Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006 and put on the record the views and interests of the people of Hindmarsh. The bill is just one aspect, but a very important one, of the greater fourth community pharmacy agreement, originally due for implementation in July last year. The five-year community pharmacy agreements were created by the federal Labor government in 1991 as a result of dissatisfaction with remuneration arrangements and decisions of the Pharmaceutical Benefits Remuneration Tribunal. The Labor government’s second community pharmacy agreement of 1995 continued to set out remuneration arrangements for pharmacies, but also began to establish mechanisms for recognising and compensating pharmacists for their expanding health care role, and worked toward a broader distribution of pharmacies throughout the community. The third agreement saw this focus on the distribution of pharmacies codified in the establishment of ‘pharmacy location rules’. This focus was intensified in 2004 with the supplementary rule that pharmaceuticals could not be dispensed from supermarkets.

The purpose of the location rules is twofold: first, to provide widespread community access to pharmaceutical services, and second to ensure the continued viability of existing pharmacies. In this fourth agreement, additional flexibility was given to the rules so as to allow for the possibility of pharmacies co-locating with after-hours medical centres or relocating into certain types of shopping centres, single-pharmacy towns and urban areas with high population growth. There is also a reduction in the minimum distance between pharmacies supplying pharmaceuticals under the PBS—from 1,500 metres to 500 metres by straight line measurement.

As with most things, perceptions of the appropriateness of the rules are varied. A few people have said that to interfere with market forces can only lead to abuse, with some people making more money than they should and with customers being ripped off, being unserviced and the like. I think everyone else in the country, including this government, the Pharmacy Guild and the Australian Labor Party, which started this process, recognises that, without interfering in the distribution of medicines covered by the Pharmaceutical Benefits Scheme, at least one of these negative outcomes is much more likely to become a certainty in areas across metropolitan and regional Australia. I am speaking of the geographic availability of medicines and the service Australians receive under the PBS.

The Australian population is ageing substantially. The electorate of Hindmarsh, which I represent, has 25 per cent of electors aged 65 or over. And people are living longer in the community. That is a good thing. By community, I mean a long-term or family home or, if not that, a newer and more manageable home unit or apartment. This means that people are continuing to be—perhaps increasingly being—out in the middle of a suburb somewhere, without nursing or caring staff to look after things for them.

Many pensioners without savings cannot afford private transport. They are too frail to use the public transport system, which would probably require quite a hike, and the prospect of PBS medicines being dispensed in blocks of chemists within regional supermarket and shopping centre complexes about five to 10 kilometres away would make life that much tougher.

The introduction of the rule banning supermarkets from dispensing pharmaceuticals deserves special attention. A concern I have with supermarkets is their capacity for unequal competition with small, often family run businesses, including community chemists. By virtue of their enormous multi- and single-store capacity, they have the substantial ability to cross-subsidise many more products than a local pharmacy. How would pharmacies be able to continue to remain viable in a deregulated environment? In the case of the local deli or butcher, many people honestly do not care, but the availability of medicines to maintain life, either in essence or at some reasonable level of quality, is a very different matter.

I have been told of the 80-20 rule which generally applies to pharmaceuticals. A pharmacist will get approximately 80 per cent of the turnover from 20 per cent of the lines. It is the remaining lines—over three-quarters—which account for only 20 per cent of the turnover that are problematic. Pharmacists keep an extensive range of drugs in stock and nothing is cheap, and these slow sellers—the over three-quarters of stock that is not in high demand—still need to be kept and replenished in a timely manner in case of demand. Pharmacists work outside the normal supply and demand market dynamic. They need to, and all governments need them to, for the good of the public’s health. Supermarkets, I believe, will lead to the withering of local access to PBS products.

A representative of the Australian Consumers Association argued on Adelaide radio station 5AA last October against community pharmacists and in support of supermarket dispensaries, with the assertion that pharmacists place a 70 per cent automatic mark-up above the government approved price for pharmaceuticals. They actually complained to the ACCC, a complaint that was, I am told, dismissed as nonsense. It appears that many consumers agree with this dismissal and do not believe their hip pockets are being sacrificed in order to financially prop up the local pharmacist’s business.

Last year I circulated a petition within the electorate of Hindmarsh calling on the federal government to negotiate an agreement which recognises the real value of community pharmacies. This sparked some correspondence from within the industry, which one would expect. I will read some of the comments I received. The Pharmacy Guild of Australia’s executive director gave his acknowledgment of the fourth agreement, stating:

We agree with your view that these measures, and more broadly the Fourth Agreement, are very much in the public interest.

Another letter said:

I am aware of your stance and have been particularly impressed with your understanding of the issues ... thank you again for your interest ... on behalf of our customers.

Another letter spoke of the fourth agreement’s community service obligation. Symbion Pharmacy, well outside of my electorate, wrote:

Reaching an agreement on the community service obligation ... will ensure community pharmacies, particularly those in rural and regional Australia, will continue to receive the full range of PBS medicines in a timely manner. We believe this is the most fiscally and socially responsible outcome that could have been negotiated. Symbion Pharmacy (formerly Mayne Pharmacy) can continue with more certainty to deliver the full range of PBS medicines across Australia.

As for the customers, it was not long before the completed petitions began flooding in. It has been the second largest response to a petition or survey that I have run since becoming the member for Hindmarsh. I have received approximately 4,000 signatures from members of the community who want the level of service they get through their community pharmacist continued and not compromised.

The level of service they want continued includes the professional advice they receive from the pharmacist, including through home medicine reviews—of which I spoke in this place last year—whereby, if a GP suspects that a patient might be finding it difficult to correctly use all of their medications, a pharmacist can go to that patient’s home and check that everything is working as it should. It may be that there are too many medications to keep up with or that prescription medicines are interacting with over-the-counter medicines that the GP was not told the patient was taking. It could be that the equipment used to administer medicines, such as a nebuliser, is old or broken. These consultations can take quite some time, but the results for the patient are excellent and often lead to the prescribed medications being more effective.

What have other people in this place said about PBS medications being dispensed from supermarkets? The member for Hinkler spoke in this place in May 2004 of the special needs of customers that would not be met within a supermarket. He said:

... pharmacies are a place where the frail, aged and chronically ill can find a little peace while trying to get clear advice on their medications.

…            …            …

That advice should not be compromised by the vagaries of the retail market or by a supermarket group’s buying arrangement with an individual supplier, or, dare I say, an individual drug manufacturer.

The member for Franklin stated:

If Coles and Woolworths were allowed to place a pharmacy within their supermarkets, there would be pressure on what products were stocked, how restricted stock could be marketed and what services could be provided. It is a clear warning to each and every one of us in this House, and through us to our communities, that the service and standards the community enjoys with its community pharmacists would change dramatically under the Coles and Woolworths corporate pharmacist regime.

And I respect the clarity of the member for Herbert’s statement when he simply stated:

... supermarkets and health do not mix. It is as simple as that.

I am relieved, as I am sure members of the community will be, to know that community pharmacies will not be driven out by supermarkets at this time. Thousands of jobs, hundreds of local pharmacies and millions of free consultations provided by pharmacists will be under threat if any new agreement fails to recognise the importance and the valuable role of community pharmacies.

What sets community pharmacies apart is that they provide careful advice to their customers on the side effects of prescribed medicines and on combinations of medicines. Community pharmacists take the time that is needed to care for their customers. As a result, Australia has half the rate of hospital admissions from medicine misuse when compared to the United States. I am glad that the federal government appears to have listened to the community’s wishes on this occasion and recognised the fundamental role that community pharmacists play in maintaining the day-to-day health of so many Australians. I commend the bill to the House.

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