Luke Hartsuyker (Cowper, National Party) Share this | Hansard source

I welcome the measures contained in the Therapeutic Goods Amendment Bill (No. 3) 2006. It will allow the Therapeutic Goods Administration to conduct a modernisation of its procedures with regard to the issue of licences and to make a further response to the report of the National Audit Office in 2004. I would like to take the opportunity to dwell on the current pressures on the health service—in particular the Pharmaceutical Benefits Scheme, the demand for alternative or complementary medicines and the response to these pressures in regional areas.

Currently, under section 37(1) of the Therapeutic Goods Act 1989, manufacturers of medicines, blood and tissues have to apply in writing for the relevant licences. The passage of this bill will enable them to lodge such applications electronically. Manufacturers will be able to track easily the progress of their applications and to make necessary amendments. It should make the process rather more attractive to manufacturers and ease the passage of new products onto the market. No information additional to that required for the existing application process will be required, so there is no extra bureaucratic burden on the manufacturer. The measure will also enable the TGA to continue to address criticisms made by the Audit Office of its data management, documentation and record keeping.

I mentioned pressure on the health service. One pressure is the public’s demand for medicines in general. We are encouraged to become more health conscious, to become more aware of health risks and to take early intervention and preventative action. That is fine as far as it goes. It is clearly better for the individual and for the finances of the health service for an ailment to be dealt with quickly and cheaply at an early stage than to be left until a lengthy, expensive treatment or surgery is required. This increased level of consciousness has led to a greater knowledge of what medicines are available and a greater demand for those medicines provided under the Pharmaceutical Benefits Scheme, or PBS. This is particularly true of expensive drugs that have proved far more effective than their competitors for a limited number of patients. However, with cost pressures, it is often hard to explain to a sufferer of, for example Crohn’s disease, why they may have to pay thousands of dollars for a drug treatment which provides them with great relief and which may remove the need for complex surgical intervention at a later date. I hope we will be able to provide improved pharmaceutical support for Crohn’s sufferers at some stage in the near future.

But I acknowledge this is both a difficult area, in assessing the efficacy of drugs, and a political area. How do we administer a program such as the PBS for greatest benefit? It is also true that many drugs coming onto the market are expensive and may be suitable for a wide range of patients. This means great cost pressure, which needs to be managed carefully if we are going to ensure that our health budget delivers the maximum benefits. The current annual cost of the PBS is $6.2 billion. I would imagine there are a few who would argue that we should cap this cost and abandon our support for medicines. But I would also imagine there are a few who would argue that this process needs to be very efficiently managed so that we reduce costs wherever we can. There is a role for the public to play in this.

I am not convinced that the increasing level of consciousness of the need for personal health has resulted in a sufficient commitment to greater personal responsibility. Prevention, after all, is better than cure. Prevention lies, in many cases, in our own hands. We all know that managing our diet, avoiding cigarettes and reducing our alcohol intake can have substantial personal benefits. However, sadly, in many cases people still overindulge and fail to manage adequately their own personal health.

Let us consider the message on diet for a moment; it is clearly not getting through. Australia is one of the fattest developed nations. The percentage of Australian adults who are overweight or obese has doubled in the last two decades—that is, 67 per cent of men aged 25 to 64 are overweight or obese, and the equivalent figure for women is 52 per cent. It is a huge problem. More worryingly, 20 to 25 per cent of Australian children between five and 17 are overweight or obese. That is double the prevalence recorded in 1986. These children and adults are at greater risk of diabetes, heart disease, stroke and some forms of cancer. The cost of obesity is estimated to be some $1.2 billion a year. If we could eliminate that, we could spend that $1.2 billion in other areas. I welcome the setting up of the National Obesity Taskforce but, unless we accept personal responsibility for our own health, obesity may end up as an absolute epidemic. I know that not all obesity is self-induced, but I think it is fair to say that much of that $1.2 billion could be saved. It is one-fifth of the current annual cost of the PBS.

There is another perhaps more easily attainable form of saving that will require if not personal responsibility then public acceptance, and that is the use of generic drugs. Many people are reluctant to accept the cheaper generic versions of a drug, particularly if they have been used to receiving the originally patented version for some length of time. As more patents expire, there will be more generics available. I believe we have to work hard to overcome this reluctance to use generic drugs so that the savings made in the area of generics can be put into new, innovative drugs that will potentially provide huge gains to people in our country.

I noted in Wednesday’s Sydney Morning Herald a report that the Indian pharmaceutical company Ranbaxy has secured listing of four of its low-cost generics on the PBS. Ranbaxy is the first Indian company to have its drugs listed, and the move is expected to generate increased price competition. There are clearly opportunities here not just to control the cost of the PBS but also to possibly help meet the cost of providing some of those innovative drugs I spoke of earlier. I should say that the cost is by no means the only criteria for listing on the PBS, but it would be unrealistic to operate on the basis that the PBS could be isolated from all cost pressures. I welcome the comments by the Minister for Health and Ageing, Mr Abbott, that savings from the introduction of generics can create headroom for spending on the newest, more expensive drugs. There are benefits here for patients, and we should grasp the opportunity.

I should remind members that the government have increased health spending in the area of aged care. We have spent in total on health some $48 billion, $20 billion more than in 1996-97. We are currently increasing the availability of new drugs on the PBS by providing more than $750 million for new treatments for colon cancer, breast cancer, heart failure and high blood cholesterol. More than 350,000 Australians are expected to benefit from these drugs.

It is worth noting that, while many express the view that the PBS should provide more and that they should pay less, the expert committee report Complementary medicines in the Australian health system, published in 2003, estimated that the annual turnover of complementary medicines was some $800 million. The total market in this area, including purchases made from overseas companies, is likely to be far higher than that. The same researchers reported that 52.1 per cent of the population surveyed had used at least one non-physician-prescribed alternative medicine, with an additional 20 per cent of Australian complementary medicines output being exported. This is clearly an area of medicine that holds a strong attraction for many people, who are prepared to spend a great deal of their own money. Without wishing to comment on the efficacy of the products, we need to ensure that the products of this apparently profitable industry are safe. It is right and proper that the TGA is active in this area. Insofar as this market represents an economic opportunity and provides choices the consumer clearly wants, the measure we are discussing today will make it easier for manufacturers to bring new products onto the market.

There are those who say that we should remove all cost restraints from the PBS and that, if a drug is licensed by the TGA and prescribed by a doctor, it should be available. There are many, including the sufferer of Crohn’s disease whom I mentioned earlier, who would no doubt welcome an expansion of the drugs covered by the PBS. We do have to have cost control, but I certainly would welcome an extension of therapeutic assistance to Crohn’s sufferers in the near future. However, it is easy to forget that budgets are limited. It is easy to forget that extra money spent on the PBS might mean less money to subsidise bulk-billing, which covers almost seven out of 10 consultations in my electorate. It might also be easy to divert funds from one area of the health budget, such as the Medicare safety net. That is an example of the difficult choices in health that need to be made and the importance of ensuring that we tightly monitor the costs of the PBS to derive maximum benefit for the community at an affordable cost to the government. If we were to overspend in one area of health, it might mean that worthwhile projects might not go ahead. Some new, groundbreaking areas in the health system may be retarded by a failure to appropriately control costs in other areas.

I would like to dwell for a moment on an important project, the Rural Palliative Care Program. It is currently supporting a number of pilot projects—one of which is in my electorate—and provides stakeholders with improved access to quality palliative care in a regional or rural setting. I think that is vitally important. I am pleased to have such a pilot in my electorate. Earlier this year, I was able to announce that Baringa Private Hospital in Coffs Harbour was to receive nearly half a million dollars to set up a palliative care service, increasing the number of palliative care beds and providing additional clinical and IT equipment. These measures will improve the quality of life of patients who have serious or life-threatening diseases, treating as soon as possible the symptoms of the disease and the side-effects of treatment and providing psychological, social and spiritual assistance as may be required during the time that that person and their family are dealing with that illness.

These new and innovative programs are the sorts of programs that can go ahead because we focused in the area of health very much on economic efficiency and economic effectiveness, which provided the budget to do these more innovative programs. The Baringa hospital project will ease the pressure on existing facilities and so make those resources available to other patients, as well as support the sufferers and their families. The funding comes from the Rural Health Strategy, which is providing some $830 million over four years for health and aged care services and workforce measures.

In June 2005, the Minister for Health and Ageing came to Coffs Harbour to open the $3 million Rural Clinical School, which is now training medical students through the University of New South Wales but substantially in rural and regional areas. The strategy behind the Rural Clinical School is that if we train our doctors in a regional setting they are more likely to practise there. The rural workforce is a major issue which needs to be addressed in rural and regional areas. It is one the government is very focused on. It is one that we are achieving in. It is one that the Rural Clinical School plays a major part in developing.

Last month, Minister Abbott was in Coffs Harbour to open a $1.2 million nursing laboratory, which included two four-bed simulated wards. The training of nurses in a regional area is basically done on the same principle as the training of our doctors—that is, if we train our nurses in a regional setting they are more likely to stay there. I certainly welcome the commitment by the government, which was substantial funding of some $850,000 under the Commonwealth Grants Scheme, to assist in the construction of this $1.2 million facility. This impressive project complements the government’s investment in 164 extra nursing places, which I announced some two years ago. These measures are all designed to address the issue of rural and regional workplace shortages and, as I said, train those health professionals in the area where we would like them to practise. Good health care is about planning. Good health care is about spending money efficiently. But, more than anything else, good health care is about the skills and empathy of the people working in our hospitals and clinics.

In conclusion, I would like to mention five people who received certificates of appreciation for a lifetime commitment to health when Minister Abbott visited Coffs Harbour last month. Doctors Jerry Power and Michael Ridley and nurses Helen Jones, Gay Bowen and Carol Brewster received certificates from the minister to recognise a lifetime contribution to the health system. It is professionals like them, who not only contribute their skills but also repay the investment in their training many times over, who are the mainstay of our health service. Whilst often we spend much time in the area of health arguing over the issue of money, I think there is one thing that is inarguable, and that is the commitment and dedication of the many health professionals who are the backbone of our system and who make it work year in, year out.

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