House debates

Wednesday, 11 September 2019


National Health Amendment (Pharmaceutical Benefits) Bill 2019; Second Reading

4:20 pm

Photo of Julian SimmondsJulian Simmonds (Ryan, Liberal National Party) Share this | | Hansard source

It's a great pleasure to rise in the chamber today to support the government's National Health Amendment (Pharmaceutical Benefits) Bill 2019. Affordable, accessible health care: that's the commitment we made to Australia and to Australians, and that's the commitment we're keeping with this bill. Last election we went to the people of Australia with a very clear plan—certainty and stability. We outlined as part of the plan a number of pillars, and the Australian people liked what they saw: lower taxes, secure borders, getting on with building infrastructure to get you home to your families sooner and safer, and a stable economy that funds essential services—and that's a key component which can sometimes be overlooked. But the reality is: a stable economy is not an end in itself. It has allowed us, and will allow the Morrison government going forward, to fund the essential services that are part of our plan to strengthen our world-class health system and guarantee the essential systems that Australians rely on and that make their lives better. Because the LNP can manage money responsibly, we can afford to do this for Australians.

Part of our plan is to make life-changing medicines more affordable, and this bill today supports the sustainability and operation of the important Pharmaceutical Benefits Scheme. The PBS has been providing medicines to Australians for over 60 years. As the son of two pharmacists, I know firsthand the difference that quality, cost-effective medicines provide to children, families and seniors. Throughout all stages of life, no doubt most of us or our family members will require at some time—knock on wood—access to medicines for illnesses that will have a profound effect on our quality of life. And that access to medicines will be via local community pharmacies, particularly for an ageing population.

As a son of pharmacists, as I said, my mum and dad own a pharmacy across the road from a retirement village. I found out firsthand and came face to face with the important work that the more than 200 pharmacists in the Ryan electorate do for the community. They are a safety net and they make a big difference to people's lives. Community pharmacists don't just dispense medicines; they help their customers in their local community deal with addiction and with mental health, they pick up conflicts in medicines and they help older Australians manage complicated cocktails of medication.

In some cases, without the PBS, medicines that many Australians rely on would cost tens of thousands of dollars per year. They would simply be out of reach for most, if not all, Australians. The Pharmaceutical Benefits Scheme, however, means that concession cardholders pay a maximum of $6.50 per script and non-concession patients pay a maximum of $40.30. In fact, 91 per cent of PBS scripts are given to concession cardholders, who pay just $6.50. Since coming to government, the Morrison government has listed over 2,100 new or amended medicines on the PBS, or an average of one per day. That's an investment of over $10.6 billion in life-saving drugs that are helping to improve the lives of everyday Australians. These medicines help people suffering from epilepsy, severe asthma, heart disease and cancer. That's one new or amended life-changing medicine every single day, making an impact on tens of thousands of Australians' lives.

To give you an idea of the importance of some of these drugs and their impacts, I will refer to some of our most recent listings. Tagrisso was recently listed for lung cancer. It was previously costing patients $88,000 per year. Venclexta, a drug used to treat leukaemia, was recently listed, but prior to this, patients would pay $165,000 per course of treatment. Ibrance was recently listed as well. It is a drug to help Australian women battling breast cancer and previously had a cost of $55,000 per year. Those are just three examples. Imagine the impact that over 2,100 medicines listed under this government have been having on the lives of ordinary Australians.

This government doesn't believe that financial circumstances should impact access to treatment. Over 90 per cent of the PBS scripts are dispensed to concession card holders, including pensioners and low-income earners. I know that Minister Hunt understands this personally. He is well acquainted with the details of many of these drugs, and I know the sustainability of the PBS system is an important reason he has brought this bill to the House. He has personally spoken with many of the families who are impacted by the drugs this government is listing. He has heard the stories of these families—of young children, wives, daughters, husbands and sons—who have a better quality of life because of the drugs listed on the PBS.

The minister has personally taken the time to come to the Ryan electorate to sit with community pharmacists; as I said, there are over 200 of them in the Ryan electorate. He sat with some of these community pharmacists and talked about their businesses, because, at the end of the day, these are small local businesses and they face challenges—issues of cash flow, supply, the ability to compete with others and their desire to take a leading role in the health care of their community. An example is the fact that pharmacies have done so much to vaccinate our community from the flu. There were over one million vaccinations last season alone from community pharmacies.

There are 5,400 pharmacies across Australia that together dispense 740,000 prescriptions a day or 270 million scripts a year. But some of them will fail, and when they do this bill is so important to provide continuity of service and, importantly, continuity of supply for PBS drugs. Australians who rely on these medicines need to have the comfort of a continued supply, and this brings me to this amendment bill. This amendment bill includes measures that will allow PBS medicines to continue to be supplied in the unfortunate circumstance where an approved pharmacist faces bankruptcy. This is particularly important in small and regional towns, where there perhaps are only one or two pharmacies available. In this instance, under these new measures, Australians who rely on vital medicines can have the security that provisions can be put in place to ensure there is no stoppage or delay in the supply of their vital medications listed on the PBS.

You would think that supply of these vital medications on the PBS would have bipartisan support, so it's shocking to recall—

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

It has. The Chifley government introduced it. Who are you kidding?

Photo of Julian SimmondsJulian Simmonds (Ryan, Liberal National Party) Share this | | Hansard source

I will take the interjections from the Labor member. Because you would think that the PBS did have bipartisan support, and then we got to 2011. In 2011, in those heady days of financial mismanagement by the Labor government, hidden away in the very small fine print of the portfolio budget statements of the Labor Party's budget of 2011-12 was an announcement—not trumpeted in a press release or anything like that, but hidden away—to say that they would stop listing life-saving PBS medicines, until 'fiscal circumstances permit'. The question is: when under a Labor government would fiscal circumstances permit?

We know they can't deliver a surplus. We know they can't manage an economy responsibly, and that's why it in fact wasn't until the LNP government that life-saving medicines were again listed on the PBS, as I said, at an average of one new medicine a day.

So imagine how many people that has helped, but imagine also that, instead of freezing it in 2011, the Labor Party had listed a drug a day on average as we have managed to do. How many Australian lives could have been saved? How many more Australian families could have spent more time with their loved ones if the Labor Party had managed the economy properly? We talk a lot in this place about financial indicators. We talk a lot in this place about the importance of having responsible management and a strong economy, but this is the human side of that. When you have a Labor Party and a Labor government that can't manage an economy, the human side of that is that Australians don't have access to life-saving drugs. Under the Morrison LNP government, they now do. Over 2,600 drugs have now been listed. So, next time we hear a scare campaign from Labor on health—next time we hear them talk about how they will spend more money on health than ever before—we will think back to their record in 2011 and 2012, when, for all the heady spending promises that they brought to the Australian people, they so damaged the economy that they got to the point where they had to look sick Australians in the eyes and explain to them why they didn't have enough taxpayer money to list these vital drugs.

Families rely on the PBS. Sick people rely on the PBS. The residents of Ryan rely on the PBS. That's why I'm so pleased to support this particular bill, which will ensure the stability and continuity of the PBS going forward.

4:32 pm

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I am shocked to hear the member for Ryan and the absolute tripe that he talks about health care. Labor invented the PBS under the Chifley government. Labor under Gough Whitlam introduced Medibank, the first universal health scheme in Australia. It was universally applauded, destroyed by the Fraser government and reinvented by the Hawke government as Medicare in 1984. To hear someone from the opposite side promote their view of health above ours is just ridiculous. At the present time, Australians are facing increasing gap costs, increasing waiting times for specialists' visits and huge discrepancies in health care between rural, regional and metropolitan populations, so to hear the member opposite talk such rubbish about health care makes me feel faintly ashamed to be in this place.

I rise today to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2019 and I've been looking forward to discussing this legislation, as I was in the previous parliament before it was dissolved. So I'm glad that this legislation has been reintroduced. This legislation deals with the supply of medicines, amending part VII of the National Health Act 1953 and making two minor changes. Labor is pleased to support this amendment because it will provide easier access for many Australians who may be put at risk of not being able to get their PBS listed medications if pharmacies fail. That being said, it would be remiss of me not to take this opportunity to school the government on some of their failures in health policy, particularly in relation to the Pharmaceutical Benefits Scheme—but more on that later.

It's been well over a year since the 2018 budget was delivered in this chamber, and yet the first change set forth in this bill implements a measure from that budget. This measure is designed to recover the costs of the pharmacy approvals process. Much like the government's promised infrastructure spend, which occurs in a galaxy far, far away, this is yet another example of the government's figures being out and their ambitions seemingly outstripping their capabilities.

This legislation deals with the costs associated with applications to open and relocate pharmacies. I suspect that this is a topic that we will be dealing with quite a bit over the coming years. I have in fact been contacted by a number of pharmacists that operate or seek to operate within my electorate. They are well versed in their statutory obligations and regulations. I suspect there is a desire for further change in this domain, but plans on this have been curiously lacking from the health minister and those opposite. Applications to open and relocate are assessed by the Australian Community Pharmacy Authority, which then makes recommendations to a delegate of the minister. This bill seeks to recover costs that are associated with this approval process from the applicants themselves. The government's figures estimate that this recovery mechanism will save Australian taxpayers around $3 million per annum.

I referred earlier in my speech to the fact that I'd been looking forward to discussing this bill in the 45th Parliament and the fact that this mechanism was introduced in the 2018 budget and has only now been reintroduced. Members may find it interesting to know that the cost recovery component of this bill had actually been scheduled from 1 July 2019. This did not occur, because of the government's failure to bring forward this legislation for debate in the previous parliament. This is yet another example of the chaos and dysfunction that is at the heart of the coalition government. It is indicative of the fact that they consistently give up on governing and preserve their efforts for badmouthing unions and denigrating Labor. It's no wonder politicians get a bad rap when they see the vacillating and the lack of effort on the part of this government in health care. The delay in action from the government has meant that taxpayers have continued to foot the bill for the pharmacy approvals process for quite a long period of time—almost two years, in fact.

The second change introduced by this bill is an important one, as it deals directly with the supply of medicines to all our constituencies. Specifically, it aims to continue the supply of PBS listed medications in the event of a pharmacy going bankrupt or being passed into external administration. Under this bill, the Secretary of the Department of Health will be given a framework that will allow them to grant and revoke permission to a trustee to supply medicines listed on the Pharmaceutical Benefits Scheme at a location where an approved pharmacist has declared bankruptcy. That is quite important, particularly in rural and regional areas, where pharmacies are facing increasing cost pressures and access pressures and, therefore, are at risk of failing.

I welcome any steps that will seek to improve access to medicines for those who need them. The government says that this will ensure that continuity of access to pharmaceutical benefits is not compromised in the event that a pharmacy is bankrupt, and I'm pleased to support this legislation. However, there are a range of other barriers that the government is well aware of that are preventing Australians from accessing medicines and that are not addressed in this bill.

The first barrier I want to draw upon is affordability. We know that for many Australians access to healthcare services is severely limited, and in some cases health care is simply unaffordable. Recently I saw a child in my clinic at our local hospital with quite severe asthma, whose mother couldn't afford the number of medications that were required to keep this child out of hospital and keep him stable. She was forced to pick and choose between what preventative medications she could buy for him. Consequently, he had chronic symptoms and had had a recent admission to hospital with his severe life-threatening asthma. We know that for many Australians, particularly those that are already financially stressed, affordability of medication is a very big issue.

I've spoken previously about how out-of-pocket gap costs are soaring for patients and the fact that 1.3 million Australians are delaying or avoiding Medicare services each and every year due to costs. That is also true of medications. The government's own figures show that Australians are not filling their prescriptions, because they cannot afford them. The Australian Bureau of Statistics estimates that one in 14 people, or seven per cent of Australians, are delaying or avoiding taking their prescribed medications because of cost. This includes people with coronary vascular disease taking statins or people with hypertension taking antihypertensives. They are really putting their own health at risk because they cannot afford the medications.

In the next few hours I will be speaking in the debate on the Health Insurance Amendment (Bonded Medical Programs Reform) Bill 2019 about the disparity that exists in access to health care across Australia and the fact that life expectancies vary in an almost stepwise fashion from inner city to metropolitan, to outer metropolitan, to rural, regional and isolated Australians. There is almost a stepwise decrease in life expectancy across that continuum. This is something the government has failed to address. We know that in the most disadvantaged areas the rate of people skipping prescriptions, at over 10 per cent, is twice as high as it is in the least disadvantaged areas, at around seven per cent. There's no disputing the fact that the cost of medication is contributing to health inequality in Australia. And we know that health inequality is contributing in a very strong way to financial inequality. I am gravely concerned that we're becoming a society where only the wealthy are afforded access to health care. I think this is a tragedy, and it's something Labor has continued to try to address since the 1940s. Our universal healthcare system is at risk if we continue along this trajectory.

Shockingly, those opposite have sought to make matters worse. Members would do well to remember that the coalition, in their horrific 2014 budget, actually proposed to increase the cost of PBS medicines by up to $5 and sought to increase the threshold for the Medicare safety net. They also talked about a Medicare co-payment, further restricting the poorest Australians' access to health care. This would have been applicable even to pensioners, demonstrating how truly out of touch the coalition are in healthcare matters. It would have resulted in patients being forced to pay an additional $1.3 billion over four years for the medicines they needed. There's no doubt in my mind that this would have resulted in even more Australians forgoing the medications they needed, putting their health care and their own lives at risk. The government sought to attack those who needed health care, taking $1.3 billion from the pockets of patients, many of whom are among the most vulnerable Australians. In stark contrast, the government, in its chaos and dysfunction, was unable to bring forward legislation that would save taxpayers almost $3 million per year. How out of touch can you get!

It was Labor's strong opposition to these out-of-touch proposals that prevented the government from implementing this measure, which would have seen the cost of medicines increase. Their leader may well have changed, but Australians would do well to remember that this Prime Minister and this health minister were part of a cabinet that sought to make medication and health care more expensive for all Australians.

We all know how much the government and the minister love to turn the PBS listings into a theatrical event. They love to boast about how well they're doing and their ability to list on the PBS something that has been recommended by the independent TGA. In reality, the government's own figures paint a very different picture. In Senate estimates, the Department of Health revealed the truth that there are more than 20 drugs that this government will never list on the Pharmaceutical Benefits Scheme because negotiations on pricing with the manufacturers have broken down. The government has been unable to work with the manufacturers of these drugs and appears to have put it into the too-hard basket. That is in spite of the fact that these medications have been strongly recommended for listing on the PBS by independent experts, the Pharmaceuticals Benefits Advisory Committee. As we all know, the committee recommends that medications are listed when they stack up on clinical and cost grounds, so the government should be striving to reach an agreement with the manufacturers, not putting it in the too-hard basket.

The government will say that the fault lies with the manufacturers, that these companies are not sufficiently motivated to list these medications on the PBS at an appropriate price. This is a dismal argument. The process of getting positive recommendations from the PBAC is quite arduous and costly and can take years, and I think the manufacturers have done their bit. The determination for these drugs to be listed is evident through the steps taken by the manufacturers to succeed in obtaining their positive recommendations. The manufacturers want the drugs listed, the experts recommend that they be listed, but the government says no. Why aren't these drugs on the PBS? It is because the government has refused to offer a fair price and is failing to invest in our Pharmaceutical Benefits Scheme, which means that Australians are missing out on these vital medications.

The government are always quick to toot their own horn when it comes to listing medications. It's time they revisited these potential listings. The coalition needs to match Labor's commitment, taken to the last federal election, of an affordable medicines guarantee. The guarantee would have seen a commitment to list all drugs recommended by trusted experts, and the government is in a position not only to match our commitment but to honour it by listing these drugs. I cannot stress this enough: we must be doing more to ensure that all Australians have equitable access to the best quality health care. We need to address the growing disparity that exists in terms of access and affordability, to ensure that we do not wake up one day and realise we have an ineffective healthcare system, similar to the United States, that punishes the poorest and where only the ruling elite and fortunate few are able to access the best 21st century care.

I'm very worried about this. Those opposite seem to think it is some sort of scare campaign; it certainly is not. I know that access to health care in my electorate of Macarthur has become increasingly difficult for those who are the poorest. I still do a clinic in our local hospital. I see those who have struggled to access private care for their children and I see some terrible outcomes for those who are the poorest in our electorate. I welcome any measures that seek to address this, but it seems the government has no plan—no plan to actually look at the increasing gap costs and no plan to look at the increasing inequality in health care—and yet the actual statistics are staring them in the face. The National Party should be ashamed of itself in the way it's allowed health care in the bush to be so poor compared to that in the city. They've done very little to address it, and they need to address it urgently. I cannot say enough that the—

Photo of Darren ChesterDarren Chester (Gippsland, National Party, Deputy Leader of the House) Share this | | Hansard source

What about geographic location of AMA members—

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I can can't hear the member opposite, sorry. Again, they're making fun of what is a very serious—

Photo of Steve GeorganasSteve Georganas (Adelaide, Australian Labor Party) Share this | | Hansard source

Order! All statements are to be made through the chair. It's not a debate between each other. It's through the Speaker.

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

Thank you, Mr Deputy Speaker. I'm happy to debate at any time. The figures demonstrate that there is very little effort on behalf of the National Party and the coalition government to address the disparities in health care across rural, regional and remote areas. I welcome any measures that seek to address this. Labor is always willing to work in a bipartisan fashion to achieve better healthcare outcomes for Australians, as we have done for many decades. These matters are above partisan politics.

However, I look forward to supporting this change in parliament to reduce the PBS safety net thresholds and welcome any steps towards making health care and medicines more affordable for those in need. But I must say that reducing the PBS safety net threshold by around $100 for general patients will not make a great difference in the grand scheme of things in terms of resolving the affordability issues that presently exist. I would hope that the government would place issues around affordability and access at the forefront of its mind when it comes to the— (Time expired)

4:44 pm

Photo of Tim WilsonTim Wilson (Goldstein, Liberal Party) Share this | | Hansard source

It's a great privilege to be able to get up and speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2019 before the House, because this bill speaks to the very clear success of the Morrison government. What this bill, even in its modesty, seeks to do is to make sure that no matter who you are, no matter where you live and no matter the challenges you face, you'll be guaranteed a supply of medicines on the Pharmaceutical Benefits Scheme in the community where you live, and with accessibility and affordability. That's at the heart of what this bill tries to achieve.

It's only a modest cost, at about $2.8 million a year, but it enables and makes sure that supplied medicines on the PBS, particularly to people in rural and regional communities, get the dividends of this government's strong economic management. We know full well that we have situations where pharmacies go into administration and that there are then challenges and problems that are faced directly by local communities in their capacity to access medicines because of the challenges faced by an individual pharmacist. What this parliament here today is saying is that regardless of who you are and where you live, you will not be left in doubt. You will not be left in the lurch. We understand that across this great continent, no matter who you are, you have a basic expectation about receiving basic medical care, whether it's from your doctor, whether it's in your hospital or whether it's emergency care, and also of course that you will have access to life-saving medicines.

This bill is particularly important because more and more Australians are living with chronic conditions, the consequence of an ageing population, and the need for additional support and assistance. That's what this bill seeks to achieve. It is relatively trivial in the grand scheme of things in terms of administration, but will have a real impact in terms of people's lives. The changes will bring applications by pharmacists in line with the Australian Government Charging Framework. The changes will help to ensure access to PBS medicines can continue uninterrupted where a pharmacy is affected by bankruptcy or external administration, and of course as I've outlined already. Where does this happen? It is particularly where there is only a single pharmacy within a community and therefore they need assistance.

And this is against the backdrop of the entire Morrison government's health agenda and its economic agenda as well, because one of the things that those people on the opposition benches don't understand is that, if you can't afford to pay for medicines, you can't afford to deliver them to the Australian people. With more conditions receiving live-changing or life-improving or life-saving medicinal support, the government faces an ever-looming and greater challenge around financing the cost of the nation's health bill. It's only when you have a clear-eyed, controlled management of our nation's finances that you will be in a position to support this type of legislation and ensure the guaranteed supply of medicines to consumers at the end of the supply chain. This is why it's a fulfilment of the Morrison government's agenda for Australians—to make sure that nobody is left behind. Through the PBS, patients can access medicines that, in some cases, would cost tens of thousands or even hundreds of thousands of dollars per year for a maximum of only $6.50 per script for concession card holders and a maximum of $40.30 for non-concessional patients. Patients will then, of course, receive free or reduced costs for scripts once they reach their safety net. And this is against a backdrop of the nearly 186 million different scripts that are signed across the country, providing access to important health and medical care.

We're averaging, as a consequence of this government's strong economic management, 31 new or amended listings per month, or approximately one per day. Compare that with the legacy of the last Labor government. We don't draw this distinction for trite political purposes or partisan purposes. We draw this distinction because, when Labor stopped listing new medications on the Pharmaceutical Benefits Scheme because their irresponsible economic management meant Australia couldn't afford to list them, that had real human impacts on real people's lives. I can't think of anything worse than when a country has been so mismanaged, as it was previously under Labor governments, that you turn around to those that are sick, those that are suffering and those that are confronting life challenges and, of course, their own mortality and say, 'We stuffed up; therefore you can't get care.' That's the eternal shame that will always hang over those who sit on the opposition benches. They get up and carp and complain because whatever we do is never enough—like when we deliver tax cuts. Even though they went to the last election promising $387 million of new taxes, apparently ours aren't cutting fast enough. It's the same with their health agenda. They constantly talk about how they want more spending but they can never map out a plan about how they're going to pay for it. And, when they've been in government—don't just judge what they say; judge what they have done and will do—they have fallen short and left Australians who are already in difficult times and sometimes in their darkest hour in the lurch. It's about time they stood up and took responsibility for their actions and their conduct, and it's about time the Australian people held them to account for their empty promises and empty hope, as they did at the last election.

This bill sits at the heart of exactly what this government is about. It's a government that's prudent and responsible, because then we're able to deliver the human dividend of making sure that, no matter who you are, no matter where you live and no matter your condition, this government and this parliament is in the best position to help, aid, assist and back you so that, when you're facing tough times, you're not doing it alone and so that you're certainly not being told by those in the Labor Party, 'Sorry, we can't help you because we can't help ourselves.' That's why this bill matters. That's why it's important to enjoy the support of the parliament despite the virtue-signalling amendments that have been put forward by our Labor opposition. Rather than talking about the fundamentals of what they would do to make sure they guarantee PBS access for millions of Australians, their consistent agenda, no matter what piece of legislation comes into this parliament, has been to drive distraction. We won't let them get away with it, because Australians can't afford to let us do so.

4:54 pm

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2019, and in support of the amendment moved by the member for McMahon. As previous speakers have indicated, Labor will support this bill, which amends the National Health Act 1953 to make two relatively minor changes to the supply of medicines.

It is well over a year since the 2018 budget was delivered, but the first change in this bill implements a measure from that budget to recover the costs of pharmacy approval processes. As many members know, applications to open or relocate pharmacies are assessed by the Australian Community Pharmacy Authority, which then makes recommendations to the minister's delegate. Under the bill before us, the cost of this process will be recovered from applicants. The government says this will save taxpayers around $2.8 million per year. I'd note that cost recovery was due to begin on 1 July 2019 but the government failed to list this bill for debate in the last parliament.

The second change under the bill aims to continue supply of PBS medicines following bankruptcy or external administration of pharmacies. The bill sets out a framework to allow the secretary of Health to grant and revoke permission to a trustee to supply PBS medicines at a location where an approved pharmacist is bankrupt. The government says this will ensure access to pharmaceutical benefits at an affected pharmacy is not compromised in the meantime.

Labor has consulted with pharmacists on this bill, and, as I said earlier, we will support it. However, I want to take this opportunity to speak in support of the amendment moved by the member for McMahon criticising the government for its record of delayed and withdrawn Pharmaceutical Benefits Scheme listings. I also want to highlight some of the barriers many Australians face, particularly in regional Australia, when it comes to accessing essential and lifesaving medicines.

The minister likes to come into this chamber and boast about PBS listings or drop a self-congratulatory press release on a Sunday afternoon, spruiking the latest listing, but what he doesn't like to talk about are those medicines that have not been listed—medications recommended for listing by the independent experts, the Pharmaceutical Benefits Advisory Committee, PBAC. Last month the PBAC made public their recommendations from the July meeting, which took the total number of drugs waiting to be listed by the minister to more than 60—more than 60 medications that have been recommended because they stack up both clinically and on cost grounds.

This includes drugs like Symdeko, which was approved in March by the PBAC. Symdeko is a lifesaving cystic fibrosis medication which treats the most common cystic fibrosis mutation, extending life expectancy and improving quality of life. The minister made a promise to those with cystic fibrosis that they would have access to Symdeko on the PBS as soon as it was approved. Six months later, and there is no word on when, or even if, the government intends to list this medication. If the minister wants to take credit for every new drug that's listed on the PBS, the minister must also take responsibility for delays in listings, and be held accountable for every drug that he refuses to list.

The government claims that it hasn't listed some medications because the sponsors aren't sufficiently motivated to list these medications on the PBS, despite the fact these same sponsors have gone to significant effort to work through the PBAC process, which can take years and significant investment. They want their medications listed on the PBS, and the experts say that these medications should be listed. But this government's refusal to offer a fair price and to invest in the PBS means that Australians are missing out on these vital, and sometimes lifesaving, medications. In contrast, Labor went to the last election with an affordable medicines guarantee—a commitment to list all medications recommended by the experts. We strongly urge the government not just to match that commitment with words, but to honour it with listings.

As the only pharmacist in this place, and someone who started work as a registered pharmacist in 1998, I have a keen and longstanding interest in the affordability of medications and access to quality health care. Long before I was the member for Dobell, I believed everyone should have access to affordable health care, including affordable medications. As a pharmacy student in 1996, when I studied drug legislation, it became apparent to me that this was a complex area. But what struck me then, and today, is how important it is to the lives of millions of Australians. We are lucky that, by and large, medicines in Australia are affordable, and that is due to the Pharmaceutical Benefits Scheme.

The Pharmaceutical Benefits Scheme is one of the pillars of Australia's universal healthcare system, a system that is world class and the envy of many countries. Labor is incredibly proud of the PBS. As many of you know, it was established in 1948 by the Chifley Labor government and has been in place in various forms ever since, despite the efforts of those opposite to tear it down. Labor fought to create the PBS, we have fought to strengthen and maintain the PBS and we will always fight to protect the PBS.

It is only through the PBS that most Australians can afford the medicines that they need, but we should not underestimate the impact the cost of medicines can have on household budgets, even with the assistance of the PBS. The cost to individuals living with complex chronic health conditions, such as diabetes, which require multiple medications, adds up. The government's own figures show that many Australians don't fill prescriptions, because they can't afford them. According to the Australian Bureau of Statistics, 961,000 people a year delay or avoid taking prescribed medicines due to cost. These are people who have seen the GP, have had their doctor's assessment and know that they need this medication but have to skip it. They have to make a choice: 'Do I fill this prescription or do I fill that prescription?' The rate of people skipping prescriptions is twice as high in the most disadvantaged areas. In the most disadvantaged areas 10 per cent of people delay or avoid filling prescriptions, meaning that the cost of medicines is contributing to the widening health gap in Australia, particularly in regional and rural Australia and particularly in the current drought. In communities such as mine in Dobell, on the Central Coast of New South Wales, the cost of medicines can be prohibitive, especially with the rising cost of living and with wages failing to keep up. People on low incomes, or income support in particular, often have to make difficult choices about whether they can afford to have their prescriptions filled.

Yesterday was World Suicide Prevention Day and tomorrow is R U OK? Day. I spent almost 10 years working at Wyong Hospital in my electorate. For most of that time I was a specialist mental health pharmacist working in acute adult inpatient mental health units. People living with major mental health problems are particularly vulnerable and most impacted by rising healthcare costs. What has the government done about this affordability crisis? It has only made it worse. In the 2014 budget the government proposed to increase the cost of PBS medicines by up to $5, even for pensioners, and to increase the threshold of the PBS safety net. This would have forced patients to pay $1.3 billion more for medicines over four years and would have caused even more Australians to skip essential medicines. Only Labor's opposition in the parliament stopped the government from implementing this cruel measure. Australians shouldn't forget that this Prime Minister and this Minister for Health were part of the cabinet that wanted to make medicines more expensive for every Australian.

Credit where it's due, Labor welcomes the government's election commitment to reduce the PBS safety net thresholds. That's why Labor matched the government's commitment within hours of its announcement in May. That's what should happen. Political parties should recognise and adopt good ideas from the other side. We urge the government to do the same with the health policies we took to the election. But let's be honest. Reducing the PBS safety net threshold from around $1,600 to $1,500 for general patients isn't going to solve the affordability crisis that I described earlier, so we strongly urge the government to consider how to improve the affordability of medicines as part of the Seventh Community Pharmacy Agreement and as part of its forthcoming review of the National Medicines Policy.

5:04 pm

Photo of Stuart RobertStuart Robert (Fadden, Liberal Party, Minister for the National Disability Insurance Scheme) Share this | | Hansard source

I thank members for their contributions to the debate on the National Health Amendment (Pharmaceutical Benefits) Bill. The government understands the importance that members place on the Pharmaceutical Benefits Scheme. For your constituents and for all Australians, the PBS has provided affordable access to medicines for over 60 years. The introduction of an application fee for all applications to supply PBS medicines brings these processes into line with the Australian government charging framework. The fee will be paid when pharmacists apply for approval to supply PBS medicines. These changes were announced in the 2018-19 budget and support the overall sustainability of the PBS. The fee will apply to all applications to establish a new pharmacy or relocate an existing pharmacy and to applications involving a change of ownership of a pharmacy. The amount of the fee will be determined prior to coming into effect and will be calculated based on the regulatory activity involved in processing these applications. The Department of Health will review the fee each year and adjust it accordingly.

The bill will also ensure access to much-needed medicines can continue following the bankruptcy of an approved pharmacist or where a pharmacy has been placed under external administration. These amendments are particularly important for rural and remote communities, where alternative access to PBS medicines may be limited. The approximate number of pharmacies affected by bankruptcy or external administration is about 20 each year. The bill provides the Secretary of the Department of Health the power to grant permission to an appointed administrator to manage the supply of PBS medicines at pharmacy premises. The new premises will assist continuity of supply of PBS medicines in the affected pharmacy until such time as the pharmacy can be sold or transferred to another pharmacist.

I'd like to thank all those stakeholders who provided input into these changes during consultation on the bill—in particular, the Australian Restructuring Insolvency and Turnaround Association, the Australian Friendly Societies Pharmacies Association, the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia. Australians have an outstanding health system and access to world-class medicines. The changes in this bill support the ongoing sustainability of the PBS. The Morrison government is deeply committed to the PBS and the Australian patients who benefit from the scheme. The PBS covers more than 5,000 clinically proven products across a range of conditions, from asthma and arthritis to diabetes and cancer.

Our government has a commitment to list all medicines on the PBS when recommended to do so by the medical experts. Since 2013, our government has made over 2,100 new or amended PBS listings at an investment of over $10.6 billion. We'll continue to list all new medicines on the PBS. That is in contrast to Labor, who in 2011 stopped listing medicines because they couldn't manage the economy. Due to our strong economic management, we're able to provide further support for patients who access the medicines they need through the PBS. Can I thank all members for their interest and support.

Photo of Steve GeorganasSteve Georganas (Adelaide, Australian Labor Party) Share this | | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for McMahon has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. The immediate question is that the amendment be agreed to.

Question negatived.

Original question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.