Page 2049 - Week 08 - Tuesday, 8 September 1992
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That motion expressed the view of the entire Assembly. The Government supported that motion and continued its planning to expand the program. On 10 May Mr Moore's Select Committee on Drugs announced that it would also examine this issue, and the Government looks forward to the receipt of that committee's report. It has been said that the Government's response to the earlier motion from this Assembly was anticipating the outcome of the committee's inquiry, but clearly that is not the case. The committee has expressed a view and the Government has responded to the demands, if you like, of the Assembly in dealing with the issue of methadone in the community.
Providing expanded services requires alternative distribution sites, other than Woden Valley Hospital. It has to be said that any option will be costly. I am therefore proposing the introduction of a charge on all clients of the Government's ACT methadone program. This charge will be set at $10 for health card holders and $20 for non-health card holders. However, the charge will not be introduced until criteria for waiving the fee under certain circumstances are developed in consultation with community and client groups.
The advantage of a charging scheme applying to expand government facilities only is that it is consistent with our social justice principles. That is, all clients would gain more convenient access to methadone treatment, regardless of their capacity to pay. Distribution through private pharmacies may be accessible only to clients who can afford higher charges. I should say at this point that the recommended fee in New South Wales is $36 a week, and it is not unheard of for private instrumentalities in New South Wales to charge $10 per day.
I believe that methadone distribution services will be best provided by the Government in order to ensure that there is a high standard of care and to avoid the problems experienced in other larger States, which are forced by their geographical size to rely on the private sector to provide methadone. I think it has to be emphasised that the provision of methadone from pharmacies is really a fall-back position for those States that do not have the luxury of a compact geographic area with numerous health facilities dotted conveniently throughout. So we are in a luxury position, if you like, when it comes to delivering these sorts of services to people who need them.
These other States, such as New South Wales, Queensland and Victoria, operate private programs, but not without major difficulties of monitoring and regulating to prevent social disturbances, increased risk of death through overdose, and diversion of methadone into the black market. They are all significant problems. I must emphasise that these are serious drawbacks to the private sector expansion that I had earlier recognised. In addition, expanding into the private sector would require establishing a costly health bureaucracy to control the private sector, to avoid the problem of deregulated distribution of methadone, as is proposed by Mrs Carnell. By expanding government services only, the resources will be expended on direct patient care, not on administration.
The ACT is uniquely placed to deliver high-quality accessible programs through government facilities because of its small size and its being a city-state. South Australia, like the ACT, operates a single central methadone program, but it is forced to use private pharmacies to administer methadone to some clients,
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