Communications and advocacy update: 4 May
4 May 2023
Here’s an update on a few of the issues AMA Victoria is working on for members, including:
- Payroll tax on medical practices - follow-up
- Targeted Consultation for Proposed Amendments to Drugs, Poisons and Controlled Substances Regulations 2017 - MDMA and psilocybine
Payroll tax on medical practices - follow-up
In the lead up to the Victorian Budget release on 23 May, AMA Victoria, joined by the RACGP Victoria Faculty, the Australian General Practice Alliance, and the Primary Care Business Council, have written to the Victorian Government regarding payroll tax on medical practices.
For our organisations, the essential matter remains the provision of clarity regarding:
- Advice on what medical practice business structure is considered compliant.
- Formal confirmation of the position of the Victorian SRO regarding rosters and websites and whether the Victorian SRO position has changed.
- Confirmation that the Government and the SRO is cognisant of the implications of the implementation and interpretation of payroll tax parameters that are deleterious to medical practices and thus patients.
- Confirmation that the Government and SRO are not specifically accelerating targeting of medical practices for audit activity.
- Mitigations the Government is proposing to obviate the predicted negative consequences to the health of Victorians and the Victorian budget should interstate revenue office’s new interpretation be adopted in Victoria.
In addition, we have requested the provision of historical audit data of medical practices in Victoria, and how the interpretation has changed over the years.
In again writing to the Victorian Government, we have noted that this matter is now more urgent, in recognition of the fact that other jurisdictions have now acknowledged that they are targeting General Practice as an industry of audit focus, and that this is subsequently causing significant unrest in the sector.
Furthermore, our organisations conveyed that we are acutely aware, and supportive, of the Government’s policy initiatives to secure the already scarce medical (and in this context, most relevantly, general) practitioner workforce in Victoria, but that the current absence of clarity on the aforementioned points is not aligned with the Premier’s strategy to secure the future Victorian medical workforce.
We will update members on the Government’s response.
Targeted Consultation for Proposed Amendments to Drugs, Poisons and Controlled Substances Regulations 2017 - MDMA and psilocybine
The Victorian Department of Health is accepting comments and submissions for their proposal to amend the access controls in the Commonwealth Poisons Standard for MDMA and psilocybine.
The Commonwealth Poisons Standards, produced and updated by the Therapeutic Goods Administration (TGA), is a federal legislative instrument that sets the availability and accessibility of certain controlled substances. States and Territories then give legal effect to the Poisons Standards through their medicines and poisons legislation. In Victoria, this state-level legislation is called the Drugs, Poisons and Controlled Substances Act 1981.
On 3 February 2023, the TGA decided to down-schedule MDMA and psilocybine in the Poisons Standards from Schedule 9 (prohibited substances) to Schedule 8 (controlled substances) in certain circumstances. MDMA will become a Schedule 8 substance when used in the treatment of PTSD and psilocybine will become Schedule 8 when used to treat treatment-resistant depression. The TGA will restrict which providers are able to prescribe these drugs under Schedule 8 - namely, only specialist psychiatrists authorised under the TGA’s Authorised Prescriber Scheme will be allowed to do this. For all other uses, MDMA and psilocybine will remain in Schedule 9.
This will take effect federally from 1 July 2023. Victoria will then automatically adopt these changes under the Drugs, Poisons and Controlled Substances Act 1981.
However, the Victorian Department of Health is considering amendments to these changes to establish additional access controls and further safeguards to minimise any risk of drug diversion and to ensure national consistency and patient safety. These changes include introducing a requirement for the prescribing psychiatrist to notify the Secretary of the Department of Health whenever they supply Schedule 8 MDMA or psilocybine. Another proposed change is to prohibit the direct supply of Schedule 8 MDMA or psilocybine to patients.
If you would like to contribute to AMA Victoria’s response to these proposed amendments, please send your feedback through to Senior Policy Adviser, Lewis Horton (email@example.com), by COB Wednesday 10 May. Please note that specific consultation questions have been provided by the Department on Page 4 of the Stakeholder Consultation Paper.