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Northern Territory of Australia
Government GazetteISSN-0157-833X
No. S77 29 July 2016
Northern Territory of Australia
Medicines, Poisons and Therapeutic Goods Act
Community Health Centres and ClinicsRevocations, Declarations and Approvals
I, Dinesh Kumar Arya, Chief Health Officer:
(a) under sections 252, 254(1) and 250(1) of the Medicines, Poisons and
Therapeutic Goods Act and with reference to section 43 of the
Interpretation Act, revoke:
(i) the notice entitled "Community Health Clinics - Non-Government
Organisations: Revocation of Notice and Declaration of Places,
Approval of Scheduled Substance Treatment Protocols and
Approval for Nurses and Midwives to Deal with Schedule 4 or 8
Substances" dated 17 November 2014 and published in Gazette
No. S114 of 19 November 2014; and
(ii) the notice entitled "Community Health Clinics - Non-Government
Organisations: Revocation of Notice and Declaration of Places,
Approval of Scheduled Substance Treatment Protocols and
Approval for Aboriginal and Torres Strait Islander Health
Practitioners to Deal with Schedule 4 or 8 Substances" dated
17 November 2014 and published in Gazette No. S114 of
19 November 2014; and
Page 1
Northern Territory Government Gazette No. S77, 29 July 2016
(b) under section 252 of the Medicines, Poisons and Therapeutic Goods Act,
declare each health centre or clinic specified in the Schedule, Part A, to be
a place to which Part 2.6 of the Act applies; and
(c) under section 254(1) of the Act, approve each Scheduled substance
treatment protocol specified in the Schedule, Part B, for each health centre
or clinic specified in the Schedule, Part A; and
(d) under section 250(1)(a) of the Act, declare each nurse or midwife
practising at a health centre or clinic specified in the Schedule, Part A, to
be an approved nurse or approved midwife (as appropriate) to supply,
administer to another person and possess the Schedule 4 and 8
substances specified in the Schedule, Part C, in accordance with each
Scheduled substance treatment protocol specified in the Schedule, Part B;
and
(e) under section 250(1)(b) of the Act, declare each Aboriginal and Torres
Strait Islander health practitioner practising at a health centre or clinic
specified in the Schedule, Part A, to be an approved ATSI health
practitioner to supply, administer to another person and possess the
Schedule 4 and 8 substances specified in the Schedule, Part C, in
accordance with each Scheduled substance treatment protocol specified
in the Schedule, Part B.
Dated 26 July 2016
D. K. AryaChief Health Officer
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Northern Territory Government Gazette No. S77, 29 July 2016
Schedule
Part A
Alice Springs After Hours General PracticeAlice Springs Hospital6 Gap RoadAlice Springs NT 0870
Amoonguna Health Service60 Whitegum DriveAmoonguna NT 0872
Ampilatwatja Health Centre15 South StreetAmpilatwatja NT 0872
Anyinginyi Health Centre71 Schmidt StreetTennant Creek NT 0860
Bagot Community Health ClinicBagot RoadLudmilla NT 0820
Barunga Health Centre322/20 Derrkolo RoadBarunga NT 0852
Binjari Health ServiceLot 71Binjari NT 0852
Bulla Health CentreLot 17Baines NT 0852
Bulman Health CentreLot 68Bulman Weemol NT 0852
Central Australian Aboriginal Congress – Alukura4 Percy CourtAlice Springs NT 0870
Central Australian Aboriginal Congress – Ingkintja19 Gap RoadAlice Springs NT 0870
Central Australian Aboriginal Congress – Larapinta Clinic5/26 Diarama CloseAraluen NT 0870
Central Australian Aboriginal Congress – Main Clinic25 Gap RoadAlice Springs NT 0870
Central Australian Aboriginal Congress – Public Health Division32 Priest StreetAlice Springs NT 0870
Central Australian Aboriginal Congress – Sadadeen Clinic2-4/70 Spearwood RoadAlice Springs NT 0870
Central Australian Aboriginal Congress – Social and Emotional Wellbeing Service14 Leichardt TerraceAlice Springs NT 0870
Danila Dilba Health Service – Darwin Clinic32-34 Knuckey StreetDarwin NT 0800
Danila Dilba Health Service – Malak Clinic3/1 Malak PlaceMalak NT 0812
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Northern Territory Government Gazette No. S77, 29 July 2016
Danila Dilba Health Service – Men's Clinic42 McLachlan StreetDarwin NT 0800
Danila Dilba Health Services – Palmerston Dental Clinic4/7 Rolyat StreetPalmerston NT 0830
Danila Dilba Health Service – Palmerston Family Centre1/7 Rolyat StreetPalmerston NT 0830
Danila Dilba Health Service – Palmerston Health Clinic7 Rolyat StreetPalmerston NT 0830
Gunyangara Health Centre90 Yunupingu DriveGunyangara NT 0880
Headspace Alice Springs5/5 Hartley StreetAlice Springs NT 0870
Iluwurru Health CentreLot 6Alexandria NT 0862
Jilkminggan Health CentreLot 30Jilkminggan (Duck Creek) NT 0852
Kalkaringi Health Centre125 Libanangu RoadKalkaringi NT 0852
Lajamanu Health Centre446 Lajamanu StreetLajamanu NT 0852
Laynahpuy Homelands Health Service86 Galpu RoadYirrkala NT 0880
Manyallaluk Health CentreLot 21Manyallaluk (Eva Valley) NT 0852
Marthakal Homelands Health Service80 Riyalanura RoadGaliwin’ku (Elcho Island) NT 0822
Mataranka Health Centre25 Gunn StreetMataranka NT 0852
Mialuni (Kildurk) Health Centre25 Baines StreetTimber Creek NT 0852
Minyerri Health CentreLot 3Minyerri NT 0852
Miwatj Health – Ngalkanbuy Health Centre105 Gakuda StreetGaliwin'ku (Elcho Island) NT 0882
Miwatj Health – Nhulunbuy Clinic1424 Arnhem RoadNhulunbuy NT 0880
Mitwatj Health – Yirrkala Health Centre144 Rankine RoadYirrkala NT 0880
Mutitjulu Clinic36 Petermann RoadMutitjulu NT 0872
Ngukurr Health CentreLot 316Ngukurr NT 0852
Ntaria Health Service293 Raberaba CircuitHermannsburg (Ntaria) NT 0872
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Northern Territory Government Gazette No. S77, 29 July 2016
Peppimenarti Health CentreLot 73Peppimenarti NT 0822
Pigeon Hole Health CentreLot 3Pigeon Hole NT 0852
Pintupi Homelands Health Service194 Yuntju StreetWalungurru NT 0872
Santa Teresa Health Centre315 Church StreetSanta Teresa (Ltyentye Apurte) NT 0872
Timber Creek Health Centre93 Wilson StreetTimber Creek NT 0852
Urapunga Health Centre20 Blyth StreetLimmen NT 0852
Urapuntja Health Service1 Sandover HighwayAmengernternenh CommunityUtopia NT 0872
Utju Health Service75 Kalleski RoadAreyonga (Utju) NT 0872
Wugularr Health Centre50 Ngalagan StreetBeswick NT 0852
Wurli Wurlinjang Health Service25 Third StreetKatherine NT 0850
Yarralin Health CentreLot 53Yarralin NT 0852
Page 5
Northern Territory Government Gazette No. S77, 29 July 2016
Part B
Title Publication Date Author
Adult and Special Groups Vaccination Schedule
March 2016 Centre for Disease Control (Northern Territory Government Department of Health)
The Australian Immunisation Handbook, 10th Edition
2015 Australian Technical Advisory Group on Immunisation (Australian Government Department of Health)
CARPA Standard Treatment Manual, 6th Edition
2014 Central Australian Aboriginal Congress, Central Australian Rural Practitioners Association Inc, CRANAplus Inc, Flinders University through the Centre for Remote Health
Childhood Vaccination Schedule
March 2016 Centre for Disease Control (Northern Territory Government Department of Health)
Declared Places Outreach Services Scheduled Substance Treatment Protocol
July 2016 Northern Territory Government Department of Health
Minymaku Kutju Tjukurpa Women’s Business Manual, 5th Edition
2014 Central Australian Aboriginal Congress, Central Australian Rural Practitioners Association Inc, CRANAplus Inc, Flinders University through the Centre for Remote Health
Northern Territory Refugee Vaccination Policy
September 2015 Centre for Disease Control (Northern Territory Government Department of Health)
NT Pneumococcal Vaccination and Revaccination Guideline
March 2016 Centre for Disease Control (Northern Territory Government Department of Health)
Scheduled Substance Treatment Protocol Mango Dermatitis
July 2016 Northern Territory Government Department of Health
Page 6
Northern Territory Government Gazette No. S77, 29 July 2016
Title Publication Date Author
Vaccination Schedule for Standard Treatment Protocol
April 2015 Northern Territory Government Department of Health
Vaccines to Adults in the Northern Territory Scheduled Substance Treatment Protocol
March 2016 Northern Territory Government Department of Health
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Northern Territory Government Gazette No. S77, 29 July 2016
PART CSchedule 4 Substances
Aciclovir
Adrenaline
Albendazole
Amethocaine
Amoxicillin
Antisera – Box jellyfish
Aspirin
Azithromycin
Benzathine penicillin
Betamethasone
Cefalexin
Ceftriaxone
Chloramphenicol
Ciprofloxacin
Clavulanic acid
Clindamycin
Clotrimazole
Codeine/Paracetamol
Dexamethasone
Diazepam
Dicloxacillin
Doxycycline
Famciclovir
Flucloxacillin
Fluorides – Varnish
Framycetin
Glyceryl trinitrate
Gramicidin
Haemophilus influenzae vaccine
Hepatitis A vaccine
Hepatitis B vaccine
Human papillomavirus vaccine
Hydrocortisone
Imiquimod
Ipratropium
Iron compounds
Isosorbide dinitrate
Ketoconazole
Levonorgestrel
Lidocaine
Metoclopramide
Metronidazole
Miconazole
Midazolam
Naloxone
Neomycin
Nitrofurantoin
Nystatin
Olanzapine
Omeprazole
Ondansetron
Oxybuprocaine
Oxytocin
Phenoxymethylpenicillin
Pneumococcal vaccine
Podophyllotoxin
Praziquantel
Prednisolone
Probenecid
Procaine benzylpenicillin
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Northern Territory Government Gazette No. S77, 29 July 2016
Prochlorperazine
Promethazine
Roxithromycin
Salbutamol
Silver sulfadiazine
Sulfamethoxazole
Terbinafine
Terbutaline
Tinidazole
Triamcinolone
Trimethoprim
Tuberculin
Vaccine – Diphtheria/Haemophilus
influenza B/Hepatitis B/
Pertussis/Poliomyelitis/Tetanus
Vaccine – Diphtheria/Pertussis/
Poliomyelitis/Tetanus
Vaccine – Diphtheria/Pertussis/
Tetanus
Vaccine – Diphtheria/Tetanus
Vaccine – Haemophilus influenza B/
Meningococcal conjugate C
Vaccine – Herpes zoster
Vaccine – Influenza
Vaccine – Measles/Mumps/Rubella
Vaccine – Measles/Mumps/Rubella/
Varicella
Vaccine – Meningococcal conjugate
C
Vaccine – Rotavirus
Valaciclovir
Varicella vaccine
Zinc compounds – Zinc sulfate
Schedule 8 SubstancesMorphine
Page 9
Northern Territory Government Gazette No. S77, 29 July 2016
Northern Territory of Australia
Medicines, Poisons and Therapeutic Goods Act
Darwin Occupational ServicesDeclarations and Approval
I, Dinesh Kumar Arya, Chief Health Officer:
(a) under section 252 of the Medicines, Poisons and Therapeutic Goods Act,
declare the health centre specified in the Schedule, Part A, to be a place to
which Part 2.6 of the Act applies; and
(b) under section 254(1) of the Act, approve each Scheduled substance
treatment protocol specified in the Schedule, Part B, for the health centre
specified in the Schedule, Part A; and
(c) under section 250(1)(a) of the Act, declare each nurse practising at the
health centre specified in the Schedule, Part A, who has the qualifications
specified in the Schedule, Part C, to be an approved nurse to supply,
administer to another person and possess the Schedule 4 substances
specified in the Schedule, Part D, in accordance with each Scheduled
substance treatment protocol specified in the Schedule, Part B.
Dated 26 July 2016
D. K. AryaChief Health Officer
Page 10
Northern Territory Government Gazette No. S77, 29 July 2016
Schedule
Part A
Darwin Occupational Services35a/12 Charlton CourtWoolner NT 0820
Part B
Title Date AuthorModel Standing Drug Order (SDO), Combined Hepatitis A and B Vaccine
endorsed on 30 May 2016
Darwin Occupational Services (DOS)
Model Standing Drug Order (SDO), Diphtheria-Tetanus-Pertussis-Polio (dTpa-IPV) Vaccine
endorsed on 30 May 2016
DOS
Model Standing Drug Order, Hepatitis A Vaccine
endorsed on 30 May 2016
DOS
Model Standing Drug Order (SDO), Hepatitis B Vaccine
endorsed on 30 May 2016
DOS
Model Standing Drug Order, Influenza Vaccine
endorsed on 2 June 2016
DOS
Standing Drug Order, Adsorbed Diphtheria-Tetanus Vaccine
endorsed on 30 May 2016
DOS
Standing Drug Order, Lyssavirus Vaccine
endorsed on 31 May 2016
DOS
Vaccine Management Procedure, Procedure No: DOS 02
22 June 2016 DOS
Vaccination Procedure, Procedure No: DOS 03
22 June 2016 DOS
Workplace Vaccination Procedure, Procedure No: DOS 04
22 June 2016 DOS
Part C
1 The qualifications prescribed under section 65(1A) of the Act.
2 Successful completion of the unit of competency HLTAID001 - Provide cardiopulmonary resuscitation.
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Northern Territory Government Gazette No. S77, 29 July 2016
Part D
Hepatitis A Vaccine
Hepatitis B Vaccine
Rabies Vaccine
Vaccine - Diphtheria/Tetanus
Vaccine - Diphtheria/Tetanus/Pertussis/Polio
Vaccine - Hepatitis A/Hepatitis B
Vaccine - Influenza
Page 12