View from The Hill: government shuts down telehealth-for-VAD bill, defying Labor conference

The government has blocked a crossbench attempt to allow telehealth to be used in voluntary assisted dying care – despite strong support for the measure at last month’s Labor national conference.

Health Minister Mark Butler told parliament the safeguards around telehealth weren’t adequate. But Butler is in an awkward position, having to reverse his stance of only a few years ago.

In 2022, shortly after the election Butler was asked about then attorney-general Mark Dreyfus proposing such a change. Butler said there had already been discussions “and we’re looking at ways in which we can move forward on it”.

The previous year, then in opposition, Butler had attacked the Coalition government for not acting. Butler said in September 2021, “The Morrison government needs to stop sitting on its hands and ensure that the implementation of those state [VAD] laws is not thwarted by the threat of prosecution under Commonwealth communications laws”.

But in government it became apparent to ministers, including Butler and Dreyfus, that Prime Minister Anthony Albanese was strongly opposed to any change (although he backs VAD itself). He has said use of telehealth would undermine confidence in VAD.

Within Labor, some sources believe Albanese is influenced by his Catholic faith, which they think has strengthened in recent years.

Shortly after parliament resumed on Tuesday following its winter break, Western Australian teal Kate Chaney moved to bring on her private member’s bill for an immediate debate and a vote. This would amend the criminal law so telehealth consultations on VAD would no longer be regarded as providing advice on suicide, which would breach the current law.

Chaney told parliament the change was supported by the Australian Medical Association, the Law Council, VAD regulatory bodies, 20 health organisations, and state attorneys-general and health ministers. She outlined individual instances where the availability of telehealth could have alleviated suffering.

Seconding Chaney’s move another teal, Monique Ryan, a medical doctor, said that the Labor platform was now in line with doctors, with dying patients and their families. “There is no good reason for delay.”

The ALP national conference said Labor would remove the bar on telehealth “as part of lawful access to voluntary assisted dying […] while maintaining appropriate clinical safeguards”.

The conference said there should be a conscience vote on VAD issues. But the government does not give its MPs free votes on procedural issues, so all Labor members were bound to vote against the Chaney move.

While Labor conference decisions are formally binding, details of implementation and timing are up to the parliamentary party, so in practice they can be easily dodged.

The telehealth issue was the only contested decision at the national conference.

Replying to Chaney and Ryan, Butler told parliament the government and the parliamentary party would decide questions of implementation of the party platform.

Focusing on safeguards, he said people might disagree about what was appropriate.

The experience of telehealth had been “quite mixed”, he said. There had been many cases where it had not been used appropriately.

I am not convinced that the current telehealth arrangements are particularly well-suited to VAD right now. They have not been appropriate for a whole range of ways in which new business models have been developed to use telehealth in a way that I don’t think is clinically appropriate.

Butler said he was keen to continue engagement but made no commitment to seek to develop what the government would consider satisfactory clinical safeguards.

Chaney told a news conference later that she thought Butler was talking about cannabis prescription via telehealth, “where there is a lot of money to be made”.

“There are so many checks and balances in place that I don’t think the issues that he raised today are applicable to VAD practitioners. There’s no money in it for a start,” Chaney said.

The government and opposition combined to quash the Chaney move in a vote 74-12. Those voting with Chaney and Ryan were the eight other independent members (Nicolette Boele, Andrew Gee, Helen Haines, Dai Le, Sophie Scamps, Allegra Spender, Zali Steggall and Andrew Wilkie), the Greens’ Elizabeth Watson-Brown and One Nation’s David Farley.

The battle over telehealth will now turn to the Senate.

Greens Sarah Hanson-Young said she will introduce a private senator’s bill this week.

Independent David Pocock told the Senate, “We have an opportunity to give people the dignity that they deserve – the last gift we can give them”.

Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.