Tuesday, 2 September 2014
The Nationals stand up for small business and many on this side, of course, do that. We are very proud of small business and what they contribute to our country. Recently retired senator Ron Boswell led the fight to protect our pharmacies in the face of competition. He fought to ensure pharmacies remained as stand-alone businesses. We need to continue this fight. From both sides of parliament, we have seen cut after cut after cut to our pharmacies. I have spoken to many of them in recent times. I have seen pharmacies close down. We even hear of pharmacies now going into receivership. It is a real concern. There are negotiations coming up with the government and I urge the government to be fair—life is about fairness. The name of our national anthem, Senator O'Sullivan, is Advance Australia Fair. I underline 'fair'.
Five thousand three hundred and fifty community pharmacies in Australia employ around 60,000 staff. Thirty per cent are in regional areas; 12 per cent of them are in rural and remote areas. Four hundred and twenty five Australian towns have one pharmacy—I will repeat that: 425 Australian towns have just one pharmacy. Sometimes it is the biggest employer in that town. People in rural and remote areas are more likely to have a health problem such as obesity, heart disease or high cholesterol, and we can throw high blood pressure in with that. It is a fact that people in rural and remote areas live shorter lives and have higher rates of disease and injury than people in major cities. They are also more likely to skip GP visits, tests and medicines because of cost.
PBS reforms are adversely impacting on pharmacies and have been for many years. Peter Crothers of Towers Pharmacy at Bourke explains the problems in his own words:
As a result of the price disclosure impact, we have not replaced one departing full-time staff member and will be putting off another part-timer.
He goes on to say that in Bourke:
We already have high unemployment, especially youth unemployment, and the social problems that accompany this like drug and alcohol abuse and domestic violence.
There are gaps in Aboriginal pharmaceutical programmes such as s100 and QUMAX (which is Quality Use of Medicines Maximised). In our area QUMAX does not apply and S100 does not subsidise the cost of Dose Administration Aids
To explain what S100 is, it is an allowance that is paid to approved pharmacies and approved hospital authorities for the provision of a range of Quality Use of Medicines services to patients in approved remote Aboriginal health service areas. Peter continues:
That means aboriginal people requiring these doses have to pay for the service—we charge $6.50 per patient per week which is about half—
I repeat: half—
what it cost us to do them, and we pick up another $1.50 or so per pack from the 5CPA incentive payments
$6.50 is the absolute limit of people's ability to pay but now we will have to increase it
Unless other agencies pick up the tab, people will drop out of Dose Administration Aids.
That is part of what Peter Crothers from Towers Pharmacy in Bourke had to say.
It is estimated that PBS reforms will have an impact of $450 million this year, which is $90,000 per pharmacy. Ten per cent of staff will be shed over the next 12 months and there will be reduced services and cutback in opening hours. Total government savings from reforms will reach $20 billion by 2020—that is $20 billion in that industry by 2020. Payments for prescriptions will be lower in 2020 than in 2010. Pharmacies need to broaden their horizons to survive.
A 2013 Grattan Institute report found that more than one million Australians who live in regional areas are denied access to basic medical care that most city dwellers take for granted. It identified seven areas containing one-twentieth of Australia's population, where limited access to GPs is imposing severe costs on individuals, doctors and the health system. Those areas include Tamworth, Goulburn and Mount Isa, as well as most of the Northern Territory and Western Australia. It found that in these areas, severe GP shortages continue to exist, regardless of the policies that have been implemented. Perhaps pharmacies can fill some of that void, is the message.
The sixth agreement between the government and the Pharmacy Guild will most likely start in July next year. It needs to maintain, where possible, enhanced existing regional programs. The Pharmacy Guild points out that its members are increasingly being asked to deliver more services to an ageing population, such as health checks, vaccinations, pain management, wound care, mental health management and even services for sleep apnoea. There are many issues the guild would like to see included in the next agreement, but there are three essential requirements: dispensing remuneration must be maintained in real terms; a transparent funding model to offset the impact of lost trading terms on core pharmacy services, such as home deliveries and health checks; and a comprehensive medicines adherence and medication management strategy.
We must ensure that our pharmacies remain viable. Where I live in Inverell—which has a population of 12,000 in town, which is the biggest shopping area for the population, of course—I have seen five pharmacies reduce to three now. In my mother's early days of dementia, the Webster-paks were put together and it was clear what she had to take each day for her medication. The local pharmacy is a place of trust. People go in to seek advice, whether it be for a cold or flu, or for aches or pains. You go in there with total trust for what the pharmacy tells you. You trust the pharmacy. You know that they do their best for you. I do not want to see any more pharmacies close their doors and people being put off. We have to consider the future of these small businesses as we progress through this agreement. It is vital that pharmacies remain viable financially. They are there to do a service, and, of course, they are now relying on delivering more services, such as blood pressure tests and diabetes tests—you name it. It is becoming a one-stop shop for many in very, very small communities, where they may have to wait for weeks to see a doctor. In some communities, sadly, we do not have GPs.
I encourage my colleagues in government to see that we do the right thing by our pharmacies in this new agreement. They have suffered billions of dollars worth of cuts over many years. The general impression was that if you own a chemist shop, a pharmacy, then you are a millionaire. That is not the case. I know it is not the case. The people I know and trust have told me; we have gone through the figures. They are putting people off and they do have to remain viable. So I encourage my colleagues in government, the ministers and the Treasurer, to see that we do the right thing in this new agreement with our chemist shops.