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Questions Remain Unanswered on Strike Rate Against Doctors

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During the June Estimates, I asked the Professional Services Review Scheme (PSRS) why there was a 100% strike rate against doctors. I was informed that only a small number of cases make it to the Committee stage after several preliminary steps.

The representative assured me that the system is fair, although she admitted that appeals are restricted to procedural issues and cannot address the merits of the evidence.

While she mentioned that the Committee consists of the doctor’s peers, she did not address my concern about the 100% strike rate.

Transcript

Senator ROBERTS: Thank you for appearing again today. At previous estimates, I was told that administrative investigations of doctors conducted by the Professional Services Review Scheme were done in a completely fair manner. Your annual reports reveal that, since 2008, there have been 173 doctors who faced administrative investigations by committees leading to sanctions. How many of those prosecutions were successful, leading to sanctions being placed upon doctors, including suspension of practice?  

Mr Topperwien: The 173 practitioners that you refer to were the ones who were referred to committees after a long process. We’ve in fact been asked to look at over 1,800 practitioners. Those 173 were ones out of the 1,800 that we’ve looked at that the director would have had concerns that there was a possibility that they had engaged in inappropriate practice. That concern that the director would have had for each of those cases would have followed an exhaustive process by which they would have looked at samples of their patient records, interviewed the practitioner, looked at the submissions that had been made and then formed the view that for each of those practitioners there was a chance that they had engaged in inappropriate practice. They were not prepared, probably for most of them, to enter into an agreement or the director was so concerned about what looked like their conduct that they thought it ought to go to a committee of their peers to fully investigate what had actually gone on. So the small number of practitioners who end up going to a committee have gone through an exhaustive process prior to even getting there. And, as I said, they came out of 1,800 practitioners.  

Senator ROBERTS: Thank you. As I said, there have been 173 doctors who have faced administrative investigations by committees, which is what you’re confirming. I’ve asked you how many were successful. You said 100—  

Mr Topperwien: I’m aware that there have been practitioners who have gone to committees where there has been no adverse outcome for them.  

Senator ROBERTS: My understanding is that the number of those who were suspended were 171, not including two doctors who passed away.  

Mr Topperwien: I’m unable to confirm here and now what those numbers actually are, but I can take that on notice and get back to you with the actual numbers of cases that have gone to committees and, in broad terms, the nature of the outcomes of those cases.  

Senator ROBERTS: Thank you. I’d be happy with that on notice. But my understanding is that, as I said just then, the number of prosecutions that were successful for the review scheme, out of 173, were 171, not including two doctors who passed away. So that’s a strike rate of 100 per cent against the doctors.  

Mr Topperwien: Of those who went to committees.  

Senator ROBERTS: That’s what I’m—  

Mr Topperwien: Of the 1,800 that we started looking at in the first place, those 1,800 came from many thousands that were first examined by the department.  

Senator ROBERTS: I accept that. I accept the 1,800 and 173. But, of the 173, there was a 100 per cent strike rate against the doctors. I went to a barrister to check this out—a reliable barrister who used to teach in constitutional law as well as practice and worked in administration for governments. This finding is an extraordinary result, because no court system goes even close to a 100 per cent conviction rate. How can the scheme claim a fair system with a 100 per cent rate of finding against doctors?  

Dr Mahoney: Would it help if I gave some extra context around the cases that come to Professional Services Review?  

Senator ROBERTS: I just want to know the answer to the question. How can a system claim to be fair when it’s a 100 per cent strike rate?  

Dr Mahoney: If I give you the context around it, that will explain it. The department may wish to add to what I’m saying, but there are a whole range of compliance activities that are undertaken by the Department of Health and Aged Care. We talk about a pyramid. You may have heard of it. At the bottom of the pyramid, the very largest number, are the practitioners who get an educational activity helping them to understand why their billing might need to be looked at or how to bill correctly. The next step above that are what are called targeted letters, where practitioners who have been identified as perhaps needing a little bit more help will get a letter that gives them some information about their own data and just asking them to look at it. That’s really all those letters do. The next step that the department has in place is an audit program. 

Senator ROBERTS: What’s it called?  

Dr Mahoney: Audit.  

Senator ROBERTS: Thank you.  

Dr Mahoney: That sometimes gets confused with other activities. But the audit program, again, is very specific. It’s done by the department. I can talk about this because my previous role was exactly in doing the work with the compliance section of the department. With audit, it’s very specific. Again, it’s particular Medicare item requirements that can be audited, as in, ‘Did you do a specific thing?’—was there a referral, for example, for a service that requires a referral. The team that do the audit work, that’s what they do. They ask a practitioner to send in a set of documents with the proof that they’ve met a requirement. That’s a compliance activity. They’re the next level up in the pyramid. Then we come up to what’s called the Practitioner Review Program. That Practitioner Review Program is going up the pyramid where the concerns about the practitioner’s billing data or prescribing data is of more concern than any of those lower levels. That, again, is a much smaller group. For those practitioners, their data is looked at very thoroughly by senior medical practitioners who are experienced in practice as well as in looking at this data. If those practitioners think that there needs to be some intervention—the department’s medical staff—then that practitioner is contacted. They are given their billing data. They are given an opportunity to have an interview with one of the medical advisers in the department. The outcomes of those—there are three possible outcomes. The first is that the practitioner has explained their billing data, it makes sense and there is no further action taken. The second, and this is by far the largest group, is where there is some concern. The practitioner is given education about why there is concern with their billing and they are given what is called a period of review to change or to make changes to what the issues are. Then their data is looked at again. Again, the majority of practitioners understand that. They take that on board, they learn it and there’s no penalty. This is all what’s gone on before anybody gets to PSR. The third possible outcome for cases that are of really serious concern to the medical advisers in the department is that those cases are referred to Professional Services Review for the next stage up the pyramid. So we’re getting quite close to the top now. The only ones above us are those that are outright fraud that we don’t deal with. That’s not compliance. I need to add a little bit to that. After interview, a very small number of practitioners will go straight—will get referred to PSR because of the level of their concerns. A small number of practitioners who are given that six-month period of review do not make changes and they may go to PSR as well when their data is reviewed after six months. Then there’s the third group of practitioners that are referred to Professional Services Review. As you would know, under the 80/20 and 30/20 rules, if a practitioner breaches those then the department’s required by law to refer those cases to Professional Services Review. So the only cases that we are looking at in Professional Services Review are those that have already been through all of that and they are near the top of the pyramid. So that’s the context around the numbers that you’re talking about. The further context, as Mr Topperwien has said, is that even of those that get to Professional Services Review, only a small number go to committee. So I hope that helped.  

Senator ROBERTS: That has. It’s confirmed some of my fears, but I’ll explain that in a minute if we need to. Isn’t this strike rate of 100 per cent of those who get referred to a committee indicative of a system loaded against doctors with little or no chance of a doctor being able to raise a fair defence to allegations made?  

Dr Mahoney: No. They have chances right through the whole process, as I’ve described, or all the processes at the department of health.  

Senator ROBERTS: I got that. You’ve given me the answer—it’s no, in your view.  

Dr Mahoney: At Professional Services Review, they again have chances to explain, describe and discuss.  

Senator ROBERTS: The system is loaded against doctors, in our view, having listened to some doctors and consulted legal advice. Is it because in the process there’s no meaningful opportunity to challenge or explain the evidence being given against the doctor? My understanding of legal practice, which is pretty limited, is that there are two aspects. A case has to be taken through the process properly. If it’s not taken through the process properly, it’s dismissed. But if it’s taken through the process properly, then they consult the evidence. If the evidence is sound, there’s a conviction. If the evidence is not sound, it’s dismissed. So process has to be followed and evidence has to be strong. Now, doctors cannot appeal the merits of the evidence. They can appeal the process. So your process is fine, but they can’t appeal the evidence. Is that correct?  

Mr Topperwien: I’d just say here that the practitioner has multiple opportunities at the PSR end of the process to challenge the evidence, bring their own evidence and have their own witnesses. They have a lawyer in virtually every case, and the evidence that is the—the substantive evidence on which the committee makes findings is the doctor’s own practice notes. It’s the doctor’s own evidence that shows that they have engaged in inappropriate practice. They have every opportunity to put other evidence if they choose to. 

Senator ROBERTS: Isn’t it correct that a result of the process is that appeals are limited to arguments about process and not about merit or evidence of the case?  

Mr Topperwien: They have an opportunity to take an action in the Federal Court at any stage of the process about whether we have acted fairly and have taken into account irrelevant considerations. We’ve not taken into account irrelevant considerations. Those are the bases on which a challenge may be made in the court.  

Senator ROBERTS: So, as I said, the doctor can appeal the process but not appeal the merits of the evidence.  

Mr Topperwien: That’s right.  

Ms Shakespeare: Senator, perhaps I’d add some more context about the scheme—the PSR. Where people are referred to committees, that’s a committee of their clinical peers that hears evidence and makes recommendations and determinations about their clinical practice from a place of clinical expertise.  

Senator ROBERTS: In theory that’s correct. But in practice it’s not.  

Ms Shakespeare: I don’t think we would accept that either.  

Senator ROBERTS: Okay. At the next Senate estimates maybe we can talk further—or maybe before then if you’d be willing to. Would you be willing to engage in a conversation before then?  

Ms Shakespeare: About the makeup of committees for the PSR? I think that’s probably something that we would be able to engage in.  

CHAIR: Senator, via the minister’s office we can seek a briefing for you.  

Senator ROBERTS: Minister, an earlier review of the scheme said the scheme must be overhauled to make it fair and allow appeals to be made on merit. What’s your government’s timetable for a review of this system?  

Ms Quinn: Senator, there have been a number of reviews conducted around the Professional Services Review. You would understand that it’s established under the Health Insurance Act, so it is a lawful—  

Senator ROBERTS: I’ve got no doubt it’s lawful.  

Ms Quinn: And considered by the parliament of the time. Concerns about possible inappropriate practice, as you said, are able to be elevated to the courts.  

Senator ROBERTS: I understand that perfectly. I’ve had it explained before and now again today very well. I understand that it was recommended earlier in a review that the scheme must be overhauled. I want to know the progress of that and when is it going to be done.  

Senator Gallagher: Let me see if there’s—  

Senator ROBERTS: Thank you, Minister. I also make it clear that fraud hurts the taxpayers. I detest it and it must stop. So we’ve got no problems there. I also can see that a doctor who stands up and has got the courage of his or her convictions can go right through that process and won’t buckle. I can see some doctors will buckle because it’s just too much. They’ll let go. So some strong doctors, I believe, are being punished. That’s what I would like to talk to. I don’t want to raise individual cases with you. That’s not my position. I’m not an advocate for individual cases. I just wanted to understand the process better. So I look forward to a conversation.  

Mr Topperwien: We are happy to talk to you in general terms about how the process works, the way that the scheme is structured, the qualifications of the practitioners who are on our panel and who are appointed to committees and how that appointment process works.  

Senator ROBERTS: Thank you.  

CHAIR: Thank you, Senator Roberts. 

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Natural Cyclical Events Impact More Than Human Activity

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Recently, I spoke in the Senate regarding the impact of this summer’s flooding on the coral reef. Coral polyps are saltwater creatures. When floodwaters impact the reef, it introduces fresh water, cold temperatures and sediment, all of which cause coral bleaching. El Niño (ENSO cycles) causes a reduction in clouds, resulting in higher solar radiation, higher temperatures, and coral bleaching.

Both of these are cyclical and not caused by human activity. Yet the Great Barrier Reef Marine Park Authority (GBRMPA) appear to be focusing solely on the “climate change is causing warming temperatures and coral bleaching” argument instead of presenting the broader picture.

I was reassured that the GBRMPA accepts that ENSO cycles play a role in coral bleaching. I look forward to more honesty and transparency on this issue from the BOM, CSIRO and the globalist controlled Australian Institute of Marine Science.

Transcript

Senator ROBERTS: Thank you for appearing tonight. Let me start with a simple question: can floodwaters entering the reef from the 28 river systems that discharge onto the reef in a rain event, such as a tropical cyclone, cause coral bleaching, either through fresh water itself, through very low floodwater temperature, or through high nutrient levels or turbidity or sediment?

Mr Thomas: There can certainly be initial freshwater bleaching from flood events.

Mr Quincey: And we did see some of that this year with the cyclones in the north.

Senator ROBERTS: It’s true that corals also bleach from water that is too cold, isn’t it? I can remember that in June 2008 that there were record cold temperatures in various parts of Queensland and the Northern Territory, including southern Queensland, and the southern Great Barrier Reef bleached because of the cold weather.

Mr Thomas: I’m not sure of that particular example. But, yes, bleaching is certainly a stress response that can be triggered by a range of different things. Most recently, though, our biggest concerns have been about warmer waters, not colder waters.

Senator ROBERTS: Was any of the coral bleaching that was evident on the reef in the first quarter of 2024 caused by freshwater and salt intrusion?

Mr Thomas: Yes, as Mr Quincey said. Probably because of flood events prior to and post Christmas in in the north, there would have been some initial freshwater bleaching. I don’t have specific details of that in front of me, though.

Senator ROBERTS: Thank you. Was any of the coral bleaching in the first quarter caused by pesticides or other chemical run-off from farming areas?

Mr Thomas: Direct attribution of those impacts would be difficult for me to provide here today, but we could take some of that question on notice.

Senator ROBERTS: Please. According to a paper from the University of Queensland, simplified: The most devastating mass coral bleaching has occurred during El Niño events … However, El Niño itself does not cause SSTs— sea surface temperatures— to rise in all regions that experience bleaching. Nor is the upper ocean warming trend of 0.11°C per decade since 1971 … sufficient alone to exceed the thermal tolerance of corals. This paper shows that a major contributing factor is El Nino reducing cloud cover, causing ‘higher than average air temperatures and higher than average atmospheric pressures’ and playing ‘a crucial role in determining the extent and location of coral bleaching’ on the reef. Is that a fair statement?

Mr Thomas: I’m not aware of that particular paper. Did you say it was the University of Queensland?

Senator ROBERTS: Yes.

Mr Thomas: I’m not aware of it. I’m sorry. But we would be very interested to read more about it.

Senator ROBERTS: We can get it to you.

Mr Thomas: Yes, please.

Senator ROBERTS: Do you accept natural, cyclical ENSO events play a crucial role in coral bleaching?

Mr Thomas: We would have to defer to climate scientists around the particular localised impacts and how they’ve played out on the Great Barrier Reef.

Senator ROBERTS: Localised impacts, not global?

Mr Thomas: For how those significant meteorological phenomena impact the Great Barrier Reef in particular, I would need to consult with other relevant experts.

Senator ROBERTS: According to the Bureau of Meteorology document ‘124 years of Australian rainfall’, there’s no trend. There’s no pattern. It’s just cyclical. There’s no trend whatsoever, down or up. It’s just natural variation, influenced by cycles. In the last five years, we’ve had three La Ninas. Your website, under the heading ‘What causes coral bleaching?’, makes the comment: The biggest cause of coral bleaching in the past 20 years has been rising water temperatures. On notice if you wish, please provide how much water temperature has increased in the last 20 years, including average and range, showing any spikes that may have occurred.

Mr Thomas: Thank you. We will take that on notice.

Senator ROBERTS: Something like that, maybe?

Mr Thomas: I’m not sure I can reproduce that exactly, but we’ll certainly take that—

Senator ROBERTS: No, I wouldn’t expect you to reproduce it.

Mr Thomas: We will certainly try to take an—

Senator ROBERTS: Thank you. Have you tested those spike temperatures that may have led to bleaching against the ENSO cycle? Have you correlated them?

Mr Quincey: I couldn’t answer now, but we would most likely consult with our colleagues not only in the Bureau of Meteorology but in the CSIRO and the Australian Institute of Marine Science, who do some of that work.

Mr Thomas: We’re not the authors of some of these reports. We work with those relevant institutions. We pull that information together. We try to synthesise it and make the best assessments we can on how we can hone our programs and better manage the Great Barrier Reef into the future. With some of the specificity and science you’re referring to, we really would need to speak to some of our experts.

Senator ROBERTS: Okay. This is the last question. The bleaching impact statement on your website, which you describe as ‘a framework to describe and categorise coral bleaching on the Great Barrier Reef’, only includes one factor: heat stress, which you attribute to climate change, ignoring these other crucially important factors. Is this about blaming bleaching on climate change, which is well-funded, and ignoring the role of natural cycles, which carries no funding? We’ve heard the United Nations say that the planet is now boiling.

Mr Thomas: Is your question about whether our framework for understanding coral bleaching is limited to heat stress?

Senator ROBERTS: Yes, it seems that it’s only limited to heat stress.

Mr Quincey: It has it there as heat stress, but the exposure blocks the subtleties of exactly what you’re talking about—about light intensity and exposure and cloud cover. Also, on our website, we really try to convey that local and regional weather in particular places has a large bearing on the outcomes that we see each summer, and those factors play into that.

Senator ROBERTS: Thank you.

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Labor’s Guide on How to Avoid Answering Questions in Senate Estimates

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Labor has been caught red-handed with a cheat sheet to circumvent democracy. The media has received a leaked copy of a manual from the office of the Prime Minister, Anthony Albanese. This clearly shows more damning evidence that Labor is seeking ways to side-step the responsibility and accountability of government.

Instead of respecting the role and powers of the Senate, the Prime Minister’s Office sends out a secret manual on side-stepping senate estimates’ questions.

This is nothing less than contempt of the senate from the PM’s office and reveals premeditated attempts at concealing the truth from the Australian people. This is a government that talks up transparency while writing the ‘How-To’ guide on hiding the facts. We will review this in more detail and will provide a detailed response on the manual.

Transcript

I speak to this motion to take note. I have yet to read the document in full and in detail, yet its existence is very disturbing, as other speakers have already said. At Senate estimates, Anthony Albanese’s office is putting words in the mouths of department heads. How can we trust their answers? We cannot trust this government. Repeatedly we’re getting the suppression of democracy—repeatedly—and we’re seeing arrogance. Let’s have a look at some data, and then I’ll come back to talking more about this document.

As of the end of December 2023—7 December, specifically—after 94 Senate sitting days in the 47th Parliament, Anthony Albanese’s parliament, 14 guillotine motions have been agreed to. Under the previous Morrison government, in the 46th Parliament, 14 guillotine motions were agreed to. Now we start to see the difference. A total of 87 bills have been subject to the guillotine in the 47th Parliament under the Labor-Greens-teals-Pocock coalition led by Anthony Albanese. In the 46th Parliament, under the Morrison Liberals, there were 59. So we have seen almost 50 per cent more under this government, under the coalition that Labor formed with the teals, Senator Pocock and the Greens, quite often with Senator Jacqui Lambie’s support.

They promised transparency and accountability. Instead we get the suppression of democracy, repeatedly. Arrogance—that’s what we say it is. Arrogance. We see that the suppression of democracy is a form of control.Always beneath control there is fear. Of what is the Albanese Labor-Greens-teals-Pocock coalition afraid? It’s afraid of truth and afraid, fundamentally, of an informed citizenry. They don’t want people to know.

The media has seen copies of the document. ‘The PMO’s secret manual on sidestepping Senate estimates questions’—that’s the headline in Capital Brief. The article says:

Capital Brief has seen a document sent by Anthony Albanese’s office advising departments on how to handle questions on notice from Senate estimates. Current and former senators say the edict represents contempt of the Senate.

Contempt of the Senate is a very serious matter. Another article in Capital Brief says:

Current and former senators, lawyers and a former top judge have said the drafting of the document could result in contempt of the Senate. … …

Anthony Albanese’s office has stood by a document it issued to senior bureaucrats which advised them how to sidestep Senate estimates questions on the basis that inquiries have “skyrocketed” since Labor came to government.

Well, that’s your job! I don’t care if they have skyrocketed. We’ll keep asking questions. I’ll get to the Prime Minister’s office’s manual—what we’ve seen of it so far; I haven’t dissected it.

When the interests of several departments are involved, the Government Guidelines for Official Witnesses before Parliamentary Committees and Related Matters call for departments to consult with other departments as part of the drafting process. This includes instances where the same or similar Senate estimates questions on notice are asked of all or multiple departments and agencies. Why are you worried about different answers from different departments? Look at some of the topics covered—well, we’ll go through that another time.

I know this is not a motion by leave to seek a variation of standing orders, but One Nation normally opposes them because the Senate should be focused, firstly, on Senate responsibilities and, secondly, on government
business. We want the government to govern. Senate estimates, though, are a vital part of holding governments and bureaucrats accountable for taxpayer funds. Why do you hide from that? Anthony Albanese’s department wants to hide the truth from the people.

We have seen the Fair Work Commission and the Fair Work Ombudsman stumbling through an answer to my questions attempting to get to the bottom of their complicity with the CFMEU and major multinational labour hire firms in stealing $30,000 to $40,000 per miner each year from thousands of casual miners in Central Queensland and the Hunter Valley. They hide the facts wilfully. The Fair Work Ombudsman office relies on fraud, repeatedly.

The Labor minister for workplace relations ignores and diverts. It’s embarrassing for departments. We look forward to reviewing the formerly secret document in detail, because democracy is at stake.

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Slow Progress on Protecting Kids from Graphic Sex Books

I asked the Classification Board about publications that are considered obscene material for children and whether the rating system available to the board to make an accurate rating is allowing such material to slip through the classification cracks.

I have for some time been campaigning on the powers the Classification Board has to stop kids having access to graphic novels that are nothing more than pornography.

After having my concerns deflected at the last Estimates, I was pleased to find the Classification Board does agree that there is a need to expand the range of options they have for the classification of graphic novels for children.

At the moment the choice is either to not classify the publication that allows any child to access it in a store or library, or R, meaning the publication can only be displayed in a plastic wrapper and sold to adults. The rating in the middle is M, which means 15 and up, however this is only an advisory rating and does not serve to limit children accessing the publication in any way.

I am pleased to see the Classification Board is now seeking to add a further, legally binding restriction on these publications.

I am concerned the time frame seems to be open-ended and will continue to pursue the Minister and the Classification Board to get this loophole closed sooner rather than later.

Transcript

Senator ROBERTS: First question—thank you for being here; that’s the first thing. I’ve asked the Classification Board before about publications that must be considered obscene material for children. Last time it
was the books The Boys and Gender Queer. Since then, the publisher, Hardie Grant, has released Welcome to Sex, which is targeted at 10-year-olds, and the author said actually eight and up. The distinction between eight and 10 is academic. This book was on the shelves of retailers like Target, where a child of any age could purchase it. My question now is the same as it was last Senate estimates. Does the Classification Board have a rating system available to it for graphic novels that allows the board to make an accurate rating, or do you need something between anyone being able to access a publication and R—restricted for sale to adults, in plastic wrapping? Do you need an intermediate classification?

Ms Jolly: As you’ve outlined, the options available for the Classification Board are restricted publications of different types, but they’re restricting publications for over 18-year-olds or freely available. The other option we have is to produce consumer advice, which is not legally restrictive, which advises that the material is not suitable for people under 15.

Senator ROBERTS: Do you need an intermediate classification, then?

Ms Jolly: I think the board’s submission to the Stevens review back in 2020 was that we felt that there would be benefit in having some greater—

Senator ROBERTS: Another category.

Ms Jolly: gradations in classifications.

Senator ROBERTS: Thank you very much. Your answer’s really clear. Minister, in my meeting with Minister Rowland, I was advised that a review of the classification system would be commenced shortly. Has that
review commenced?

Senator Carol Brown: The review is being taken in two stages. Stage 1, of course, you would understand, included the piece of legislation that was passed recently in the parliament and received royal assent on 14
September, and that will commence next year, in March 2024. The stage 2 reforms aim to bring the scheme into alignment with the modern media environment, particularly the treatment of online content. Do you want me to tell you what those reforms go to?

Senator ROBERTS: I really just want to know: is it looking into options available for written publications?

Senator Carol Brown: This is a result of the 2020 review of Australian classification regulation, the Stevens review, which was handed to government in 2020 and released in 2023, and one of the things that it is looking at is to ensure that the classification criteria are evidence based and responsive to evolving community standards and expectations.

Senator ROBERTS: Is it looking into the options available for written publications—another classification, for example?

Senator Carol Brown: The review is quite broad, and it will refine the purpose and scope of the National Classification Scheme, so it will establish—

Senator ROBERTS: The review has commenced?

Senator Carol Brown: Informal consultation with government stakeholders has commenced. Public consultation will occur early in 2024.

Senator ROBERTS: So it is looking into options available for written publications. The public will get the opportunity to comment early in 2024. What is the time frame for recommendations?

Senator Carol Brown: I might hand to the deputy secretary to give you some time lines—if that’s what you’re after?

Senator ROBERTS: Yes, please.

Mr Windeyer: I don’t think I can give you a date for conclusion at this point. I’m happy to take on notice to see if we’ve got some more precise time lines developed at this point, but the key point is: we’ve started
preliminary consultations with some internal-to-government stakeholders. Public consultation will commence early next year. But I don’t have a set date for the conclusion of the review.

Senator ROBERTS: Could you take that on notice.

Mr Windeyer: I’m happy to take that on notice.

Senator ROBERTS: Thank you.

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TGA Suppresses Superior Safety of Medicinal Cannabis

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I reminded the Therapeutic Goods Administration (TGA) about information that was provided to me during previous estimates regarding alleged harm from medicinal cannabis. My question was not answered. Instead I was given an excuse as to why adverse events are not recorded for cannabis.

This is not true. There is a second register of adverse events, which is a TGA internal register called AEMS. Medical practitioners have been reporting adverse events to this database for years. The TGA’s own data shows that medicinal cannabis has caused 515 adverse events since 2012. Medicinal cannabis was the sole suspected medication in 454 of these – 174 were serious and 10 were fatal. As Professor Skerritt pointed out in Estimates, cannabis is widely prescribed in palliative care and this outcome is to be expected in end-of-life care where patients are receiving pain relief. In other words, patients died while taking cannabis — not from taking cannabis.

The reason the TGA did not answer my question on the relative harm of cannabis over pharmaceutical medication is because it’s not even a contest. Cannabis has been prescribed over 4 million times across this period and discounting palliative care, medicinal cannabis has not caused a single death or permanent incapacitation. Compare this to over a thousand reports of death just in the last two years from COVID injections. The pharma funded TGA acts in service of the pharmaceutical state and will do everything in their power to ensure medicinal cannabis is not made available to everyday Australians at an affordable price.

One Nation has produced a bill to down-schedule medicinal cannabis so that it can be prescribed by any doctor and filled by any chemist. This simple and long overdue reform has been blocked by the Liberal, National and Labor parties despite strong public support for the measure.

I will continue to advocate for policies that improve the health, well-being and prosperity of everyday Australians.

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Reserve Bank wants a Central Bank Digital Currency in Australia 

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A Central Bank Digital Currency goes hand in hand with the idea of a Digital Identity. With all of your information and money stored online, central banks or governments could turn off your access to money and society in the blink of an eye.

The last time I asked the Reserve Bank about a Central Bank Digital Currency, there seemed to be no real plans. Conveniently they are now considering it, just as the feared Digital Identity Bill proposal is being pushed by Government.

Transcript

[Chair] Senator Roberts.

Thank you. Thank you for appearing again. I’m gonna start with a sincere compliment, Mr Debelle. I’ve been impressed with your frankness and your directness and your succinctness. You convey a lot of confidence and I would also like to start by complimenting the Reserve Bank for the answers I received in the last estimates, which after examination were complete and factual. So question one, Chair: the Reserve Bank has now signed on to the International Central Bank Digital Currency Platform, Project Dunbar, and I quote, “aims to develop prototype shared platforms for cross border transactions which will allow financial institutions to transact directly with each other in the digital currencies issued by participating central banks.” Now, as I understand it, Mr Debelle, Australia will be testing this platform, along with Malaysia, Singapore, and South Africa, which suggests we have a digital currency to use, to test the platform. Where is the Reserve Bank on the development process for the Reserve Bank Digital Currency and what’s the timeframe here for testing and implementation?

Hello, pass that one to Ms Bullock, please, Senator, she’s the expert in this space. Well, has carriage of this, at least.

Thank you, Senator. So, the first thing to note is that Project Dunbar is a proof of concept, so I’d distinguish it from a pilot. Pilot is where you actually have actual real money. This isn’t a pilot, it’s actually a proof of concept. So really, what it’s about is going through the technical infrastructure you might need, the legal arrangements you might need, to patent requirements you might need to set this sort of multicurrency approach up. So there is no Central Bank Digital Currency, we don’t have one, the other central banks don’t have one, it’s purely a proof of concept, if you like, It’s a little bit of a desktop exercise with a little bit of experimentation with technical approaches to do it, so there’s no actual Central Bank Digital Currencies involved.

Okay. Thank you. Oh, sorry.

I was just gonna go on to your second question, if that’s all right.

Okay.

So, your second question was about where we are at with Central Bank Digital Currency. So, we’ve had a multiyear process in this. We’ve done some small experiments. We’ve experimented internally with the concept of a wholesale Central Bank Digital Currency. Again, it’s not real, it’s just sort of a mock-up if you like, and we’ve done that internally to see whether or not individual banks could perhaps use it for settlement between them. We’ve also expanded that fairly recently. There was a report in December, Project Atom, which was an experiment again with Commonwealth Bank, National Australia Bank, Perpetual and Consensus and ourselves. And the concept here was, again, a proof of concept. It wasn’t a pilot; a proof of concept to see whether or not a Central Bank Digital Currency, paired with tokenized syndicated loans, would actually make a more efficient way of having syndicated loans transacted through the economy. We released the report on that in December and I think it proved that there were some efficiencies in this area, but –

Excuse me, did you say there were inefficiencies?

Efficiencies.

[Roberts] Efficiencies.

Efficiencies. So, syndicated loans is a very manual process, and quite lengthy, and what the project proved was if you tokenized the syndicated loans, you had a Central Bank Digital Currency to transact amongst the various players in the syndicated loan, that actually that made that a much more efficient process. Whether or not you can do it with normal payment systems as well is another question, but we didn’t test that, so there’s that. We’re also participating, as you mentioned, in Project Dunbar with the Bank for International Settlements Innovation Hub and those three other countries, and we’ve recently formed ourselves a Central Bank Digital Currency Group in the Payments Policy Department, and we’re going to be engaging with the Digital Finance Cooperative Research Centre, which is looking at all sorts of things digital. We’re going to be engaging with them on looking at Central Bank Digital Currencies as well, so that’s a little bit of a potted history of where we’re at with our work on this.

Okay. Thank you. If a new digital currency is to be created out of electronic ledger entries, will existing amounts of cash be converted into digital dollars? The public may be confused about how this is going to work. Can the Reserve Bank please provide a simple overview of what happens after the project gets the green light? Where’s the value coming from? So when we have a cash?

What we’re assessing, Senator, really, is exactly that: their value, given we have a pretty decent payment system as it is, which includes cash, clearly, but also electronic settlement, and you sort of nailed the question, really, which is: is there value in this? Is it worth the investment at this stage or not? Michelle, I don’t know if you wanna add anything to that.

The only thing I’d add, Senator, is that there is no suggestion in which we are getting rid of cash. This concept is not to replace cash and it hasn’t even been decided that we would do it. This would be a decision not for the Reserve Bank, but for, in fact, the Government, and it wouldn’t be replacing cash, so that’s very clear.

When I was talking about the value, I wasn’t talking about the value of the process. Is it gonna be more efficient? Is it worth doing, so I appreciate your answer and that quite clearly, that’s one valid interpretation of my question, but what I was getting at was, if someone’s got so much value in Australian dollars, how will that be converted into digital currency dollars or whatever the currency is? Will they still have that purchasing value?

Sure. So the way that most central banks are looking at this around the world is that the central bank itself won’t be providing people with digital money. It will work like cash does. So at the moment, if you want cash, you go to your ATM or your bank and you withdraw some cash from your bank account. A digital currency, if we had one, would work in a very similar way. You would go into your bank and your bank would have presumably a digital wallet, or you’d have a digital wallet, and you would take some money out of your bank account and you would put it into Central Bank Digital Currency, just like cash. So you can think about it in a very parallel way.

Yes, but if someone’s got $2,000 in cash today in their bank account, will that give them the equivalent purchasing power if there’s a conversion into digital currency?

Yes. Correct. It would be exactly the same as if it was a $100 bill or $100 on your mobile wallet.

Okay. Thank you. Now the BIS is involved. So, one specific case: our foreign exchange reserves are used to settle international transactions. These will now be replaced with the Reserve Bank Digital Dollars, if it goes ahead. Is the process to simply replace the US dollars we have in reserve with US Government-issued crypto dollars or a similar value-basis digital currency?

[Debelle And Bullock] No.

[Bullock] Do you wanna take this?

Straight to the chase: no, Senator, we would still continue to hold $USD reserves in the instruments we currently hold them at, which is primarily US Treasuries.

Okay. That’s pleasing to hear. What are the risks in doing this, for example, if this was handled badly, not necessarily from the Reserve Bank, but for the people you’re dealing with overseas, if the system wasn’t tight? What are the various risks that you can foresee that need to be managed?

This is why I think there’s a lot of water to flow under the bridge before any advanced economies really have launched into this. There are obviously cyber issues. You need to make sure that the system is secure. Overseas consultations demonstrate that people are very concerned about privacy, which is a very valid concern, but by the same token you’re also concerned about a use of digital currency for criminal purposes, so there’s a balance there. Another concern, that is one that most central banks identify, is concerns about the banking system and whether or not there might be a flight of deposits, if you like, to the Central Bank Digital Currency, which would have implications for banks’ balance sheets, potentially make it easy to run on banks, if people were concerned about banks, so there’s a whole lot of financial stability risks and issues associated with it. That’s just a sample of some of the issues that need to be considered if we were going to go in this direction and have some sort of what I would call “retail” Central Bank Digital Currency.

Thank you. Two more questions, Chair. Digital or cryptocurrency is not backed by any asset. It’s literally an exercise in trust that the government can protect the value of someone’s currency. Is this the time now to start talking about getting an asset backing behind this new currency, such as gold?

Senator, just like cash at the moment, it would be a feat currency, which is to say it isn’t backed by anything. And you’re right. It’s all about trust in the institutions of the country, in the government, in the Reserve Bank, so in that sense, it would be just like cash, if we were going down this route, it would be an unbacked currency.

But it’s backed by the government’s capacity to raise revenue from its citizens, basically.

Backed by the government’s capacity to raise revenue, did you say?

Yep.

Thank you. Last question. During COVID, there’s been a hell of a lot of money spent on non-productive outcomes. As much as food and rent can be considered non-productive, they’re essential, but they’re non-productive, the outcome of long-term borrowing for short-term gain is inflation. Is spending on productive capacity: roads, railways, bridges, dams and irrigation in this recovery phase, likely to produce a lower inflation outcome across forward estimates than continuing to spend on what can only be described as economic sherbet?

I don’t know, I mean, that’s an an interesting question, Senator. I mean, I’m not sure I would draw that distinction, I think food I would regard as a pretty productive and essential service, an essential thing for people to consume, so, I mean, we build roads for a purpose, not just because, which is to satisfy people wanting to use them, and the same with food and same with shelter, so not quite sure how we can draw such a clean line between what’s productive and unproductive.

Well, perhaps, well food is essential, as I said, perhaps spending on non-productive assets: entertainment, instead of travelling overseas, people are buying new cars, that kind of thing. What I’m talking about is spending on such items that may be essential, but not producing increased wealth, could lead to inflation. That’s the risk. On the other hand, spending on something that increases productive capacity, like a dam with irrigation systems to supply increased food productivity and lower the cost of food, leaves people better off and wealthier overall. That’s what I was getting at: a productive capacity, rather than just consumption.

There is a reasonable amount of dollars investment in infrastructure at the moment, that’s increased quite a bit, both from the Commonwealth and the State Governments, so that sort of spending is absolutely happening. Again, I’m still not quite sure I would draw such a clean distinction. In the end, people consume what they want to consume and I’m not sure it’s up to us too much to tell them what’s good and bad about that, within reason.

Well, that’s a wonderful statement to hear coming into my ears now. I love that, but yeah, sorry?

I said, “I thought you’d like that.”

So what we’ve got, though, is an acknowledgement that there is money being spent on infrastructure. You’ve answered my question. I just personally believe, Chair, that we need to spend more on improving our productive capacity. Thank you very much. Again, Chair, I’d like to put on record that the Reserve Bank always answers quickly, succinctly and factually. So thank you. It’s really appreciated.

[Chair] Dr Debelle, you’ve got a fan there.

[Roberts] Yep. He has.

[Debelle] Thank you.

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