House debates

Wednesday, 16 July 2014


National Health Amendment (Pharmaceutical Benefits) Bill 2014; Second Reading

3:48 pm

Photo of Graham PerrettGraham Perrett (Moreton, Australian Labor Party) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2014 and state up-front that I am proud to be a part of the party that will oppose this $1.3 billion tax increase on medicines. Why? Because it will hurt Australians. It will hurt almost every Australian, and I guess it is important that we see it through the prism of that horrible budget visited on the Australian people back in May—a budget that seeks to divide, change and conquer Australia and turn it into something that it is not and I hope will never be. This particular policy indicates that attack by the government on the view that the collective should support those that need help versus the view of the government that the individual is paramount and, if the individual can look after themselves, 'I'm all right, Jack, and forget about the rest.' That is the fundamental message of that budget delivered by Prime Minister Abbott and Treasurer Hockey and that is why we are opposing this particular budget initiative.

When it comes to health, we do have completely different approaches. We have seen it historically: Labor was the party that brought in Medibank in the first place. The conservative side of the chamber tried to tear it down under Malcolm Fraser. Labor under Bob Hawke brought in Medicare, and obviously John Howard saw that it was a part of the Australian fabric and accepted it. However, this extreme government that we have—this Tea Party collective that has taken hold of the ministerial leather—has tried to take down a universal approach to health care.

I notice that the COAG reform council report released in June found that, when it comes to filling prescriptions, one in 12 people back in 2012-13 delayed or did not fill their prescription due to cost. Obviously that has health implications for people. Let's look at what happens when you move to disadvantaged areas for people not filling out their prescriptions. The figure then jumps up to one in eight people not filling out their prescriptions. We know what happens if people do not fill out their prescriptions. If you are only taking medicine every second day or if you have a course and drop one of them then the efficacy of the medicine can be completely negatived. You can actually waste money by not taking the full prescription course. The saddest part is that this same COAG reform council report said that, when it comes to Indigenous communities—and I say this in particular for the Indigenous affairs minister, who is Prime Minister Abbott—more than one in three Indigenous Australians did not fill their prescription due to the costs associated. We know full well, as does the former health minister, the current Prime Minister, what will happen when you put an extra price on medicines.

This $1.3 billion tax needs to be seen through that prism by a former health minister who knows the consequences and knows that means—and I am not being dramatic here—that people will lose their lives. That is the reality of people not following prescribed courses of medicine. The Indigenous affairs minister—the Prime Minister—knows that if one in three Indigenous people are not filling their prescriptions due to the cost then this $1.3 billion tax will be particularly visited on Indigenous Australians, who already have so many challenges when it comes to health, geography, education and other social disadvantages, particularly incarceration.

Let us put that in context. We hear from all of the speakers opposite—wait a minute; that is right, there were not any! There was one speaker. This great health initiative has been trumpeted by those opposite, yet this incredible number of people who cannot even get enough people together to start parliament on time could not find a single speaker for this piece of legislation. Not a single person from the backbench was prepared to defend it. That is ridiculous!

If this is really about the sustainability of the health system, the revenue would be going into the PBS and into Medicare. Instead, this is just a price signal. That is what it is. For some reason, those opposite can grab a price signal when it comes to health but not when it comes to saving the planet and the health consequences that will flow if we do not take steps to stop global warming. Those opposite run a million miles from anything to do with putting a price on pollution and global warming; however, when it comes to health, they are in like Flynn to put a price on the sickest people in society, particularly Indigenous people and those living in disadvantaged areas.

This once proud Liberal Party that used to believe in markets is all over the shop. They have got a distorted view of what they are about. As I heard the member for Corio say on television this morning, it is because they are an extreme government. They are not governing for that sensible middle of Australia. I see that John Howard, the former Prime Minister, is here in Canberra today. He understood what it was like to govern for the middle because he had a marginal seat. He understood that that is what Australia is all about. You do not need the extreme Tea Party ends or the Greens ends of the spectrum. You should govern for the middle. That is where the national interest is best represented. But those opposite have lost control of their agenda and are ignoring history.

This is all a part of their ideological campaign to turn Australia's universal healthcare scheme, set up by Labor, into that two-tier, user-pays system favoured by the United States, which has been shown by every sensible health economist to be a waste of money. When comparing the costs associated with medicine in the United States to those just over the border in Canada, there is almost a two to one cost differential, or even more in some states, because the insurance companies have grabbed hold and medicine has become inefficient. Basically, if middle-class people—teachers, firemen, nurses and the like—get sick, that can be the end of a family, the end of a dynasty, in terms of having a job and a way of life, and suddenly they are out on the street. That is not the Australian way. That is not the way we believe in. That is not the sort of Australia we want.

I ask those more sensible people opposite to grab hold of the agenda and come back to a sensible, fairer budget because we will not support Prime Minister Abbott's unfair slug on sick Australians. It is built on lies told before the last election. I clearly remember the Prime Minister saying that there would be no cuts to health. This piece of legislation before the chamber now has a strong odour of mendacity attached to it. It is a pong that you could smell west of Cunnamulla, a long way away, and the people of Australia have tracked it down.

Mr Marles interjecting

I think that is in the Deputy Speaker's electorate. He would know Cunnamulla very well—and west of Cunnamulla!

The reality is that this legislation, like so much of this budget, is about an ideology rather than a sensible approach to health care. It comes on the back of the $80 billion cuts to public hospitals and schools, a tax on doctor visits and the hundreds of millions of dollars taken out of preventative health. A stitch in time does save nine, particularly in health. The Rudd and Gillard governments discovered that we have been neglecting preventative health and that is where the savings are. Do not try to treat a diabetic or a heart attack victim when they arrive at the emergency department, give them some counselling beforehand.

These changes are trying to take Australia's health system back over 50 years. That is the reality of all these cuts. Early in his career, only nine months in, the health minister is in the running to take the baton of the worst ever health minister in Australia. That baton is being held in the Prime Minister's office. It is the baton that he received as worst ever health minister when he cut $1 billion from Australia's health system. So the member for Dickson will not have far to go to get the baton back from the member for Warringah. However, he should be ashamed of himself.

The reality is that the PBS works differently from the MBS. All of us pay a Medicare levy and high-income earners, thanks to Labor, pay a Medicare levy surcharge, but there is no such thing when it comes to the Pharmaceutical Benefits Scheme. So Labor does not support this legislation, especially in the context of all these other taxes that the government, which said they would not increase taxes, want to increase, including for doctor visits, for pathology and for medical imaging.

A few weeks ago when I was with the shadow health minister, Catherine King, in a medical practice in Moorooka we heard of the problems associated with trying to explain to patients, particularly those who have English as their second language, that they will now have to pay to go to the doctor. People will not understand the $2 in red tape and the $5 on the never-never that the GP co-payment will require. It will be so hard for medical practices to recoup that money—to get it off their patients.

The reality is when we were in government we did make some tough decisions—decisions that many in the Labor Caucus argued about because of the costs it would mean for the Australian public. But we made some tough decisions to make sure that the PBS was on a sustainable footing. There were tears and there was gnashing of teeth among the Labor Party when we made our changes to this, but we put it on a sustainable footing. The government's argument—that their intention is for the PBS to be growing in a sustainable way—is a complete nonsense. If that were the case they would invest this money back into the health system. That is the reality. Instead they are putting the money into the Medical Research Future Fund—a commendable initiative, I admit; we should be investing in funding future medical research. That is what the NHMRC is about. We, as a Labor government, would support that; we understand that. But this price signal of $2 in red tape and $5 for the never-never is all about putting out a price signal and putting fear into pensioners, the poorly paid, Indigenous Australians and, particularly, rural and remote Australians, when they are arguing it is all about putting the PBS back on a sustainable footing.

The reality is the PBS is actually growing in a sustainable way. At the moment we are an ageing society; one in five Australians is over 65. That brings challenges but we have had plenty of time to prepare for it, and I commend earlier governments for some of those initiatives. Let us have a look at the PBS. It is growing at a much lower rate than expected and, in fact, recent budget updates have shown that the PBS is actually growing at a slower rate than was expected. So there is no emergency—no emergency at all. It is not growing by accident; it is because of the decisions that Labor took—measures that were opposed, and campaigned against, by the very people occupying the government benches.

Those PBS price disclosure reforms—there was a lot of lobbying going on in the corridors of Parliament House when they were rolled in—have delivered billions of dollars in savings for the government. At the moment the government spends around $9 billion a year on the PBS. Accelerated price disclosure has slowed the real rate of PPS growth and put it on a sustainable footing. The member for Lilley Wayne Swan's last budget predicted that these savings would deliver more than $1.8 billion in savings. That is not acknowledged by the health minister in his many rants at the dispatch box. He is all about revisiting a couple of things that seem to eat at him for some particular reason, but he does not acknowledge the hard work and the hard decisions that were made by previous Labor health ministers.

If we look out to 2017-18, the savings would actually be about $20 billion—Labor's hard decisions delivering savings in the best interests of the nation. These savings should be used to ensure that more drugs are available—the drugs of the future and life-saving drugs such as Kalydeco. One of my constituents—sorry, Deputy Speaker Vasta, it was one of your constituents from Upper Mount Gravatt; I have sent it on to your office—came to see me a few weeks ago. She is suffering from cystic fibrosis and she is looking at getting affordable access to Kalydeco. I know how heartbreaking it is when these people turn up at your office. I do not have permission to name her, but she has a letter that I have sent on to the health minister seeking access to a drug that is routinely available in the United States, the United Kingdom and other European countries. Over 95 per cent of eligible patients in the world outside Australia will soon have access to Kalydeco, and she was asking when the health minister and the health department would show compassion to the vulnerable in our community. For anyone who knows someone suffering from cystic fibrosis, you know how tough a row that is to hoe. That is why we need to have sensible savings, not random, obscene savings such as this legislation proposes.


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