Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Hansard source

I move:

That this bill be now read a second time.

The Pharmaceutical Benefits Scheme (PBS), as I said in speaking to the previous bill, is one of the cornerstones of our health system. It has provided Australians with affordable access to quality medicines for almost 60 years and is justifiably regarded as one of the best systems of its kind in the world. One of the reasons it has been so successful is that PBS subsidies are provided directly to consumers at the point of purchase of medicines in the community.

At the same time, the PBS provides an efficient, transparent and predictable system for industry and the supply chain.

In 2006-07, government expenditure on the PBS was approximately $6.4 billion and we expect it to be around $7 billion this year. This is a significant level of government expenditure, but we believe that the money is well spent.

This bill contains a number of largely technical amendments to the National Health Act 1953, with the exception of a safety net measure that will provide great relief to families separated by poor health or working for the government overseas.

Debate interrupted; adjournment proposed and negatived.

These changes will strengthen the PBS and improve access to PBS entitlements. I will now outline each, commencing with the safety net measure that I just mentioned.

The PBS safety net, as people in this House know, protects individuals and families who need a large number of medicines from high cumulative health costs.

Members of the family can combine certain PBS charges toward a joint safety net tally. In 2008, the PBS safety net thresholds are $290 for concession card holders and veterans, and $1,141.80 for general patients. The same threshold applies for a family unit, whether as an individual, a couple or a family with dependent children. After a family reaches the safety net threshold amount, all members of the family benefit from the reduced PBS charges for medicines for the rest of the calendar year. In 2008, the copayment reduces from $5 to free for concessional payments, and from $31.30 to $5 for general payments.

In broad terms, a PBS family for safety net purposes consists of a person, their spouse, and dependent children. Under the current rules, a legally married or de facto couple must be living together on a permanent basis to qualify as members of the same family. If a couple is living apart permanently, neither person meets the PBS definition of spouse to the other. In that case, each person is treated as an individual with a separate safety net for him or herself, together with any dependants in the person’s care, meaning a much higher threshold has to be reached by the couple.

This rule currently applies even if a couple is living apart permanently due to illness or infirmity; for example, if one partner is living separately in long-term nursing care. For such couples, the effect of having separate safety nets is that they may need to pay up to twice the amount in PBS contributions to reach the safety net threshold as they otherwise would.

The amendment in schedule 3 removes this harsh rule and improves access to the PBS safety net for legally married or de facto couples living apart permanently due to illness or infirmity. It provides relief to couples, particularly elderly couples, at a difficult time in their lives. It will allow such couples, who are currently treated as individuals, to use the safety net as a family, in the same way as they would if they were still living together.

This amendment extends the PBS safety net definition of spouse so that a legally married or de facto couple living apart permanently due to illness or infirmity, of either or both persons, is not taken to be living separately on a permanent basis.

This will mean that couples, often long-time life partners, can continue to be treated as members of the same family for the PBS safety net. They will be able to contribute PBS payments to the same safety net threshold; be included on the same safety net concession or entitlement card once the threshold is reached between them; and both will have access to reduced copayments for medicines supplied as safety net benefits.

In effect, this change will mean that the amount of PBS payments required for both members of the couple to reach the safety net is the equivalent of one safety net threshold—not two. It has the potential to reduce the out-of-pocket costs for PBS medicines for such couples by an amount equal to the relevant safety net threshold amount.

This is an important measure that will provide significant financial relief and appropriate recognition to eligible couples struggling to afford their medicines. There is no good reason why people who, as a result of illness or infirmity, are forced to live apart should not have the same PBS entitlements as other couples. This is essentially a matter of fairness.

It might assist the House, given the time of day, if I table the rest of the speech in accordance with the one that has been distributed. The other measures are mostly technical measures which will have benefits for Australian residents who are working for the government overseas. If that is an appropriate method for the House, I will do so.

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