Bruce Scott (Maranoa, National Party) Share this | Hansard source

I am delighted today to rise to speak about the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006. I want to first point out that it is through this coalition government that living in rural and remote parts of Australia has vastly improved since this government was elected a little over 10 years ago. Communications, infrastructure and technology have been enhanced, education and health facilities are more accessible and road, rail and air links have been improved. This bill is just another way the Australian government is assisting people who live in rural and remote communities and recognising the unique environment in which they live.

Pharmacies deliver one of the essential services in rural communities, as they are not just dispensaries. They offer communities the opportunity for first-aid items. Pharmacies sell cosmetics and gifts, and some have photographic services. But, more and more, pharmacies are involved in a variety of other health care services such as testing and screening, medication reviews, post-hospital care, wound management and public health programs such as quitting smoking. Clearly, pharmacies located in rural areas provide a unique point of difference to pharmacies in urban areas, and the importance of such businesses in rural communities is extremely high. Further, pharmacists themselves get personal satisfaction from providing a valuable service to the communities and assisting customers with their health needs.

However, many people living in rural and remote communities have limited access to pharmacies because of the tyranny of distance and the frequent unpredictability and nature of our weather. The introduction of this bill will mean people living in regional and rural areas will have greater access to pharmacies. While this bill seeks to make some headway in improving access to pharmacies, it makes the assumption that pharmacies will relocate to rural and remote areas of need. In practice, this may not happen quickly, or at all, and people will still find it difficult to easily gain access to pharmacies because of the size of some of the towns.

For the benefit of the House, I would like to outline the unique situation that people in many parts of my electorate are in when accessing pharmacies. For instance, the little town of Thargomindah, which is located some 200 kilometres west of Cunnamulla and more than 1,000 kilometres west of Brisbane, has a population of 250 people. It is the largest town in the Bulloo shire; it is the main town in the Bulloo shire—a town of 250 people. That shire and that town do not have a pharmacy. Thargomindah does have an outpatient centre and the Royal Flying Doctor Service visits once a week. Obviously, it is not financially viable for a pharmacist to open a pharmacy in a small western Queensland community like Thargomindah.

This scenario is not uncommon. Many communities across my electorate of Maranoa would be in a similar position to the one I have just described at Thargomindah in the Bulloo shire. People living on remote properties and in small towns where there is no pharmacy have to plan trips to their closest major town, often taking time off work. These trips are often infrequent and, as such, people plan their trip and have several jobs to take care of when they visit their nearest major town. For instance, they might visit their doctor, go to the local library, pay their bills and do their banking. Of course, having visited their doctor they may need to get a prescription filled, necessitating a visit to their local pharmacy.

I mentioned earlier that it is not uncommon for people in my electorate to have to drive two hours or more in some cases just to physically access a pharmacy. This can mean a trip of 200 or 300 kilometres just one way so they are able to get prescriptions filled and receive the medication prescribed to them. This is a great commitment for these people in terms of time and costs. Obviously there are car costs, such as fuel and maintenance. In addition, when people do go to town they may find that the roads are closed because of rain—we hope this will happen more often in some parts of my electorate. They can be closed for several weeks at a time. Currently most of my electorate is in the grip of the worst drought that I have known and the record is extended every day that the drought does not break in western Queensland. In contrast to that, when we do get rain we get flooding rains that often mean the roads are cut for weeks on end. Of course, these rains come without any great warning to the community, as we saw with the cyclone in North Queensland recently.

Mr Deputy Speaker Hatton, I am sure you would agree that such a situation would be foreign to many people living in our large regional centres or, in fact, our capital cities, like the one that you live in. We acknowledge that the people who live in these rural communities live there by choice and they understand the circumstances which they confront. It is not a complaint; it is just confronting the reality of where they live. That is why the federal government will be assisting people who live in rural and remote parts of Australia to have access to medication.

In the past few months I have received several concerns from not only pharmacists who service these regional towns and smaller communities but also consumers who have to access medication on a regular basis. These concerns have come from various parts of my electorate, including my home town of Roma; Barcaldine, where I will be next Thursday; Blackall, south of Barcaldine; Charleville; and Dalby. Constituents and pharmacists have been getting in touch with my office.

The main issue for people is not being able to have repeat prescriptions filled inside the 20-day rule and have the cost count towards the PBS safety net, even though they have made a special trip into town to have them filled. If the trip is made inside the 20 days and the person knows they will run out of medication before their next trip into town, they must purchase the medication, but they are disadvantaged by the cost not contributing to the safety net. Many people in my electorate have been caught trying to fill a repeat inside the 20-day rule.

I understand the fourth community pharmacy agreement makes allowance for people living in rural and remote parts of Australia to gain medicine in a timely manner under the 20-day rule and under regulation 24. However, there are some fundamental problems even with this regulation. Firstly, without the use of this regulation consumers have to pay the full price for the medication and, as I said earlier, it will not count towards the safety net. A further element is that doctors will need to insert ‘regulation 24’ on the initial script and all repeats have to be filled at the same time. In that case each lot of medication case counts towards the safety net. Perhaps it is through a lack of understanding, awareness or eduction that regulation 24 is not widely used. I am not casting aspersions on doctors or pharmacists. It is something that we need to do more about. We need to advise doctors, particularly those in rural and remote communities, that regulation 24 is a way around the 20-day rule in certain circumstances for people needing access to these medicines.

I understand the need for the 20-day rule in an attempt to reduce medicine stockpiling. I think we all on both sides of the House agree with that. This is good public policy, particularly when, for example, older people may accidentally take medication that is past its expiry date. When people have timely and affordable access, pharmacists can monitor the medication they are taking. Pharmacists are part of the triangle of health care in all of our communities, so we need pharmacists to be part of medication management. In many ways, the pharmacist is like the eyes and ears of the doctor after the doctor has prescribed the medication, because patients see their pharmacist more often than they see their doctor unless there is a need for a return visit to the doctor.

This bill is the start of making access to pharmacies easier, but it will not end there. Regulation 24 will assist people living in rural and remote parts of Australia to access pharmacies, but we need to do more on education so that people are aware of this regulation and understand how it works. I know this because I have had personal representations from people in my community who have been caught out unknowingly. There is another way around this. As members of parliament, we hear from our constituency about problems when they arise. This bill will certainly make some of the changes needed, but we need education and awareness. We need to advise our constituency through newsletters and in whatever ways we can that regulation will change things and make it easier for people living in rural and remote parts of Australia. I commend this bill to the House and look forward to working with the minister to develop more ways of providing reasonable pharmacy access to people living in rural and remote communities.

I have mentioned Thargomindah, in the Bulloo shire, which does not have a pharmacy, and I am sure that many other electorates across rural and remote Australia are in a similar situation. But they do have visits from the Royal Flying Doctor Service, which is an icon of the mantle of safety for all Australians. I would like to take the opportunity to again place on the record my appreciation for the work of the Royal Flying Doctor Service and the doctors, pilots and nurses who deliver this service in so many rural and remote parts of Australia. They are a great, dedicated team. I commend them and thank them for the work they do.

See this speech in context