Tuesday, 30 November 2021
Health, Aged Care and Sport Committee; Report
Mr Deputy Speaker Freelander, I'd like to start by acknowledging the member for North Sydney, the Chair, and you, the Deputy Chair, of the Standing Committee on Health, Aged Care and Sport for your work throughout this inquiry into the approval processes for new drugs and novel medical technologies in Australia. In fact, if it wasn't for you, I wouldn't have been invited to join the committee as a supplementary member, so, personally, I thank you. To the committee members, including the member for Makin and the member for Moncrieff, thank you for making me and the member for Higgins welcome as supplementary members for the inquiry.
As others have said, there is no doubt Australia has one of the best healthcare systems in the world, underpinned by Medicare and the Pharmaceutical Benefits Scheme and designed to provide quality, safe and affordable health care to all Australians. But we have much more to do. As COVID-19 has shown, the further you live outside of a big city, the more vulnerable you are and the worse your quality of life is likely to be, especially if you're living with chronic disease. Acute shortages of healthcare workers and higher out-of-pocket costs are leading to longer waiting times and poorer health outcomes for the seven million Australians living in regional and remote Australia.
In the time I have today to speak on the report, I am going to focus on the areas of affordability and access, particularly around medicines, as a pharmacist of over 20 years. I know that community pharmacies play a vital role in our healthcare system. There are almost 6,000 community pharmacies across Australia, and in communities outside big cities pharmacies are often the only place where locals can seek health care, where they can walk in without an appointment and get quality up-to-date information and advice. In fact, in some 70 towns in Australia that are without GPs or other allied health support, pharmacists and pharmacies are the only health care available.
Mr Deputy Speaker, as you know, pharmacists are some of the most trusted healthcare professionals in the world, but they are facing serious challenges when it comes to caring for and supporting their communities and their patients. We often talk about patient centred care. I think there is a big gap between the rhetoric and the reality, particularly for the most vulnerable people, and especially those living outside of big cities. The last two years have been particularly tough, with the COVID-19 pandemic causing global supply chain disruptions and local outages in many communities. I remember a parent talking to me about not being able to get infant Panadol for their child and being very concerned about what they might be able to do to make sure that their child was safe and well. I've had people talk to me about not being able to access Ventolin inhalers and asking, 'If I see my GP and I get a prescription, am I more likely to be able to get a Ventolin inhaler than if I go in and ask over the counter?' These are essential medicines, vital for Australians, and what COVID-19 exposed was, in a well-designed healthcare system, the vulnerabilities, particularly in global supply chains, leading to local outages. This has made it harder for Australians, as I've mentioned, particularly for those seven million Australians living outside of big cities, in regional and remote communities across Australia, to access life-saving medicines that they both need and deserve. This is being seen in hospital settings. There were already problems before COVID-19, but those vulnerabilities have been further exposed. There have been outages in common, routine, day-to-day medicines that have put patients at risk.
A key recommendation of this report has been around the supply of medicines on the Pharmaceutical Benefits Scheme. We must, all of us, make sure that medicines, particularly new medicines, are always universally affordable for all Australians wherever they live and whatever they earn. It is so important, and I want to reference some of the remarks the Pharmacy Guild of Australia made as part of the inquiry that led to this report. The Pharmacy Guild of Australia made a submission where they spoke about the cost of new medicines, particularly to the community. They said:
New medicines are likely to be highly specialised and have the potential to be significantly more expensive than anything currently available on the market. For small businesses like community pharmacies, this presents a serious cash flow problem and business risk
It is really important that we make sure that community pharmacies, the almost 6,000 community pharmacies across Australia, are able to provide medicines affordably to their communities, and especially to the most vulnerable.
According to the Australian Institute of Health and Welfare's latest report, just over one in 20 Australian adults, or 6.6 per cent of the population, delayed or avoided filling a prescription because of the cost. I've heard from community pharmacists who have had patients come into their pharmacy with a bundle of prescriptions and a trolley of groceries, almost apologetic that they have buy the essential groceries that they need before they can decide which prescription to get filled. I've had parents say to me, 'Can I get one of the antibiotics filled and share it between the two children?' Or, 'Can I take this medicine every second day to stretch that one-month prescription to last two months?' This shouldn't happen in a wealthy country like Australia. Australians shouldn't be forced into a position where they are having to decide which medicines they can skip or which script they can avoid or delay filling. That shouldn't happen in Australia because that is a risk to the individual. It's also a risk to our healthcare system and to our economy. It's bad for patients and it's bad for the economy. In the Hunter, New England and Central Coast region of New South Wales, which is the community that I represent, the number of people avoiding or delaying filling scripts is higher, as it is outside big cities—6.8 per cent. The high cost of medicine is, as I mentioned, forcing people to delay or avoid seeking treatment and care. It is bad for their health, it is bad for our healthcare system and it is bad for the economy.
Pharmacists are also calling for adequate training prior to any new medicine or novel medical technology coming onto the market so that they can provide the most up-to-date and effective advice to their patients. This is vital. As I said before, pharmacists are some of the most trusted and relied upon healthcare professionals in our communities, and they're well-placed to support patients who need highly specialised medicines, and new and evolving therapies. But they need to be properly supported, with timely access to the most up-to-date and evidence-based information to protect the health and best interests of their patients.
There is also a need to address renumeration. I have spoken about this before. Pharmacists were asked early to put in expressions of interest to be part of the COVID-19 pandemic response. Because of the way that the vaccines were rolled out, many pharmacists and pharmacies weren't able to participate in the vaccine rollout until June. That was the earliest that pharmacists were able to participate. Now we're seeing that Pfizer has been recognised as a universal booster. Pharmacists are being paid $16 per jab. There are 27 different requirements they have to comply with in order to be able to provide a jab. I have heard that some pharmacists reluctantly feel they will not be able to continue to participate in the vaccine rollout. As state and territory governments stand down mass vaccination centres and vaccine hubs and they're relying more and more on the network of GPs and pharmacies across Australia, I don't know how they can justify the poor remuneration for pharmacies. It's a big concern to me. The current arrangements don't reflect the costs associated with ordering, handling and dispensing these vaccines. This needs to be properly addressed.
In the time I have left, I would like to put my full support behind pharmacists and other allied healthcare workers being properly supported in the work that they do. It's essential that all healthcare professionals are able to work to the full scope of their practice, to make sure that all Australians can get proper health care—especially those Australians living outside of major cities. As the Pharmacy Guild have said in their submission:
Pharmacies often are presented with very little incentive to stock or be involved in supplying high cost specialised medicines.
This must change so that all Australians can access the care they need. As the Pharmaceutical Society of Australia said in their submission:
Australia has a strong track record in the regulation of therapeutic goods underpinned by an evidence-based framework as well as timely and cost-effective considerations around access to and subsidisation of medicines and therapies for patients.
As I said at the beginning, Australia has one of the most highly regarded healthcare systems in the world, underpinned by Medicare and the Pharmaceutical Benefits Scheme. This has been a bipartisan inquiry, but it can't go without mentioning that those two schemes were Labor initiatives. I know the first time I met you, Deputy Speaker Freelander—and this is why you're in this place—you said to me, 'I will not end my medical career as I started it: without Medicare.' I think it is so important to all Australians that we have universal health care: health care for everyone, wherever they are born, wherever they live or grow old. I think that's something that this report has underscored: the need to make sure that all Australians have access to quality, affordable health care.
I commend the report to the House. I would like to again thank you, Deputy Speaker, for your work; and that of the chair, the member for North Sydney; the member for Moncrieff; the member for Makin; and the member for Oxley who couldn't be here today. Thank you.