House debates

Monday, 22 May 2023

Private Members' Business

Albanese Government: Health Care

7:08 pm

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

I move:

That this House:

(1) notes the Government is easing cost-of-living pressures and making hundreds of common medicines cheaper by allowing millions of Australians to buy two months' worth of medicine for the price of a single prescription;

(2) acknowledges that for at least 6 million Australians, this will:

(a) halve their medicine costs;

(b) require fewer visits to the general practitioner and pharmacist;

(c) save Australians more than $1.6 billion over four years;

(3) further notes that this policy comes after the Government's policy to reduce the Pharmaceutical Benefits Scheme general co-payment from $42.50 to $30, which has saved Australians more than $58 million on 5.1 million prescriptions in the first three months of the laws coming into effect; and

(4) commends the Government for its commitment to make responsible and targeted cost-of-living relief.

The Albanese Labor government is easing the cost of living and taking the pressure off people living on the Central Coast. Our budget has been carefully calibrated and targeted to ensure relief is provided to those who most need it while not adding to inflation.

On the Central Coast, Medicare and health are the key issues that constituents call us about. In our budget, Medicare and health were centrepieces, because it is the health of the community that is paramount. As a doctor and as someone who is very passionate about the health care of Australians and the people in our electorate, I am very happy to see this as a focus. In my practice as a doctor and in my service as a parliamentarian, the patient must and will always come first. Our government endeavours to put patients first and to make health care and medications cheaper and easier to access. I have seen first-hand the impact of people not being able to afford health care and not being able to afford their medication.

I note the significant changes to how medicines are dispensed at pharmacies across the nation have now been announced by the health minister, the honourable Mark Butler. From September 1, eligible patients with a Medicare card or with a concession card will be able to be prescribed with 60 days' worth of medicine after consultation with their doctor. This change will mean six million Australians will halve their medicine costs and need fewer visits to the GP and fewer visits to the pharmacist. In Robertson, almost 42,000 people will benefit from our cheaper medicines.

The changes were recommended by the pharmaceutical benefits advisory committee in 2018. However, the former Liberal government did not act to implement any measures to improve access to health care or access to medication. It is unsurprising that, from the former Liberal government, the member for Riverina, a government that cared little for the health care of Australians. As we saw too often from the previous government, they were more occupied with pork barrelling taxpayer funds for projects that were never built. We also have an opposition leader who once proposed healthcare tax and who oversaw a massive period of neglect of our healthcare system while he was the health minister—attacks on Australians accessing health care, a leap back to the days when health care was unaffordable, a leap back to when it was unable to be accessed by the masses, leading to excessive and unnecessary morbidity and, even worse, mortality.

Importantly, the changes announced in this budget to make medicines cheaper are what other countries already have in place. Examples include New Zealand, Canada, France, where patients have access to multiple-month medications on a prescription. These changes will ensure Australians can purchase two months' worth of medicines on a single script. An aspect of this policy that I want to highlight for the people of the Central Coast is that our veteran community will benefit from this change.

The Albanese government has a proud record of making medicines cheaper for all Australians. On January 1, for the first time in the 75-year history of the PBS, the general co-payment was reduced from $42.50 down to $30. In the first three months, 5.1 million prescriptions have been cheaper, saving more than $58 million. In Robertson, that is $384,102 saved because of the Albanese government's cheaper medicines changes that started this year. On top of the government's cheaper medicines policy, our record $3.5 billion investment into Medicare means more people will be able to access a doctor, because Labor is the party of Medicare.

I make this commitment that I will continue to work with all stakeholders in the healthcare space because that is what is required. When these changes were first announced, I was the first federal MP to meet with local pharmacists. I was one of the first local MPs after these changes were announced to meet with local doctors, because that's what is required to progress and to move our country forward positively so that we can create a better future for all.

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

Is there a seconder for the motion?

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

I second the motion.

7:14 pm

Photo of Monique RyanMonique Ryan (Kooyong, Independent) Share this | | Hansard source

Australia's universal healthcare system is one of its greatest assets but last year the strengthening Medicare task force report identified a need for clear and simple value propositions for consumers, general practice and other primary care providers. To this end, I have been advocating for GPs to be able to prescribe medications for 12 months at a time, with two months supply, for medically stable patients with chronic medical conditions.

This change to the PBS schedule will decrease the need for routine GP and pharmacy visits for many Australians and it will reduce the cost of those medications by halving the dispensing costs. Allowing up to a year's supply of medications on a single prescription will save many patients at least one doctor visit a year, and the two-month supply option will save patients up to $180 per year per medication. Those savings will be particular valuable for pensioners and concession card holders were not helped by the government's recent reduction in PBS co-payments. Concession card holders will save more than $43 per year per medication.

We know that the out-of-pocket cost of medications is a key reason for many Australians delaying or failing to fill some of their prescriptions. The Office of Impact Analysis recently reported that one in five Australians aged 16 to 24 found prescription medications to be unaffordable. In 2021-22, because of cost concerns, more than 770,000 Australians delayed or didn't fill prescriptions. Those Australians were more often women. They were more likely to be young people and they were more likely to be affected by long-term health conditions.

The cost of medications is exacerbated by the increasing out-of-pocket cost of GP visits, which is on average $47.91 in Kooyong alone. Time spent away from work for those visits and for trips to the pharmacist impacts productivity. Amending PBS guidelines to increase the number of supplies that can be dispensed at each visit will reduce inconvenience to patients. It will cut the cost of dispensing for the patient and for the PBS and will increase the agency of patients in safely managing their own medication. Patients will benefit from a larger supply of medications in one go, with longer dispensing intervals and larger medicine pack sizes.

This change is sound policy. It's consistent with the most recent national medicines policy review and it's consistent with the policy of the Department of Health and Aged Care on the quality use of medications. It's supported by medical and consumer groups. Both the AMA and the Royal Australian College of GPs supported this change when it was proposed first in 2018 and subsequently.

Now, concerns have been expressed by community pharmacies regarding potential adverse impacts of this change. I'm fully supportive of it being rolled out in tranches to enable those pharmacies to adapt appropriately. It's important that we continue to look to the regions to ensure that those in rural settings have access to the same competitive prices for medications as those in metropolitan settings and that we ensure adequate supply of all medications for all Australians. Pharmacists will benefit from the expanded support for vaccine delivery in the recent budget. They should be appropriately supported for the work that they do, and we should continue to actively consider how we can safely increase their scope of practice.

It's time to cut the red tape. It's time to improve access to medications for all Australians. I'm really proud to have effectively advocated for this important change to pharmaceutical dispensing laws in Australia. It will reduce the need for routine GP visits, it will decrease pharmacy visits for repeat dispensing of medicines and it will lessen the cost of medicines for those people with longstanding medical conditions. We have to continuously critically review all aspects of our healthcare delivery to improve both cost effectiveness and quality of care in all parts of the system. I commend this motion to the House.

7:18 pm

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

I'd first of all like to thank my friend the member for Robertson for moving this motion. It is important that we acknowledge the significant achievement that our government has made to deliver cheaper medicines to millions of Australians. The reason that I am in this place is to try to make sure I fulfil my promise to my electorate to make medical care cheaper and more equitable not only across my electorate but across the country. I am very proud to be part of a Labor government that is doing this self-evidently and appropriately in spite of the battles that they are facing against vested interests. I would also like to acknowledge the member for Kooyong, who, indeed, like me has long advocated for extended prescribing times. This will certainly make a huge difference to the way medicines are delivered to some of the most vulnerable Australians.

Our cheaper medicines policy came into effect on 1 January this year and reduced the general co-payment for medicines on the PBS from $42.50 down to $30. Besides being a price drop for patients, this is the first time in the 75-year history of the PBS that the general co-payment has been dropped. It's important also, and one of the main reasons for me speaking on this motion, that this will make health care much more equitable for some people, particularly families, who are very vulnerable in this cost-of-living crisis.

I saw firsthand as a paediatrician the disastrous effects of the coalition's ignorant policy on health care in Australia, with a lack of access to GP visits, more expensive medicines, more difficulty for patients to access specialist care and a breakdown in our outpatient system and our public hospitals. This government, the Albanese Labor government, is attempting to change the way that health care is delivered in Australia to a more equitable system. We've had 10 years of neglect and we're not going to fix it all in one budget, but, certainly, the last budget was a huge effort to redress the balance of health care in Australia.

At the moment, Australians who are wealthy can access the best health care in the world, but people who are vulnerable, because of either a lack of income or living in rural and regional areas, are really struggling to access health care that sometimes falls to Third-World levels. We see that in our Indigenous populations with conditions, like rheumatic fever, that have been eradicated in virtually every other developed country in the world still being present in some of our Indigenous populations. We see life expectancies for people who live in rural and regional areas persistently being many years below those of people who live in the inner cities and have access to some of the best health care.

In my electorate, from Rosemeadow to Ruse, from Glen Alpine to Harrington Park, from some of the poorest areas to some of the wealthiest areas, these changes that we have made, not just our prescribing rules but also the changes that came into effect on 1 January, will make a huge difference to the equity of access to health care. I applaud that and I congratulate the health minister, Mark Butler, for doing that. This has resulted in savings already of half a million dollars in Macarthur—amazing—in just a few days.

Going forward, this policy will save Australians more than $1.6 billion over the next four years. If you couple that with the changes to Medicare, the increase in the bulk-billing rebates with the general rebate for a standard GP consultation going up by over 30 per cent, it will make equity of access a really important feature of this first term of the Albanese government. I applaud it. Patients can now halve the number of times they visit a GP for regular medications. They don't have the inconvenience of having to turn up at a pharmacy every 30 days for routine medications that they may well have been stable on for more than 20 years. It's very important for health care in our communities that in the 21st century we make our systems more efficient.

I know there are concerns from pharmacies and by pharmacists. I've met with many of them and I understand their concerns, but I would encourage them to come back to the table. There are ways that we can help our pharmacies, particularly in isolated rural and regional areas, like some of the small towns around my electorate. We can look at ways to try and improve their scope of practice. We can look at ways of trying to improve their general practices. But they must come back to the table. This government has done amazingly well, and I'm proud to be part of it.

7:23 pm

Photo of Michael McCormackMichael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | | Hansard source

I do not agree with the motion, but I do find it very difficult to criticise a man who has earned the respect of all in this place and certainly many, if not most, in his own electorate—it would be most, because he keeps getting re-elected! To the member for Macarthur: well done. I have been on trips overseas, and I know that he puts people's health first and foremost, whether they are in Papua New Guinea or here in Australia. I will also acknowledge that I am the only speaker in this debate who is not a doctor. I will acknowledge that.

The Australian Medical Association would have been very pleased with and proud of the three previous efforts. The AMA, which for some reason did not support a rural medical school network when it was first proposed by—we'll say the National Party, but it was the coalition—remained opposed to it and vehemently opposed the notion of a medical school network. This will put doctors in the bush, getting their training from start to finish. That is going to be a game changer that will be transformational for rural and remote areas.

This is about our pharmacists, who in many cases, particularly in remote Australia, are the only frontline medical professionals in those centres. They deserve every bit of support. We've heard members opposite and the member for Kooyong talking about what Labor has done in this space when in government previously, yet I well recall being in my first term, from 2010 to 2013, when Labor took medications off the PBS schedule because they'd run out of money. They'd run out of somebody else's money to put them on, and they took them off the schedule.

Don't just take my word for what is before us tonight. Let's hear from Claire Robertson, a pharmacist proprietor of Blooms the Chemist in Sturt Mall in Wagga Wagga. She says that the 60-day dispensing is likely to increase the current medicine shortage, resulting in patients and community members being unable to access the medication they need. She says it has the potential to result in medicine-hoarding. She says it means there will be more medicines in the home, and this may lead to increased risk of overdose. She says it will exacerbate our already overburdened healthcare system and will impact pharmacies' ability to deliver best-practice healthcare. She's right, of course.

Luke van der Rijt, Michael O'Reilly, Tom Adamson and Darko Bogdanovic, the proprietors of Southcity Pharmacy in Wagga Wagga, said: 'Minister Butler has dismissed this policy as something that won't have an effect on community pharmacy, but as you can see from the numbers,' which they correctly worked out, 'this is, quite frankly, categorically incorrect. I think everyone is now aware that this policy will cause numerous medications to go out of stock. Even if the medication is available, the pharmacy will be under such financial pressure that they won't have the cashflow to hold stock for the community. Wait times to get prescriptions will blow out two days.'

Victor Vo is a small-business owner of two pharmacies in Ariah Park and Ardlethan the Riverina electorate, both rural towns located in the Temora Shire. He is absolutely concerned about equitable, timely, safe and affordable access to high-quality and reliable supply of medicines and medicines-related services for all Australians, and with ensuring that medicines are used safely, optimally and judiciously, with a focus on informed choice and well-coordinated person-centred care. Yet he is very concerned that this policy does not achieve the objectives that he sets out to do as a health professional and, indeed, that probably even the government would like to perform.

Wendy Patey is a constituent from Boree Creek and Lockhart Shire and therefore the Riverina electorate. She phoned my office to say that this policy is ludicrous. She fears it will lead to the closure of the small pharmacy at Urana, and if that happened the people of Boree Creek would have to drive to Lockhart or Narrandera to have their prescription filled. Diane McGill from Pleasant Hills in New South Wales is also very concerned and wrote to us with some very personal issues about the medication that she is on. She is also concerned for her local friendly pharmacist.

I have spoken to Trent Twomey from the Pharmacy Guild and he, like many, is very concerned that this is going to force the closure—they say—of chemists, who provide such a valuable service, particularly in rural, regional and remote Australia. I ask the government to reconsider this.

7:29 pm

Photo of Peta MurphyPeta Murphy (Dunkley, Australian Labor Party) Share this | | Hansard source

Member for Riverina, you're not the only non-doctor contributing to this debate; I am now contributing. I'm not a doctor, but I am a significant consumer of the health system. I don't want any sympathy for that, but I want to say that I absolutely understand why this policy helps people who need medicine and are on medicine for chronic illnesses. I absolutely understand when the minister talks about the greatest risk of noncompliance with medicine being when your script runs out. If you have to fill a script every month, what that actually means is that every 3½ weeks you need to remember to go to the pharmacy to fill your script before your medicine runs out, or you have four or five days without it. It will make a massive difference not just financially to patients but to their health care and to their lives.

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

The time allotted for this debate has expired. The debate will be adjourned and the resumption of the debate will be made an order of the day for the next sitting.

Fed eration Chamber adjourned at 19:30