Annette Ellis (Canberra, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Pharmacy Location Arrangements) Bill 2006. The purpose of this bill is to amend the National Health Act 1953 to make several changes to arrangements for approving pharmacists to provide medicines under the Pharmaceutical Benefits Scheme. These amendments are the result of the fourth pharmacy agreement between the Commonwealth and the Pharmacy Guild of Australia, which commenced on 1 December 2005. The agreement provides for new pharmacy location arrangements to commence on 1 July 2006, and this bill gives effect to some of the issues around those arrangements.

Changes in the pharmacy location rules will allow co-location of pharmacies with large medical centres that operate extended hours, allow the location of pharmacies in small shopping centres, allow the relocation of an additional pharmacy to one-pharmacy rural towns and one-pharmacy high-growth areas without regard to the usual distance criteria, remove the requirement that a specified number of commercial establishments must be open and trading before an approved pharmacy can relocate to a shopping centre and provide greater flexibility for pharmacies located in private hospitals by allowing the establishment of satellite dispensaries for hospital in-patients.

Labor will support this bill because the changes will have several benefits, especially for people living in rural and remote areas and growing suburban areas. We have some concerns—a second-reading amendment has been moved—and I will address some of the concerns that I personally have. However, the co-location of pharmacies and medical centres will help people to access pharmacy services for acute medication needs at the time of their medical consultation. The location of pharmacies within small shopping centres recognises the trend in retailing towards smaller centres with larger supermarkets. The existing requirement—large shopping centres with at least 30 commercial establishments—limits access to pharmacy services in many retail developments.

The fact that not all of the required commercial establishments in a shopping centre need to be open and trading at the time of the application approval will also increase access to pharmacy services. In some cases, this requirement has delayed access to pharmacy services in new shopping centres. Rules for relocation of an additional pharmacy to single-pharmacy rural towns and high-growth urban areas will mean a second pharmacy can be approved in these communities. This will assist all those members of our community who need to access pharmacies at all sorts of hours, which should be as convenient as possible for them. For all of these reasons, Labor will support this bill.

However, as I have said, there are some concerns, and an amendment has been moved by the member for Lalor. This legislation raises several issues of concern in relation to the provision of pharmaceutical services in Australia. While I support the location of pharmacies in medical centres, I am concerned that there may be a growing trend towards the corporatisation of pharmacies and what this will mean. The government and the pharmaceutical industry must monitor the impact this legislation will have on the role of local pharmacies, and I use the word ‘local’ advisedly. I am aware that there is concern within both the industry and the community that the role of local pharmacies could be devalued if the sector becomes overcorporatised. I believe it is important that the people in my electorate of Canberra continue to be able to access the expertise and individualised service provided by their local pharmacist.

Another major issue of concern to me is the impact the Howard government policies have had on the PBS and the affordability of essential medicines. Since the introduction of the 21 per cent increase on PBS copayments in January 2005 and the 12.5 per cent cuts in generic medicines in the middle of 2005, the PBS growth rate has now fallen to 2.5 per cent and 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. These are very big figures. This is good news only if you put budget savings ahead of health outcomes. The Minister for Health and Ageing and the Treasurer consistently confuse PBS sustainability with cost cutting and never look at the impact on the overall health system and the ability of patients to afford their needed medicines.

The government’s own figures show clearly that fewer prescriptions are being filled in some crucial categories, such as for cardiovascular conditions, for anaemia and blood-clotting problems, for hormone replacement therapy needed because of thyroid, pituitary or pancreatic problems, and for mental illness, epilepsy, Parkinson’s disease and Alzheimer’s disease. It is obvious that rising out-of-pocket costs due to increased copayments, special patient copayments and therapeutic and brand premiums are hitting the sickest and neediest Australians, meaning that too often they must choose between buying their medicines and the other necessities of life.

And the impact of changes to the PBS safety net and of the new 20-day rule, which the previous member referred to, is yet to kick in. In the meantime, the Treasurer, the Minister for Finance and Administration and the Minister for Industry, Tourism and Resources push on with their plans for more PBS budget savings. They either are oblivious to the consequences or do not particularly care. It seems that these decisions are being made with little, or without any, reference to the minister for health. This is a serious concern, one that we consider seriously on this side of the House. It brings into question the important balance that must be struck between financial responsibility and the health outcomes and considerations that we would all expect in our communities.

I conclude by reiterating my concern in relation to the corporatisation of medicines generally and pharmacies particularly. I would dare to say that many members in this House have already seen that beginning to happen. We are seeing small medical surgeries close down as they are corporatised into larger centres throughout our urban areas, let alone our rural centres, and we then see the corporatisation of pharmacies attached to them in a physical sense. That means we are running the risk of the removal of the small corner pharmacy, which provides an invaluable service to most members of our community.

Over the years that I have been fortunate to serve in this place, I have had many a discussion with pharmacists and pharmacy organisations within my community. I understand what they are attempting to do and they understand our concerns. At the end of the day, it is fair to say that the good pharmacist sitting down at the shopping centre, available for discussions with our community as they get their medicines and prescriptions, is a very valuable community service that we must ensure stays as viable as possible into the future.

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