House debates

Tuesday, 27 September 2022

Bills

National Health Amendment (General Co-payment) Bill 2022; Second Reading

5:42 pm

Photo of Sussan LeySussan Ley (Farrer, Liberal Party, Shadow Minister for Women) Share this | | Hansard source

I'm pleased to speak on the National Health Amendment (General Co-payment) Bill 2022, which amends the National Health Act 1953 to reduce the Pharmaceutical Benefits Scheme general co-payment by $12.50, saving patients out-of-pocket costs. The opposition remains absolutely committed to ensuring Australians have access to affordable medicines when they need them. We support this legislation to reduce the cost of medicines, noting that it is the result of a copycat election promise made by Labor responding to the coalition's commitment to ensure Australians could save hundreds of dollars every year on the cost of essential and life-saving medicines. The coalition has a strong record of delivering affordable, life-saving medicines for all Australians, and we encourage the Albanese government to continue with our policy to list all medicines on the PBS that are recommended by the Pharmaceutical Benefits Advisory Committee.

This bill amends the PBS general co-payment from the current amount of $42.50 to the new amount of $30, taking effect from 1 January 2023. For certain medicines or treatments that have a Commonwealth price between $30 and $42.50, indexed annually, the bill gives pharmacists an option to discount that price to general patients by more than a dollar while supplying as a PBS prescription. This ensures no patient is worse off after the reduction of the general patient charge, given the established practice for pharmacists to be able to discount medicines that have a Commonwealth price at or below the current general patient charge.

The bill gives effect to an election commitment made by Labor in response to the coalition's clear leadership on this issue, as I said. On 30 April 2022, the coalition announced an election commitment to reduce the PBS general patient charge by $10 as part of an annual $150 million hip-pocket saving for Australians. We planned to wind the clock back on the cost of medications, reducing the cost per script back to 2008 prices. Following this announcement, on the very next day, Labor announced that they would reduce the charge by $12.50, so we're pleased we could lead the government into making commitments on this important policy area to support the hip pockets of Australians who rely on essential medicines and treatments. It's worth reminding the House of the coalition's record on affordable medicines because we do have a strong track record of providing Australians with timely, affordable access to effective medicines, treatments and services.

When we were in government, we listed more than 2,800 new and amended medicines on the PBS, representing an average of around 30 listings a month. Most recently, from 1 April 2022 our strong economic plan meant that we were able to assure that patients suffering from severe heart failure, high cholesterol and high blood pressure could afford cheaper medicines to treat their conditions. We were also able to list life-saving drugs to support Australians with asthma, prostate cancer, Castleman disease, HIV and Crohn's disease. This includes the PBS listing of Trelegy Ellipta 200, which was funded by our government, to be expanded for Australians with severe asthma. Asthma, as members of the House know, is a common chronic condition and can become serious, especially if untreated. Without the PBS subsidy, over 1,000 Australians may have paid more than $1,000 a year for treatment.

Another integral listing supported by the former coalition government was an oral treatment that has shown improved survival outcomes for patients with prostate cancer who have specific gene variants. Prostate cancer is the second-most-common cancer diagnosed in men in Australia and the third-most-common cause of cancer deaths, with an estimated 1 in 6 men diagnosed with prostate cancer by the age of 85. And we did not plan to stop there. In the coalition's 2022-23 budget we provisioned $2.4 billion for more new and amended PBS listings. These listings also included critical treatments for breast cancer, cystic fibrosis, severe eczema, asthma, spinal muscular atrophy, HIV infection and heart failure.

In conclusion, I restate that the coalition, the opposition, will support Labor's bill and we do agree with their intent, which was first promulgated by us during the campaign, to make medicines cheaper. We do encourage them, with the constant advances in medicines, new treatments and expansions of treatments for existing drugs to existing conditions, that they continue and commit to listing medicines on the PBS that are recommended by the Pharmaceutical Benefits Advisory Committee.

5:47 pm

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

5:59 pm

Photo of Rebekha SharkieRebekha Sharkie (Mayo, Centre Alliance) Share this | | Hansard source

At the start I acknowledge the speech made just then by the member for Dobell. Every year there's just one speech in the parliament that really stands out and makes you think. I acknowledge the words of great empathy, knowledge and compassion of the member for Dobell.

I too rise to support the National Health Amendment (General Co-Payment) Bill 2022. This bill will reduce the Pharmaceutical Benefits Scheme co-payment for medications to provide Australians with more affordable access to necessary medicines. The bill will cut the cost of the PBS co-payment from the current maximum of $42.50 per script to $30 per script—at most, a reduction of around one-third of the current cost for general patients. That is an extraordinary saving, particularly when people have multiple scripts. This bill will ease the cost-of-living pressures and produce public health benefits. I therefore commend it to the House.

It's excellent we're doing this for scripts, but in order to get the script you have to go to your doctor. That is what I am hearing about from so many constituents and from so many GP practices that are no longer able to bulk bill or have closed their practice. That has really happened in the last six months. I'm deeply concerned for many of my residents, whether they be on JobSeeker or the pension, the age pension or the disability pension. We're finding that in the past many GP practices were able to bulk-bill patients in those circumstances, but they're no longer doing this. In my electorate I have a number of constituents who are, potentially, delaying going to the doctor. It's a false economy, because it's costing our health system more if people delay treatment.

This National Health Amendment (General Co-Payment) Bill 2022 is a very welcome piece of legislation. I have written to and met with the Minister for Health and Aged Care, asking the government to address this urgent issue with respect to GPs no longer being able to bulk-bill. In regional areas, like mine, people are waiting weeks and weeks to see a doctor, and sometimes they're cancelling at the last minute because they just don't have that $80, in many cases, to put forward as a co-payment.

While this is incredibly welcome—around scripts and the cost of medication—we need to make it so that you can go and visit your doctor, particularly if you are on any kind of Centrelink payment. This includes self-funded retirees, the cohort that always gets forgotten in all of this. I'm hearing from many people in my community that are no longer able to afford the doctor at all. I worry that while the scripts have been made cheaper many of them won't visit the doctor to get the scripts in the first place.

To return to this piece of legislation, this is an excellent first step. I do hope that lifting the rate of the Medicare rebate for GPs is the next urgent step we address in this place so that health care can be a universal need for all.

6:03 pm

Photo of Libby CokerLibby Coker (Corangamite, Australian Labor Party) Share this | | Hansard source

I would like to begin by acknowledging the member for Dobell's emotional and heartfelt words. As a pharmacist she knows just how important it is for people to be able to afford medication that they desperately need. Choosing between buying much needed medications and putting food on the family table or helping another member of your family with their medication, making that choice, is a decision no Australian should ever have to make. My electorate of Corangamite is also impacted. I have pharmacists and GPs in my electorate who are telling me that it is a decision their patients are making.

I have a Drysdale pharmacist, Chris Walsh, in my electorate who says that many who come to him are struggling to afford their prescription medicines. Some families with chronic illness are foregoing their own health needs in order to pay for necessary medications for their children or to pay for food or power bills. It's unacceptable. That's why the Albanese government is committed to reducing the maximum amount Australians pay for their Pharmaceutical Benefits Scheme medicines. This bill delivers against our commitment before the election.

It was a Labor government that first introduced the legislation to make life-saving drugs more affordable, back in the 1940s. It was John Curtin and Ben Chifley who fought hard to ensure affordable access to pharmaceuticals. Establishing the PBS wasn't easy. And it is now an essential pillar of our healthcare system. Of course, the other pillar of health care in this country is Medicare. That is also a Labor government creation. The Whitlam government introduced universal health care in 1975, known then as Medibank. The Fraser Liberal government made significant changes to it from 1976 and then abolished it in late 1981. It took the Labor Hawke government to reinstate universal healthcare in 1984 as Medicare.

Together, Medicare and the PBS are arguably the best universal healthcare system in the world, and they're certainly the envy of many nations. Universal health care is in Labor's DNA. That's why the Albanese government will continue to protect it, ensuring affordable access to health care for all. Medicare and the PBS go hand in hand. They are both essential to maintaining the good health of Australians.

The PBS remains a cornerstone of our healthcare system. However, it has to be adapted to keep up with modern medicine, community needs and rising living costs. That's why this bill is so important. The PBS provides significant direct assistance of around $13.8 billion each year to make medicines affordable for all Australians. The Albanese government is committed to ensuring that Australians continue to have access to affordable medicines. It's a refreshing change after nine years of neglect from the former government—years of economic and structural neglect that have contributed to the rising costs of living which are placing increasing financial pressure on Australians.

We know that some people are cutting back on essentials like medicines to make ends meet. This bill will help ease that squeeze on household budgets for millions of Australians—many of them, the most vulnerable in our community. The maximum cost to general patients for PBS medications has doubled since the year 2000. The previous government did little to mitigate the rise. For the first time in its 75-year history, the maximum cost of general scripts under the PBS will now fall, thanks to this bill.

This bill amends the National Health Act to reduce the maximum general co-payment under the PBS from the current maximum of $42.50 to just $30. This reduction of $12.50 for each script represents a saving of 29 per cent—almost one-third—for general patients. Around 3.6 million Australians with current prescriptions over $30 will immediately benefit from this Albanese government initiative. The 29 per cent saving doesn't include brand premiums, which are additional charges imposed by manufacturers. However, the optional discount will allow pharmacists to provide a further discount to general patients on those prescriptions with a Commonwealth price between the new co-payment of $30 and the current co-payment of $42.50. The amount paid by the patient will still be counted towards the safety net, ensuring that no Australian is adversely impacted by the changes.

Millions of Australian will be eligible for that saving under this bill, which will put close to $200 million back into the pockets of Australians each year. That means that an individual will save $150 a year for one monthly script or $300 to $450 a year for two to three scripts a month. And what an amazing difference that will make to families who are struggling.

The Australian Bureau of Statistics has said that the high cost of medications meant that around one million Australians delayed filling or didn't fill their prescriptions in 2019 to 2020. That's a worrying statistic, with real life health consequences. Cutting the price of medications by nearly one-third will mean that more people can afford to have the treatments they need to stay healthy without worrying so much about the price.

It's no wonder that, in my electorate of Corangamite, these changes are being enthusiastically welcomed, by both people needing medications and pharmacists dispensing them. Pharmacist Scott Wilkes, of Bannockburn Pharmacy, told me that this bill is a big step to ensuring medicines are affordable and relieving the pressures on vulnerable people in his community. He said that it's becoming more common for customers to cease having their scripts dispensed due to cost-of-living pressures. He related the story of a recent customer who wouldn't fill her own prescription; she only filled those of her children. She had received her monthly power bill and felt she simply couldn't afford to pay for her medication. That is tragic. She went without her medication to ensure a warm house for her kids.

Scott said that, while many elderly people are struggling with the rising costs of living, affordability appears to significantly worsen for those under 65 years of age. That's the age group most likely to have mortgages and children. So it's appropriate that people aged between 18 and 37 years old make up about 27 per cent of the portion of Australians who will immediately receive cheaper medicines. Scott said that the changes in this bill will provide relief for patients and their families who have had to make stark choices between buying essential food, paying for the energy to keep their houses warm and buying essential medicines.

It's no wonder that the National President of the Pharmacy Guild of Australia, Professor Trent Twomey, recently welcomed the changes in this bill and congratulated the government. Professor Twomey said:

Making medicines cheaper would help reduce medicine non-medical adherence, which directly contributes to higher healthcare costs, including preventable hospital admissions and re-admission.

Other peak bodies, including the Australian Patients Association, Chronic Pain Australia and Musculoskeletal Australia have also welcomed the measures in this bill on behalf of their patients. President of Chronic Pain Australia, Ms Fiona Hodson, said recently that the reduction in the co-payment would be welcome news to one in five Australians living with chronic pain. Ms Hodson said that medical affordability remained a key issue for patients as they manage their complex and chronic conditions.

Over the past year or so I have met with many of the local GPs in my electorate to better understand the challenges that they and their patients are experiencing. I spent a whole day in a clinic in my electorate and was told about the struggles that people are having in seeing a GP and in being able to afford their medications. GPs tell me that it is heartbreaking when they write a script for a much-needed medication for a patient knowing that there is little chance that they can afford to have it filled or at least not for the full period they need the medication for. It seems that patients are often deciding to fill a script that might give them immediate relief—for example, pain medication—while not filling a script that actually is very important for their longer-term health. Under this bill, general patients taking expensive medications, such as for the prevention of stroke or for asthma or diabetes, and so many other life-changing medicines will no longer have to choose between their script and household expenses. This bill will help to ensure that they receive the essential medical and pharmaceutical care needed to prevent severe illness and to keep healthy—and that is a great outcome.

But it is not enough to simply introduce these important cost-easing changes; it is essential that the changes are not overtaken by rising living costs. That's why the general patient co-payment will continue to be indexed on 1 January each year. The indexing from 2024 will be calculated off the new general co-payment amount, securing savings for Australian general patients well into the future. The Albanese Labor government will keep the cost of medicines down and help to ease the cost-of-living pressures that Australians are facing now. All Australians should have access to universal and world-class medical care. No-one should have to choose between filling a prescription that their doctor has said is important for their health or providing for their families.

Right now Australians are paying the high price of a decade of government with missed opportunities and drift. This bill will make a real difference to the household budgets for millions of families. The Albanese government is taking action. We are tackling the day-to-day concerns of Australians. We have plans to make medicines cheaper and to make it easier to see a doctor. Millions of Australians will benefit from cheaper medicines from this bill thanks to an Albanese government. Just as for Medicare, it was Labor that built the PBS, and it is Labor which will protect it. This bill will help ensure that all Australians can access affordable medicines when they need them.

6:15 pm

Photo of Kylea TinkKylea Tink (North Sydney, Independent) Share this | | Hansard source

I rise today to speak on behalf of the people of North Sydney on the National Health Amendment (General Co-payment) Bill 2022. As we move into the last quarter of 2022, and with the holiday and festive gifting season rapidly approaching, there is no doubt most Australians are finding it harder to juggle or simply meet living expenses. Whether we're single, coupled or part of a family, we're all experiencing levels of inflation we have not seen since 1990, with economists predicting it will rise yet further to somewhere in the vicinity of 7½ per cent before the year ends. In real terms this means many more people are actively weighing up their purchasing decisions as the price of essential items like fruit and vegetables, bread and cereal and clothing all increase to varying degrees. There are many things driving this inflationary pressure: floods and heavy rainfall in major production areas across New South Wales and Queensland; grain supply shortages prompted by Russia's invasion of Ukraine; higher freighting costs both domestically and internationally; and disrupted production lines due to COVID.

Interestingly, however, one area that has reportedly seen an average consumer price decrease in the nine months to September is medicine. Reports indicate that the price of pharmaceutical products has fallen by 1.1 per cent. This price drop is largely driven by an increasing number of consumers qualifying for subsidies under the Pharmaceutical Benefits Scheme. So while the share that these products are taking up in our ordinary consumer shopping basket is decreasing, the overall cost to us as a society via our government is increasing. Reports indicate that the true average dispensed price—that is, the price of the medication with both the patient co-payment and the government benefit—per prescription of a product on the Pharmaceutical Benefits Scheme increased by five per cent to $70.65 in 2020-21, as opposed to $67.34 in 2019-20.

In this context, then, as the government tabled this bill during our last sitting period I confess I was struck by the quandary that this proposed legislative reform creates for us as a society. While this legislation will reduce the price consumers pay for a medicine listed on the Pharmaceutical Benefits Scheme by around 32 per cent from its current cost of $42.50 down to $30, ultimately the cost differential—the $12.50 that the consumer no longer pays directly—will still be borne by Australian taxpayers as we rightly maintain this parliament's commitment to fund the overall PBS program.

Since the program's expansion in 1960, patients have generally contributed to covering the cost of their medicines by paying a fixed amount of the overall cost. Concession card holders pay less, and rightly so. Overall, once a patient has spent a certain amount on their medicines they can qualify for the PBS safety net, which then sees people pay a lower amount for their medicines, with concession card holders receiving them for free. In the truest sense, then, the amendments proposed in this bill will most benefit those who do not routinely purchase a substantial number of PBS listed medicines a year and who do not qualify for a concession card.

This is when we must recognise the reality that while the price may not be paid up front, it will eventually be covered by the public purse through the tax we pay. The impression of money saved here should not go unchallenged. Make no mistake: I sincerely believe we have one of the best healthcare systems in the world in Australia, and I am a massive advocate of our public health system. Indeed, for most of my adult life over the last 30 years I have worked in one way or another to improve the quality of care that Australians receive when they need medical assistance. In some instances, this has seen me actively work to have life-saving medications added to the Pharmaceutical Benefits Scheme.

Initially established as a limited scheme in 1948, with free medicines for pensioners and a list of just 139 life-saving and disease-preventing medicines provided free of charge for others in need in the community, the Pharmaceutical Benefits Scheme as we know it today is a much-valued provider of timely, reliable and affordable access to necessary medicines for all Australians. For all its strengths, however, the reality is we must ensure we do not lose sight of the public costs associated with operating the Pharmaceutical Benefits Scheme.

Data on the cost of the Pharmaceutical Benefits Scheme in this immediate past financial year does not appear to be available as yet. However, assuming a level of cost consistency, let's look at data from the end of June 2021. Government expense for the supply of medicine for that financial year was nearly $14 billion—or $13.8 billion to be precise. That compares to $12. 6 billion in the previous year. That's an increase of nine per cent in 12 months. At the same time, the overall number of prescriptions written and presented increased by 2.4 per cent to a total of just under 214 million compared to just over 208 million for the prior financial year. There were 906 different medicines across 5,380 brands listed on the Pharmaceutical Benefits Scheme at that time.

While I'm not proposing to vote against this legislation, I am challenging this parliament to address the question: if this cost is not covered by the consumer, where will the required revenue come from? Are the ultimate financial beneficiaries of the investment made in our substantial Pharmaceutical Benefits Scheme—that is, the manufacturers who are benefiting from these purchases—giving back to our society through the payment of appropriate company taxes? What we found when my team investigated this sector was that the way the sector currently works is that it appears that, whilst the total income for the pharmaceutical manufacturers with an Australian business number was just over $29.5 billion, only $2 billion of that income was deemed taxable. That's just under seven per cent. On this income, then, just $420 million in tax was paid. That's $420 million in tax against an expenditure of $14 billion by the Australian government. I'm not an accountant, but something here just doesn't seem to add up.

As I said earlier, I'm not challenging or questioning the value of the Pharmaceutical Benefits Scheme for our society, and I would fight to ensure it is maintained and continues to provide for all Australians as needed. In the current economic circumstance, where research shows us that many are finding it harder to juggle the expense of everyday items like medicines, I support the reduction in the co-payment amount for consumers. But, as a pragmatist and on behalf of the people of North Sydney, I would challenge both this government and our parliament to be clear on how it is that we see this program continuing to be funded into the future. We cannot simply shift costs from one column to another and expect Australians not to notice. As this legislation passes through the House, then, I look forward to seeing what must surely follow in quick succession, and that is greater detail on how this government intends to pursue multinationals to ensure they are, in fact, paying their fair share. I commend the bill to the House.

6:24 pm

Photo of Gordon ReidGordon Reid (Robertson, Australian Labor Party) Share this | | Hansard source

Today it gives me great pleasure to speak on this piece of legislation, the National Health Amendment (General Co-payment) Bill 2022. In my experience as an emergency doctor, medication affordability is an enormous issue that has been plaguing our health services both on the Central Coast and right across Australia for a significant period of time.

There are three words that describe this bill: equity, equality and access—three words that we must strive for not only as a government but as a community. This piece of legislation achieves just this. Millions of Australians, including thousands of people in my home electorate of Robertson, will benefit from reducing the Pharmaceutical Benefits Scheme co-payment from the current maximum of $42.50 per script to a maximum of $30 per script—a discount of $12.50 per script. According to the Australian Institute of Health and Welfare, in 2020-21, 314 million prescriptions were dispensed under the PBS and RPBS, and in total Australian consumers paid $3.2 billion towards PBS and RPBS prescriptions. This is not just a measure that will help ease the cost of living. This is not just a measure that will ensure that those on the Central Coast will have more money in their pocket after visiting the chemist. This measure will save lives. I will repeat that for everyone in the chamber and all those listening at home: this measure will save lives.

To outline the meaning of that, I now take you back to my first speech, which I gave to this 47th Parliament and where I described a particular shift I completed in the emergency department. On that day in the emergency department, people presented for myriad reasons, but one major reason they presented to the emergency department was medication access and affordability. People were presenting to the emergency department because they were unable to afford any of their prescription medications. We are talking about patients with multiple chronic illnesses, with multiple co-morbidities, without any pharmacological intervention, meaning that, due to cost and their ability to meet such costs, they are not taking any of their medication. People have to choose between putting food on the table and filling their scripts. The result is exacerbation of pre-existing illness and people becoming incredibly ill from conditions that can be managed with medication.

People were also found to be rationing medications, meaning people were taking their vital therapeutics for illnesses such as diabetes mellitus, hypertension, hypercholesterolaemia or epilepsy every second or every third day. In these scenarios, these honourable but forced decisions to put the wellbeing of their family and loved ones above their own can have devastating consequences. Manageable conditions like I mentioned earlier—hypertension, epilepsy, hypercholesterolaemia, diabetes mellitus—spiral rapidly out of control, leading to hospital admissions, intensive care or, quite shockingly but real, death.

These are not just scenarios; these are human beings. These are people. These are people's mothers, fathers, grandmothers, grandfathers, brothers, sisters, children, friends, going without and risking their lives. Why? It's because they cannot afford their medications. For those with diabetes, this potentially means uncontrolled hyperglycaemia, numerous microvascular and macrovascular complications or prolonged uncontrolled blood sugar, leading to conditions like blindness or kidney failure. For those with hypertension, high blood pressure or hypercholesterolaemia—high cholesterol—this means a potential cerebrovascular accident, or stroke, or this means an acute myocardial infarction, or a heart attack.

Chronic health conditions not controlled by the consistent medication that they require can rapidly deteriorate into acute presentations requiring immediate intervention, hospitalisation or even worse. This is not something that should be happening in this country. We pride ourselves on being able to care for our most vulnerable, to care for our elderly, to care for our community. Our most vulnerable do not deserve to be punished financially for their vulnerability. They deserve to be supported. Therapeutics are a powerful and essential support. Affordable access to medications is vital for patient health outcomes, vital in avoiding progression of serious illness and vital for sustaining life in so many throughout our community.

Increasing accessibility and affordability of medications has direct benefits not only for the individual, but also by reducing the pressures and the burden on the greater health system. Let us take the example of a patient, a single parent with high blood pressure and high cholesterol. It's a not uncommon scenario. They can afford to either feed their children or travel to the chemist to pay for their medications. They choose their children. Their blood pressure, their hypertension, their hypercholesterolemia—high cholesterol—skyrockets, and they begin to experience chest pain. They call an ambulance. The ambulance arrives, and on scene ECG confirms the patient is having a heart attack. Emergency childcare is organised—another added financial burden for an already struggling family—and the patient is rapidly transported to hospital. A myriad of tests are run in emergency, each with a cost to the health system but a cost that is required to save the patient's life. The patient is transferred to the intensive care unit when there's a bed available. Every hour of waiting is also costing the family in childcare and the health system in resources. They require a surgical procedure to relieve the pressure on their heart and restore adequate blood flow. After a few days in intensive care, the patient stabilises and is transferred to the ward for monitoring.

Upon discharge home, the patient needs more medications as a result; more follow-up appointments with their GP; specialist services with a cardiologist; rehabilitation for deconditioning; and more support at home. These are all additional financial and resource burdens to both the family and the health system right across the country. After all this has happened, the family is now even less likely to be able to afford their medications that they so desperately need.

Put simply, if an individual can afford access to their medications, this means more stable health for that individual, both physical and mental health. Their condition is well-managed and far less likely to acutely deteriorate or exacerbate. This means that they're less likely to require an ambulance. They're less likely to require a bed, tests and resources in the emergency department. They're less likely to take up a scarce bed in the emergency department, the intensive care unit or the hospital ward. They're less likely to need to engage in rehabilitation services. They're less likely to require increased general practitioner appointments and specialist services.

The benefits of this legislation extend well beyond the individual. As I've said before, our overflowing emergency departments, our overflowing hospital wards, our overwhelmed general practitioners, our inundated ambulance services and our national economy all stand to benefit because of this legislation. This piece of legislation is proactive, it is practical and it is sensible, something that has been missing from healthcare legislation for the last decade.

The Albanese Labor government, our government, has committed to reducing the maximum amount Australians pay for their Pharmaceutical Benefits Scheme medicines. That was a commitment we made at the last election, and now we are starting the process to deliver on that commitment. Our communities and vulnerable Australians deserve to be supported. They do not deserve to be punished. Financial barriers should not be preventing the people in my electorate on the Central Coast or people right across Australia from complying with their therapeutic regiment. This financial barrier represents a heavy burden for so many people. One of the reasons that I ran in the 2022 federal election was to ensure that all Australians—in particular, those in the electorate of Robertson—have access to universal and world-class medical care. Our goal is equity, equality, access. The introduction of this bill and the associated changes to the Pharmaceutical Benefits Scheme represent this government's, our government's, commitment and investment into Medicare, they represent our investment into health services and they represent our investment into the wellbeing of the Australian people.

The reduction to the PBS general co-payment of $12.50 means that the maximum Australians, including those in my electorate of Robertson, will pay for PBS medicines drops from $42.50 down to $30. This is a 29 per cent saving. This investment will provide savings to general patients of around $190 million each year. This investment will assist in easing pressures on our health services, this will assist in easing pressures on our hospitals, this investment will assist in easing pressures on the economy and this investment will save lives.

What we've been hearing from the opposition since we came into government in May is: how are we going to help with the cost of living for the Australian people? Seemingly that's been the question of choice at question time. But I don't think the opposition's been listening too well, as every moment of our governance has put the Australian people first. This legislation is simply another measure that we are taking to assist Australians and, in fact, rectify what years of neglect by Liberal Party have had on our cost-of-living pressures. I want you all to hear this now: the Albanese Labor government is putting people first. Not only is this an investment into medication affordability and the health of people across the nation; this is providing cost-of-living relief for millions of Australian families.

6:38 pm

Photo of Bridget ArcherBridget Archer (Bass, Liberal Party) Share this | | Hansard source

It's a pleasure to rise today and speak on the National Health Amendment (General Co-payment) Bill 2022. As we see the cost of petrol, food, rent, mortgages and all other basics rise and rise this year, I'm thankful that there will be some relief on the wallet of Australians with the reduction of the PBS medicines co-payment. On 30 April this year, I joined Professor Trent Twomey from the Pharmacy Guild of Australia and local pharmacist Brad from the local TerryWhite Chemmart in Mowbray to announce our election commitment to cut $10 per script for PBS listed medicines, so I of course welcome this legislation by Labor extending on our initial announcement.

It's important to note the bipartisan support of a reduction in co-payment as the most significant cost action in supporting our community to access PBS listed medications since the scheme began over 60 years ago. I do recognise that the Pharmacy Guild has rallied for adjustments to prescription prices for many years. A few days before the coalition's announcement, Professor Twomey spoke about the impact medication costs were having on the average Australian family, saying:

This is especially affecting middle-income households, with over a quarter … of people who aren't entitled to a concession card struggling to pay for their scripts at the point o f sale.

…   …   …

Some people have been skipping medicines entirely, with 17 per cent saying they have been unable to purchase their medicines.

He also said, if we can't afford the treatment that is prescribed, we're going to add to the pressures on the health system. Whilst welcoming the announcement in northern Tasmania in April, he recognised the difference that this will make to thousands of Australians, saying:

This is a first and very real step towards addressing medicine affordability, helping our patients paycheck to paycheck at the cash register.

The CEO of the Australian Patients Association, Stephen Mason, also welcomed the bipartisan support for a reduction in costs of accessing PBS medication, saying that the issue of affordability of prescription medicines is an ongoing concern for many Australians. He said:

Our research has found that almost 36 per cent of people believe that prescription medication is too expensive and 20 per cent of people say it's outside of their regular budget.

For thousands of northern Tasmanians taking common medications, including for blood pressure, high cholesterol, pain relief, depression, diabetes and more, this cost saving at the counter will make a demonstrable difference to their budget, particularly those who are spending hundreds of dollars a month on necessary medications.

Nobody should be forced to choose between taking life-saving medication and putting food on the table. I've heard firsthand from pharmacists of seeing patients come in and weighing up which medicine they can afford to buy that week or month and, rather than buying all the necessary medications, they're making choices over what they can possibly purchase to get by, including, for example, asthmatics, who are choosing reliever medication as it's cheaper than preventative medication. As parliamentarians, we should look at taking any reasonable steps necessary to prevent this situation, and this legislation is a step in the right direction.

As proud as I am of my island state, we are unfortunately overrepresented in chronic disease for a number of reasons, but due in large part to our ageing population. Compared to mainland Australia, Tasmania has a higher proportion of people over the age of 45 years and a smaller population of younger people than nationally. Tasmania also has the oldest population nationally. In 2016, Tasmania's median age was 42, compared with the national figure of 38—and it is well documented that chronic diseases increase with age.

A Tasmanian health report in 2018 on chronic disease estimated that the proportion of Tasmanians aged 65 and over is expected to grow from around 19.5 per cent in 2016 to 27 per cent by 2056. Unsurprisingly, this will have profound implications for our healthcare system, a number of which are already being experienced, with our number of diabetes, heart disease and strokes amongst the highest nationally. Further, with an ageing population and people living longer, cancers are becoming more prevalent and are now overtaking all other conditions as a leading cause of disease burden. In Tasmania, this translates to a significantly greater healthcare burden for the community than is generally appreciated.

The report also noted that arthritis was the most frequently reported diagnosed chronic illness by Tasmanians aged 60 years, with more than one in two Tasmanians reporting being diagnosed with arthritis. The second most common was cataracts at just over 28 per cent, followed by depression and anxiety at 19.1 per cent. Asthma was reported by 17.1 per cent of that 60-and-over age group, with 13.8 per cent being diagnosed with diabetes. Of course, we know that these health conditions are not exclusive to older Tasmanians, with many younger Tasmanians living with the same conditions and also, of course, paying for those medications. Thankfully, a number of medications to help with these conditions are listed on the PBS, which will now see a reduction from $42.50 per script to $30 per script.

It takes a community of dedicated health professionals to diagnose, treat and manage an individual's health or sometimes many health conditions, and it's important to recognise the role that general practitioners pay in ensuring the best outcomes for their patients. However, with the provision of the PBS run through pharmacies, I wanted to use this opportunity to highlight the work of community pharmacies, particularly in light of World Pharmacists Day this past Sunday, 25 September. This year's theme was 'Pharmacy united in action for a healthier world', publicly recognising the vital role that pharmacists play in caring for patients. From Brad in Mowbray, Rhys in Summerhill, Ivo and Helen in Riverside and Dianne in Ravenswood, to name a few, I know of the dedication and care that local pharmacists, all across northern Tasmania, have for their patients.

It's estimated that there are more than 14 visits to a community pharmacy per year for each man, woman and child in Australia, and the stronger the patient-pharmacist relationship, the better the health outcomes that can be expected. Pharmacists are the custodians of the PBS and play a vital role in the primary health care of all Australians. Community pharmacists are medicine experts, providing professional advice and counselling on medications, including their use and effects, as well as general health care. Their services are highly accessible, and, in the vast majority of cases, their services are offered to consumers without the need to make an appointment. Regardless of where they live, all Australians have the same access to PBS medicines within 72 hours at no financial disadvantage. And, of course, we have seen the role that pharmacies have played as they join general practitioners and community clinics in administering COVID-19 vaccines over the past 12 months, which is also to be applauded.

I have a few more facts on the strength of community pharmacies. We should be proud of our world-class standards. The majority of pharmacies, currently over 90 per cent, are accredited by a quality assurance framework called the Quality Care Pharmacy Program. The Australian community pharmacy workforce is made up of around 60,000 people, including pharmacists, interns, specially trained dispensary technicians and pharmacy assistants. Community pharmacy is a more than 15-billion-dollar health industry, including more than $10 billion in prescription sales per year, and community pharmacies dispense more than 30 million prescriptions annually, with the average community pharmacy dispensing 54,482 prescriptions per year.

The coalition remains committed to ensuring Australians have access to affordable medicines when they need them, and we have a strong record of providing Australians with timely, affordable access to effective medicines, cancer treatments and services. When we were in government, we listed more than 2,800 new and amended medicines on the PBS, representing an average of around 30 listings per month—medications such as Orkambi, which has been found to reduce the need for hospital visits, some daily medications and physiotherapy for cystic fibrosis patients. Prior to being placed on the PBS in 2018, the life-saving drug was cost prohibitive to most patients, costing up to $250,000 a year. With over 100 cystic fibrosis patients in Tasmania, around 40 young Tasmanians, including northern Tasmania's Luke Emery and Hobart's Jack Dyson, are benefiting from this medication and paying a maximum of $39.50 per script.

Earlier this year, former health minister Greg Hunt proudly announced one of the final treatments to be listed under the PBS under his watch: Trikafta, a groundbreaking drug described by the CF community as life changing and life saving. At the cost of almost $21,000, some families were re-mortgaging their homes to access the medication. Once listed on the PBS, and with the implementation of this bill, the payment will come down to just over $30 a month. And I can only imagine the pure relief and joy that the accessibility of this medication is bringing to so many cystic fibrosis patients across the country.

In addition to Trikafta, the 2022-23 federal budget also included the new PBS listing for Trodelvy, for the treatment of triple-negative breast cancer, giving around 800 Australians precious time with loved ones and saving them up to $80,000 a treatment. The drug has shown reductions in tumours in 30 per cent of women taking it, giving them up to an extra 12 months to live. The success of the listing on the PBS came after 18 months of campaigning by the Breast Cancer Network Australia, who advocated for the medicine to put metastatic breast cancer on the radar and, according to BCNA head of policy and advocacy, Vicki Durston, to also give patients 'one last roll of the dice'. Ms Durston went on to describe the listing of Trodelvy as a significant milestone, highlighting the fact that triple-negative breast cancer is an aggressive form. There are limited options for what these patients can receive, and they have very poor clinical outcomes. We can't underestimate the financial relief this will bring to so many patients and their families, but it is the extra time they will gain to spend with those they love which is utterly priceless.

Reducing the PBS medicines co-payment at a time of ever-increasing cost-of-living pressures is a step in the right direction in supporting hardworking Australians. I support this legislation and I look forward to hearing what other steps the federal government will be taking to bring additional cost-of-living measures relief to our communities.

It is important to note that this does not take effect immediately and, along with other measures that the Labor government has been saying will help address the cost of living, it is somewhat down the road. I reiterate that it's important to note that Australians are suffering from financial stress right now. Whilst these measures will go a long way to help, assist and support with the cost of living, they are down the road and we need to turn our mind to the issues Australians are facing right now.

6:50 pm

Photo of Kate ThwaitesKate Thwaites (Jagajaga, Australian Labor Party) Share this | | Hansard source

I am so pleased to be speaking today in support of the National Health Amendment (General Co-payment) Bill 2022, which delivers on one of our government's very important election commitments. It has been a huge day for this government delivering on election commitments. We've had introduced today legislation for cheaper child care—thank you, Minister Aly. We have had our legislation for a national anticorruption commission introduced today. In fact, we've also had our legislation for the respect at work amendments, which will really make Australian workplaces safer places for women. And now we have this legislation around making medicines cheaper for Australians.

All of these are really important reforms that directly affect the lives of people in our communities, because that is what this government is about. We are about introducing changes that make this country a better place and that directly affect lives. I have to reflect that that was certainly not my experience during the three years I spent sitting on the other side of this chamber. In fact, we came into this chamber for bills that were really about presenting a political wedge. They were not about things that impact people's lives. As I said, I am so proud to be standing here today to talk about this important piece of legislation, delivering on our election commitment and, importantly, really making a difference to the lives of people in my community and to communities right across Australia.

Of course there are challenges that communities across Australia are facing at the moment. As the federal government it is for us to do the best we can to support people and to make sure that we are making their lives easier where we can. I do know that this bill will make a difference in the lives of people in my community. Whether you are in postcode 3081, 3087 or 3088, or in Jagajaga, I know you're facing cost-of-living pressures. I know that this bill, which makes medicine cheaper, will make a real difference in your life.

Put simply: this bill is about making medicines cheaper. It's part of our plan for strengthening Medicare and strengthening the Pharmaceutical Benefits Scheme. In the last few years we've seen cost-of-living pressures continue to impact across our country. I have had many people in my community, particularly older people when it comes to the cost of medicines, come to me and talk about how day by day, week by week these costs are adding up and they hadn't felt prior to the last election that they had a government that understood and was taking action on cost-of-living pressures.

We know that, when people are facing cost-of-living pressures in these areas, sometimes spending on medicines can be one of the areas that go. That, of course, should not be the case in a country like ours. People should not be facing difficulties getting access to affordable medicines. While there's no single fix to cost-of-living pressures, our government is doing a bit that will make a difference to people's lives and deliver some relief. They will get the support. It will help make a difference to those day-by-day, week-by-week budgets and pressures.

Through our government's reduction to the PBS general co-payment we will be putting more money back into the pockets of Australians. This is the first time in the 75-year history of the PBS that the maximum cost of general scripts will fall. Under this bill the cost of scripts is being cut by 29 per cent, with the maximum cost to drop by $12.50, dropping the price overall to $30. So, for someone—say, a parent or a grandparent—in my community who might be filling one script a month, this means they could save $150 a year. For a family in my community who might be filling three scripts a month, this change means that every year they could save $450. That is a substantial difference.

By cutting the price of medications by nearly one-third, we're ensuring that more people can afford to get the medications they need to stay healthy, without having to worry so much about the price. Of course, we know that, in addition to the cost pressure, there is that worry pressure for people around how to make sure that they and their families stay healthy. We do want to reduce that burden as well as the cost pressure—because medicines aren't an optional extra; they're essential, and they shouldn't be the things that people are cutting from their budget.

Since 2000, the price Australians have paid for prescription medications has doubled, which is putting more and more pressure on those who are filling their scripts every month. Under this measure, our government is helping to address this by putting close to $200 million back in the pockets of Australians each year. This change will benefit about 19 million Australians, and 3.6 million Australians will immediately benefit when these changes come into effect from the start of 2023.

As the minister highlighted in his contribution to this debate, the PBS has a long history. And it's a proud Labor history. It was due to the hard work of two Labor giants, John Curtin and Ben Chifley, that the PBS was introduced in the 1940s—despite pushback from others of the time, including the Liberals. So I can assure those in my community and beyond: under our government, the PBS will continue to be supported. We are committed to seeing the PBS work as well as it can and to providing it as an avenue for people to access medicines at an affordable price.

We do know that, as I said, making medicines cheaper needs to be just one part of our plan to reduce the cost of living—and, again, I point to the cheaper childcare reforms that our government brought in this morning. This is another significant cost that families face, and it's a cost that, again, has really significant costs if people are cutting back on childcare through being unable to afford to access it. So there's absolutely more for us to do, and we are getting on with it.

There is, of course, more for us to do in health. Before the pandemic, we knew there was work to do to make our country's health systems the best they could be, and, post pandemic, that has obviously been reinforced. It is going to take hard work from our government, and from governments and service providers across the country, to make sure that Australia's health system is as robust and as strong as it should be, so that it provides the care that all of our communities rightly expect. Our government is taking the challenges in our health sector seriously. Beyond this bill, it is an area that we are focused on and will continue to focus on.

I recognise that, in my home state of Victoria, there are significant commitments also being made by our state government, which shares that focus on supporting the health sector and the workers who keep it going every day. My electorate is home to a sizeable medical precinct, with the wonderful Austin Hospital, the wonderful Mercy hospital, Warringah Private Hospital—we are very fortunate to have some wonderful health care locally. And, because of that, we also have wonderful health workers—doctors, nurses, administrative staff, cleaners and many others—who either call Jagajaga home or work in my electorate. I do want to take this opportunity, while I'm talking about our health system and how we can make it as strong as possible, to once again thank all of those workers for the extraordinary work that they have done throughout the pandemic and continue to do today.

We have, in my electorate, recently seen a fantastic commitment from the Andrews Labor government. It will upgrade the emergency department at the Austin. That reinforces once again that it is Labor governments, at both state and federal levels, that deliver on health.

We know that, when the cost of medicines is too high, we see situations where people feel that they have to make an impossible choice between getting the healthcare they need, providing for their family or in fact putting their health at risk. My colleague the member for Robertson did a wonderful job of explaining the very real consequences of that, which he has seen in his work as a health professional. I'm sure we'll hear from the member for Kooyong about her perspective, as a health professional, on that. And we certainly benefit in this place from having so many people with direct experience here.

According to the ABS, in the 2019-20 period there were close to one million Australians who delayed getting a prescription filled or who didn't get it filled at all because of costs. That's a situation our government doesn't want to see anyone having to face, for them or a family member or a friend. We also know from recent data that nearly two in three Australians have been provided with at least one PBS medicine. So it's clear the PBS is well utilised and is a benefit to our overall health system. It's something that people do rely on. As people age, or for people with a disability or experiencing health conditions, there is an increased likelihood that they will need to be supplied with medicines. If you are not personally someone who receives medicines on the PBS, you would, of course, have friends or family members who do. For people who need multiple medications, the situation with prices has meant that they've had to decide between medication for immediate relief of pain or other symptoms or medication that will support improvements to their long-term health. In the cases where this choice has come up for people, it's understandable that they have chosen to look at that short-term fix, potentially exacerbating long-term conditions. This is not a situation that we want people to be facing. It's not good for them or our wider communities.

Every Australian should be able to access world-class, universal medical care. It is one of the things that I think really sets our country apart from others, that in our community people know that if they need care they will get it and they will get it at an affordable price. It shouldn't send them to situations where they feel they are making unacceptable choices or facing unacceptable levels of debt or cost pressures. So by making medicines cheaper we are supporting some of the fundamentals of our health system and we are helping to address the cost of living pressures that I know many in my community and other communities are experiencing at the moment.

Importantly, no patient will be worse off under these changes. Pharmacies can still offer optional discounts in situations where the Commonwealth price is between the new and current co-payment amount. The savings this will deliver for Australian will continue over coming years. The general patient co-payment will continue to be indexed each year. From the start of 2024 it will be calculated off the new co-payment amount.

This bill before us will make a real difference to people and families in my community and to communities across the country. It will make a real difference to household budgets and it will help to relieve cost of living pressures. It is just one of the many ways our government is taking action to deliver on our election commitments and to respond to the needs of Australians. We're not wasting time. We're getting on with it because we know that people are looking to us for reforms that make their lives easier, that make this a better country for all of us. We are making medicines cheaper, and more broadly we will be making it easier for people to see a doctor and access a world-class system.

Labor's record in this space speaks for itself. We built Medicare and we will always protect Medicare and do the work needed to make sure that it continues as one of the fundamental underpinnings of our health system—the system that people know means they can see a doctor and do so in an affordable way when they need care. We built the PBS and we will always protect it, as I have explained. We know that people have been facing really difficult choices when it comes to the cost of medicine and making those decisions around their household budgets and whether they are deciding to take, perhaps, all the medicines that have been recommended for them. We have heard as part of this debate conversations that people have been having with doctors or pharmacists: 'Do I really need this one this month? Can I choose to just take this one this week?' Because they weren't sure that they would be able to afford all that had been prescribed for them.

That is absolutely no way to run our country's health system. That is not a choice that Australians should be facing. It is a choice that our government is trying to make sure no-one will face, so that families will know they can afford the medicine for their children, and older people will know that when they have complex needs they will be able to afford all the medicines they have been prescribed. That's what this bill is about. It is about making sure that we have a health system that delivers now for our country and our communities, but it's also about making sure that we have a health system that is built to deliver into the future and that makes sure that people in this country know that they have affordable access to life-saving medicines. I commend this bill to the House.

7:05 pm

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

7:20 pm

Photo of Ged KearneyGed Kearney (Cooper, Australian Labor Party, Assistant Minister for Health and Aged Care) Share this | | Hansard source

I rise to support the National Health Amendment (General Co-payment) Bill 2022, and it is my great pleasure to stand in support of this legislation today. It's a bill that we know will have a real, tangible impact on people's health and their hip pocket. The bill will implement our election commitment to reduce the Pharmaceutical Benefits Scheme general patient co-payment by $12.50, by amending the National Health Act 1953.

From 1 January 2023 the current co-payment of $42.50 will be reduced to $30. This is the first time the PBS co-payment has been reduced by any government. We went to the election with a plan to create a better future for all Australians, and, with the rising cost of living that's hitting Australians at the moment, this bill will deliver on that commitment and give much needed cost-of-living relief. Delivering a stronger, fairer Medicare system will mean a better deal for all Australians and will mean better health care.

Coming out of the recent census, the ABS have reported some disturbing statistics about the social determinants of health. We know that a postcode can actually determine your life expectancy. This is shocking for a wealthy country like Australia. There can be up to, in some parts of this country, a 30-year difference on your life expectancy depending on where you live. This is unacceptable. It's policies like this, universal access to health care and decreasing the cost of medicines across the board, that could indeed go a long way to helping that gap close.

My partner has multiple health issues. He spends a lot of money on medications every month. I tell him it costs our family a fortune to keep him alive, but it's a good thing. That's because we can afford that. I have a good income; he has a good income. We know that he can afford those pills and will get that medication. But there's no question that many Australians are doing it tough and may not be able to afford it like I can, like he can. Their health loses out because of it. They sacrifice their health because they can't afford it.

It's issues like this that contribute to that shocking statistic about the social determinants of health care. I've heard from my constituents, in my electorate of Cooper, and people from right across Australia about how hard it is right now, how the cost of living is hitting their family budgets. I'm proud to be part of a government that is taking this incredibly seriously.

I'm proud to be part of a government that thinks health care should be universal, that where you live shouldn't determine whether or not you can afford to see a doctor or buy the medications you need, that where you live shouldn't determine what your life expectancy is. I'm proud to be part of a government that is taking this incredibly seriously. From our Jobs and Skills Summit and the actions that have come from it—a strong push to get people trained and into work to make sure that anybody who wants a job can get a job—to an increase in the minimum wage which will ensure our lowest paid workers get a pay rise, from our decision to back the Fair Work Commission in giving a pay rise to everybody on the minimum wage or in aged care, to making child care cheaper, to ensuring that people can get cleaner, cheaper energy, we know there's more to be done.

That's what Labor governments do, and I'm proud to speak in support of this bill today. It will make a substantial difference to household budgets and the long-term health of Australians. In 75 years, the Pharmaceutical Benefits Scheme has not seen a cut of this size in the cost of medicines. From establishing Medicare to introducing the NDIS, Labor governments have delivered on health for all Australians for decades. Nineteen million Australians will be eligible to benefit from the savings created from this bill. That's $190 million each year that will be saved by patients.

Under this legislation, the maximum cost of scripts will be brought down from $42.50 to $30. That's a reduction of almost 30 per cent. That is significant to a family on the minimum wage. There are 3.6 million Australians with current prescriptions over $30 who will immediately save on medical scripts. That's 14 per cent of the population—from our kids to our elderly Australians—who are looking at a real change to cost-of-living pressures as a result of this bill.

It's vital that they receive this support, because we know that right now there are individuals and families who are choosing between filling a script for a medicine they need or putting food on the table, and taking daily medications—medications that have been prescribed to be taken daily—only every other day thinking that they are saving costs by doing that, when actually they are making sure that the medication is not having the effect that it should.

Let's not forget that we are the country of Medicare. We are the country of universal health care, yet this is a reality facing so many Australians right now. Australians haven't just magically found themselves in a situation where it has become harder and more expensive to see a doctor or more expensive to pay for medicines or to stay healthy. This is the result of a decade of neglect and negligence by the former government. They failed abysmally when it came to dealing with the issues facing our economy and our health system, and Australians are paying the price for their inaction, quite literally.

When the costs of medicines and medical treatment are prohibitive, when everyday people can't afford the treatments they need to live full lives, there are really serious consequences. It's led us to a situation where we know that individuals are desperately trying to negotiate which medication they can go without that month, that week or that day. We have heard some compelling arguments from other members of this House today about how that is affecting their constituents, the people that they deal with on a daily basis that they see. I see the member for Kooyong is about to make a presentation. I'm sure she would know firsthand the impact that this could have on her patients.

The Australian Bureau of Statistics has told us that 900,000 Australians delayed or didn't get a script filled in 2019-20. That means that they are choosing to go without medicines that a doctor has prescribed for their health, that a doctor said is important and necessary for them to achieve or maintain good health. We have talked to people and industry leaders about this issue for a long time, and we have consulted with key pharmacy stakeholders, who have shared it's like on the ground with patients. From my time as a nurse, hearing these stories is heartbreaking. I've seen up close the risks of going without crucial preventative medicines and the impact on people's long-term health. This is serious; this is about risking people's lives No-one should put in that situation.

So, as we embark on the important task of reforming our health system, I'm proud to support this bill, which will help people avoid ever having to make that awful choice. It will mean that parents and carers will not have to skip out on essentials that month so that their kids with asthma have their puffer. It means that John, who takes the drug Apixaban to reduce his risk of stroke can afford to keep scripts filled. This is a life-saving medication. It is an anti-coagulant medication which lowers the risk of life-threatening blood clots that can lead to stroke. It is listed on the PBS and it currently $42.50 a script. John has been prescribed the recommended dose of five milligrams twice daily, which means he needs 26 prescriptions a year. That is a cost of $1,105 a year that John has to find in his budget or risk going without.

And John is not alone. Approximately one million Apixaban prescriptions are dispensed every year. With a reduction to the patient co-payment, John and thousands like him will now save $325 a year on this life-saving medication. That's a massive saving, and it's one that will make it much easier for people like John to be sure they can afford the medicines that they need. So it's not just support with the cost of living that this bill delivers; it also delivers greater access to healthcare and a healthier life, the ability to avoid serious illness and the ability to keep your family healthy. In cases like John's, it delivers the ability to avoid life-threatening illnesses. This is an incredibly powerful reform. As a nurse, I know how difficult it can be for people to manage the health needs of themselves or their loved ones. It's complex and often tiring and stressful to navigate managing your health—

Debate interrupted.