George Christensen (Dawson, National Party) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2015, which, I note, does not contain the words 'transpacific partnership' in it anywhere. But, for the benefit of the previous speaker, the Minister for Trade and Investment is on the record as specifically saying that he will not accept a deal which undermines the PBS. All of the stuff that we just heard is quite irrelevant once you take that statement on board.

The bill before us comes as a result of negotiation with the Pharmacy Guild and other stakeholders for the Sixth Community Pharmacy Agreement. Negotiation with stakeholders across the medicine supply chain for this agreement was part of the government's Pharmaceutical Benefits Scheme access and sustainability package of reforms. The important thing about sustainability is that it does cut two ways. Firstly, the long-term future impact on taxpayer dollars must be sustainable obviously because taxpayers are not the unlimited ATM that some in this place, particularly on the opposition benches and over behind me on the crossbenches, think that they are.

Secondly, the businesses that do provide these valuable health services must be sustainable. If those businesses were to become no longer viable, there would be no service provision, and that was a risk that the Labor Party was willing to make during negotiations for the previous agreement—actually not during those negotiations for the previous agreement but when they actually broke that agreement. They broke the Fifth Community Pharmacy Agreement. It was in place when Labor took the decision to change it without consultation with the industry during that time when the Rudd-Gillard-Rudd government was creating havoc. I do not know exactly whose decision it was—the knifer or the knifee. Either way, they both ended up with their fingerprints on the knife handle, right alongside the opposition leader's fingerprints—and I bet he is looking forward to tomorrow night's viewing on the ABC.

It was just before the 2010 election was called that the Leader of the Opposition had dispatched his first Prime Minister and Labor announced they would change remuneration to pharmacists under the PBS. The changes were made, as I said, without consultation and in breach of the agreement, so it was not surprising that the Pharmacy Guild was shocked by those actions. At the time, the guild issued a statement on 16 August 2013 which said:

The changes may force some pharmacies to close their doors or slash important services for the elderly, very young or chronically ill with the risk particularly high for the more than 1,000 pharmacies in rural and regional areas, and for the 410 Australian towns which have just one pharmacy.

It went on to say:

The Pharmacy Guild of Australia national president Kos Sclavos said the unexpected change would leave each community pharmacy $90,000 out of pocket in 2014-15, when added to existing price change arrangements.

I offer that short extract from Labor's 'How to destroy business and kill jobs' playbook for two very important reasons. Firstly, that betrayal by Labor made pharmacists very wary of what might be in store under the sixth agreement, which was being negotiated this year. I held numerous meetings with pharmacists in my North Queensland electorate of Dawson while those negotiations were going on. Pharmacists in Mackay, in the Whitsundays, in the Burdekin and up in Townsville did have a fear, based on what Labor had done, about this new agreement. They feared the worst for their business and the worst for the health needs of their local community. Secondly, I hark back to that Labor decision to show the perilous nature of the position in which pharmacists were placed under the previous Labor government to reinforce how important it is to get this agreement right from both sides of the ledger—sustainability for tax payers, yes, but also sustainability for important health care providers in our community.

Fortunately the Liberal-National coalition government understands that business has to remain viable to stay in business. If pharmacies do not stay in business, we would lose an important first line of health provision for the community. If we look to what the health minister and the Pharmacy Guild have negotiated here, we can see there are benefits for pharmacy, which include: a more than doubling of program funding from $613 million to $1.2 billion; a continued growth in prescription volumes; the moving of dispensing fee growth from wage cost index to the consumer price index; and $1.5 billion for an administration handling and infrastructure fee. The administration, handling and infrastructure fee will bring pharmacy remuneration back to the average it was under the Fifth Community Pharmacy Agreement. By delinking that from the cost of medicines, the fee now recognises there are costs associated with the dispensing of medicines regardless of the price of those medicines.

When I was talking to pharmacists in my electorate, they explained some of the valuable services they provide to the community that they simply could not perform if this government had not come up with a sustainable deal. One of those services is medicine deliveries to the elderly. There are many old people who do not have the means or the ability to get into the pharmacy to have those prescriptions filled. I went into a Dupuy's Pharmacy in Mackay and in the back room was a great team of pharmacists working on all of this. It was surprising to see what happens in the back end of a pharmacy that you do not actually see behind the counter. They were beavering away on all these home deliveries and also deliveries to aged-care centres. This is stuff that we do not see that pharmacists do every day, making sure those pills are correct, that the prescriptions are all laid out, that there is going to be no problem once it is delivered to a nursing home and someone else is administering it. It is sometimes, I have to say, painstaking stuff that they are doing. But that is all happening and now it is being recognised.

There are many other maintenance programs, checks and testing that pharmacies provide the customers at no charge and at no expense to the taxpayer. Some of those now will get some payments. There are many benefits that the Sixth Community Pharmacy Agreement will provide to the community simply by making pharmacy more sustainable as a business. More specifically, the agreement includes a doubling of investment in pharmacy primary care support by taking funding to $1.26 billion over the next five years. This investment recognises how important pharmacies can be and are as primary healthcare providers. In so many ways these pharmacies can be the first port of call for minor ailments to get people out of the GP system, to get them off bulk billing, taking pressure off Medicare and the public health system by dealing with these minor problems quickly and efficiently.

Pharmacies already deliver important services such as medication reviews and dose administration aids, but there is much more that they can do. Many member of the community already consult with their pharmacists as a first port of call for things like coughs, colds, bumps and bruises. This is not to suggest that pharmacists are replacing doctors when a doctor is needed, but it is recognition that pharmacists are very well qualified to recommend when a doctor should be consulted and when they can simply sort out a problem with the patient there in the pharmacy. Part of the new funding under this agreement will be specifically targeted at trials to provide evidence for both new and existing programs. The government's expert Medical Services Advisory Committee will be overseeing new and existing programs for greater transparency and to ensure the programs are both cost-effective and evidence-based.

Another part of this agreement—it was probably a little bit more controversial in the lead-up to negotiations—is that, under this legislation, the government signed a five-year deal with the Generic Medicines Industry Association and the Pharmacy Guild as part of a broader package of measures. The PBS reform is one of the biggest proposals we have seen in the past decade, and the government has come to an agreement that will significantly reduce the price of generic medicines for patients and taxpayers.

I would say that, as we go forward with that, we are going to have to be very careful that we are not simply changing around drugs that people might be accessing and end up costing more. I hope there is going to be some monitoring of this, because it was pointed out to me by pharmacies that sometimes there are false economies in this approach. But let's have a look and see how this goes a year down the track.

The optional discounting is also one area of contention, and I have to say I am still a little bit unconvinced about it, but nevertheless it is part of the agreement, and we go forward with the agreement given the Pharmacy Guild has signed off on it. The pharmacy agreement includes an optional discounted co-payment that will, I admit, give savings to consumers. Where that optional discount is applied, concessional patients' co-payment will be reduced from $6.10 to $5.10. Where a patient uses, for example, 40 scripts a year, that apparently translates to an up-front saving of $40. I note the average concession cardholder uses about 17 scripts per year and could save about $17 per year. In the older age brackets, where more significant savings for consumers are made, the average concessional patient in the over-65 age group uses 43 scripts per year, making their potential saving $43 for the year. I worry about the impact that some of this may have on smaller pharmacies, particularly in rural and regional areas, and I hope we are going to monitor this to ensure that we do not see a lessening of competition as a result of this part of the agreement. The guild has agreed and signed off on this, but I think we need to monitor it.

This government acknowledges that the health needs of some people are higher than the needs of others, and these people will continue to have the full protection of the PBS safety net. As result of this agreement, those patients could also benefit from lower monthly costs for their medicines in the lead-up to reaching that safety net. Once the patient reaches the safety net, all their medicines are free of charge.

The cost of medicines can be very high for many families, and it is the role of the PBS to ensure medicines remain affordable. Since forming government less than two years ago the Abbott government has doubled the number of drug listings for consumers, making 652 new and amended drug listings on the PBS at about $3 billion. That is already double the 331 new and amended drug listings that were under the previous, Labor government. Among those new listings are new life-saving drugs for breast cancer, melanoma, blindness and the debilitating shingles virus.

These are important measures for reducing the cost to consumers, but we cannot forget that there is a service provider in the middle who also faces cost burdens, and many of these pharmacies, especially in regional areas, are marginal and struggling. I really do say we cannot afford to lose them.

I note that during this process there were a lot of attacks on the sector, not the least of which was an extraordinary attack by News Limited journalist Sue Dunlevy, whose partner, I might point out, is a senior adviser to the shadow health minister. Her article on 15 March this year, where she likened pharmacists to crooks ripping off the taxpayer, ran under the banner 'How a pharmacy monopoly pushes up your medicine price and makes pharmacies million dollar businesses'. She certainly has not been talking to Robert Di Marchio, who owns the Guardian Pharmacy in the Burdekin; Allan Milostic, who runs another small pharmacy in Airlie Beach; Lynne Dupuy and her pharmacy in Mackay; or Bill Brewer and his pharmacy at Annandale. These pharmacies are simply small businesses. It is not multimillionaires or billionaires running it; it is everyday people, good people, and they need to be considered in this process.

It was important that the government underwent extensive consultation with this vital industry rather than simply taking a slash-and-burn approach to small business or an approach where they were completely ignored as Labor did or riding roughshod over them like they did with breaking the fifth agreement. I know that the government has tried to strike a balance between what is good for the consumer and keeping pharmacy viable—and I have to say that that is also good for the consumer—but I have to note that neither I nor pharmacies in my electorate are 100 per cent happy with this outcome. We have to remember that these businesses suffered a huge step backward under Labor, and it is going to take a huge step forward to get them back to where they were.

In effect, what Labor did when they broke the fifth agreement was to slash health funding. What this government has done with the sixth agreement is to restore funding to health while making the system more sustainable for taxpayers and sustainable for the providing services. In the meantime, there are significant savings for consumers. All in all, I do support the bill, with some concerns. I hope that the monitoring of this will see those concerns not be concerns at the end of the day.

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