Controlled Medication

I seek leave to make a brief explanation before asking the Minister for Mental Health and Substance Abuse a question about the Controlled Substances Act.

The Hon. J.M.A. LENSINK: In May 2006 the Department of Health issued a discussion paper, with recommendations to address the anomaly that enrolled nurses are able to administer schedule 8 (drugs of dependence) medications in high-care facilities. For the benefit of members who are unfamiliar with this situation, enrolled nurses are permitted to administer both S4 and S8 medications in low-care facilities, which by their nature have fewer rostered registered nurses. With the Australian government’s policy of ageing in place, many low-care facilities have a majority of residents who are receiving, in effect, high care. In contrast, in highcare facilities enrolled nurses are permitted to administer S4 medications but, currently, they are precluded by state government regulations from administering S8 medications.

I am advised that the department’s discussion paper found that there is no greater risk of harm to residents arising from the administration of S8 medications than from S4 medications in high-care and low-care facilities. My questions are:

1. Does the minister concede that there is an anomaly with the regulations?

2. Does the minister agree with the discussion paper, which states that ‘if the controlled substances legislation does not allow for enrolled nurses to administer impress stock, then there is no flexibility and delegation of this role cannot be accommodated’?

3. Have the proposals been referred to the Controlled Substances Advisory Committee; and, if so, what is its recommendation?

4. Given that the minister was briefed on this issue last year, what are the reasons for the delay and when will we see some amendment to the legislation?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): Indeed, there was a discussion paper sometime ago. There was extensive consultation around this and some changes were recommended to the administration of schedule 8 medications. I will need to take the rest of the questions on notice and bring back a response, because I do not have those details with me today.

Thursday 3 April 2008

In reply to the Hon. J.M.A. LENSINK (31 May 2007).

The Hon. G.E. GAGO (Minister for Environment and Conservation, Minister for Mental Health and Substance Abuse, Minister Assisting the Minister for Health): I have been advised that:

1. The Nurses Board of South Australia determines what is in the ordinary course of duties for their profession. In some instances, what is thought to be an appropriate duty for an enrolled nurse to perform has changed, which has resulted in a small anomaly under the controlled substances legislation.

2. The reference to a lack of flexibility and delegation if the controlled substances legislation does not allow enrolled nurses to administer imprest stock is inaccurate. The control mechanism is through the issuing of a licence to the health service for possession under an imprest system of supply.

3. The proposals were referred to the December 2006 Controlled Substances Advisory Council meeting. The Council recommended that consultation with the acute health sector should commence with the view to proposing changes to the legislation in regard to the administration of drugs of dependence by enrolled nurses. This would cover enrolled nurses in all health services, both in acute and residential aged care settings.

4. Consultation with the acute health sector, as recommended by the Controlled Substances Advisory Council, has been completed. Additional information is being considered in relation to the impact of the proposed changes on the aged care industry. Appropriate legislative changes will be progressed once this information has been considered.