Judi Moylan (Pearce, Liberal Party) Share this | Hansard source

I thank the member for Moore, who is not in the chamber at the moment, for seconding the motion and also for his sensible contribution so far to this discussion as a member of parliament and as a medical practitioner. On 25 February this year the Minister for Health and Ageing announced the deferral of listing of a number of Pharmaceutical Benefits Scheme medications that had received a positive recommendation from the Pharmaceutical Benefits Advisory Committee. In subsequent interviews the minister justified the deferral on economic grounds, saying that, until the budget returns to surplus, positive recommendations will not be listed on the PBS unless offsets can be found. Under this system a recommendation by the PBAC to the minister will be referred to cabinet and then referred to a subcommittee consisting of the Treasurer, the Minister for Finance and Deregulation and the Prime Minister if the Prime Minister is available. The committee will then decide on the listing according to the budget bottom line rather than their primary obligation to make available to every Australian citizen best-practice medicine.

Although the minister said that medications that are new or could save lives may be listed by the government, the process will add further unnecessary layers of paper shuffling in what can only be described as a cumbersome and inefficient process. Further, it puts the health of many Australians at risk by denying them best-practice medicine. The ingenuity of mankind will ensure that new and more effective medications are regularly being discovered. My grandfather would likely not have lived until his mid-70s had it not been for the discovery of insulin. Sick and bedridden, he lay for months with his severe malady and was saved from an early death only through the discovery and the availability of insulin. By leaving decisions as to which medications should be listed on the Pharmaceutical Benefits Scheme to a subcommittee of cabinet, on the basis of the budget bottom line, instead of to the expert members of the PBAC, the government risks putting the lives of many Australians in jeopardy. Interference with the recommendation of the expert panel is almost unprecedented. There have been a couple of cases, such as Viagra, but in the past it has been very rare that cabinet has not accepted the recommendations of the PBAC.

This system risks setting up a two-tier system of health where those on low or middle incomes are unable to afford access to best practice medicine. The minister for health has not placed a time limit on when positive recommendations would be considered, except for the blanket statement that the process will continue at least until the budget is in surplus. Given the way we are going, I do not think we can look forward to that any time soon. The government has already spent all of the extra income and budget revenue that the resources boom has delivered to Australia, and then some. It has recklessly squandered taxpayers' money on harebrained schemes such as the now failed insulation program and the botched GroceryWatch and Fuelwatch schemes.

To make up for this maladministration of finances, they are now looking to deny Australians reasonable access to best practice medicines, based on the recommendations of its own expert body. The AMA vice-president, and a former member of the government's expert independent Pharmaceutical Benefits Advisory Committee, Steven Hambleton, was accurate in his appraisal that the government is politicising the drug approval process. In an article by Sue Dunlevy in the Australian on 10 March 2011, Dr Hambleton said that the new rules were about 'overt rationing of health care', and I concur.

Among the greatest concerns is the sheer lack of transparency. The decision to defer is arbitrary. Cabinet, especially ministers concerned with finances, lacks the expertise to adequately judge which medicines should and should not be deferred in the process and undermines the role of the PBAC. Brendan Shaw, from Medicines Australia, said the government should accept the independent advice to list medicines on the PBS. He said:

The Government's own expert committee has said making these medicines available is cost effective, is value for money and is the right thing to do. It's unclear what expertise or experience cabinet ministers have at their disposal to override the decisions of their own expert committee. The Government has brought politics into what was an effective and depoliticised process in a highly-sensitive area where people's health and indeed their lives are at stake.

The cost of medicines has already been subject to an economic evaluation by the PBAC; there is no need for further analysis. This policy that the government has implemented is short-sighted, as products which could have cost the government less have already been deferred. There are examples piling up of patients suffering conditions such as schizophrenia, chronic disabling pain, lung disease and blood clots having to forgo best treatment or having to pay up to $100 per month, instead of the PBS co-payment of $34.20. As I said, it sets up a two-tier system, because those who are on low or middle incomes are unlikely to be able to afford the full cost of these medications.

I think this further diminishes the government's commitment to its mental health policy that has just been announced, because conditions such as schizophrenia can be treated. There are amazing new medications coming onto the market and, in many cases, they allow somebody suffering from severe mental illness to fully participate in the workplace and in the community. Without those medications, these people are unable to properly function in society. So I think it is false economy and false savings and it is not the best outcome for those whose lives are put in jeopardy through not being able to access best practice medicine.

In February, the government saved $30 million, for example, by delaying subsidies for seven new medicines, including Duodart, a treatment for benign prostate cancer; a new schizophrenia medication, Invega Sustenna; and a lung medication, Symbicort. Withholding new improved medications can have a significant impact on the quality of life for many Australians and indeed, as I said, on their capability to fully participate in the workforce. It is therefore a false saving. I call on the government to reverse this policy and to allow the PBAC to resume its premier position of providing critical advice to cabinet on what medications should be listed. Clearly, this is not a matter for ministers of this government to decide entirely; they should be guided by this expert panel. As I said, in the past there have been very few occasions when the recommendations of that expert panel have not been listened to or taken heed of by cabinet and where those medications have been refused a listing.

The government is deciding on the basis of the budget bottom line. But, as I said, we have seen an awful lot of squandering of money on schemes which, at best, could be called harebrained schemes, which have failed. I would have thought that this government has a primary responsibility to ensure the good health and quality of life for every citizen in this country. On that basis, I would hope that the minister would reconsider this decision on the listing of medicines and the recommendations of the PBAC.

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