Rob Mitchell (McEwen, Australian Labor Party) Share this | Hansard source

We will not support the member for Warringah's unfair slug on Australians that is built on lies before the election.

The role of the PBS scheme is to provide equitable access to medicines that people need when they need them. It will be the sick, particularly those with chronic diseases, rather than pharmaceutical industry that will feel the pain from these budget measures. The COAG Reform Council report released in early June found that 8.5 per cent of people in 2013 delayed or did not fill their prescriptions due to cost. In disadvantaged areas this figure is 12.4 per cent, and for Indigenous people it rises to 36.4 per cent. The last time the Liberal government increased the tax on medicines in 2005, prescriptions for some essential medicines fell by as much as 11 per cent.

I spoke to Mr Kevin Cooper from Kilmore today. He is 82 years old. Unfortunately, he is an Essendon supporter, but apart from that he is a good bloke. He lives in the Dianella Village aged care hostel in Kilmore. Every day for the rest of his life Mr Cooper must take 22 different tablets: 12 tablets for breakfast, one at lunch, two in the afternoon, five for dinner and two before bed. Every day he has to do this. These medicines that keep Mr Cooper alive are already costing him $90 a month. It might not be a lot to you and I, but it is a lot when you are on a pension and most of your money goes to accommodation. Mr Cooper will be one of the many hundreds of thousands of people will be slugged an extra $12 to $15 a month, pushing his prescription costs to well over $110 a month on the piece of pension that he keeps for himself.

Were these changes really about the sustainability of the health system this revenue would be going back into the PBS and into Medicare. But it is not. We know that these changes are part of the Liberal's ideological campaign to get rid of Australia's universal health care scheme—to create a two-tiered scheme where user pays is the principle. The Abbott government must recognise that medicines are not a cost but a critically important investment for better health care for all Australians. As the Medicines Partnership of Australia stated in April this year:

PBS medicines along with the professional advice and support of doctors and pharmacists keep people alive and out of more expensive hospital and residential aged care settings. They keep people productive in the economy, in the paid workforce and caring for family members.

Some of Australia's most senior doctors have already warned that the changes in the Abbott budget will put Australia's health system back over 50 years. Philip Clarke, Professor of Public Health at Melbourne University, said on 2 May this year:

… general co-payments are already quite high by world standards and these are at a level that may discourage use of beneficial medications. They also have the potential to increase downstream costs, for instance, through increased hospitalisations.

For people with concession cards, the current $36.90 co-payment is already quite high by world standards. National Seniors Australia reported that many people with chronic illnesses live in poverty due to their illnesses, with some spending 25 per cent of their income on managing their illnesses. Co-payments to the PBS are a real burden amongst so many other co-payments. Thirty per cent of people between the ages of 50 and 64 report financial strain in the past five years due to the cost of prescription medicines, compared to 13 per cent for those aged 75 plus; 41 per cent of those aged 50 to 64 who face financial strain have sought cheap alternatives; and 18 per cent of those aged between 50 and 64 who face financial strain have not filled their prescriptions.

The PBS works differently from the Medicare benefits scheme. We pay a Medicare levy and high-income earners pay a Medicare levy surcharge. There is no such thing for the PBS. Labor does not support this, especially in the context of taxes this government wants to increase and introduce for doctor visits, pathology and medical imaging. Labor made changes to the PBS in government which has put it on a sustainable footing—what we see today is another unnecessary slug on Australians who already have high out-of-pocket costs—such as the introduction of accelerated price disclosure, which sped up the rate at which the government takes advantage of falls in the marketplace of generic drugs. This has resulted in slowing the real rate of PBS growth over the forward estimates.

The complete nonsense of this government's argument is that if the government's actual intention was for the PBS to be growing in a sustainable way, the government would put the money into the health care system. But it is not. Instead, the government is putting the money into a Medical Research Future Fund. The current Minister for Health sat here for three years and did not ask the question of the health minister in the former parliament. He has refused to guarantee that the government will not shirk on its responsibilities to continue funding medical research in the future through the NHMRC, should it be re-elected. Labor invested unprecedented levels of funding into state-of-the-art medical-research facilities. If you want to fund medical research, you do not do it by taxing sick people and stopping them going to their GP.

In the forward estimates, the PBS is growing slower. The reason this has happened is no accident. It has occurred because of the measures Labor took. They are measures opposed and campaigned against by those opposite, to make the PBS sustainable without punishing the patients. As the Medicines Partnership of Australia pointed out on the 24th April 2014:

PBS expenditure actually fell last financial year and is forecast to rise at a rate lower than GDP growth throughout the current forward estimates, a fact confirmed in Mr Hockey’s latest figures. How it is then suddenly forecast to start increasing by nearly $1billion a year is unexplained.

The PBS price-disclosure reforms overseen by Labor during two terms in government have ensured that the PBS is sustainable and it has delivered billions of dollars in savings. At the moment the government spends around $9 billion per year on the PBS. The accelerated price disclosure has slowed the real rate of PBS growth and put the PBS on a sustainable footing.

In Labor's last budget these changes were expected to deliver more than $1.8 billion in savings. Taking the package announced in 2007 to 2017-18 the savings are closer to $20 billion. These are savings that this government should be using to ensure that the new drugs of the future or lifesaving drugs, such as Kalydeco, are listed as quickly as possible once they have been recommended by the Pharmaceutical Benefits Advisory Council. But that is not what we are seeing with this government.

Consistent with its approach to governing, so far, especially when it comes to health, this government is saying: 'You will pay.' At present, the PBS safety net threshold for general patients is $1,421. Once the PBS safety net is reached, general patients only pay $6 per prescription. For concessional patients, that goes to $360, and they will pay no out-of-pocket cost for medicines once that is reached. PBS safety net family arrangements also apply, where a family can combine PBS amounts to help them meet the safety net sooner.

The bill proposes to increase the PBS safety net by 10 per cent plus CPI indexation on 1 January, each year, from 2015 to 2018. The combined pensioners association, again, when asked about the PBS said:

A 2008 study found that when the Howard Government increased the price of PBS medications for pensioners, pensioners avoided purchasing life-saving medications.

It stands to reason that pensioners will limit their purchase of PBS medications when the co-payment jumps by 13% … This will be aggravated by the increase in the safety-net threshold, which will see a pensioner pay up to $427.80 per year …

This is bad legislation. It is bad legislation by a bad government built on lies. They should be condemned for it.

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