Belinda Neal (Robertson, Australian Labor Party) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical and Other Benefits—Cost Recovery) Bill 2008, which introduces a number of amendments to the Pharmaceutical Benefits Scheme. The bill before the House today amends part VII of the National Health Act 1953. The Pharmaceutical Benefits Scheme has operated successfully for almost 60 years in Australia. It is a mechanism that brings access to affordable quality medicine to thousands of working families in Australia. The PBS is regarded around the world as one of the fairest and most equitable systems for the delivery of affordable medicine. The Australian health system has its problems, but I am extremely proud of it when I compare it with some of the extremes around the world, schemes that either do not provide proper health care or provide health care at a great cost, such as in the US. True health care is not universally available, and I am very proud that here in Australia we provide health care at an affordable level. Medicare, coupled with the Pharmaceutical Benefits Scheme, is the true basis of that.

The Pharmaceutical Benefits Scheme is not only a scheme that provides affordable pharmaceuticals; it is quite a flexible scheme. I wish to congratulate the Minister for Health and Ageing on her response in this budget to the request by a number of type 1 diabetes sufferers, particularly young people, that the insulin pump be put on the PBS. I was thrilled and excited to see that the minister, in her warm-hearted way, was able to respond to that request and to provide that item on the PBS. I had the pleasure of having a delightful young girl, Lauren Espedido, visit me in my electorate. She suffers from type 1 diabetes and, along with her parents, she explained to me the real need to be able to access the insulin pump and for it to be affordable. If you have to pay for it entirely yourself, it costs approximately $8,000, I am informed, which is obviously out of the reach of many working families. The family put their case to me and I passed on those views and made a representation to the minister, along with a number of other people in the community and in the parliament, and I was thrilled to see that the minister was able to include that request in the budget provisions. I, and also on behalf of the Espedidos, wish to express a very heartfelt thankyou to the minister for that positive and quick response.

The Minister for Health and Ageing described the PBS in her second reading speech as an ‘efficient, transparent and predictable system for industry and the supply chain’. It is also a system that provides significant benefits for consumers both in terms of reduced prices for pharmaceuticals and in the simplicity of its use. The unique feature of the scheme is that PBS subsidies are delivered directly to the users at the point at which they purchase the medicines they require. The PBS is a much valued part of the Australian healthcare delivery infrastructure. Over the nearly six decades of its existence, the scheme has attracted significant government expenditure to keep it viable and relevant to the changing needs of Australian society. But there is a concern: the PBS rises on average at a rate of 4.6 per cent. So, unless we are careful, unless we take care to make the necessary adjustments, the cost of the scheme will mean that it is no longer viable and we cannot continue to provide it to the Australian community. So constant adjustments, sometimes minor in nature, are necessary to ensure that the scheme continues to operate effectively and is viable.

In 2006-07 government expenditure on the PBS was approximately $6.4 billion. It is expected that around $7 billion will be invested in the PBS this year. While this represents a large amount of government expenditure, the PBS has been shown to deliver significant benefits to the Australian community. In my opinion, as the PBS is part of our universal health care it is money well spent. The provisions in the current bill will enhance access to the PBS entitlements for many Australians and strengthen the scheme as a whole.

The bill proposes four minor amendments to the National Health Act 1953. Schedule 1 expands the criteria for determining that brands of pharmaceutical items are comarketed and provides that the minister may determine that comarketed brands cease to be comarketed. Schedule 2 provides for people who are otherwise eligible for pharmaceutical benefits to access those benefits while working outside Australia as officers of the Commonwealth or of a state or territory—and, of course, for their accompanying spouses and dependent children. Schedule 3 allows legally married and de facto couples living apart permanently due to illness or infirmity to use PBS safety net arrangements jointly as if they were living together. It is very unfortunate that up until now elderly couples, perhaps married for 30, 40 or 50 years, have been treated, in their minds, as not married if one of them becomes ill or has to enter a nursing home. Many people find that, as well as the financial impact, extremely distressing. Schedule 4 makes minor changes to two PBS related definitions and removes provisions for the gazettal of determinations made in relation to pharmaceutical benefits that may be prescribed by participating dental practitioners and authorised optometrists.

Safeguards currently built into the PBS guidelines affect the ability of Australian government officers to obtain supplies of PBS medicines when working outside Australia. Accessing medicines in some overseas locations may be difficult or uncertain. In some places where officers are sent to perform duties for an Australian government, the range and quality of medicines available locally may not match those of medicines available through the PBS in Australia. In addition, the supply of medicines and their quality may be unreliable or medicines may only be available at a high cost.

Schedule 2 of the bill, as I have outlined, proposes amendments to the act which will allow people who are otherwise eligible for pharmaceutical benefits to access those benefits under the PBS while they are working outside Australia. This provision will provide great assistance to such officers and their families. The present prohibitions on export of PBS medicines for or to other persons outside Australia remain in place. The new arrangements do not cover people working overseas for private companies, studying overseas, providing services as an independent contractor to governments, conducting personal business, travelling as tourists or living overseas permanently. The changes to the eligibility criteria are limited in scope and do not allow broad access to the PBS for people outside Australia. Several Commonwealth departments have been seeking these changes for some years. It is estimated that around 3,000 people will be eligible for this extended assistance.

I want to say a bit more about the safety net for couples living apart. This provision will allow legally married or de facto couples living apart permanently due to illness or infirmity to use the PBS safety net jointly. The PBS safety net provides that families can combine certain PBS charges toward a joint safety net tally. After the threshold is reached, all members of the family benefit from reduced charges for PBS medicines required for the remainder of the calendar year. The act defines who is a member of a person’s family for PBS safety net purposes. As currently defined under the act, when a couple are living apart on a permanent basis, they are deemed not to be members of the same family for the PBS safety net. A separate safety net is used for each person, together with each person’s dependent children. This rule also applies for couples living apart permanently due to illness or infirmity. This means that the PBS contributions required to reach the safety net threshold for both persons may be double that required if the couple were living together.

Schedule 3 amends the act to extend the definition of family for PBS safety net purposes by amending the definition of spouse. Under the amendment, members of a legally married or de facto couple living apart permanently due to illness or infirmity are not taken to be living separately on a permanent basis. This will result in the members of such couples being entitled to safety net benefits in the same manner as if they were living together. PBS payments will be able to be combined toward the same safety net tally and a reduced copayment rate will apply for both persons when the threshold is reached. This will benefit such couples by potentially reducing PBS outlays to reach the safety net by up to 50 per cent.

These important amendments will provide significant financial relief and appropriate recognition to eligible couples struggling to afford these medicines. There is no good reason why people living apart as a result of illness or infirmity should not have their marriage recognised through this legislation. This is a matter of fairness and equity of access to the entitlements of the PBS.

Taken together, these new arrangements will help strengthen the PBS. As I mentioned earlier, the success of the PBS is that the subsidies, which allow access to reduced prices for pharmaceutical medicines, are provided directly to the consumers at the point of purchase. Families will be assisted greatly by these new measures, especially couples living permanently apart. The modest costs involved—approximately $300,000 a year to provide PBS entitlements for families of officers working overseas, and approximately $1.1 million per year for amendments extending PBS entitlements to couples living apart—are but a small fraction of the total PBS expenditure, which, as I said, is expected to be $7 billion this year.

The cost of these measures to the public purse is far outweighed by their contribution to the public good. These amendments are a clear demonstration that the Rudd Labor government recognises the importance of the PBS in maintaining the health of Australians. Affordability, equity and access with regard to quality pharmaceutical medicines are vital to this goal. The bill before the House today delivers on these objectives. I commend the bill to the House.

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