in practice to make a significant policy change—in this case legalising medicinal cannabis—and to examine a piece of legislation that enables this policy intent to be realised.
We must look at what it means in practice to develop legislation and regulation that enables such a significant policy change, and we must always have the wellbeing and success of individuals and our community as our core driving principle. This is always, though, a balancing act. As members have noted, this was a hard task. We all learned along the way, and other members of the committee have raised this morning the diversity of views that were presented to us.
The committee could not support the draft bill in its current form. For reasons my colleagues, in particular Dr Bourke, have outlined, we were unable to support this bill on a number of grounds. Mr Rattenbury in a subsequent submission to the committee asked two important questions, and I took them very seriously as well: what level of imperfection is tolerable in exchange for allowing sick and dying people access to a treatment that can assist and help relieve suffering and, secondly, what action do we take while waiting for the completion of clinical trials or for TGA-approved drugs or for a coordinated model of government supply?
Supply is, indeed, a key issue. If we enable supply through the proposed methods in the draft bill, we support some current users—I should add that we heard it is clear not all current users would have been eligible to access the scheme under the draft bill—but we open up exposure to other users currently not with access to the scheme.
There were technical details which, again, crossed the threshold in my view of what is tolerable for the broader community. I was surprised at the level of community input; I had expected more from users of medicinal cannabis. As a result, it was unclear how many people currently use cannabis for medicinal purposes and certainly how many would use it for the purposes that would have made them eligible for legal use under the scheme. Of course, for those suffering terminal illnesses, I was very aware that they may have passed and could therefore not come before the committee and, equally, that there would be many people who would not want to go public with their use of cannabis.
I have some glimpse into the daily pain of people suffering. One contributor suffers ankylosing spondylitis, something my dad has lived with for over 50 years. To say my dad is a bit of a trooper on this is an understatement, and I know he is in pain every day. Some days are better than others.
On the question of the ACT going it alone, we could have gone alone. I do not believe in the perfect outweighing the good, but our sheer size would make this extraordinarily difficult and costly. Cost is an issue, not an excuse. In every case it is the opportunity cost. What cost, for example, to establish our own scheme and what use could that funding be otherwise put to?
The equity of the proposed draft bill would be profoundly inequitable. Could parents of a young child dying of cancer learn all the skill necessary to grow their own cannabis and could an elderly couple access the black market? Equity issues are important.
One contradiction I found in the evidence presented to us was that many proponents of medicinal cannabis told us lawmakers and bureaucrats should leave the details of the decision to patients and their practitioners. Yet the clear evidence from health professionals to the committee was that this was not something they endorsed. In that case we must find a better way, and lawmakers and bureaucrats have a role to play here. Bottom line: I think this was a bit of cop-out from some proponents, although I found evidence from the AMA that they were unaware of any doctor with a patient accessing medicinal cannabis slightly incredulous.
Health professionals want a more scientific approach. Some, I believe, may set their bar too high and this is where a trial like that about to get underway in New South Wales is valuable. I do not think trials are a cop-out. They should go down the path to developing a safe and consistent pharmaceutical product. It is clear to me that the illegality of cannabis has prevented proper research. We must find a way to change this. Drugs save lives, and although not part of the evidence to the committee, my reading of community debate is that sometimes we can be complacent about the research and development and effectiveness of pharmaceutical products in this country, as we have seen tragically recently around the debate on childhood immunisation and preventable deaths from whooping cough.
It is an irony—if it was not so serious it might be amusing—that many of the fiercest proponents of a science-based approach to climate change, for example, with whom I totally agree, do not find the same strength in their arguments on pharmaceutical products, for example, like vaccinations. I want to see the long-term goal of cannabis-based products that are rigorously researched and tested and become part of mainstream research.
Patients and those in pain and their families deserve treatments that are reliable, safe and proven. They need to know, especially if it is children. I acknowledge that it is a long way away, and if it were my child I am sure I would struggle with that wait. But progress is made in stages. Unfortunately, it was clear for me and the committee that the thresholds we were asked to weigh up, the action we were asked to consider, could not be crossed.
I want to thank again everyone involved, especially Mr Rattenbury for bringing this bill to the Assembly. It has started the conversation, one that is now national and widespread. I believe we have crossed the Rubicon on this issue; there is no going back from the genuine recognition that cannabis-based products can relieve enormous suffering, but the risk to users and the risk to our community, the imperfections, are too high to endorse this bill.
As the committee notes, we recommend the ACT government write to the commonwealth minister requesting further support is provided for affordability and access to Sativex and Marinol for more patients and for more guidance to medical practitioners. We recommend the poisons standard be amended to facilitate medical and scientific research into medicinal cannabis. We recommend the ACT government work with all other states and territories on further clinical trials, and I will be very interested to follow the New South Wales trial. We also encourage the government to work to make sure there are ACT patients who can access the trial if possible.
We also outline a number of significant regulatory concerns raised in this report. There are no simple answers to any of these concerns, most especially around supply but we must take these seriously and act with compassion in our hearts and our minds on the realities of a scheme that will work. Unfortunately, this bill did not get us there, but I am sure a national approach will. We should play an active role in this.