Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

Community pharmacies play a vital role within our community. I find it very disturbing that it has taken this government so long to reach that conclusion. It has taken this government up until now to acknowledge the fine role that our community pharmacies play within our communities throughout Australia. Whilst I will support the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006, I do think it very important that I place on the record that I support the second reading amendment that the shadow minister for health has presented to the House tonight. That amendment condemns the government for its failure to investigate the impact of the PBS copayment increase on patients’ access to needed medicines; for the recent changes to the PBS safety net; and for the confusion and difficulties caused by the new 20-day rule. These are all issues that constituents within my electorate have raised with me and all issues that I think go to the safety of the way medications are used and supplied throughout Australia.

The changes to the pharmacy location rules introduced by this legislation have the potential to improve access to pharmacies and pharmaceutical services through the PBS for people who live in rural and remote areas and in developing suburbs. I feel that that is a very good thing. It is important that people can get the advice that they need from their local pharmacies when they are sick and when there is no doctor available. People also need to know that the advice they get is accurate. If there is no pharmacy within the area that a person lives in, they are severely disadvantaged.

I was speaking to an elderly resident recently who lives in the Shortland electorate. She has been housebound. The only way that she was able to get her medication was by her local community pharmacy delivering that medicine to her home. That is so important for her wellbeing, for her recovery. It shows the types of services that our community pharmacies provide. If there were no community pharmacy within that area then this elderly woman would have to go without the medication that she so vitally needs.

I think it is fairly important that I go through what the actual changes to the pharmacy location rules will mean. They will permit the co-location of pharmacies with large medical centres that operate extended hours. Obviously, that is of vital importance because, if you can see a doctor after hours, you need to be able to have the prescription that that doctor provides you with made up. Quite frequently, at the moment those pharmacies are not located anywhere near the medical centres and the person may have to wait until the next day to be able to have that prescription filled. If they can co-locate on the premises, that will obviously advantage those people who see their doctor.

The changes will allow for the location of pharmacies in small shopping centres, which I think speaks for itself. They will also allow for the relocation of an additional pharmacy to one-pharmacy rural towns and one-pharmacy high-growth areas without regard to the usual distance criteria. This has been a bone of contention for many years and I think this is a sensible change.

The changes to the pharmacy location rules will also remove the requirement that a specified number of commercial establishments are open and trading before an approved pharmacy can relocate to a shopping centre. For developing areas, that is obviously an important change. It is also an important change for very small communities. The changes also provide greater flexibility for pharmacies located in private hospitals by allowing the establishment of satellite dispensaries for hospital in-patients.

I thoroughly concur with those changes. Unfortunately, I think that this government has failed the pharmacy operators, pharmacists and the Australian people with the long, drawn-out process that was undertaken in signing the latest agreement. I was approached by pharmacists because they were really concerned about the government’s failure to say once and for all that they would not support the location of pharmacies in Woolworths and Coles. They were most concerned that this would erode the quality information that the Australian people were used to receiving from their pharmacists.

I was speaking to one pharmacist within the Shortland electorate last year. He had worked in Scotland. He had been a pharmacist in various places in the UK. He had worked under a system where pharmacies were allowed to operate within supermarkets. He told me that the government was deluding itself if it thought that it would maintain the same quality of service that is provided to people at the moment by their local community pharmacy.

I think the fact that the CEO of Woolworths, Roger Corbett, had the ear of the minister for health played a very large part in the delays in reaching that agreement. We all know in this parliament that the government is a slave to big business. If big business wants a change then the government will jump. The government was prepared to accept the argument that the changes were about flexibility, making it easier for people to obtain their medication and making the medication cheaper. But overseas experience has shown that exactly the opposite result is achieved. So I think that the government stands condemned for its inaction in reaching that agreement. It is very important that that is placed on the record and that the people of Australia are aware of how this government allowed this to drag on and on. We came back into this parliament, I think on two occasions, extending the time of the last agreement.

If the government had really been acting in the interests of the Australian people, they would have recognised, as I said earlier, the valuable role of community pharmacies. They would be very aware that it is our pharmacists who provide people with the advice they need when they are taking medication. Pharmacists, when they fill a prescription, give advice on how to use the medication. On one occasion I was taking medication and my doctor had not told me that I should not eat a particular product and that eating that product had the potential to make me very ill. It was the pharmacist who said, ‘When you take this medication you should not eat that particular food.’ That is the kind of advice that pharmacists are giving people each and every day—and that is prescription medication.

When my children were young I visited the pharmacist when they had a cold, an earache or some minor complaint. Before going to the doctor I would seek the advice of the pharmacist. You could rely on that advice. If the pharmacist thought you should take your child to the doctor, they would give you that advice. That is why pharmacies play such a valuable role in our community. It is not the Australian way to place pharmacies in supermarkets and have the level of advice and service that would be provided there. It is not the kind of service that Australian families and Australian people deserve.

In reaching this fourth pharmacy agreement and the new pharmacy location rule, the Howard government have tried to paint a very pretty picture, stating that they have achieved a very positive outcome for the Australian people. This is despite the fact that they took so long to negotiate this agreement. It is also important to put on the record that the government have really undermined our PBS. These protracted negotiations have gone along with this general undermining of pharmacies and the PBS. Since the introduction of the 21 per cent increase on PBS copayments last January and the 12.5 per cent cut in generic medicines in the middle of the year, there has been a massive decline in the number of prescriptions being filled. I say ‘massive’, but it is when you consider it in the context of the provision of prescriptions that maintain the health of the Australian people. There has been a 2.5 per cent decline in the growth rate of the PBS, and that is expected to drop even lower. Based on the most recent Medicare Australia data, savings to the PBS for the next financial year could amount to $1.38 billion, with 11.4 million fewer prescriptions being filled.

What that means is that Australians are no longer taking vital medications that they need to maintain their health. It is argued very strongly by this government that the increase in the use of the PBS is a financial burden to Australia, that there should be fewer prescriptions filled and that Australian people should pay more for those prescriptions. But I would say to the government: there is a cost associated with that also. Those prescriptions prevent people from getting ill and prevent increased health costs in other areas. The government should think very seriously about that. Not only does it lead to a greater severity in illness and increased hospitalisation; it also leads to an increase in unemployment and more people needing to receive income support. The areas that it pervades are enormous.

As I mentioned, the only good news in the decrease in the use of medication is in the budget bottom line. It does not do anything for health outcomes. The government constantly confuses PBS sustainability with cost cutting, and it never looks at the impact on the overall health system and the abilities of patients to afford their medications. I have had constituents come into my office and tell me that they cannot afford to purchase their medication. I have had other constituents come in and tell me that they share their medications because of the increase in costs. That is not good enough. These are patients that suffer from quite critical conditions that really need medications, such as cardiovascular conditions, blood conditions, mental illness and epilepsy, just to name a few.

It is obvious that the rising out-of-pocket costs due to increased co-payments, special patient co-payments and therapeutic and brand premiums are hitting the sickest and the neediest Australians, which means that too often they must choose between buying their medication and putting food on the table, buying their medication and putting petrol in their car or buying their medication and giving their children books for school. I do not think that is the Australian way, and I do not think that is the kind of society that we want.

The impact of the change to the PBS safety net and the new 20-day rule is yet to kick in. Many people do not understand the implication of the 20-day rule. Many people will find that, because of the 20-day rule, the safety net will not kick in when they expect it to. The thing that makes me really sad as I stand in this House tonight and talk about these changes is that on one hand we have changes that will improve access to community pharmacies but on the other hand the government is increasing the costs of health in every way. Pharmaceutical benefits are no exception to that rule.

This government has a philosophy that the user should pay—and pay through the nose—for all the services that they receive. I have a different philosophy. My philosophy is that if you are sick you should be able to get the medication that you need. My philosophy is that if you do not have a lot of money—because you are not as well off as members on the other side of this House—you should be entitled to the medication and the medical treatment that you need. Your needs are as great as those on the other side of this House and their friends. Although I will support this bill, I reiterate that the government stands condemned for its failure to investigate the impact of the PBS copayment increases on patients’ access to medication and the recent changes to the pharmaceutical benefits safety net and for creating the confusions and the difficulties associated with the 20-day rule.

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