Today’s question comes from a Victorian based private event and other first aid/medical services provider.  My correspondent has:

… read your posts about doctors not being permitted to authorise the use of scheduled medications for paramedics use and similar topics.

I am wondering if you could clarify about the purchase and storage of scheduled medications by doctors for patients [see note 1, below].

The context is that we deploy medical teams to remote sites, normally in a public event setting. The teams include Doctors and nurses. Let’s assume that we don’t have a health services permit. The information included here – https://www2.health.vic.gov.au/public-health/drugs-and-poisons/medical-practitioners-medicines-control/managing-drug-dependency/medicines-storage-in-gp-clinics [see note 2, below] – states that the we can purchase, store and administer s4 and s8 medications as long as the medications are only accessible by doctors. The article states this includes PBS drug bag items and pharmaceutical samples but it doesn’t clarify if it is limited to these items.

I am seeking clarification if a Doctor can purchase quantities of s4 and s8 medications for the purpose of storing them and having them on standby to administer to patients that they will encounter when they are deployed to remote sites. Once again, assuming that we don’t have a health services permit and assuming that only doctors will have access to the medications. I am also referring to medications which are not in the PBS Drug bag list.

If the answer is ‘yes’ under what authority and by what means would they make the purchase (eg we already know it’s illegal for a doctor to write a script in their own name to obtain the medications so how would they obtain these heavily controlled substances to keep on standby).

I assume the question would be a similar logistical problem that clinics without health services permits would face.

Notes

  1. I assume that the post ‘about doctors not being permitted to authorise the use of scheduled medications for paramedics’ was Doctors delegating authority to carry drugs (August 20, 2014)).
  2. The web page my correspondent has referred to (above) discusses the Drugs, Poisons and Controlled Substances Regulations 2006 (Vic). The 2017 regulations came into force on 23 May 2017.  Without checking every statement in the web page, the 2017 regulations do appear to be substantially the same as the 2006 regulations described on that page.

Discussion

Section 13 of the Drugs, Poisons and Controlled Substances Act 1981 (Vic) says:

any registered medical practitioner … is hereby authorized to obtain and have in his possession and to use, sell or supply any poison or controlled substance (other than a Schedule 1 poison) or drug of dependence in the lawful practice of his profession as a registered medical practitioner …

Despite the gendered language (‘his possession’) this applies to all medical practitioners, not just men – Interpretation of Legislation Act 1984 (Vic) s 37.

A medical practitioner may also supply a scheduled drug to a person for the purpose of providing medical treatment to that person (Drugs, Poisons and Controlled Substances Regulations 2017 (Vic) r 36)).

The medical practitioner in possession of schedule 4 drugs must kept ‘locked and secured’ and is only opened when the medical practitioner or another person authorised to possess the drugs (eg a nurse) is present (Drugs, Poisons and Controlled Substances Regulations 2017 (Vic) r 73 ‘General security requirement—Schedule 4 poisons’).  Schedule 8 poisons must also be secured under more stringent conditions (rr 74 and 75).

A registered medical practitioner can therefore, be in possession of, and supply schedule 4 and 8 drugs without the need for a ‘health services permit’.

The questions asked

I was asked:

  1. Can a Doctor purchase quantities of s4 and s8 medications for the purpose of storing them and having them on standby to administer to patients that they will encounter when they are deployed to remote sites. Once again, assuming that we don’t have a health services permit and assuming that only doctors will have access to the medications. I am also referring to medications which are not in the PBS Drug bag list.

Answer: Yes.  The doctor can carry any s4 and s8 drugs that are necessary ‘in the lawful practice of his profession as a registered medical practitioner’.

  1. If the answer is ‘yes’ under what authority and by what means would they make the purchase (eg we already know it’s illegal for a doctor to write a script in their own name to obtain the medications so how would they obtain these heavily controlled substances to keep on standby).

Answer: The authority comes from section 13 of the Drugs, Poisons and Controlled Substances Act 1981 (Vic).  A doctor can’t write a prescription to obtain drugs in order to treat themselves (Drugs, Poisons and Controlled Substances Regulations 2017 (Vic) r 17) but that is not to the point. The point of a prescription is to allow another person ie a pharmacist to supply a drug to a person who needs it for their care and that in turn allows that person to be in possession of the drugs that are prescribed for his or her treatment.

To answer this question, however, requires advice from a pharmacist but it would appear to me that a doctor could simply buy schedule 4 and 8 drugs from a licensed wholesale or retail drug supplier (ie a pharmacist).  No doubt there are forms to be completed to ensure that the supply is recorded and that the purchaser is a medical practitioner so, as I say, the details would come from a pharmacist.

Disclaimer

As noted my correspondent comes from ‘a Victorian based private event and other first aid/medical services provider’ and wants to know the answers for the no-doubt commercial activities of that supplier.  This blog is a source of general information and discussion, not legal advice. A business that is operating in this field cannot rely on this blog for advice on the requirements for their actual practice. For advice that can be relied on my correspondent needs to get, and pay for, local legal advice or approach the Department of Health