Wednesday, 11 September 2019
National Health Amendment (Pharmaceutical Benefits) Bill 2019; Second Reading
I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2019, and in support of the amendment moved by the member for McMahon. As previous speakers have indicated, Labor will support this bill, which amends the National Health Act 1953 to make two relatively minor changes to the supply of medicines.
It is well over a year since the 2018 budget was delivered, but the first change in this bill implements a measure from that budget to recover the costs of pharmacy approval processes. As many members know, applications to open or relocate pharmacies are assessed by the Australian Community Pharmacy Authority, which then makes recommendations to the minister's delegate. Under the bill before us, the cost of this process will be recovered from applicants. The government says this will save taxpayers around $2.8 million per year. I'd note that cost recovery was due to begin on 1 July 2019 but the government failed to list this bill for debate in the last parliament.
The second change under the bill aims to continue supply of PBS medicines following bankruptcy or external administration of pharmacies. The bill sets out a framework to allow the secretary of Health to grant and revoke permission to a trustee to supply PBS medicines at a location where an approved pharmacist is bankrupt. The government says this will ensure access to pharmaceutical benefits at an affected pharmacy is not compromised in the meantime.
Labor has consulted with pharmacists on this bill, and, as I said earlier, we will support it. However, I want to take this opportunity to speak in support of the amendment moved by the member for McMahon criticising the government for its record of delayed and withdrawn Pharmaceutical Benefits Scheme listings. I also want to highlight some of the barriers many Australians face, particularly in regional Australia, when it comes to accessing essential and lifesaving medicines.
The minister likes to come into this chamber and boast about PBS listings or drop a self-congratulatory press release on a Sunday afternoon, spruiking the latest listing, but what he doesn't like to talk about are those medicines that have not been listed—medications recommended for listing by the independent experts, the Pharmaceutical Benefits Advisory Committee, PBAC. Last month the PBAC made public their recommendations from the July meeting, which took the total number of drugs waiting to be listed by the minister to more than 60—more than 60 medications that have been recommended because they stack up both clinically and on cost grounds.
This includes drugs like Symdeko, which was approved in March by the PBAC. Symdeko is a lifesaving cystic fibrosis medication which treats the most common cystic fibrosis mutation, extending life expectancy and improving quality of life. The minister made a promise to those with cystic fibrosis that they would have access to Symdeko on the PBS as soon as it was approved. Six months later, and there is no word on when, or even if, the government intends to list this medication. If the minister wants to take credit for every new drug that's listed on the PBS, the minister must also take responsibility for delays in listings, and be held accountable for every drug that he refuses to list.
The government claims that it hasn't listed some medications because the sponsors aren't sufficiently motivated to list these medications on the PBS, despite the fact these same sponsors have gone to significant effort to work through the PBAC process, which can take years and significant investment. They want their medications listed on the PBS, and the experts say that these medications should be listed. But this government's refusal to offer a fair price and to invest in the PBS means that Australians are missing out on these vital, and sometimes lifesaving, medications. In contrast, Labor went to the last election with an affordable medicines guarantee—a commitment to list all medications recommended by the experts. We strongly urge the government not just to match that commitment with words, but to honour it with listings.
As the only pharmacist in this place, and someone who started work as a registered pharmacist in 1998, I have a keen and longstanding interest in the affordability of medications and access to quality health care. Long before I was the member for Dobell, I believed everyone should have access to affordable health care, including affordable medications. As a pharmacy student in 1996, when I studied drug legislation, it became apparent to me that this was a complex area. But what struck me then, and today, is how important it is to the lives of millions of Australians. We are lucky that, by and large, medicines in Australia are affordable, and that is due to the Pharmaceutical Benefits Scheme.
The Pharmaceutical Benefits Scheme is one of the pillars of Australia's universal healthcare system, a system that is world class and the envy of many countries. Labor is incredibly proud of the PBS. As many of you know, it was established in 1948 by the Chifley Labor government and has been in place in various forms ever since, despite the efforts of those opposite to tear it down. Labor fought to create the PBS, we have fought to strengthen and maintain the PBS and we will always fight to protect the PBS.
It is only through the PBS that most Australians can afford the medicines that they need, but we should not underestimate the impact the cost of medicines can have on household budgets, even with the assistance of the PBS. The cost to individuals living with complex chronic health conditions, such as diabetes, which require multiple medications, adds up. The government's own figures show that many Australians don't fill prescriptions, because they can't afford them. According to the Australian Bureau of Statistics, 961,000 people a year delay or avoid taking prescribed medicines due to cost. These are people who have seen the GP, have had their doctor's assessment and know that they need this medication but have to skip it. They have to make a choice: 'Do I fill this prescription or do I fill that prescription?' The rate of people skipping prescriptions is twice as high in the most disadvantaged areas. In the most disadvantaged areas 10 per cent of people delay or avoid filling prescriptions, meaning that the cost of medicines is contributing to the widening health gap in Australia, particularly in regional and rural Australia and particularly in the current drought. In communities such as mine in Dobell, on the Central Coast of New South Wales, the cost of medicines can be prohibitive, especially with the rising cost of living and with wages failing to keep up. People on low incomes, or income support in particular, often have to make difficult choices about whether they can afford to have their prescriptions filled.
Yesterday was World Suicide Prevention Day and tomorrow is R U OK? Day. I spent almost 10 years working at Wyong Hospital in my electorate. For most of that time I was a specialist mental health pharmacist working in acute adult inpatient mental health units. People living with major mental health problems are particularly vulnerable and most impacted by rising healthcare costs. What has the government done about this affordability crisis? It has only made it worse. In the 2014 budget the government proposed to increase the cost of PBS medicines by up to $5, even for pensioners, and to increase the threshold of the PBS safety net. This would have forced patients to pay $1.3 billion more for medicines over four years and would have caused even more Australians to skip essential medicines. Only Labor's opposition in the parliament stopped the government from implementing this cruel measure. Australians shouldn't forget that this Prime Minister and this Minister for Health were part of the cabinet that wanted to make medicines more expensive for every Australian.
Credit where it's due, Labor welcomes the government's election commitment to reduce the PBS safety net thresholds. That's why Labor matched the government's commitment within hours of its announcement in May. That's what should happen. Political parties should recognise and adopt good ideas from the other side. We urge the government to do the same with the health policies we took to the election. But let's be honest. Reducing the PBS safety net threshold from around $1,600 to $1,500 for general patients isn't going to solve the affordability crisis that I described earlier, so we strongly urge the government to consider how to improve the affordability of medicines as part of the Seventh Community Pharmacy Agreement and as part of its forthcoming review of the National Medicines Policy.