Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

I too rise to speak on the National Health Amendment (Pharmaceutical Benefits) Bill 2016. While this side of the House support this bill in principle, there is some hesitation. The hesitation is there because the government has a tendency to slowly but surely chip away at our country's most important safety nets. We have seen this in the past. This means that we on this side must be absolutely vigilant. We have seen it, for example, in the government's refusal to support our legislation that would reverse cuts to penalty rates. We have also seen it in respect of pensioners, people with disabilities and the unemployed. Most of all, we have seen it with respect to our universal health system—that is, Medicare.

Just last month we celebrated Medicare's 33rd birthday. It was a Labor government under Bob Hawke that introduced the reforms to make universal health care a reality in our country. Medicare is one of the most significant reforms in Australia introduced by the Hawke government. These were very hard-fought reforms that were opposed by Conservative governments and Conservative oppositions at every point. As I have said before in this place, it took two Labor governments more than two decades to embed what is now Medicare, and we will not see it undone.

The PBS is an integral part of our healthcare system, just as Medicare is. The Pharmaceutical Benefits Scheme began as a limited scheme in 1948. We just heard the shadow minister and member for Ballarat speak about Curtin, who introduced this particular scheme with free medicines for pensioners and with a list of 139 life-saving and disease-preventing medicines free of charge for others in the community at the time. It is now part of the Australian government's broader National Medicines Policy. People on low incomes, especially aged pensioners and disability support pensioners, rely heavily on the PBS. These are our most vulnerable people, and any proposed changes can have a significant effect and impact on their ability to access affordable medicines. As I said earlier, this is why we must be vigilant about these issues.

The bill that we are discussing today makes three technical changes to the administration of the Pharmaceutical Benefits Scheme. Firstly, the bill regulates the use of computer programs in respect of the PBS. It 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 automated, online processing of PBS claims so that pharmacists do not have to submit hard copies of 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. I know that some pharmacies already have their own systems in place to allow prescriptions online if they are repeat prescriptions over a long period of time.

While this seems like a relatively benign aspect of the bill and one that will hopefully simplify the process for both pharmacists and customers, we have seen other implementations of IT systems that are meant to streamline processes, make it easier for the public, reduce the paperwork and make it quicker turn into a debacle. For example, the census was the last one that I can remember. The Centrelink debt recovery program, which is a new, automated system, is also a debacle. This government has a history of bungling the transition to automated computer systems. I hope it is not the case with this one. It is often our most vulnerable Australians who pay the price. Certainly, those who rely on the PBS are some of our most vulnerable people.

This is why I am relieved that the bill includes a number of safeguards regarding the use of computer programs. Firstly, the bill stipulates that the minister, secretary and chief executive will retain ultimate responsibility for decisions made on their behalf by these computer programs. This is vital, because when things go wrong, as they have a habit of doing under this government, someone needs to be held responsible. An example of this was the census debacle, where the responsibility was not handled by anyone—not one, single minister wanted to take responsibility for that debacle with the census back in September. In addition, the minister, secretary and chief executive, or their delegates, will be able to override a decision made by a computer program if they are satisfied that it is incorrect, and decisions that are currently reviewable by the Administrative Appeals Tribunal will remain reviewable, regardless of whether they are made by a computer program or not. These are important safeguards, and I sincerely hope that these changes do not cause more problems than they are trying to solve, as occurred with the census debacle that we had last year.

Secondly, this bill addresses the supply of pharmaceuticals after a disaster or in exceptional circumstances. It enables pharmacists whose premises, for example, have been affected by disaster or exceptional circumstances such as fire, flood or a natural disaster to supply pharmaceutical benefits at nearby alternative premises for up to six months. This is a good thing because they continue to serve that community around them, and we know that pharmacists do a great job serving the community, so this would be an added benefit. Of course, there would be some disruption for a short period but, as quickly as possible, they would be able to continue those services within their communities. The bill is also intended to help maintain access to medicines for communities that have been affected by disaster or exceptional circumstances. It will improve arrangements for affected pharmacists, who are currently required to submit a full pharmacy application for temporary premises. It is taking out some of the paperwork and time delays to get up and running again for the benefit not only of the pharmacist, so he can keep his business viable, but also for the community in and around that area.

Thirdly, the bill will also address and rectify an inconsistency about the supply of medication through the PBS benefits on the day of a person's death. A quirk in the current law provides that benefits cease on the day prior to the death, but we know that people cannot predict nor say when that period will occur. So it is a bit silly that the law provides that the benefits cease on the day prior to the death because, obviously, pharmaceuticals and drugs can be taken right up to the end. This brings the PBS legislation in line with social security legislation because other social security benefits apply from the date of death. Therefore, the bill will enable PBS benefits to be provided to beneficiaries and their dependants on that day of their death.

Labor is supporting this bill. With respect to patients, we feel that the bill offers the opportunity to marginally improve access to PBS medicines, and stakeholders including the Pharmacy Guild of Australia and the Royal Australian College of General Practitioners have expressed their support for the bill. But it is important that we remain vigilant. We will be watching the rollout of computerised decision-making closely. As I said, the previous history of this government shows that when they roll out new IT systems they have turned into an absolute debacle. The aim of these reforms, especially the use of automated computer systems, is to simplify the processing of claims and prescription approvals. We will be keeping an eye on it. It should reduce red tape for pharmacists and prescribers. But, as I have said before, we have seen this government repeatedly bungle IT projects, including the census and the availability of Medicare and PBS data on data.gov.au. We cannot have a situation again where Australians are made to pay and suffer because these automated processes fail to work and customers end up having to prove the computer wrong, as we have seen in so many cases currently before Centrelink with its disastrous debt recovery program.

In addition, we must be vigilant because the government has shown us time and time again that it is hell-bent on diluting our public healthcare scheme. This bill does nothing about the real threat to the PBS, namely the government's plan to increase the price of every medicine by up to $5. I have spoken about these so-called measures before, but there are also the 'zombie measures' which are still there from the notorious 2014 budget. They have been reintroduced under various bills et cetera, and they have been tied to other reforms. One thing is certain: the government will not kill them off and they are still there. Make no mistake, the government is determined to increase co-payments by $5 for general patients and by 80c for concessional patients. This means that our most vulnerable citizens—the poor, the elderly, pensioners and the sick—will be worst hit by this government's plans to cut the PBS. If the government has its way, a general patient filling two scripts per month would be $100 per year worse off on medicines alone. Just as the additional Medicare co-payments that the Turnbull government wants to introduce would have the effect of discouraging people from going to see their doctor, it is the same thing with the PBS: the more expensive medicine becomes, the less likely people are to fill their prescriptions.

The latest Australian Bureau of Statistics Patient Experience Survey shows that up to 10 per cent of people already delay or avoid filling a prescription due to the cost. And, as is so often the case, those who are most disadvantaged already will be the worst hit. We know from the research that people living in areas of greatest disadvantage are twice as likely to skip prescriptions as people living in areas of least disadvantage. This will only get worse if the Prime Minister gets his way and increases the price of medicines.

We saw how Australians reacted to the Turnbull government's plan to tamper with Medicare. The opposition is committed to reversing the Prime Minister's plan to raise the price of vital medicines. Millions of Australians voted against the Prime Minister's price hikes to medicines—the shadow minister and member for Ballarat mentioned that earlier— and his other health cuts. So far he is not listening. That is nothing new, unfortunately—but we on this side are listening.

Medicare and the PBS are the heart and soul of our universal health care system and the envy of many countries around the world. Medicare ensures people can access life-saving treatment when they need it. Last year around 21 million Australians accessed Medicare services—including GP visits, vital tests and scans, and hospital treatments. Australians do not want to be like the US when it comes to health care. We do not want the Americanisation of our universal health care system, which is one of the best in the world. We have already seen a drop in bulk billing rates, with many Australians already paying more to see their doctor.

Now this government is going even further, with over $2 billion in new cuts to Medicare still to come. Middle-and working-class Australians will be paying more out-of-pocket costs for visits to their local GP, prescription medicine, medical tests and scans, cancer treatment and    dental services. Nobody wants to head down the same path as the US when it comes to health care. Access to healthcare should rely on your Medicare card, not your credit card. Labor gave Australians Medicare and we will protect it for a long as we can. We will ensure that we fight hard to ensure that Medicare is protected.

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