Page 2766 - Week 11 - Tuesday, 20 October 1992

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very appropriate statements about due care and attentiveness would appear to be at risk. But I go on. Mr Berry's approach also suggests that, under this new approach, medical practitioners will be employed for an extra 12 hours a week. There are an extra 200 patients; an extra 12 hours a week means that each client will get 10 minutes per month. They have 3.85 minutes in the health centre and they have 10 minutes per month with their medical practitioner. So far they are doing very well.

Turning to counselling, initially they were not going to put on another counsellor; but finally the select committee rightly pointed out that it would appear to be fairly important to do that, so we have a counsellor. The counsellor, I find from speaking to a few of them, can see at the absolute most eight patients per day, and that is not taking into account time taken for education and for all of the other jobs that need to be done. Eight patients per day, day in, day out, is 40 patients per week. These lucky people on our new methadone program may see a counsellor every five or six weeks. So, we now have 3.85 minutes, 10 minutes with the doctor, and a counsellor every six weeks or so. This does not seem to be stacking up overly well in terms of due patient care. But we go on.

Mr Berry's expanded methadone program - and I am still interested in Mr Berry's response to this - would seem to be contravening section 80 of the Drugs of Dependence Act. This was brought up in the Estimates Committee, I agree, and Mr Berry undertook to get a legal opinion. Hopefully, that too will be forthcoming later on today. Section 80 of the Drugs of Dependence Act says:

A person shall not supply a drug of dependence upon prescription unless the person is -

(a) a pharmacist;

(b) a medical practitioner;

(d) a veterinary surgeon.

Mr Berry's approach has none of those people directly involved in the supply of the methadone. We have 3.8 nurses, level 1; but we do not seem to have any pharmacists, medical practitioners or anybody else to personally supervise. So, it would appear that this area of the legislation has been overlooked. But so be it.

Even assuming that Mr Berry can find some loophole in the law to allow nurses to supply methadone on prescription, there are the takeaway doses to take into account. Now, 200 patients, or even 116 patients, at the clinics by two takeaway doses a day is quite a number. The exact figure is 232 doses that have to be dispensed each week, with the patient's name and label and so on. That will take at least a day of somebody's time, none of which is costed in Mr Berry's approach. This leads me to doubt very much Mr Berry's figures. In his figures he has also gone on to cost the pharmacy option, but it is important first of all to requote some of the comments on the proposal for pharmacy distribution of methadone prepared by the Alcohol and Drug Service last August and September. This has been quoted earlier, but I think it is important for it to be quoted again. The report says:

The Board of Health and the Minister have endorsed a proposal to expand the ACT Methadone Program by establishing additional methadone places with the assistance of approved community pharmacies.

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