Chris Hayes (Werriwa, Australian Labor Party) Share this | Hansard source

It is about time that this legislation appeared in this place. I welcome the provisions of the amendments that appear in the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006. I think it is a win for consumers, not only those in rural and remote areas of Australia but also those in the fast-growing outer metropolitan areas and suburbs, including those in my own electorate of Werriwa. I have no doubt that the prospect of more pharmacists, with increases in competition as such pharmacists seek to differentiate themselves from one another on the basis of service, will be a good thing for consumers.

The fourth community pharmacy agreement will allow the relaxation of the location rules—the subject of this bill—and allow pharmacists to set up in large medical centres and indeed in some shopping centres. But the relaxation of the rules will not go to allowing pharmacies to be set up in supermarkets, which is a concept that I personally remain opposed to. I think relaxation in that respect would simply allow supermarkets to cherry-pick locations with a view to maximising services within a particular supermarket chain, which would very clearly be at the expense of regional and some outer metropolitan areas.

Getting back to the matter at hand: the National President of the Pharmacy Guild, John Bronger, said on 8 November last year:

Neither side has got everything it wanted, but at the same time I believe on the whole this Agreement will underpin access and equity of the PBS and pharmacy care to all Australians ...

He went on to say:

Pharmacists serve the community in many ways with passion and commitment.

This is an important point. As you know, I represent the electorate of Werriwa, which embraces areas of Liverpool and Campbelltown. In that area we have about 50 pharmacists. These pharmacists play an important role in communities like mine. This statement made by Mr Bronger reminds me of the work of pharmacists like Paul Sinclair in Ingleburn, who is very active in his local community.

Paul Sinclair owns the local pharmacy, but he also has a healthy interest in the improvement of our local community. He is an executive member of the Pharmacy Guild. Paul also has the time to be heavily involved in the work of Kids of Macarthur. He is actually chair of Kids of Macarthur, which is a group made up of locals who wish to make a real difference in children’s health services. Indeed, Paul is also the chair of Myrtle Cottage, which provides services for the frail, the disabled and those needing respite. Without labouring this issue, Kids for Macarthur does a fantastic job in my area. It purchases equipment for the paediatrics department in our local hospital.

My family was a direct beneficiary of the work of Kids of Macarthur when my recently born grandson, Noah, developed sleep apnoea. As a local resident, I have to say that, when a child turns blue around the mouth and suffers the effects of not breathing, to know that you have specialists like Dr Freelander and the staff of Campbelltown’s paediatric department on hand is, quite frankly, very much something to be proud of. Their degree of commitment will remain with me, and I praise the work of the people of the Campbelltown Hospital. It is a hospital that has been much maligned in the press. Quite frankly, it is a hospital that has a lot of dedicated people. On behalf of my grandson, Bernadette and I and my family are very indebted to the professionalism shown by the people of that hospital.

I welcome the contribution of many pharmacists to the community that I live in and recognition of the ongoing benefits that pharmacists like Paul Sinclair play in their community. It is not the focus of this bill, but it should at least be acknowledged.

An improvement to the access to pharmacies is only one part of the fourth community pharmacy agreement. The other issues that are dealt with in these changes are the way that the Secretary of the Department of Health and Ageing is able to approve more than one pharmacist to supply pharmaceutical benefits. There is no doubt about the importance of pharmaceutical services to Australians, and there is no doubt about the importance of the PBS to people. It is virtually impossible to consider changes to the operations of more than 5,000 pharmacies throughout Australia without taking some time to reflect on the operations of the PBS.

There is absolutely no doubt that the PBS must be kept sustainable. Australians have come to expect, and rightly so, that they will be able to have affordable access to the medicines they need. With some having just celebrated a decade of the Howard government, it is timely to reflect on the impact that this government has had on affordable access to medicines and on the PBS. To put it simply, this government has not been the best friend that Medicare has ever had. For 10 long years it has consistently acted to undermine our system of universal health care. It has attacked Medicare, underfunded hospitals, systematically dismantled the PBS, ignored mental health and abandoned all commitment to public dental health. It has also cut training places for GPs, which has resulted in patient to GP ratios of more than 1,700 to one in my electorate. I bring to your attention, Mr Deputy Speaker Wilkie, that one GP to 1,000 is the preferred level of the federal Department of Health and Ageing. Even this government considers that anything above one GP to 1,400 is an area of serious need and yet my area of Werriwa has one general practitioner to 1,700 within our electorate. That is the record of this government when it comes to health care. Despite promises made in the heat of the last election campaign—and I think the words ‘ironclad guarantees’ were used, if I remember correctly—this government continues to chop and change the rules when it comes to our medical system. This government keeps changing the rules, and sick Australians, the people who rely on the great system we once had, are paying the price for these changes.

The changes to the PBS introduced last year have meant a diminution in access to affordable medicines. The government has justified this on the basis of cost and long-term sustainability of the system. This government’s concern with cost cutting has overridden any concern that it may have once had for health outcomes. The medical implications of continued cuts to the PBS have taken a back seat to budgetary implications under this government. The facts speak for themselves. Last year the government introduced changes that, simply put, reduced access to the PBS. Since the 21 per cent increase in the PBS copayments and the 12.5 per cent cut in the generics, PBS growth has fallen by 2.5 per cent and is expected to fall further. As I understand it, based on the most recently available Medicare Australia data, savings to the PBS for the next financial year could amount to $1.38 billion, with 11.4 million fewer prescriptions. This is nothing more than cost cutting.

The government figures also indicate that people’s health is being put at risk. Fewer prescriptions are being filled in categories such as cardiovascular conditions, hormone replacement therapy, mental health, epilepsy, Parkinson’s disease and Alzheimer’s disease. These reductions point only to one thing—and that is not a decline in the incidence of those conditions. What they indicate is that people are making a choice between putting food on the table and filling their prescriptions. It is a sad day for all of us when people are making purely financial decisions about their health.

These results are prior to the impact of the PBS safety net and the introduction of the 20-year rule. There is considerable anger in the community about these most recent changes to the PBS. People are confused by the operations of the new 20-day rule. More and more people will be forced to make health decisions from a financial perspective rather than from a health and safety perspective, yet the relentless march to the Americanisation of our health care system continues under this government.

This march has manifested itself not only in the ongoing and almost habitual cuts to the PBS but also in increases in private health insurance premiums. Recently Australian families copped it again when the Minister for Health and Ageing could not help but approve yet another increase to private health insurance premiums. This time it was 5.7 per cent, and the minister was pleased because this was the lowest increase since 2001. It was only 5.7 per cent this time, but there has been an overall increase of 39 per cent since 2001. For an average working Australian, that is a shameful figure. In the simplest terms, this 5.7 per cent increase in private health insurance premiums means that families in south-west Sydney—in fact, families across Australia—will now be expected to pay up to $150 more for their private health insurance. Of course, every single taxpayer gets to share in this joy through the $3 billion a year subsidy that goes to the private health insurance industry!

The government needs to shift its focus from cutting costs in one area of health care in order to prop up another area within the health care budget. When it comes to the health care system, this government needs to shift its focus from the health budget to health services. Australians should not be forced to choose between putting food on the table and filling their prescriptions. The gradual erosion of things in the Australian system that people hold dear has to stop—and, for the welfare of the vast majority of Australian families, I believe it has to stop sooner rather than later.

I welcome the changes to the location rules that take into account the need for people to have good access to their pharmacist. I support this bill and I support the work of the great many pharmacists in this country in what they do for our community. Consumers will benefit from the changes contained in this bill but, at the same time, this legislation will allow pharmacists and pharmacies to continue to play an important role in their local communities.

However, while I support the changes contained in this bill, I believe that this government needs to take a serious look at its management of the health care system and reconsider its priorities in that regard. Health care is about care for the sick—it is not about care for the bottom line of the budget.

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