Motion – Stinson – Establishment of a Select Committee into Access to Urinary Tract Infection Treatment
Thursday 1 December 2022
Thank you Mr Speaker.
I move that this House establish a Select Committee to inquire and report into:
Barriers facing sufferers of urinary tract infections (UTIs) in gaining timely access to treatment
The applicability of implementing Queensland’s Urinary Tract Infection Community Pharmacy Service in South Australia and
Any other related matters.
I am seeking the support of this House to establish a Select Committee into Access to Urinary Tract Infection Treatment for the hundreds of thousands of South Australian women who endure the excruciating and sudden pain of an uncomplicated urinary tract infection – better known to sufferers as a UTI.
Women like my mum, women like my friends, women like my colleagues – and women like me.
Personal story
Mr Speaker, imagine you are lying in bed fast asleep. It’s 2am. Suddenly you wake up. You can feel that you simply must race to the loo. When you get there you experience a sharp pain shooting through your lower body. It’s like a thin metal pin has been shot into you and the more you try to relax, the more it hurts. It’s so painful you scream out loud.
Mr Speaker, imagine you’re at work. You’re in a very important meeting with very important people. The discussion is getting complicated and you’re trying to follow the points being made. But you can’t concentrate. You can’t sit still. You can’t get comfortable. All you want to do is leave, go to the bathroom, or maybe lie down. And you’re getting stressed that you might just have an accident. But you struggle on – knowing this as much a mind game as a physical taunt.
Mr Speaker, imagine that you’re caring for children. You’re bouncing on the trampoline in the backyard, playing chasies and having a great time. Suddenly you feel a familiar discomfort. You know what’s coming. And you know that pretty soon you’re not going to be running around or jumping on a trampoline – or even moving much at all.
Mr Speaker, imagine you’re on a plane. Everyone has taken their seats and is settled in. You grab your book and try to get comfortable for the three hour flight. The plane takes off. You find yourself watching for the seatbelt light so you can get up and use the toilet. It’s that feeling again. This is going to hurt. And it’s going to be a tough few hours – and maybe a tough few days.
Mr Speaker, you’re lucky to be travelling in a remote part of Australia. This is what you live for. You’re in the back of a 4WD and you’re on a rocky road. It should be a beautiful experience in the wilds of the Flinders. Instead it’s the most painful experience of your life as every bump shoots pain through your body. Miles from a doctor – you know you’ll be enduring this for many days to come. So much for that adventure!
Experiences like this are shared by so many women – and some men too. These particular experiences I’ve shared – are my own.
I used to be terribly embarrassed and ashamed about this. Let’s face it, talking about wee isn’t the most elegant thing. I have to admit standing in front of you all and talking about it right now is pretty embarrassing.
But I have found that in recent years when I have spoken about it with close friends and family – that so many other women endure the exact same thing as me.
There is of course comfort in sharing such experiences and other sufferers are very supportive.
But so many of those conversations I have end up in a discussion about the long wait for medication and how unnecessary it feels to have to endure such sharp and sudden – yet entirely familiar – pain, as we wait to see a doctor, get a script and go to a pharmacy to buy medication.
In this place we are essentially shift workers and the hours can be unpredictable. We have jobs that involve obligation and responsibility. And we have busy personal lives too. And that’s no different to many other South Australians.
This modern lifestyle can make it hard to get to a doctor and there’s no denying that getting a GP can take days or weeks. In country areas the wait can be much longer.
Like many others I’ve sought detailed medical advice and tried to find a permanent fix. I’ve followed the medical advice about how to avoid a UTI – and I’ve drunk more cranberry juice than anyone should have to in a lifetime! But when the pain strikes there is one solution for me – and many others – and that’s a short course of antibiotics.
Stats
Half of all South Australian women will suffer a UTI at some point in their lives. And one in 20 men will be struck by the painful condition too.
A UTI is commonly caused by bacteria in the urethra, bladder and/or kidneys and is often difficult to predict or prevent.
The infection causes intense pain during urination, the constant sensation of needing to urinate and discomfort throughout the period of infection.
While alkalinising drinks may relieve symptoms for some people, for most sufferers antibiotics are required to address the infection.
Currently sufferers must book an appointment with a GP to obtain a script for medication and then have that filled at the pharmacy.
For many people, this can mean days of pain and discomfort before securing an appointment and effective treatment.
If left untreated, or if treatment is delayed, the condition can result in admission to hospital for kidney infection or other complications.
Queensland has recently allowed specially-trained pharmacists to assess patients and provide UTI medication, following a successful pilot program.
The NSW government last month announced legislation to allow pharmacists to provide a wider range of medications.
In Victoria, state Labor made an election commitment which I expect they will fulfil given their re-election to government.
While some of these interstate approaches include additional medications other than UTI treatments, it is important to note the SA Select Committee I’m proposing is intended to focus only on UTI medication.
Many people have said to me, why don’t you just legislate the change immediately? Why even hold an inquiry?
It’s a fair question.
And an understandable question from sufferers who’d like to have access to medication through their pharmacist as quickly as possible.
The reason is this.
I take women’s health seriously. Labor takes women’s health seriously. And I’m quite condiment this Parliament takes women’s health seriously.
We owe it to women to carefully and thoroughly examine models of care and treatment that meet their needs in a safe and timely way.
I am aware that there are divergent opinions between different medical disciplines – and differences of opinion between professionals who share the same discipline.
There are also valid questions from consumers and practical considerations about the best type of scheme to suit South Australia.
This is the purpose of the inquiry I’m proposing .. to tease out those questions, seek out answers and the most appropriate arrangements to suit patient needs.
I am unashamed that this inquiry is about putting UTI sufferers first. Putting the health needs of women first.
Of course we must rely on medical evidence to ensure any scheme is as safe as it can possibly be, but I am not interested in a turf war.
I’m interested in what’s best for sufferers.
The point has been made, and will continue to be made I’m sure, that there is a need for more GPs in order for patients to be able to see a doctor faster.
I agree.
Just last week the AMA released it’s report into the GP workforce finding (and this is from their own media release):
Australia is facing a shortage of more than 10,600 GPs by 2031–32, with the supply of GPs not keeping pace with growing community demand.
In the decade to 2019 demand for doctors’ services increased by 58 per cent, that’s equivalent to the workload of 10,200 full time GPs.
In the 5 years to 2021, only the equivalent of 4,200 full time GPs were added to the workforce.
On average both male and female GPs have been trending towards fewer hours per worker. The combined effect has been a lowering of average hours worked across the GP workforce.
These are worrying figures. Action is needed. And this government is acting on those needs.
But in reality – in the real world in which we are living – there is not going to be a flood of new GPs within weeks or months.
And in those weeks and months and years ahead – more women are suffering an uncomplicated UTI that could possibly be treated faster in consultation with their pharmacist.
I’m interested in their needs in the reality of this world right now.
Scope of inquiry
As I said, the purpose of this inquiry is to investigate. To ask questions, to seek answers, and to arrive at useful recommendations to the Parliament.
Areas the Committee may choose to traverse include but are not limited to:
Regional and remote access to UTI treatments – and the question of providing access where both pharmacists and doctors are scarce
Affordability of treatment
Privacy and confidentiality
The training already provided to university qualified pharmacists and what that training equips them to do currently
Additional training in relation to any future scheme
The actual model of care itself – with particular reference to the Queensland approach and how that might be improved upon or tailored to suit South Australian needs
Follow up contact and collection of data on outcomes
The periodic review of such a scheme
The usefulness of trials or pilot periods for South Australia and the design of any such scheme
The issue of antibiotic resistance – which is a very serious concern – and whether that is an issue in relation to pharmacy-based provision of UTI medication
Current alternatives to GP appointments including online based prescription services
I am sure there are also other topics that will arise in the course of written and verbal submissions.
Although I don’t wish to traverse the ins and outs of the Queensland model in detail at this juncture – because I believe in the inquiry process and its capacity to deeply delve into that model in due course – I might just pause to point out an important factor.
What we’re talking about here is the assessment of uncomplicated UTIs. Under the Queensland model, if a pharmacist identified complicating factors (such as pre-existing complex medical conditions) or wasn’t convinced that a patient was likely to be suffering a UTI, they referred that patient to a GP. This is an important point in the interests of patient care.
Witnesses
With the establishment of this committee, I look forward to hearing from all interested parties in the medical professions as well as advocacy groups – but most importantly UTI sufferers – about their views on how we can make access to timely, effective and safe treatments for UTIs a reality for them.
Conclusion
I urge members of this House to support the establishment of this committee.
We owe it to sufferers of this very common affliction to investigate any ways we can make life easier a less painful for them.