Emma McBride (Dobell, Australian Labor Party, Assistant Minister for Mental Health and Suicide Prevention) Share this | Hansard source

Since my first speech, I've spoken many times in this place about the cost of medicines and about Australians faced with difficult choices about which of their prescriptions they should skip or avoid or what else they could go without so they could simply afford to fill their prescriptions—choices people shouldn't be forced to make. Today, as a pharmacist, as a local MP and as someone who has been pushing for more affordable medicines, I'm proud to speak in support of this legislation.

Through the National Health Amendment (General Co-Payment) Bill 2022, the Australian government will reduce the maximum amount Australians pay for their medicines on the Pharmaceutical Benefits Scheme, or PBS. But, before I go to the bill, I think it's important that we recognise how we got here. The Pharmaceutical Benefits Scheme, or the PBS, was established back in 1948, then as a limited scheme, so Australians had equal and affordable access to life-saving and disease-preventing medicines. Establishing the PBS was not easy. As the Minister for Health and Aged Care has said, it was John Curtin and Ben Chifley who fought hard to create the PBS. It took two High Court challenges, two referenda, constitutional changes and long battles with the British Medical Association, as it was then called, with the Liberal Party and with many others over 15 years to make the PBS what it is today. I am proud that today we're continuing that long Labor legacy of investment in medicines.

It was a Labor government that back in 1944 first introduced the legislation to make life-saving drugs more affordable. After almost a decade of neglect by the former government, it's a Labor government that is determined that medicines will be affordable well into the future.

Under the PBS, patients pay a co-payment towards the cost of each PBS medicine, with the Australian government generally covering the remaining cost. Patient co-payments are currently set at $6.80 for concession card holders and a maximum of $42.50 for those ineligible for a concession card, known as general patients. The co-payment for general patients has doubled since I first registered as a pharmacist in the late 1990s. According to ABS figures, in 2019-20 more than 900,000 Australians delayed or avoided filling a script due to costs. All Australians, whatever they earn, deserve access to the medicine their doctor has prescribed and their pharmacist can fill. No-one should be forced to choose between filling their prescription for potentially life-saving medicines and putting a roof over their head or food on the table. Yet that is what many people, particularly women, are being forced to do.

Over a third of women living in the electorate of Dobell, which I represent, on the New South Wales Central Coast struggle to afford prescription medicines, according to a recent survey. The survey conducted in January of this year showed that 37 per cent of women who were not entitled to a concession card—that is, general patients—have struggled to find the money to pay for essential medication, while 20 per cent of people across Dobell have been forced to go without medication altogether because they simply cannot afford to pay for it.

As a pharmacist, I have seen this firsthand working in community pharmacies or hospitals on the Central Coast. Patients have walked into the pharmacy after a medical appointment, handed me a bunch of prescriptions for their family and asked which medications they could skip or avoid. I've had a mother ask me, following an appointment for her two children, whether they could share a bottle of antibiotic mixture because she couldn't afford to purchase two. Working in acute mental health inpatient units, I've seen the devastating impact on people, their loved ones and their families because they couldn't afford their medications and have ended up in crisis and brought in by police or ambulances for long inpatient stays. In Australia today, that's not good enough. They deserve better.

The PBS is a significant component of the Commonwealth's investment in our healthcare system, providing significant direct assistance, with $30.8 billion in the 2020-21 to make medicines more affordable. Under the National Health Amendment (General Co-payment) Bill 2022, a reduction in the PBS general patient co-payment by $12.50 will mean that the maximum Australians will pay for PBS medicines will drop from $42.50 down to $30. This is a 29 per cent saving. Approximately 19 million Australians will be eligible for savings under this bill. These general patients could collectively save around $190 million each year. A person filling one script a month could save around $150 a year. Those filling two scripts a month could save around $300 a year. With the cost of living rising, this is a significant reduction for people and families and their budgets, and 3.6 million Australians with a current prescription over $30 will immediately save on prescriptions under this legislation. No longer will general patients taking Apixaban for the prevention of stroke have to choose between their script, their groceries or their mortgage. This will mean they receive the effectual treatment to prevent serious illness.

The PBS safety net is intended to protect Australians who rely on a large number of medicines in a year from excessive out-of-pocket costs. Individuals and families who are general patients and who spend an amount equal to their safety net threshold on co-payments in a calendar year receive further prescriptions for that year for the concessional co-payment of $6.80. From 1 July 2022, the general patient threshold is $1,457.10. The amount paid by the patient will still be counted towards the safety net, so no Australians will be worse off under these changes.

Every year—in fact, nearly every month—new medicines are added to the PBS and access to existing medicines is expanded to new patient groups in line with emerging evidence about the safety and efficacy of those medicines for broader indications. Treatment options for patients are ever expanding, and the PBS continues to expand with them.

In the electorate I represent on the Central Coast of New South Wales, there are many people who rely on PBS medicines and Medicare, people like William from Gorokan, who contacted my office earlier this year regarding his health concerns, the number of medications he needs and the increasing costs he faces. He was very relieved to hear of our commitment to reduce the cost of medicines, and I am relieved for William and other people in his position that this legislation delivers on our commitment.

Ross is an aged-care worker from the Central Coast who I spoke to today. Ross told me he takes multiple medications each day and uses a puffer. Ross said that this measure will make a real difference for his family. In Ross's words, 'This measure is putting money back in the pockets of people who need it most.' As an aged-care worker on a modest fixed income, this will make a real difference for his family. Ross said to me that it will go a long way to covering the cost of his kids' registration so that they can play sport. As Ross said, this measure is putting money back into the pockets of people who need it most. Australians across this country deserve to be able to afford medicines and to be able to get the preventative care they need to keep them well.

There is further good news for people accessing PBS medicines. From 1 October 2022 Australians will pay less at their pharmacy for new and updated medicines on the Pharmaceutical Benefits Scheme because of the government's price disclosure policy. A visit to the pharmacist will be cheaper for thousands of families and will result in out-of-pocket savings of over $130 million for Australian patients and almost $930 million in savings for taxpayers.

Conditions for which patients will have access to more affordable medicines include migraines, breast cancer, stomach ulcers and bipolar disorder. Up to half a million patients with stomach ulcers or gastroesophageal reflux disease can now expect to pay a maximum of $26.74 per prescription for esomeprazole 40 milligram tablets—a saving of up to $6.84 per prescription.

As a pharmacist—despite my best efforts I'm still the only pharmacist in this place—I am very proud to be able to support this legislation. My whole working life I have wanted to make sure that people who most need medication can afford it. I remember standing in an outpatient clinic in a mental health unit and a patient coming up to me and saying: 'I can't afford this medication. Which one can I skip or which one can I delay?' This is after someone had had a really long inpatient stay. The whole multidisciplinary care had meant that they were able to recover and have a life ahead of them with some hope and optimism. This is what this does.

This bill today means so much to me personally, having spent my whole working life trying to make sure that the most vulnerable in our community can access the care that they need. To be standing in this parliament today and supporting this legislation means so much to me personally and as a local MP. I know it will give hope to people who are struggling, to people who need it most, to people who struggle to get out of bed, to people who struggle to put a roof over their head, to people who are sleeping rough and to the people we have discharged to caravans, caves and no fixed abode. This has to change. In a country like Australia we can't have the most vulnerable people in our communities—those living with chronic enduring mental ill health—struggling to be able to afford the essential medicine they need to help them get well and stay well. We cannot continue to discharge them back to the circumstances that made them sick. This has to change.

In conclusion, I spoke to a good friend of mine today—pharmacist Robert King on the Central Coast of New South Wales. He was so delighted to know that this legislation was being put to the House today. He said to me, 'In the current environment it's a great cost-of-living measure and will help people improve compliance with day-to-day medication, which is so important for preventative health.' As Robert King said to me today, this is important for preventative health and it's important for household budgets. We must support this legislation so that it can get through in the spring sittings so that next year Australians will be able to afford medicines.

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