James Stevens (Sturt, Liberal Party) Share this | Hansard source

I rise to happily speak in favour of the National Health Amendment (General Co-Payment) Bill 2022, which is about implementing an important coalition policy commitment that was made during the election and, I think, matched by the Labor Party later that afternoon. It must have been quite cruisy being in the policy team of the Labor campaign in the recent election, because, most of the time, they spent the day just agreeing to do the same thing that we'd announced earlier in the day. I'm starting to enjoy coming here and speaking about all these bits of legislation that see us implement policies that we announced during the campaign and would have implemented if we were successful. Thus, the Labor Party are happily obliging us in some of those areas. I think this is the third bill this week that I've spoken on which is a bill from the previous government or a commitment that we made during the election. I'm very pleased to have the Labor Party supporting that commitment that we made and to speak in support of a bill that will put it in place.

In the midst of this cost-of-living crisis that we are facing in this country and, frankly, across the globe, it is very important that we take every opportunity to relieve pressures on people. The cost of pharmaceuticals is probably one of the most worthy areas in which we can reduce that burden on people across the country, and this bill enables a reduction in the co-payment for people who purchase medicines that are listed on the PBS. I'll come to that in a bit more detail in a moment, but, firstly, I want to take the opportunity to reflect on how lucky we are to have the health system that we have in this country.

Yes, it is commonplace in political debates for people to pointscore—there will possibly be some of that later in my contribution, and there has been some of that in other contributions—but we are really, really lucky to have the health system that we've got in this country. There are definitely members of this House who have more experience than me—those who are healthcare professionals—and have probably seen parts of the world that have health systems with elements that they argue are better than in this country. But, whilst we can always improve, I think we are really lucky to live in this country and to have the standard of health care that we've got, the dedication of the healthcare workforce that we've got and the standard of care that we've got. Our system is comparatively much more affordable than some countries that are known to be wealthy countries. People would be surprised to realise and recognise just how unaffordable health care and basic, fundamental medical treatment are in some of those nations.

I've experienced a few of them. I was travelling in the United Kingdom, which has a pretty good health system, and took a companion who'd had an accident to the NHS. It was very similar to and as accessible as our system, and I had just as good an experience as I've had in the Australian system. Equally, I've had experiences with the health system in the United States and, in particular, the struggle to access that system. It's not just the experience that I had but also one that is so common—the stories you hear about how unobtainable proper health care can be for so many millions—probably hundreds of millions—of Americans and the exorbitantly high costs that they have.

I was an employer in the United States. A subsidiary of my business unit operated in the United States, and I had a few employees under the American system. I came to understand that, when you get a job in the United States, the most significant thing is getting your health insurance paid by your employer. They're more interested in that than what the rate of salary is, because it is vitally important to have employer funded health insurance. If it's not through your employer, you really have a very limited safety net in place to provide your health services in that country—or sometimes none at all. I'm very glad that we don't have that circumstance in Australia. I'm very proud of the system that we've got.

I also take the opportunity to thank all the people that work in our health system—all the healthcare professionals right across the various disciplines, who have always done a great job looking after the most vulnerable in our society but have had particularly significant challenges in the last few years, doing all the things that ordinarily have to happen in our health system and on top of that managing a pandemic and doing so many things that have made the burden of their already very difficult roles that little bit higher. They do it not with complaint; I think it was just remarkable and a great testament to people in the system, the extent to which, despite the additional burdens that were added to their workload, including the various elements of managing the pandemic and the facilities they were in, sometimes dealing with some quite difficult people who were not being reasonable and not being understanding of what they were doing and going through—not understanding restrictions placed on them that were all about keeping them safe. We thank all of those great heroes of the last couple of years for what they have done.

We are debating, though I don't think there's a lot of argument. I think everyone is in agreement to support this bill, so we're having a discussion about the importance of the government program the PBS and something that will reduce the co-payment that is made by the two elements of this, the general and concessional rates and then the safety net within that as well. In particular, at the general level, there is a significant reduction to the co-payment. As I said, this was announced by the coalition in the election campaign, and we made many announcements on an ongoing and in the budget a significant announcement about the PBS from an access point of view. In the election, we announced this dramatic reduction in the co-payment, and the Labor opposition said, later their day, I think it was, that they would match it, and so here we are implementing it.

The cost of medicine is a significant burden on anyone that's got a requirement for ongoing prescription medicine, and in particular this tends to be the most vulnerable people in our society. We do have the concessional stream as well as the general stream, but any people that have a burden of ongoing requirement for prescription medication under the PBS deserve as much support as we can afford to provide them. I think the statistics are that a little over 80 per cent of the total cost of PBS related prescriptions are borne by the government. I think it was 81 per cent for the government and 19 per cent for the consumer co-payment. I apologise if I got those statistics slightly incorrect, but it's in that vicinity. I think that's great. We'd obviously love to be able to finance the system completely, but it's certainly important that there is a stake in it so that people, where they can afford to play a part, do so under the system we've got.

This reduction is an important step to recognising that the burden probably was a little higher than any of us would have liked, and this is a way to put a reduction in place. We also feel particularly for people who have got very significant medication requirements. There's obviously the PBS safety net that kicks in for people once they reach a certain number of scripts in a year, and that's a very important additional support for people who have a large volume of medication requirements. This is obviously something that's further providing support to people that require the PBS.

In the previous government, I was very proud in the term that I was a part of that government, but over its nine years a large number of medications were listed on the PBS, and that in particular is one of the great legacies of the nine years of the coalition government. That was because we had the economic settings in place and the budget position to be able to afford it. We listed a huge number of new medications on the PBS and, of course, they were all extremely worthy listings. We had very robust processes in place and undertaken to list drugs on the PBS. I'm sure that those with much more expertise than me would have a lot of examples of more that need to be listed. I hope that this new government can take some inspiration from our record and list more drugs on the PBS that are worthy and legitimate to be within that scheme at the same rate that we did. When we came into government, there had been a freeze on listings. The previous Labor government had eventually said, 'We just can't afford to list any new medication for the foreseeable future.'

Obviously we want people of this country to have access to the most up-to-date, most effective medications recommended by clinicians, researchers and experts or any treatments that they need that will put them in the best place to deal with their condition or that will bring comfort for whatever condition needs to be treated. All Australians should have the highest standard of care, including pharmaceutical care, that is available. It's really important we remember to hold the new government to account as far as making sure that we are seeing the listings on the PBS so that treatments that are agreed by clinicians and researchers as effective are being supported through the PBS.

It would be a spectacularly additional burden on anyone that already had a significant health or medical condition that they were confronting and getting treated for to need any form of prescription medication that was not on the PBS. I'm sure some of the costs for non-listed medications would be absolutely horrendously expensive and probably prohibitive for people in getting access to that treatment. If we ever had a circumstance where people couldn't get treatment in this country because we didn't have a system that was providing them access to that without the need for exorbitant financial contribution from them then we would, in fact, be in that situation that I experienced in the United States, which I hope we never see in this country.

I think there's complete unanimity amongst the legislators of this House and amongst all participants in our political process that we want to have a health system that is adhering to that fundamental principle that your personal economic situation should have nothing to do with your ability to access the best-quality health treatment that you need to hopefully help you recover from or live with and manage to the highest ability of modern medical science at that point in time that you can. That's certainly the society that I want to always live in. For quite a few decades now, there's been relatively strong bipartisanship around that fundamental principle.

Health is such a significant area. It's an important area to all of us. It's also a significant area as far as the resourcing that's required to provide that absolutely world-class system. I'm not delusional enough to think that we won't have ongoing debates about various elements of health policy and how we should be delivering different programs. It's a particularly added complexity in this country because we have multiple levels of government with various involvement and roles within the full ecosystem of health and health treatment. Those fundamental principles are vitally important. We all want to live in a country where every Australian has access to the highest possible standard of health care. So this is a bill that we happily support on the basis that it will contribute, in some way, towards enhancing our system to be even more than it is right now. I commend the bill to the House.

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