Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

I rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2016. This bill puts into effect three minor technical changes to the administration of the Pharmaceutical Benefits Scheme, and Labor is, I will say the outset, supportive of this bill. Labor welcomes the practical benefits which will arise from the passage of this bill in making the administration of the PBS more efficient for pharmacists and for patients. The bill allows the Minister for Health, the Secretary of the Department of Health and the Chief Executive Medicare to delegate administrative actions, including decision making, to computer programs. This will allow for the automated online processing of PBS claims so that pharmacists do not have to submit hard-copy prescriptions to the Department of Human Services for reconciliation. It will also allow approvals for certain prescriptions to be granted online rather than on the phone or in writing as at present.

The bill allows pharmacists whose premises have been affected by disaster or exceptional circumstances—flood or fire, for example—to supply pharmaceutical benefits at nearby alternative premises for up to six months. Affected pharmacists will apply to the secretary of the health department for permission to operate from alternative premises. The secretary will exercise discretion over whether the usual premises have been affected by a disaster or exceptional circumstances and whether the alternative premises are substantially in the same location, and other administrative questions. The bill is intended to help maintain access to medicines for communities that have been affected by a disaster or exceptional circumstances. It will also improve arrangements for affected pharmacists, who are currently required to submit a full pharmacy application for temporary premises and are only paid 90 per cent of the value of claims until that application is approved. The bill also clarifies that PBS benefits can be provided to concessional beneficiaries and their dependants on the day of their death. A quirk in the current law provides that benefits cease on the day prior to death, consistent with social security legislation, because other social security benefits apply from the date of death.

These are, as I said at the start, largely administrative changes which have been welcomed by stakeholders across the sector. However, I want to flag that Labor will be watching the rollout of computerised decision making very closely. Automated processing of claims and prescription approvals should reduce red tape for pharmacists and prescribers. I know many GPs in particular have seen the authorised prescribing process as a bugbear for quite some time. The automated processing of claims should certainly assist with reducing the time that GPs are spending on the phone waiting for approvals rather than having that done through a computer system, which will hopefully mean that GPs are able to spend more time with their patients than waiting on the telephone.

But, as have seen on a number of occasions, this government has bungled IT projects, including of course the census, the availability of Medicare rebates and the problems with Medicare and PBS data on data.gov.au being de-identified, and with the way in which the government or the health department released that data. More recently, we have seen the government's farcical approach to the implementation of the National Cancer Screening Register—frankly, a complete and utter bungle which has pushed back the rollout of a lifesaving cervical cancer screening test. This government has an appalling record on IT, and we hope that the rollout of the technology that this bill allows for does not have the same fate. I acknowledge that this bill does include some safeguards: the minister, secretary and chief executive will remain responsible for decisions made on their behalf by computer programs; the minister, secretary and chief executive will be able to override a decision made by a computer program; and decisions that are currently reviewable by the Administrative Appeals Tribunal will remain reviewable, regardless of whether or not they are made by a computer program.

While this bill makes three minor improvements to the administration of the Pharmaceutical Benefits Scheme, it does nothing about the real threat to the PBS: the government's plan to increase the price of every medicine by up to $5. The so-called zombie measures from the notorious 2014 budget remain government policy to this day. In the horror budget of 2014, the government announced cuts of $1.3 billion from the Pharmaceutical Benefits Scheme, to be achieved by increasing co-payments and safety net thresholds. The measures include increasing co-payments for general patients by $5 and for concessional payments by 80c for every single script. PBS safety net thresholds would also be increased each year for four years, with general safety net thresholds to increase by 10 per cent each year and concessional safety nets to increase by the cost of two prescriptions each year, making it harder and harder for patients to reach that safety net. These increases are in addition to the existing annual indexation of co-payments and safety net thresholds in line with the consumer price index.

Labor has consistently fought these cuts, and so far we have prevented them from becoming law—despite the fact that, having passed this place, they have never been presented before the Senate. The government knows that Labor has the numbers in the Senate to block them, and we have consistently done that since the 2014 budget. Despite this, the Prime Minister included the PBS price hike in the 2016 budget. It has been included in the mid-year economic and financial outlooks and, frankly, it has continued in the government's rhetoric—a clear signal of the commitment to continue with this measure. The most vulnerable, the poor, the elderly and the sick will be hit worst by this plan to cut the PBS. As an example, a general patient filling two scripts per month will be $100 per year worse off on medicines alone.

The more expensive a medicine becomes, the less likely people are to fill their prescriptions. The latest Bureau of Statistics Patient Experience Survey shows that up to 10 per cent of people already delay or avoid filling a prescription due to cost, and of course the impacts are unequal. People living in areas of greatest disadvantage are twice as likely to skip prescriptions as people living in areas of least disadvantage. I note we just had a really good debate about rural health; I would like the government to consider perhaps some of the other measures that it has in the health policy area and the impact that they have on the health of those Australians who live in rural and regional Australia.

Affordable medicine is at the heart of Medicare, yet if the government get their way, Australians will be forced to pay more for every script every time they get sick. The changes to the PBS, which are budgeted to start on 1 July this year, will drive up the cost of health care for every Australian. Pensioners, families and the chronically ill will be the hardest hit. During the election, Labor stood up to protect Medicare by reversing the Prime Minister's plan to increase the cost of medicines. Delaying access to medicine and treatment can result in illnesses worsening and the ultimate cost of health care increasing. Labor believe all Australians should be able to access affordable, quality health care when and where they need it. That is why Labor built Medicare and the PBS and why we will always fight to protect access to universal, affordable health care for all Australians.

Legislation to establish the PBS was first introduced by Labor Prime Minister John Curtin during the Second World War. It was part of the government's social compact with Australian citizens. This was Labor's response to the need to provide access to newly available antibiotic drugs for the whole population, not only for the minority of people who could afford them. At the time, the Conservative opposition opposed the plan, seeing universal health care as an underhand plan to nationalise medicine. It was not until 1960 that Australians had access to the comprehensive PBS that Curtin had envisaged in 1944.

Then, as now, the Liberals cannot be trusted with the universal healthcare system that is so important to all Australians. Millions of Australians voted against the Prime Minister's price hikes to medicines and his other cuts to health. So far, he has not been listening. But today we again call on him to do so. While Labor support the passage of this legislation to make minor improvements to the administration of the PBS, we once again call on the Prime Minister to drop his plan to raise the price of medicines. The PBS is a central pillar of Medicare and our universal healthcare system, and Labor will continue to fight for it.

See this speech in context