House debates

Wednesday, 16 July 2014


National Health Amendment (Pharmaceutical Benefits) Bill 2014; Consideration in Detail

4:32 pm

Photo of Ms Catherine KingMs Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | | Hansard source

What an absolute disgrace. You are gagging debate on a bill that is the first of this government's health budget bills. What is so important that this health minister cannot debate his own budget bill? Where are you going that you cannot spend the time on debating the first of your health budget bills? This is a bill that hardly any of you on the other side of this chamber were able or had the courage to speak for. Very few of you did, and none of you from marginal seats were able to say why you think it is okay, in the context of imposing a GP tax and cutting billions of dollars out of public hospitals, to increase the costs of medicines for everybody. More importantly, why you aren't defending those people in your constituencies who have chronic diseases and need multiple pharmaceuticals? What is so important that you will not debate this bill properly?

Members on this side of the House have been well and truly ready to debate and oppose this appalling bill. This is the first of your health measures. We have questions about these bills. What modelling have you done? What impact will this bill have on patients across the country? We already know that the last time the Howard government increased the Pharmaceutical Benefits co-payment there was a drop in people filling their prescriptions for essential medicines. We know that the COAG Reform Council's report, recently released, stated very clearly that there are many patients who are non-compliant with their medications and who are not filling their prescriptions because of the cost. This is a bill that seeks to fundamentally increase the costs of medicines by 15 per cent and to change the safety net—to make it harder and harder for vulnerable patients to access medicines. What do those on the other side of this chamber have to say about it? Absolutely nothing! They have not told us about the modelling they might have done to see what it will do. It is a $1.3 billion hit on all those in this country going to a chemist trying to fill a script.

This government does not want to debate it—it is not able to debate it. There was a paltry list of speakers from the other side yesterday. Four of them were trotted out to speak on this bill, and some of them were unable to defend it. There were no speakers from the government today. The minister did not want to allow the debate to continue and was not able even to sum up. This minister has some questions to answer on this bill. What modelling have you done? You are obviously modelling in that $1.3 billion that there will be people who do not fill their scripts. What modelling have you done about the impact of this? What modelling have you done on the combined impact of this and your GP tax? What modelling have you done on the impact on Australian families? You clearly want people to use less medicine; that is what the measure is designed to do. You have clearly decided that with this $1.3 billion, which you are ripping out of the pockets of sick patients trying to access medicines, there will be less usage and fewer people filling their scripts. What is the cost going to be on the health system—in terms of people's presentations to doctors and hospitals? People will be avoiding the care of their GPs because of your GP tax, and they will be avoiding medicines. They are serious questions that you should answer.

What have you factored into that $1.3 billion that you are ripping out of the pockets of patients trying to access money? You have been entirely focused in this budget not on the health of the population, not even on the sustainability of the health system, but on how you can cut health—not keeping people healthy, not keeping people well, not providing opportunities for people through the healthcare system to actually increase their capacity to participate in the social and economic life of this country. And this bill is just an example of it. It is the start of your horror budget when it comes to health and your horror budget when it comes to patients in this country. The fact that you are unable to properly debate it, unable to put up speakers on it, shows just how paltry this government's policy development is in the space of health. And, frankly, it is an absolute disgrace that you want—(Time expired)

4:37 pm

Photo of Stephen JonesStephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | | Hansard source

This is an absolute outrage—that the coalition today have gagged debate on the National Health Amendment (Pharmaceutical Benefits) Bill 2014, this important bill. I make this point: they had the opportunity to let the people of Australia vote on this proposition, but they did not have the courage to put this proposition to the people of Australia not 12 months ago when we went to a general election. They then ram the bill into the parliament and demand that we vote on it without having a full debate. Well, there is a very good reason they will not let us have a full debate on it: they do not want sunlight on it.

As the shadow minister, the member for Ballarat, has pointed out just now, they could not even fill a speaking list on it. In fact, the shortest queue in the building yesterday was the queue of government MPs who were willing to stand up in this place and defend this atrocious legislation. Only four speakers were willing to stand here in this place yesterday and defend this atrocious legislation. There is a very good reason for that. We know that one of the last reports that the COAG Reform Council published before the government shut it down—because they do not like the message that the COAG Reform Council is giving them—showed that there are already people who are failing to fill the scripts that their health professionals have told them are essential for their health. There are already people who cannot afford to fill those scripts. In fact, in June they found that around 8.5 per cent of people were already delaying or failing to fill their prescriptions.

If you look at disadvantaged Australians, the figure is even higher. Around 12½ per cent of people from disadvantaged areas are not fulfilling their scripts, because they cannot afford to. And then there are Indigenous Australians. We have heard a lot of fine words from the Prime Minister. In fact, I very much enjoyed the Prime Minister's speech on the Closing the Gap report, when he put his hand on his heart and said that we needed to do more to close the gap in health outcomes between those with Indigenous and non-Indigenous backgrounds. I can tell you that this measure is going to have a calamitous effect on Indigenous health, because already, as the COAG Reform Council is telling us, around 36 per cent of Indigenous people are going to the doctor and the doctor is writing them a prescription for pharmaceuticals that they need to help them with their health conditions and they are unable to get that prescription filled, because they cannot afford it. What is going to happen when the cost of their prescriptions goes up by 13 per cent? That is what is happening. That is what members on that side of the House today are going to be voting for. They are going to be voting for a 13 per cent increase in the cost of prescriptions.

Yesterday we had the marvellous spectacle of the Deputy Prime Minister of this country standing at that dispatch box and telling people during question time that costs would always be lower under a coalition government. Have you ever heard any greater nonsense than that—the Deputy Prime Minister of this country saying that costs are always going to be lower under a coalition government? Well, here is one group of costs that are not going to be lower under a coalition government—a 13 per cent increase in the cost of pharmaceuticals. And the Prime Minister is fond of saying that prices are going to go up and up and up and up. Under this legislation, members on that side of the House are about to stand and vote in favour of a bill that sends the prices of pharmaceuticals in this country up by 10 per cent, as a minimum, and increases the safety net on the pharmaceutical benefits by 10 per cent per annum between now and 2018.

Is it any wonder that there was not a member of the National Party who was willing to stand and defend this legislation? That is because it is a complete breach of the policy that the National Party took to the election in 2013. They led Australians to believe that they were actually going to decrease the cost of pharmaceuticals. But when they stand and vote on this legislation, within an hour, they are going to be breaking that promise to the Australian people. (Time expired)

4:43 pm

Photo of Alan GriffinAlan Griffin (Bruce, Australian Labor Party) Share this | | Hansard source

This legislation—the National Health Amendment (Pharmaceutical Benefits) Bill 2014—is ideology disguised as reform. This is bad policy. It is policy that is going to affect low-income earners. It is policy that is going to affect Indigenous Australians. It is policy that is going to affect people in regional and rural Australia. It is policy that was not exposed to scrutiny by the Australian people at the last election. We heard from those opposite that there were not going to be cuts in health. But I will give one thing to the then shadow Treasurer: he made a speech a year or so before, in London, where he said, 'The age of entitlement has to end', and the circumstances were that things had to be done. In fact, in that speech he flagged co-payments around a range of different areas in the medical field. He flagged some of those things.

But where was it in the coalition's policy in the lead-up to the election? It just was not there. There was no mention. Since the election, we have had Churchillian appeals to ensure that we must all suffer. But I tell you what: you are suffering a lot more if you have a young family and you need access to medical facilities, you are suffering a lot more if you are a senior citizen in a situation where you need essential medications, you are suffering a lot more if you are an Indigenous Australian who has difficulty in accessing health services. And this legislation is part of a series of initiatives.

I am not surprised that those opposite are not speaking up in favour of this. They just want it to go through—because they are embarrassed. Many of them, I believe, are ashamed. They know what is happening out in their electorates: the same thing that is happening in ours. When we go out there, front the community and talk about what is going on, what is happening in this parliament, what is happening from the government many of them voted for—I can tell you what they are saying. They are saying: 'I did not vote for this. This is not what I thought I was getting. This is not what I was told by Tony Abbott. This is not what I was told by the local candidate for the coalition in the election campaign.' Instead they are getting these sorts of initiatives.

It is supposed to be, we hear, about sustainability and cost. Yet that flies in the face of what has been happening with PBS costs in recent years. The Labor government worked in consultation with the medicines industry to rein in PBS costs. Good reforms were done then—real reforms that delivered a cap, effectively, on the growth that was, for a while, quite unsustainable. In addition, if it really were about sustainability, what the government would be saying is: 'We are making this saving. We will take that money and put it into the area that we are trying to sustain.' But that is not where it is going. It is going into a medical research fund—and all we know about that is that we have a name for it, that it is going to cure everything and that it will happen down the track. That is cold comfort for the many people in Australian society who need access to medical services now, that is cold comfort for people in rural and regional Australia and that is cold comfort for Indigenous Australians who will be dealing with the pointy end of health reform—as this government calls it—in the years ahead.

The COAG Reform Council report released in early June made it clear that, when you increase costs to individuals, you can expect them to make choices—as we have seen in other jurisdictions. What we will see is as many as one in 10 people not accessing the medications that have been prescribed for them. These are not medications that they might like; they are not medications that they think it might be fun to take; they are medications that have been prescribed for them by registered medical practitioners—experts and professionals in their fields who have taken the Hippocratic oath, which is all about providing people with the services they need to maintain their health and wellbeing. In question time today, a number of members of the opposition, including the member for Ballarat and the Leader of the Opposition, discussed a petition signed by many medical professionals. There has been a massive outcry from medical professionals, making it very clear that this is not good health policy.

Despite all that, this bill will get through this place. I note that the member for Dickson, the Minister for Health, has said that the Labor Party have supported co-payments for 50 years. It is true—we have supported co-payments in this area for 50 years, but the argument that all co-payments are the same is ridiculous. It is like arguing that all taxes are the same. It is a joke.(Time expired)

4:48 pm

Photo of Bob KatterBob Katter (Kennedy, Independent) Share this | | Hansard source

First I want to single the minister out for great praise. He is one of the very few people in this parliament who has acted at great cost to himself personally in taking a moral stand on an issue. Having said that, if there is one group of people who are under enormous pressure at the present moment, it is our pharmacists. As one pharmacist said to me, 'Every single thing I have on my shelves Woolworth and Coles now have on their shelves—and they are selling them for less than I can buy them for.' There are discussions taking place that this has to stop, otherwise Coles and Woolworths will use their muscle power to force down supplier prices. If the suppliers are forced to reduce their prices to Coles and Woolworths, they will have to increase their prices to the independent pharmacists. That is one issue.

The second issue is that the income of pharmacists from prescriptions is being cut by 25 per cent. Of all the classes of people in Australian society today that I would not put the king hit on, the pharmacists would be the first. The Anglican schools in my town are only there because of the immense efforts and personal financial sacrifice of the Griffiths family, who own one of those pharmacies. The Catholic schools are only there because of the generosity and hard work of the Collins family. The same Michael Collins, a pharmacist in that town, put up about a quarter of the money to get the Cowboys rugby league team going in Northern Australia, which gave our young men, and a million rugby league fans who live up there, a chance to go into the national league—and of course six of our State of Origin players came from there. He has worked tirelessly to get our own local rugby league going. He is an absolutely exemplary citizen in every respect. These are the people who are copping the king hit here. I cannot understand the logic of the government in doing it.

Older people—and the demographic in Far North Queensland is very old people—can pay upwards of $100 a month for pharmaceuticals. Once you get over the age of 69 or 70, you are looking at $100 a month at least. We are talking about an extra $20 here. It does not sound like much, but if they pay, as we do in North Queensland, $3½ thousand for rates and $3½ thousand for insurance—that is half of their income gone on insurance and rates. I do not know how people are able to afford a feed! We have had two cases of people pulling their own teeth out with a pair of pliers because—the queues are so long in Queensland now that you can forget about getting it done there—they could not afford a dentist.

The government has made a very bad error here. Of all the areas of the economy that I would not hit, the pharmacists would be first. The last government hit them for 25 per cent of their prescription income and they are now under violent attack from Woolworths and Coles, which is cutting off all of their other income—you are going to take these people out of our community.

I will conclude on a personal note, which I cannot help but bring to the attention of the House, because I think most families would have had an incident such as this. I had a small pimple near my ear; because it was sensitive I raced into the pharmacy here in Canberra at about five to 10 and arrived just before closing time. I asked the pharmacist, 'What would I put on that?' She said, 'I think that's shingles. If you treat it within 48 hours you won't get it, but if you don't then you will be out for three months, and it is very painful. You will be completely out of commission and in very great pain.' She rang up a doctor she knew. It was two minutes to 10 at this stage, and she was about to go home. The doctor stayed on to see me. It was shingles. The doctor told me I was going to beat it by about three or four hours, and I raced back to the pharmacy. I tell this story to emphasise the great value of the pharmacists in our society.

4:53 pm

Photo of Tim WattsTim Watts (Gellibrand, Australian Labor Party) Share this | | Hansard source

Before those opposite were elected to the government benches, they promised us that if elected they would be a government of no surprises. I must not have been paying attention during the last election, because I missed the section of the Real Solutions policy pamphlet where those opposite promised that they would be jacking up prices of prescription medicines for pensioners in our community and jacking up prices of life-saving drugs for the most vulnerable in our community. I must have missed that promise because I was distracted by their promise that under a coalition government we would get lower taxes and no new taxes. I must have missed the promise for the $7 tax every time you go to the GP and for the hike in prescription medicine costs. I must have missed the promise when I heard the then opposition leader, now Prime Minister, on the Today show saying that his very reason for being in politics was to reduce taxes in Australia. Since then, I have lost count of the number of bills I have spoken on in this parliament in which those opposite are doing exactly that: increasing taxes for the deficit repair levy, increasing taxes for the GP tax and increasing taxes for prescription medications.

These broken promises show what the priorities of those opposite are. It is not deemed good enough by those opposite to put a price signal in place for polluters in our society. They do not want to deter carbon pollution in response to climate change. I note that the member for Wentworth is in the chamber. On this point, he correctly identifies a price on carbon is a way to respond to this issue. However, the government deems it good enough to put in place a price signal for pensioners wanting to use prescription medication. That is what this is about. When the Minister for Health talks about the sustainability of the PBS, he is not talking about investing more money in the PBS. The $1.3 billion slugged on Australians under these changes is not being reinvested into the PBS. The only way that this bill goes to the sustainability of the PBS is if it deters the use of prescription medications in our community. Those who will be most deterred are the most vulnerable in our community—pensioners, low income earners, families and those who use the most prescriptions in their day-to-day life.

I recently visited Williamstown Emergency Relief, a great organisation in my community run by Carol Willis, the wife of former member for Gellibrand the Hon. Ralph Willis. The volunteers in this emergency relief community group deal with some of the most vulnerable in our community. During my recent visit, I heard directly the stories of the pensioners, the unemployed and the vulnerable in our community. They, to a tee, told me that the thing that worries them the most about the government's changes in the recent budget is the $7 GP charge and the increase to PBS payments.

Those in this chamber should understand that these are not trivial amounts to these people. These are people who are barely keeping their head above water as it is. These are people on the cusp of homelessness, moving in and out of stable accommodation. Whether they are being treated for mental health issues, chronic diseases, vulnerability factors or social determinants for homelessness, these people wear more of the costs of prescription medicine and wear more of the costs of GP co-payments than those of us in this chamber, who are lucky enough to live in economic security. These are the people who are going to stop using prescription medications in response to this bill. When the Minister for Health is talking about the sustainability of the PBS, he is talking about the most vulnerable in our community using less of the medications that they need to live a civilised and healthy life.

I visit the retirement homes in my electorate, and I can tell you that pensioners are ropeable. They hear the Prime Minister come in here and say that pensions are not going to be reduced, even though it seems to be a magical savings item in the budget where pensions increase yet the government saves money. I can tell you that pensioners are not mugs. They know exactly what the implications of the budget are for them, and they know what the GP co-payment and these changes to the PBS are going to mean for their budgets. The Prime Minister likes playing dress up and he likes having pictures taken of him with working Australians in all kinds of workplace costumes. He better pack a hard-hat the next time he visits a retirement home in my electorate, because pensioners are coming after him. They know that he is coming after them, and they are angry.

That brings us to what the last budget is about. It is about the kind of nation that we live in. Do we live in a nation of universal health care, a nation where it is not means that determine whether you get access to affordable, high-quality health care, but your citizenship and your status as a member of our community and as an equal? Australian people did not vote at the last election to tear up this compact. They did not vote at the last election for this bill. They do not want it and I will be voting against it in this parliament.

4:58 pm

Photo of Cathy McGowanCathy McGowan (Indi, Independent) Share this | | Hansard source

Along with telecommunications, public transport, education and climate change, access to health, doctors and pharmaceuticals are some of the major issues that got me elected to this place. It gives me great pleasure today to stand and represent the people of Indi, who over the last two months have asked me to come to this place and ensure their voices are heard.

Following the budget, I undertook a budget impact statement around Indi. I asked the people of Indi what for them were the most concerning issues that I needed to bring to this place. Of all the issues that I mentioned above, health and access to affordable health care was the No. 1 issue. It matters more than almost anything else to people in rural and regional Australia, and why not? Because without good health, it is so difficult to do anything else.

There is another issue that comes with health and access to health in rural Australia, and it is about being sick. If you are sick in rural and regional Australia, it becomes very expensive. It is not just a matter of going to the doctor; it is not just a matter of buying your pharmaceuticals, which we are discussing today; it is a matter of transport, getting access to the doctor or getting access to the cities where you need specialist care. With transport comes the backfill: who is going to do your job at home when you are no longer there? With illness, there is also care: who is going to look after you and who is going to help you with your dependants—the other people whom you care for? Of course, there are the costs of drugs and doctors—and it all adds up. During the budget impact tour, I heard one particular story that brought this home to me.

This was the story of two brothers who lived 20 kilometres out of Wodonga. One of the brothers has cancer, and he is being cared for by the other brother, who is farmer. So, together, once a week, they have to go to Melbourne to access the specialist care that the brother with cancer needs. These young men, who are in their twenties, are not well off. The brother who is the carer is doing full-time caring, so he is without paid work. The brother who is ill is obviously unable to work. They cope with our poor public transport in north-east Victoria and, once a week, they go down to Melbourne and then they come back. They spend the whole day trying to govern their lives around it. As they spoke to me in the supermarket, in the High Street in Wodonga, outside Coles, there were almost tears in their eyes as they tried to explain to me and have me understand the cumulative effect of what was happening in their lives, as one after another of these extra costs were loaded on them. But the really sad thing was that they only had a limited budget, and there was no way known that they had more money coming into meet it. These were the health costs, the transport costs, the electricity costs—the energy costs that were coming in over winter and there were also all the other things that had to be done that made up their life—and they had no money left. As they stood there, they said: 'Cathy, there's probably not much you can do. You don't hold the balance of power in the government, but could you take our voices to Canberra? Could you make sure that our voices are represented?' So I am really pleased today to be able to say on their behalf that I have brought their issue here, and I hope it is heard by my colleagues on all sides.

The final thing I want to say is that it is very unusual for me to stand up in this place and agree with everything that the member for Kennedy has said. Today I say: we are on the same page, Mr Katter. It is the effect of this legislation on chemists and pharmacists that is going to have the most long-term impact. I think this has to be what we call 'unintended consequences', because there is no way known that my colleagues opposite could deliberately set about destroying local businesses and taking away their profitability—which is exactly what the chemists in Wangaratta and Wodonga are saying to me will happen. So I hope it is a mistake. I hope that in the next budget we get to rectify some of this, as common sense comes in.

In bringing my comments to a close, I ask my colleagues opposite, particularly those who represent rural and regional seats, to give some thought over the next few months to what we need to do about this, because there are a whole lot of things coming together here. I ask that we pay particular attention to a rural and regional impact statement so that when the budget comes down next year we can actually look at it and understand the effect of all of its implications, and then we can take the action that we need to take.

5:03 pm

Photo of Justine ElliotJustine Elliot (Richmond, Australian Labor Party) Share this | | Hansard source

I rise to also oppose this unfair medicines tax. This is essentially what it is. This bill increases the Pharmaceutical Benefits Scheme co-payment for general patients by $5 to $42.70 and by 80c to $6.90 for concessional payments. It is an unfair measure and a cruel measure as well. In fact, it is part of the government's unfair and cruel measures in their budget of broken promises. Before the election, we had all the Liberal and National candidates in my area in the north-coast of New South Wales running around and telling everyone: no cuts to health, no cuts to education and no changes to pensions—but that is exactly what we have seen. The budget will have a devastating impact on regional areas such as in my electorate of Richmond, particularly the $7 doctor tax and the petrol tax. There is also the $80 million that is being ripped out of health and schools, and of course the cuts to pensions. In my area we have a lot of older Australians. This has just been devastating. This latest attack—the increase in the PBS—is another cost increase for them, particularly on the back of the doctor tax. They are extremely concerned. A number of weeks ago I had a rally in my electorate, and over 300 people attended. One of the big concerns people had with the budget were the health cuts and how they were going to impact the elderly.

This bill is about the ideological views of those across the chamber in terms of dismantling Medicare and destroying access to universal health care. In regional areas, this will impact so much more harshly. It is one of the major issues that people have brought up with me since the budget. As we have said, Labor will oppose this $1.3 billion tax increase on medicines, because it will have a devastating impact right across this country. As we have heard, the COAG Reform Council report that was released in early June found that 8.5 per cent of people in 2012-13 delayed or did not fill their prescription due to cost. In disadvantaged areas, this figure is 12.4 per cent; for Indigenous people, it is 36.4 per cent. So we can see that people are making those very conscious choices about accessing medicines, depending on their capacity to pay—and that certainly goes against everything in terms of universal health care. The last time a Liberal-National government increased the tax on medicines, which was in 2005, prescriptions for in essential medicines fell by as much as 11 per cent. So this measure is really devastating for people right across the country but particularly for those in regional areas.

We have already seen so many people within the medical profession—many senior doctors, many nurses right throughout the health community—who have signalled their concerns about these changes to the health system. In my area, many people have expressed their concerns about them as well. The latest increase that we are talking about today, this medicines tax, comes on the back of all the other harsh cuts in the budget and will be devastating. When we were in government we made changes to the PBS that put it on a very sustainable footing; but what we are seeing from this government is just another tax being placed upon people. You saw under us that the PBS was growing in a sustainable way, and that happened because of the very good measures that we took. But when it comes to this government, they are saying that the sick should pay—and they are making them pay more, through increases such as in this bill. What is really devastating is that it is making those who are most vulnerable pay for it. The people who are most vulnerable are those who need to access health services but who will now have to pay so much more to do so.

It worries me that today we heard the Treasurer on radio saying we may need to look at other savings. What does that mean in terms of future cuts to our health and hospital systems? What else is he potentially proposing on top of things like the $7 doctor tax that he will be applying and this medicines tax? What other potential cuts will we be looking at? In question time the Prime Minister refused to rule out further cuts to hospitals and schools and family support. People have had grave concerns about the impact of this budget so far and they are particularly worried about possible future cuts. I am worried about those who need health care, particularly those in regional areas and especially those elderly people who do have much more complex care needs. We saw a report released the other day indicating that in areas like mine we have people who have a higher incidence of stroke, and that is because of the number of elderly people who live there. The very people who need to access health services regularly are those who have complex health needs, and these are the people who will be impacted on the most when they are going to their doctor or getting blood tests or X-rays done or are purchasing medicines. It is these people, who can least afford it, who will be devastated. That is why I am opposing this bill.

5:08 pm

Photo of Lisa ChestersLisa Chesters (Bendigo, Australian Labor Party) Share this | | Hansard source

About 18 months ago the current Minister for Health, when he was the shadow minister for health, popped into Bendigo. He had a press conference out the front of Bendigo Health and he was talking not about this increase in the PBS that he would introduce as health minister, not about the new GP tax that he would introduce as health minister and not about the funding cuts that he would make to Bendigo Health—he was talking about the carbon tax, out the front of a hospital. He had an opportunity, when he was in my electorate, to be truthful, to come clean and tell the truth and let people know what his plan would be when he became the health minister. That is what upsets people the most about this issue. Yes it will make it hard for people, yes it is going to attack the most vulnerable in our community who already have tight budgets, but it is even more worthy of note that the health minister when he was the shadow minister went around the country and stood next to the CEOs of health facilities and organisations but not once did he mention that in government he would be the minister that increased the PBS co-payment.

The National Health Amendment (Pharmaceutical Benefits) Bill will tax the most vulnerable. It will particularly attack people in regional areas. In my electorate of Bendigo, roughly 30 per cent of the electorate survive on a household income of less than $600 a week. Every single attack on their budget, like we will see with the GP co-payment and the increase in PBS costs, will hit these families hard. We need to ensure that we are investing in preventative health. One of the best ways to do that is to make sure that people take their medicines; to make sure that they are staying out of emergency rooms and hospital emergency departments by taking their medicines. Some people I have met who are upset about this change are taking three or four medicines a day. They are saying to me 'Which one won't I take?' because of the cost that is now being imposed upon them. We need these people to be taking all of their medicines—not one or two but all of them—to ensure that they do not end up in our emergency wards. If the government were serious about ensuring that we had a healthy Australia and healthy regional communities they would not be increasing the PBS co-payment—they would be looking at ways to reduce the cost of medicine. It is so important that people take the medication they have been prescribed by their doctors so they do not end up in our emergency rooms. That is the opposite of what will happen because of this bill.

My question to the minister is what economic modelling has he done on that issue? Do we have any evidence to show whether people not taking the medicines they need will increase the number of people presenting at emergency? My other question to the minister is about life expectancy. We have already heard publicly from the member for Mallee that life expectancy in the country, in the bush, is 4.7 years less than it is for our city counterparts. We already know that people in the country are less likely to go to a doctor and are less likely to have their prescriptions filled, not just because of cost but because they just put it off—'We'll be right, mate.' Because they make those decisions, their life expectancy is less. Will life expectancy in the bush be decreased even further because people cannot afford to have their prescriptions filled and take the medicine they need?

I wish to raise the examples of two people who have spoken to me about this very issue—about how this will hurt their families. Ian is a healthcare professional himself. His son has diabetes and his wife has a chronic heart condition. Both of them require ongoing medication to ensure that they can live a good life. He expects the cost to his family alone will be about $1,000 a year because of the increases he will face. This money will go straight from their budget into the government's coffers. The other person is a chef who lives in Woodend and works at the country club bakery. His wife had a heart transplant 12 months ago and he is worried about the increase in the cost of the medication she takes just to ensure she continues to live a good life. This is a bad tax, a nasty tax, and it is going to hit people in the country the hardest.

5:13 pm

Photo of Tony ZappiaTony Zappia (Makin, Australian Labor Party, Shadow Parliamentary Secretary for Manufacturing) Share this | | Hansard source

The government can come into the chamber and gag the debate but it cannot hide what the National Health Amendment (Pharmaceutical Benefits) Bill does and it cannot hide from the Australian people, who know exactly what is going on. What is going on is that the government wants to increase the cost of health care across the country, and this bill is only one measure that goes towards increasing the costs of health care for people in Australia. The University of Sydney has done some modelling on all of this, and it will cost the average Australian family an additional $200 a year as a result of the collective changes that this government is making to health expenditure. It is not just a matter of increasing the cost of medicines by $5 for the average person and 80c for concession card holders—it is all the other changes that collectively make a difference.

If it was in isolation, Mr Deputy Speaker, you could perhaps argue a case where you needed to increase the fees—but this is not in isolation. I want to go to some of the other measures that the government is bringing in, in order to change the cost of health care in this country and move us away from the universal health care system that we have to one where the user pays. And regrettably, the people who will pay the most will be Indigenous people, the elderly, the unemployed, and low-income earners; the people who are struggling the most already. They will be hit not only by the additional health costs but also by a range of other measures, relating to social welfare payments, that the government also wants to impose on them. The additional pharmaceutical costs will come on top of the $7 GP payment that families and individuals will incur every time they go to a doctor. And every time they go to the doctor, there is every chance they will come out with a prescription. There is every chance they will come out with an X-ray notice or a pathology notice—which means another $7, on top of another $7, and then the $5 for the medicine on top of that. And if you have a family, then you multiply that over and over again.

Then we have an additional cut of $600-odd million to the nation's dental programs by this government. When you cut dental costs, again, you indirectly affect the health of individuals. And that, in turn, means that there are other costs which inevitably arise from the poor health is associated with people not looking after their teeth because they simply cannot afford to. Ultimately, it becomes another example of a false saving: you save a few dollars up-front, but you pay for it in the long run.

I want to go to an additional matter relating to the cuts which this government is making in respect of health support around Australia—that is, the $16-a-day supplementary payment made to residential homes for the patients that live in those homes. If someone within a residential care facility has dementia, and is currently getting $16 a day, and they have that $16 cut, it is not just $16 a day—it amounts to $5,800 a year of additional costs that that family is now expected to fork up. I can assure members of this House that this is a real cost. A member of my community whose wife is in a residential care facility came to see me. He said: 'the $16-per-day payment has been cut—where am I going to find, as a pensioner, another $6,000 a year, on top of all the other costs that I am being asked to look for, in order to take care of my wife and myself?'

Members opposite—and I note that they did not particularly come in to support this legislation—know in their hearts that the changes and the cuts being made by this government to the health services of this country are going to cost families dearly. They know that the cuts are unwarranted. They also know that there was no announcement of these cuts in the election campaign in September last year. They also know—even though they come into the chamber and deny it—that families are hurting, and that families are very angry about the changes that the government wants to impose with respect to health costs around the country.

This is part of an overall strategy of a government which wants to change the system; from the one we currently have—where we have universal health care—to one where individual families pay for it. Australian families are awake to that. No amount of running away from the debate on this bill in this chamber; no amount of members opposite not wanting to talk about it—and no amount of the minister saying that this is about trying to have a sustainable health system—will take away the truth that this is nothing more than an attack on the vulnerable people of Australia.

Photo of Craig KellyCraig Kelly (Hughes, Liberal Party) Share this | | Hansard source

I thank the member for Makin. The question is:

That the bill be agreed to.

5:18 pm

Photo of Warren SnowdonWarren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | | Hansard source

I made a contribution to this debate on the National Health Amendment (Pharmaceutical Benefits) Bill 2014 earlier, and I pointed out a couple of very salient facts. We know that, the more expensive medicines are, the harder they are to get. For disadvantaged people—of whom there are many in my electorate—this is an absolute nightmare. I would remind the House of the COAG Reform Council report, released in early June, which found that we already have a situation where, in 2012-2013, 8.5 per cent of people delayed or did not fill their prescriptions due to cost. In disadvantaged areas, this figure is 12.4 per cent, and for Aboriginal and Torres Strait Islander Australians it is 36 .4 per cent. We know that this—and the Prime Minister has said it—is really a demand-reduction measure. The Prime Minister is ensuring that that 36.4 per cent will grow—that the people who most need access to medicines in this country will not access those medicines because of increased cost.

Mr Deputy Speaker, you cannot justify this position, if you juxtapose it with the Prime Minister's stated objective of being the Prime Minister for Indigenous Affairs. On the one hand, he is supporting the Closing the Gap initiatives—so he says—and on the other, he is introducing policies through this budget which will have a material impact by lessening the opportunities for people to extend their lives. These measures will mean that people who need access to preventive medicines to control chronic diseases will not get access to those medicines. And we know that, already—before the introduction of these measures—36.4 per cent of Indigenous people delay or do not fill their prescriptions due to cost.

It is salient to remind ourselves that the last time a Liberal government increased the tax on medicines—in 2005—the number of Australians getting the prescriptions they needed for some essential medicines fell by as much as 11 per cent. So let us make this very clear: the impact of these measures will be that people who should get access to medicines, because of who they are and where they live and the state of their health, will not access those medicines. I ask the minister, who is unfortunately not in the chamber: what happens to those people who currently have access to concessional medicines through section 100? What will happen to those people? Are those costs being absorbed in the process, through the health services that provide those medicines? Are they expected to be picked up by the pharmaceutical companies, or by the chemists—who is going to take up these costs? Or are they going to be exempt? We need to know this. I ask the minister to let us know, very clearly, what impact of these measures will be. Now, of course, only around 50 per cent of Aboriginal and Torres Strait Islander Australians access Aboriginal community controlled health organisations. The remainder access the mainstream health system and they will not get access, in large part, to these concessional drugs in any event. They will go to their doctor in south-east Brisbane, or south-west Sydney, or somewhere, to seek help—and they will find that not only do they have to pay the $7 up-front to get access to the doctor but also, when they are then prescribed medicines—and they might have multiple prescriptions, as a result of a need to address chronic disease—they have to pay this extra impost. And a substantial number of these people will not access these medicines. That will inevitably mean that families who need access to medicines for the health of their kids, themselves, their parents—their whole extended family—will not have access to those medicines. The outcome for those people is going to be crook; yet, we hear nothing from this government about how it might exclude these people. We should not have this in any event. We all know that. We know that the government's own backbenchers do not support it, because very few of them—I think five—have been in here to advocate for it. What does that tell us about the support from the government for these sorts of measures? They can read the tea leaves as we do. They understand the reality of what is happening in their communities as we do. They understand that the people who will be most affected by these measures are the people who can least afford it and who are the sickest in the community.

The government should be condemned for this proposal. I ask the minister, yet again, to come in here and explain to the Australian community why they would put such an impost upon the people who can least afford it and who are the most vulnerable in our community. The Prime Minister can prattle on all he likes about being the Prime Minister for Aboriginal and Torres Strait Islander Australians, but he clearly is not and he clearly does not care. This budget is replete with measures that are designed to undermine and attack the rights of Aboriginal and Torres Strait Islander Australians, including the $500 million cuts in program funding over the next little while.

5:23 pm

Photo of Sharon BirdSharon Bird (Cunningham, Australian Labor Party, Shadow Minister for Vocational Education) Share this | | Hansard source

I want to take the opportunity, as brief as it is to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2014. I think there is something particularly sad about the fact that this debate has been gagged by the Minister for Communications, but the hypocrisy is fairly consistent with the government's approach to most policy areas. I am taking the opportunity to make it clear that I oppose this bill and in the short time available to each of us to put something on the record for the House about why I have that view. Like my colleague the member for Lingiari, I want to talk about a group who are particularly vulnerable in all our communities and who do not often have a good rate of accessing health services: young people.

When I talk about young people, I am talking about post-school-age young people who are struggling in insecure and unreliable jobs, who might have irregular income or a little bit of income support, obviously at the lower level as is the case with younger people—it is going to be even worse under this government for people under 30. All of us with kids in their 20s are pretty horrified at the government's thought that anybody under 30 is going to be living at home for ever and a day. I would have thought that most of them would have been encouraging young people to get out and be independent and not be looking for some support from home at the age of 30.

Sadly, for many young people, there is not a home to look to for that support. Like many of our colleagues, the member for Throsby and I often visit some of the homeless services for young people in our area and talk to these young people. A lot of them are also young parents. What is the reality of the cumulative effect of health initiatives that they now face in this government's budget? Let us put that together. Let us say there is a young mum living at one of those services with a toddler. She is homeless, has very limited income and is probably trying to get some education to improve her chances in life. Then the flu hits and they get sick. They go to the doctor; it is $7 for both consultations: her own and her child's. That is $14 to start with, under the brilliantly conceived GP tax that is about to dismantle the universality of our healthcare system. The doctor says, 'Look, I just want you to go and have a quick blood test each. I want to do some diagnostics.' So they go to the local pathology service—that is another $7 each. There is $14 extra there. We are up to $28 already. Unsurprisingly, you are not allowed to read your own pathology test, so you have to go back to the GP for another appointment for the both of you. There is another $14. Now we are up to $42, and we have not even got to the point of filling the script. This is the cumulative effect of the impost that this budget is putting on people who can least afford it in the health sphere. For that family, there will be another $5 to $6.90 added to the cost of the prescription. For two prescriptions that is at minimum another $10. This one period of illness will cost an extra $50 for that mum and her kid on what they would previously have had to pay.

The outcome of that situation is that people will make the decision not to go to the doctor. If the doctor gives them a reference to a pathologist or any other sort of diagnostic services, they will walk out saying, 'Yes, doctor, I will go and do that,' and they will not follow up and get it done. If they follow it up and get it done, they might then be deciding whether to go back to the doctor and considering whether they can afford it. Even if they go back to the doctor for some peace of mind about the outcome of the tests, it is increasingly likely that they will not get a prescription filled. Every barrier you put in the chain of decision making about accessing health services increases the likelihood, particularly for the most vulnerable, that patients will drop out of that chain and not access those services. That is the reality we face.

I would have thought everyone in this place would understand that an ounce of prevention is much better than the cost of the cure. We all know that if you get preventive and primary health care right and you get people engaged and participating, you save money for the budget bottom line in the long run. It is not only bad health policy but also bad fiscal policy as well.

Last week, I got a letter from a radiology group in my own electorate expressing grave concerns about the impacts of exactly the sort of scenario I have outlined. This bill should be opposed. It is bad policy. It is a bad fiscal decision.

5:28 pm

Photo of Adam BandtAdam Bandt (Melbourne, Australian Greens) Share this | | Hansard source

Whoever you voted for at the last election, no-one voted to pay more to see the doctor and no-one voted to pay more for their medicines or for their tests. It is no wonder that the health minister, who gagged this debate, is not in here during the detail stage to defend it, because this is one of the most unpopular measures of the Abbott budget—and it is up against some pretty stiff competition. We are at a fork in the road where we decide whether Australia is going to retain a universal healthcare system or go down the American road where, when you get sick, the first thing that they check is not your Medicare card; it is your credit card.

It is very clear that if this were at all evidence driven this government would not be here with this bill because there is no evidence that Australians are being overserviced by medical practitioners. There is no evidence that our Pharmaceutical Benefits Scheme is being misused. The cost of medication for chronic diseases and the sustainability of the PBS should be considered as part of an overall health policy. Yes, it is true that some costs are increasing as new medications come onto the market. But the government is not offering a vision or a blueprint for overhauling how we deliver health services. There is no vision for the workforce, chronic illness or managing aged care. All we have is fabricated panic over costs and budgets. This confected panic is taking this country in the wrong direction.

If they want to balance the budget, there are options available to the government. The government could go to the likes of Gina Rinehart and wealthy mining companies and say, 'You've got to pay the same tax on your fuel as everyone else in the country does when they go and fill up the bowser.' If you took that and other concessions from mining companies into account, it would generate $13 billion over the forward estimates. The government could go to the big banks and say, 'The IMF has said we are giving you somewhere in the order of $2 billion to $3 billion of subsidies every year. Perhaps you ought to pay for that. Perhaps you ought to contribute that.' That would give us $11 billion over the forward estimates. But no. It takes courage to stand up to the wealthy and the powerful and ask them to pay their fair share. A coward takes the axe to the young, the sick and the poor. That is what this Prime Minister has done, and this bill is an example of it.

The government is going to create a far bigger social and economic problem that all Australians will face in the future if this bill passes. We currently pay in this country the third highest out-of-pocket expenses in the OECD. By world standards the proportion of GDP that Australia expends on health is comparatively low, and it has remained low for decades. Australians already pay more than their fair share in meeting their health costs. Australians already have one of the best-performing health systems in the OECD. This government is suggesting, as part of a deterrence measure, that the cost of seeing a doctor should go up and the costs of getting tests and getting medicines should go up. It is $5 here and $7 there, but this government does not seem to realise that in one visit to the GP you can be whacked multiple times. There is a proposal for $7 extra to visit a doctor. If the doctor sends you off for a test it is another $5. If they send you want to get a prescription after that, there is another $5. If you do that a couple of times a year, taking your kids to get their vaccinations or other family members for tests, the costs will add up.

Over the last three years, we have had confected outrage from the Liberal Party about how they supposedly care about the cost of living. They come in here and say, 'We've got to get rid of the carbon tax because of the impact it is having on cost of living.' Then they turn around and in the same breath say, 'We are going to make you pay more to see the doctor. If you get sick, we are going to make you pay more for that. If you need a test, we are going to make you pay more for that. Meanwhile, we will let the likes of Gina Rinehart off the hook. We will let the big banks off the hook.'

There is a reason that around this country tens of thousands of people are out in the streets regularly marching against this budget. There is a reason why if an election were held today this government would be smashed. That is because, whoever you voted for, what is becoming now clear is that this government lied its way to power. It is the job of this parliament to hold the government to account. The Greens will stand steadfast in opposing this government's move to dismantle universal health care in this country.

5:33 pm

Photo of Chris BowenChris Bowen (McMahon, Australian Labor Party, Shadow Treasurer) Share this | | Hansard source

Another budget bill and another tax increase on the Australian people—a $1.3 billion tax increase. This time what is the crime of the people who are being taxed? Is it that they are engaging in bad behaviour? Is it behaviour which is antisocial? Is it something that the government of Australia says we have to stop? No. They are being taxed for being sick. They are not taxed for going to the doctor on this particular occasion but for needing medicine. This is emblematic of everything that is wrong with this government and this budget.

The Treasurer comes in here and he huffs and puffs and he beats his chest about budget repair and the need for tough choices and tough decisions. This is a tough decision for those who rely on medicines for their wellbeing. It is a tough decision on them. It is not a tough decision on the Treasurer; it is a tough decision on the Australian people who are paying the price for his deceit and mismanagement.

The Treasurer talks about budget repair and so you think, 'Maybe difficult decisions are necessary. Maybe to return the budget to surplus over time we need to make some decisions to see if government revenue can be increased.' There is only one slight problem. Not one single cent of the money in this bill will go to budget repair. It will not go towards returning the budget to surplus. It will not go to the budget bottom line. No, the Treasurer thought, 'I've got a good idea: I will wedge the Labor Party. I will develop a new fund for health and medical research.' The Australian people are awake to his games. The Australian people are awake to his deceit. They know that this is just a ruse to ensure this Treasurer's and this Prime Minister's wish to increase taxes on people who have committed no crime other than working hard and occasionally getting sick. It is what they planned before the election and what they chose to deceive the Australian people about during the election campaign.

The Treasurer this morning was on radio and said, 'There are alternatives, you know. There are alternatives to the budget. We could do other things. We could cut other things and avoid the federal parliament.' The Prime Minister, the Treasurer and the Minister for Finance have been very keen to tell us over the last two months that there are no alternatives. Now this morning the Treasurer said there are alternatives. He blusters his way through in a way which I am sure the Australian people, again, will see through.

Two months, almost to the day, after this budget was introduced parliament is still debating the budget and the Australian people are still angry about the budget. We are still seeing the impact on consumer confidence and sentiment. Just today we saw the latest survey on consumer anxiety. It is up again. It is the highest since the consumer anxiety survey by the National Australia Bank started. That report nails the Treasurer and says that it is directly down to his rhetoric, his reactions and his policies.

The Treasurer says there are alternatives. I am perhaps going to surprise the House when I say that I agree with him. For once, he is right. There are alternatives, because budgets are full of alternatives. The Treasurer says there is no alternative to increasing the tax on medicine. He is wrong. He was right this morning when he said there are alternatives.

One alternative would be to drop his expensive and unfair paid parental leave scheme. That is alternative number one. Alternative number two would be to drop Direct Action, which subsidises carbon pollution in this country at a cost to taxpayers. Alternative number three might be to reverse his changes to high-income superannuation. He says that everyone has to pay their way. He lectures and he blusters, but if you happen to be on a very high income, 'Oh no, we are going to give you a tax cut for your superannuation.' Alternative number four might be to reverse his $1 billion gift to multinational companies that choose not to pay a fair rate of tax in Australia. He purposely withdraws a sensible tax measure to ensure that multinational companies pay their fair share of tax in Australia, a measure introduced by the previous government. One of this Treasurer's first acts is to withdraw and reverse that measure. That is another alternative.

It just goes to show this government's twisted and warped priorities. They prioritise a tax increase on people who commit the crime of being sick and people who commit the crime of needing medicine. We all know, because we all have constituents who take a lot more medicine than we do. They need to because their doctor told them they need it to be well again. They will be paying more every day.

This Treasurer is so out of touch, so arrogant. He says, 'Oh, it is just a couple of middies or a half a pack of cigarettes,' as he lectures the Australian people, especially those on low and middle incomes who commit the crime of being sick. No wonder this government is the most unpopular government in its first term that we have seen in a long time. This budget is a millstone around the government's neck and the Treasurer's neck, because it deserves to be. It deserves to be because it is unfair and shows how out of touch this Treasurer and Prime Minister are.

5:39 pm

Photo of Shayne NeumannShayne Neumann (Blair, Australian Labor Party, Shadow Minister for Indigenous Affairs) Share this | | Hansard source

This is a $1.3 billion increase in health costs to Australian households. The COAG Reform Council, abolished by this government in their budget of broken promises and betrayal, revealed that Indigenous people are 36.6 per cent less likely than non-Indigenous people to actually fill a prescription. This is what this government is going to do. If they use a price signal to raise costs and make it harder for Indigenous people and others across the country to fill a script, people are less likely to fill the script or they are likely to delay it. There will be worse health outcomes for the country.

On Sky News - Agenda, in November 2012, the health minister referred to the PBS as 'tracking sustainably'. What happened? Somewhere along the line the ERC program across there actually got hold of him and said, 'You have to make some cuts.' So, instinctively, like the Liberal Party always does, because it is in their DNA, they hurt the vulnerable, those who are sick, those who are less fortunate, the disabled, those who come from low socioeconomic regions, and those who come from rural and regional areas, as well. That is what they have done here.

Where are the members from marginal seats—the people from the LNP, in Queensland? They are very happy to ask questions in question time, one after another—Petrie, Bonner, Brisbane, Ford. One after another they get up and ask questions in question time, but they do not have the political courage to come in here and speak on these types of bills, because they know in their heart of hearts that this will go down badly back in Queensland in their marginal seats. They know this will increase costs for households in Brisbane, in Logan, in Ipswich, in Beenleigh, in Rockhampton, in Townsville and in Cairns—all across those areas.

This is almost like one of the scripts of TheHollowmen. In fact, we have seen Rob Sitch referring to this. He appeared in The Hollowmen, and he said his production company Working Dog created and produced the program At the Melbourne Press Club recently he remarked on the striking similarity between the government's proposed medical research fund and the events of an episode of The Hollowmen that I happen to like. My youngest daughter, Jackie, also likes it and we often play it. Rob Sitch said, 'When the budget came out it was like they had watched the show and said, "That is actually a really good idea."' As in The Hollowmen, I have a sneaking suspicion that the government's medical research fund was a late inclusion in the budget.

Chief Scientist Ian Chubb revealed on the ABC that even he had not been consulted about the fund. So it was all cooked up in Treasury and Finance. I wondered if you could come up with something better in the Working Dog production catalogue. The plan for the second Sydney airport was ripped out of the plot of The Castle. Or there could be a sequel to The Dish in which the CSIRO scientists struggle to keep the observatory running between the savage cuts of the Abbott government. Or we could have a version of Thank God You're Here in which the member for Wentworth would come back and save the Liberal Party.

But this is a serious issue for the Australian public, because across the country we will see people having worse health outcomes. Those opposite say that it is just a small amount, but it rises again and again and the number of prescriptions rises again and again before you hit the threshold. So, people across this country will have worse outcomes.

They say that Labor did nothing about it. But we did. There is $1.8 billion in savings via the accelerated price disclosure provisions, going up to about $20 billion across the forward estimates and beyond. We made serious attempts to get the PBS under control, and we had it under control. In November 2013, even the minister said that it was tracking sustainably.

So what is the difference? He has been rolled by the Treasurer and the Minister for Finance. That is what has happened, and Australians will suffer because of it. The vulnerable, the sick and the disabled will suffer. It is so typical of the Liberals, the Nationals and the LNP to do this, because in their heart of hearts there is a big divide, and we can see on their faces and in their voting records every day what they think about the poor, the disadvantaged and the sick, and this bill is typical of it.

5:44 pm

Photo of Ms Catherine KingMs Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | | Hansard source

I just want to remind the House where we are up to in this debate on the government's decision to increase the cost of pharmaceuticals, the cost of medicines, for every Australian. There will be an increase of $5 for general patients and 80c for concession card holders every time they get a prescription at the pharmacist. As well as that, substantial changes to the safety net make it harder and harder for people to reach the safety net, particularly those patients the safety net is designed for—those who have multiple use of medications because they are really, really sick.

We are up to the consideration in detail stage of the bill. Consideration in detail is where a minister is asked questions about a bill and asked to defend why he has taken the decision to construct a bill. The minister has not been in this chamber at all during this debate. I do hope he will be here shortly, because some questions have been raised during consideration in detail that we would like some answers to. The member for Lingiari in particular has asked a question around section 100 and the impact that this bill will have on concessions for Aboriginal and Torres Strait Islanders who are accessing pharmaceuticals through Aboriginal medical services. What will happen to them as a result of this bill? Will Aboriginal medical services be expected to absorb the extra costs arising from this bill? Has money being given to Aboriginal medical services to deal with the extra costs imposed on them by this bill, or will individual patients have to pay? It is a very serious question, and the minister needs to answer it.

We are opposing this bill because, in the entire context of what the government are doing, it is transferring costs onto patients—and I will talk a bit about why they are intending to do that. We also asked whether any modelling has been done of the impact on people taking their medications. It is clear that the government have worked out that a certain number of people will not fill scripts for their medications. We want to know what that number is. How many people are they expecting not to fill their prescriptions and what is the impact of that overall on people's health? For example, how many scripts does the average pensioner fill? How many scripts does someone with a health care card on average fill? How much more will it cost per year for the average pensioner before they reach the safety net? How much more will it cost per year for the average health care card holder before they reach the safety net? What will the cost per script be by July 2018, when the safety net is at 68 scripts? Can the government guarantee that the safety net will be capped for 2018 at 68? They cannot guarantee it. They have said in the bill that the increases will stop there, but we are not certain about that at all. In fact, I do not trust this government one iota when it comes to health. So we want to guarantee that that is actually the case. What will the safety net be for general patients by July 2018, after it increases by 10 per cent plus CPI every single year? And is this it when it comes to the Pharmaceutical Benefits Scheme? We know the government are trying to run a false argument about the measures in this bill being about the sustainability of the PBS. The only way they can genuinely be about the sustainability of the PBS is if the government are expecting people not to fill the scripts they are supposed to fill when they go to the doctor and are told, 'You need this medicine.' Not a dollar of this is going back into the PBS.

The question I have the minister is: how many new medicines that are currently coming through the PBAC pipeline—we have Kalydeco being used as an example in this debate—will now be listed out of this $1.3 billion? And what are they? We pretty much know that the answer to that is going to be absolutely zero, so it is not about the sustainability of the PBS. This is about a revenue-raising measure to transfer costs onto patients and to deal with the budget. (Time expired)

5:49 pm

Photo of Gai BrodtmannGai Brodtmann (Canberra, Australian Labor Party, Shadow Parliamentary Secretary for Defence) Share this | | Hansard source

Before the election those opposite made one very simple, very clear promise to the Australian people when it came to health, and that was that there would be no cuts to health. This promise was made to the Australian people and this was the expectation that the Australian people had when they voted in a coalition government. But the bill we are debating tonight just shows that that was a complete broken promise. It was completely worthless. It was not worth the paper it was written on. The government are cutting health and they are doing so in the full knowledge that it will have the most adverse effect on the people who can least afford it.

This bill means that, for every script, general patients will be paying $5 more and concessional patients—I do not think people fully appreciate this—will be paying 80c more. I am proud that Labor is opposing this cruel and callous attack on the most vulnerable members of our society. This legislation is a $1.3 billion tax increase on medicines, and it will hurt every Australian. It must be noted that it comes on top of the attack on the universal healthcare system, which is part of Labor's DNA. We introduced it. Universal health care is part of Australia's social fabric. That is the strong message that has been communicated to me by the people of Canberra through my community forums and through my mobile offices since this budget was released. The coalition is looking at introducing not just changes to the PBS but also a $7 GP co-payment and a $5 reduction in the Medicare rebate.

We already know that tens of thousands of Australians do not get their scripts filled because they cannot afford to do so. In fact a COAG Reform Council report released in early June found that 8.5 per cent of people in 2012-13 delayed or did not fill their scripts due to cost. In disadvantaged areas this figure is 12.4 per cent. For Indigenous people it is 36.4 per cent. This is the existing system—this is what is happening at this point in time. What is going to happen in the future when the most disadvantaged, the most vulnerable in our society, do not get their scripts filled? What sorts of health implications will there be on those individuals and what impact will it have on emergency services in our hospital systems?

Yesterday I presented a petition in this House that was signed by over 600 clients, staff and friends of the Winnunga Nimmityjah Aboriginal Health Service in Narrabundah. Those people were not just from Canberra but from the region—from Eden-Monaro, from Hume. The shadow minister has visited this health service with me a number of times, as has the Leader of the Opposition. The petition called on the Abbott government to abandon its unfair and unaffordable changes to Medicare and the PBS.

During my visits to Winnunga I have spoken to staff and clients. I know that this legislation will hurt those who can least afford it. The staff at Winnunga have told me they have already had to cover the cost of prescriptions for some of their clients, because they simply cannot afford them at the moment. This increase in the cost of prescriptions will mean that even more of their clients will be unable to afford their medicines and that, unfortunately, Winnunga will further have to absorb the cost of the $7 Medicare co-payment in addition to the additional cost of these prescriptions. That is possibly going to total $300,000 or more per year.

The fact is that the Abbott government's changes to Medicare and the PBS are part of an ideological campaign to get rid of our universal healthcare system—something that is sacred to Australians; something that is part of our DNA; something that is part of the Australian social fabric. They want to create a two-tiered user-pays system. Labor will not support the Prime Minister's unfair slug on sick Australians that is built on lies told before the last election. Last week, I held two community forums in Canberra. Every single person there, without exception, was very, very cranky about this budget. I do not know whether those opposite have held any community forums on the budget, but I know that from a Canberra perspective, community members are not happy. One woman at the community forum who was a pensioner aged in her 80s had come along because she wanted to say she felt that this budget was a direct attack on the sick and elderly, like herself. Her pension has been cut through the lowering of the indexation. She will now have to pay more to go to the doctor, which she does monthly. She will now have to pay more for her prescriptions when she gets them filled multiple times a month. It is an attack on the sick. It is an attack on the elderly. It is an attack on the disadvantaged. It is an attack on the vulnerable. It is cruel and callous.

5:54 pm

Photo of Peter DuttonPeter Dutton (Dickson, Liberal Party, Minister for Health) Share this | | Hansard source

I move:

That the question be put.

5:59 pm

Photo of Don RandallDon Randall (Canning, Liberal Party) Share this | | Hansard source

The question is that the question be put.

The DEPUTY SPEAKER (18:05): The question is that the bill be agreed to.