House debates

Wednesday, 28 September 2022


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

4:16 pm

Photo of Zali SteggallZali Steggall (Warringah, Independent) Share this | | Hansard source

I rise to speak in support of the National Health Amendment (General Co-payment) Bill 2022. I welcome the measures on behalf of the people of Warringah. These measures are intended to ease in a small way the cost of living crisis that affects so many Australians. I have to say that I was shocked and disappointed to learn the extent to which people have been impacted by the cost of the current general co-payment. When we are provided with the numbers, it is quite staggering to understand the extent to which it has had an impact.

Easy access to healthcare should be a right afforded to all in Australia. Unfortunately, it's clear that the current co-payment of $42.50 per script has been too expensive for a large segment of our population. Reducing the maximum co-payment to a capped $30 per script will be a welcome relief to many people.

According to the Australian Bureau of Statistics, some 900,000 Australians either delayed purchasing medication or missed script refills altogether between 2019 and 2020 due to the prohibitive costs of medicines on the PBS. That's a shocking number. It's unacceptable that any Australian should be forced to forego regular health care due to costs. It's not the Australia that we aspire to or the goal of legislation in this place.

So I welcome the 29 per cent saving on PBS medicine costs that will benefit Australians and help to ease some of the cost of living strains currently experienced. We must remember that patients are often prescribed multiple concurrent scripts at a time. Some one in five Australians live with chronic conditions that require perpetual treatment. While we are incredibly lucky to have subsidised health care in Australia, the cost of the general co-payment, when applied to each script, can add up very quickly. It can be a substantial cost to individuals to keep themselves and their families healthy. We should not and cannot allow health care to be unaffordable even under a subsidised scheme. If passed—and I sincerely hope it will be, as this should have the bipartisan support of everyone in this place—the bill will positively impact approximately 19 million Australians, who will be eligible for savings when accessing medicines on the Pharmaceutical Benefits Scheme. The savings to individuals will be substantial, with those filling a single monthly script estimated to save nearly $150 per year. For those filling multiple scripts each month, the savings will continue to increase accordingly.

I support the bill, and I urge the government to ensure that access to medications is not compromised with a more affordable cost. We must ensure supply always meets demand, and we may see a sharp increase in uptake. I certainly hope that there's been preparation for this. I seek the government's assurance that the co-payment reduction is the most efficient way to improve affordability to PBS medication. Affordable access to health care needs to be the core goal of the amendment, with the benefits being afforded directly to the Australian public.

In Warringah, constituents seek my help to combat cost-of-living pressures. Many are doing it tough. It's expected that things will get worse. We need to appease cost-of-living pressures. I certainly hope there will be more announcements from the government in the upcoming budget. But, in the meantime, I believe this bill seeks to do this in part and is a good first step. The government needs to implement this correctly and thoughtfully to ensure access and quality is not compromised at any stage, of course. It's not a luxury to have access to quality health care. It always must be ensured. As federal representatives in this place, we must implement reasonable improvements to access and affordability to health care. I'm aware there are many more things that need to be addressed and changed, but I welcome this initial step. I commend the bill to the House.

4:21 pm

Photo of Zoe McKenzieZoe McKenzie (Flinders, Liberal Party) Share this | | Hansard source

I rise to speak to this bill, the National Health Amendment (General Co-payment) Bill 2022. While this is a government bill, like most good public policy in this place, it follows the former coalition government's lead in a commitment made in April of this year to reduce the PBS general patient charge by $10. This was the single most significant change to the cost of and access to medications since the PBS was introduced more than 70 years ago. The coalition has a strong record of providing Australians with timely, affordable access to effective medicines, cancer treatments and services. In this respect, I acknowledge the unequalled work of my predecessor, Greg Hunt, who, as health minister between 2017 and 2022, was the best friend of those who rely on Australia's Pharmaceutical Benefits Scheme.

During the time of the previous government, more than 2,900 new or amended listings on the PBS were made at an overall investment of around $16½ billion. By listing these medicines on the PBS, the coalition ensured Australians can have access to affordable, life-saving medications that would otherwise cost thousands or hundreds of thousands of dollars without any subsidy. This took medicines which were out of the reach of almost every Australian, costing hundreds and thousands of dollars, and made them accessible for less than $6.80 with a concession card. Some of the final listings of the previous government under the then Minister for Health, my predecessor in the great electorate of Flinders, Greg Hunt, were life-altering medications. Zolgensma is for the treatment of spinal muscular atrophy in children less than nine months old. This treatment serves approximately 20 patients each year, but before subsidy it would have cost $2.5 million per treatment. Now, it's less than $6.80 with a concession card. Then there was Trodelvy, for the treatment of triple negative breast cancer, which now saves an average of 580 patients a year $80,000 per course of treatment.

In my first speech in this place on Monday, I discussed the loss of my mothercraft nurse, Molly, to melanoma in 2015, a cancer I myself had developed but survived a few years earlier. In just that time, since 2015 to now, the changes made to the PBS by the former government mean melanoma is now a manageable form of cancer for many, if not most. In March 2020, the coalition government expanded the PBS listing of Opdivo for advanced melanoma. Opdivo is a breakthrough immunotherapy drug which helps the body's own immune system to find, attack and destroy cancer cells. Without that PBS expansion, around 1,500 patients a year would have had to pay more than $100,000 per course. I know better than most that these listings change lives.

The coalition remains absolutely committed to ensuring Australians have access to affordable medicines when they need them. Of course, while this copying of coalition policy is most welcome, we on this side do know what Labor's record has been on the PBS in the past. In the 2011 budget, the then government deferred the listing of products on the PBS 'until fiscal circumstances permit'. For those who question this, I can help you with your homework: it can be found in the 2011-12 budget papers, section 2, departmental outcomes, under part 2, 'access to pharmaceutical services'. In layman's terms, the Labor government stopped listing medicines. This included medicines for endometriosis and IVF, schizophrenia, prostate conditions, chronic obstructive pulmonary disease and asthma. In addition, in 2011, Labor's then Minister for Health and Ageing, Nicola Roxon, put out a media release which stated: 'The government has also considered a number of other medicines, such as medicines for conditions where existing treatments are already available on the PBS, but has decided to defer listing of these medicines at the current time. These medicines will be reconsidered for listing when circumstances permit.'

In announcing this legislation, the Albanese government highlighted the reduction as a cost-of-living relief measure. However, it does not take effect until next year. While the opposition supports reducing the cost of medicines, we note that it does not kick in until January and that this is the only cost-of-living relief measure the Albanese government has announced and implemented so far. Australians need help now. The government must outline what actions they are taking to alleviate the significant cost-of-living pressures families are experiencing across Australia.

We support Labor's announcement to reduce the maximum general co-payment for medicines on the PBS, noting its copycat nature, made after our own election commitment to reduce the co-payment back to 2008 levels. Given Labor's record of failing to list medicines on the PBS, we will be watching them carefully when it comes to this extremely important part of our healthcare system. The coalition will continue to hold Labor to account for its promises to the Australian people and advocate to make medicines cheaper for Australians.

4:27 pm

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

Over the last two days, the House of Representatives has debated legislation to introduce the biggest cut to the cost of medicines for Australian households in the 75-year history of the Pharmaceutical Benefits Scheme, a cut for general patients of almost 30 per cent of the maximum cost of their scripts, from $42.50 to just $30. It was a Labor government that first introduced the legislation to make life-saving drugs more affordable, and the Albanese government remains committed to ensuring that the PBS continues to enable Australians' access to affordable medicines.

After almost a decade of Liberal neglect, the costs of living are soaring, with many Australians cutting back on essentials to make ends meet. They're being forced to choose between filling prescriptions for potentially life-saving medicines and providing for their families. The National Health Amendment (General Co-payment) Bill 2022 amends the National Health Act 1953 to reduce the maximum general patient co-payment under the PBS from the current maximum of $42.50 to $30. From 1 January 2023, around 3.6 million Australians with current prescriptions over $30 will benefit through this Albanese government initiative. People filling a prescription for one medication per month will save around $150 a year, while a family filling prescriptions for two or three medications per month could save $300 to $450 per year. The bill will ease the cost-of-living pressures that Australian households are experiencing around the country.

This bill will also have a profound benefit for public health. There's no doubt that all Australians place great value on the medicines and essential health care the PBS provides. All Australians deserve access to universal, prompt and world-class medical care. As the member for Robertson reminded us through his contribution to this debate, the essence of this bill can be captured in three words: equity, equality and access. The Australian Bureau of Statistics has told us that as many as 900,000 Australians every single year are choosing to go without medicines that their doctors have prescribed for their health—medicines that their doctors have said are important for the maintenance of their good health. Pharmacist after pharmacist has told stories of their customers coming into their pharmacy, putting a number of scripts on the counter and asking for advice about which ones they can go without because they can't afford to fill all of the scripts that the doctor has said is important to their health.

Members contributing to this debate have highlighted the positive reactions they have received from their local communities in support of this bill and have recounted many community interactions which highlight the direct and significant impact the passage of this bill will have on individuals and families right across Australia. We heard from my good colleague the member for Dobell right here that, as a pharmacist, she has seen firsthand patients who have walked into her pharmacy after a medical appointment, handed her a bunch of prescriptions for their family and asked which medications they could skip or avoid. She spoke yesterday about a mother who asked her if her two children could share a bottle of antibiotic mixture because she couldn't afford to purchase two.

We heard from the member for Corangamite, who related the experience of a local pharmacist who's working every day with people in the community who can't afford their prescription medicines. Some of these people come with chronic illness and are forgoing their own health needs in order to pay for necessary medications for their children or to pay for food or power bills. We heard from the member for Robertson, who saw patients present at his emergency department because they were unable to afford any of their prescription medicines.

We know this policy will make a difference because Australians are telling us it will. This bill will ensure patients receive the essential medical care needed to prevent serious illness and stay healthy. It will also allow Australians to shop around to get the best price for their medicines. The bill will ensure that no Australian will be worse off under this change by including provisions to allow pharmacies to continue offering discounts at current levels to their customers.

Right now, Australians are paying the price for a decade of missed opportunities and drift. Through this bill, we will make a real difference to household budgets for millions of families but also to people's health. Just like with Medicare, it was Labor that built the PBS, and Labor will always protect it so that all Australians can access affordable medicines when they need them. I thank all members for their contributions to the debate on this bill.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.