Duncan Kerr (Denison, Australian Labor Party) Share this | Hansard source

The shadow minister has moved amendments in this House to the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006 and drawn attention to the government’s failure to investigate the impact of the PBS copayment increases on patients’ access to needed medicines; the recent changes to the PBS safety net, which mean that patients must pay more out of pocket; and the confusion and difficulties presented to patients, doctors and pharmacists by the new 20-day rule on repeat prescriptions.

Certainly I would join with the shadow minister in emphasising that the neediest and sickest of Australians will now be forced to choose between buying their medicines and other necessities of life, and there is no doubt that the 20-day rule will make it increasingly difficult for some patients to get their PBS costs to count towards the safety net. The shadow minister drew attention to the fact that this is not just confusing and troublesome for patients; it is making life difficult for busy doctors and pharmacists. There are many legitimate reasons why patients will require access to their medications within 20 days of the dispensing of their previous script.

Whilst all those general points are extraordinarily important in this debate, tonight I want to highlight a particular circumstance that has come to me through one of my constituents, Mr Jack Clear, because it draws a particular issue to the fore. I put it before the House that this is an issue that fully justifies the shadow minister’s concerns about the 20-day rule but I also propose it to the government by way of some requirement for it to take attention of the way in which this policy is being implemented.

Mr Jack Clear is a man who requires a number of medications and is of course deeply troubled by the increased costs that the changes to the PBS will impose upon him. But, more particularly, he is a person who from time to time seeks repeats of prescriptions that have been issued. Some little while ago he came to me—and I was certainly not mindful of this debate; this is a matter which arose quite independently of it—because he had tried to have a script dispensed 21 days after the last dispensing. He was told by the pharmacist that this fell within the 20-day rule, so he could not count the cost of the script towards the PBS safety net. It would appear that, whilst it was the intention of the legislation to ensure that the 20-day rule permits a script to be dispensed after that period expires, on the 21st day, a number of pharmacies are using a dispensing program called ‘Winifred’, which interprets the 20-day rule as meaning that there must be 20 days in between each dispensing date—that is, it starts counting the days on the day after the script is dispensed. So, in effect, it is adding an extra day to what I believe was the intention of the parliament. In that instance, Mr Clear was presented with a quite expensive account for the drugs which were dispensed, which cannot count towards the safety net.

I do not doubt that, given that this is a computerised system that is operating across a number of pharmacies, similar circumstances will apply to a number of people. Those people, properly being aware of the nature of the rule, will present themselves to their pharmacy in order to get a particular drug dispensed, believing that they will be automatically entitled to the benefit of the safety net. They will discover that in fact the set-up that the pharmacy operates to implement the government’s decision precludes them from being able to access the safety net payment. That of course will mean that those persons cannot make the scripts that they have had dispensed count towards the safety net.

The pharmacist that my office spoke to said that the government’s intention was not unambiguous, that the meaning of the legislation was unclear. Plainly, the pharmacist and those who are part of the network of pharmacies that are using the prescription system that operates in this instance understood the government’s legislation in the manner which caught Mr Clear unawares, to his great cost.

I would like it made plain by the government that the intention is such that, if a person applies on the 21st day after the dispensing of a drug, they are not excluded by the operation of the rule. That would seem to be a commonsense understanding of the intention of the parliament—although, in defence of the pharmacists who are themselves, I am certain, trying to make the best of a complex and highly unsatisfactory legislative rule, section 84AAA is, on its face, not so simple in its interpretation as to preclude the interpretation that the pharmacists have put into operation through their computerised system, to the detriment of those who come forward on the 21st day to seek the dispensing of drugs and coverage under the PBS. I believe the government should act immediately to clarify this section of the legislation and to ensure that dispensing programs that are being operated across Australia by pharmacies are made consistent with the understanding that I would hope this parliament has embraced in this legislation.

It is one thing to note that the 20-day rule itself is capable of causing considerable difficulty. It does not recognise that there will be perfectly legitimate reasons why some patients wish to acquire their medications in a shorter period after the dispensing of a previous prescription. For example, they may be travelling interstate or they may have particular requirements that limit their capacity to travel. Some are handicapped. Some are not as mobile as others. They may rely on friends to make occasional visits. In particular, those living in rural and regional areas do find it difficult to make arrangements to travel to pharmacies as easily as those living in metropolitan Sydney, Melbourne or even Hobart. It is one thing to acknowledge that. It is another to then have this catch-22 situation apply that, where somebody acknowledges and acts in good faith on the expectation, having allowed 20 days to expire since the dispensing of their script, they will still fall foul of these new rules. The government should make it plain that those who have been caught by this problem are sought out, reimbursed and reincluded in the safety net, because I imagine that the circumstance of my constituent Jack Clear would not be unique.

Those are the specific points that I wish to add to this debate, and I commend them to the minister at the table to convey to the Minister for Health and Ageing. They are specific concerns that emerge irrespective of the passage of this legislation, but they only go to emphasise the cavalier way in which this government is treating those sick and neediest Australians who are dependent on the PBS safety net to enable them to have their medicines at a reasonable price.

I am certain that the difficulties I refer to are not ones of malice. The rules that have been brought in are confusing and troublesome, not only for patients. They will be making life difficult for busy doctors and pharmacists. They confront doctors and pharmacists with considerable difficulty in providing the services that they would wish to their patients in the manner which they believe is in the best interests of patients. It is certainly not my intention to engage in any pharmacy-bashing speech but rather to say that this is an issue that requires resolution. It requires goodwill on behalf of the government. Irrespective of the overall intention of the legislation, it needs to be clarified to ensure that dispensing programs that are utilised by pharmacies across Australia to give effect to the government’s intention are uniform, correct and do not result in persons who would be properly and lawfully entitled to receive benefits under the PBS safety net being excluded from them.

Given the time—I think there is only a minute to go—I will conclude my remarks at that point. The Labor opposition hopes that the concerns it has expressed by way of the proposed amendment moved by the shadow minister do have some reflection in the actions of government and are not simply ignored, because these issues are important. They impact directly on those who are needy and sick in our community.

Debate interrupted.

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