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

Yes, I am happy to address that issue. You are right that we have made a change. We have supported suggestions that were put to us by you, the Macular Degeneration Foundation, Vision 2020 and the opposition and have agreed, both in the House and in the Senate, that the determinations will not include any cap on that measure relating to the injection of a substance into an eye which affects Lucentis.

What we have done, given requests made by the opposition previously, is table our draft determinations. We are not permitted by the rules of this place to have final determinations until the bill receives royal assent, so that item will no longer be in the final determination; otherwise, the exposure draft that has been provided is exactly as has been provided to and debated in the House. There were concerns and requests by the opposition and others that they be able to look closely at the contents of that determination for the IVF measures and the obstetric measures et cetera. We gave an undertaking that there would not be any changes to that determination other than this one, which is agreed. We accept that there were concerns that it might have unintended consequences.

I have to take issue—as will probably not surprise anyone listening to this debate—with some of the quite inaccurate comments being made by the shadow minister. On budget night, when these measures were announced, it was quite expressively identified that as part of this measure consultations would be undertaken, particularly with the sector, to restructure the IVF items. They are a complex range of items. We made quite clear that as part of that budget measure there would need to be a restructuring. The shadow minister opposite can pretend as much as he wants that that is a changed position. He can say ‘backflip’ as many times as he likes. In fact, that was exactly what was always intended. That process delivered an outcome that was ultimately accepted by the industry and by consumer groups and I am pleased was finally also accepted by the opposition.

The only thing that has been changed since budget night is our agreement to exempt Lucentis. It is not listed as Lucentis; it is listed as an injection of a therapeutic substance into the eye but, around here, of course, particularly among nonprofessionals, we have been calling it the ‘Lucentis exemption’ and we are happy to agree with that change. But I think it is a bit rich of people, particularly the opposition—and we see this also in a range of other measures so I might as well put it on the record in the House right now—to demand consultation and then to pretend that, because consultation takes time and because through consultation processes we come up with options that work for people, somehow the government is not doing its job properly.

I just conducted yesterday with the Prime Minister the 25th consultation on our health reform agenda. Anyone who thinks that we are not consulting on extensive health reforms has just been living in another country for the last six months. On our budget measures you simply cannot have it both ways. For example, with the introduction of nurse practitioner changes where questions have been asked about why the descriptors are not yet available, the descriptors are not yet available because the consultation meetings with doctors, nurses and others who have asked to be involved in drafting those provisions are drafting them. The shadow minister can come in here as many times as he likes, but it will not divert us from pursuing significant reform that was neglected by the previous government. It might be new initiatives like MBS and PBS access for midwives and nurse practitioners or it might be making measures like the Medicare safety net sustainable so that it can continue into the future and so that some of that money that perhaps was being misused—going into the pockets of specialists instead of to patients—can be redirected to better causes.

I think this outcome is good. I am happy that this change has delivered some relief to people who were concerned about the impact for macular degeneration, and I welcome the opposition’s belated support for this measure.

Question agreed to.

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