Mark Dreyfus (Isaacs, Australian Labor Party, Shadow Attorney General) Share this | Hansard source

I rise to speak on the National Health Amendment (Safety Net Thresholds) Bill 2019. As has been made clear by speakers before me, Labor will support this bill, the purpose of which is to reduce PBS safety net thresholds from 1 January 2020.

Labor made it clear—certainly since not later than the election, when we matched the government's commitment to reduce the PBS safety net thresholds from 1 January—that we will support, and would support, this legislation when it was brought to this House. That's what responsible political parties should do. They should recognise good ideas when they are brought forward. They should recognise legislation that has beneficial effects for the Australian community and they should support legislation that has beneficial effects for the Australian community. It shouldn't be a matter of saying, 'That's a Labor idea; therefore, we won't support it,' which, regrettably, is something we hear constantly from those that are presently occupying the government benches.

We saw it today in the talking points that were leaked. These are, of course, the written instructions that go out like holy writ from the Prime Minister's office to government ministers telling them what they must say on each and every topic that might arise in the politics of the day. Unsurprisingly—I say 'unsurprisingly' because we hear it constantly inside this chamber—there were 34 references to Labor in the 14 or so pages of these talking points. That tells you a lot about this Liberal government. It tells you they're practically bereft of ideas themselves and all they can think of to do is attack Labor at every opportunity, and that's what passes for their idea of political debate.

But that is not enough for political debate. What we actually are looking for in this chamber, what the Australian community is looking for is engaged debate on policy, debate which actually weighs up the advantages to the Australian community of adopting particular policies, the costs to the Australian community of adopting particular policies and whether or not legislation that's proposed will, in fact, achieve the aims that it is stated to achieve. The idea that, when one side of politics comes up with a good idea, the other side of politics is prepared to adopt it, should not be regarded as an unusual idea. We would urge the government to adopt that approach to the health policies we took to the election on 18 May. But, of course, that's not what this Liberal government, which has now been in office for more than six years, wants to do. It actually, as its stock in trade, thinks that it's sufficient simply to attack Labor.

But let's return to this particular bill. Let's be clear: although this bill puts forward a desirable objective, it won't actually fix the crisis in medicines affordability that we have seen on this government's watch in the more than six years that they have fitfully governed. The government's own figures show that many Australians don't fill prescriptions because they can't afford to. That's a deeply distressing statistic to have to put before this House. The Australian Bureau of Statistics, the government's own agency, says that some 961,000 Australians every year delay or avoid taking medicines that have been prescribed to them by their treating doctor, and the reason that they don't go and purchase those medicines, or put off taking those medicines, is cost. That is a very sad state of affairs, and it gets worse when you consider how localised or in what parts of Australia this delaying or avoidance of taking medicines that treating doctors have prescribed is occurring. The rate of people who are skipping prescriptions from their treating doctor is twice as high in the most disadvantaged areas, at 10 per cent, as in the least disadvantaged areas, where the rate is only five per cent. That, of course, means that the cost of medicines is contributing to health inequality in Australia.

We want to see a health system that absolutely every Australian benefits from because they are holding a Medicare card, not because they are holding some particular kind of credit card. It's vital that health services, which include prescribed medicines, be affordable and available to every single Australian who needs those medicines. Unfortunately, when you look at what this third-term government has done about the crisis that's revealed by the statistics that I've just referred to, you can see only that the government has basically tried to make it worse.

You could start with what the government did in the 2014 budget right at the start of this government's period of more than six years in office. What happened in the 2014 budget was that the government proposed to increase the cost of PBS medicines by up to $5 even for pensioners and to increase the thresholds for the PBS safety net. The PBS safety net is vital for people who have chronic illnesses because, once you reach the threshold, which is already set at a fairly high level, you move to a lower rate of payment for prescribed medicines. What this uncaring Liberal government proposed to do in the 2014 budget was increase the threshold, which would have meant that more money would need to be spent by people with chronic illnesses before they were entitled to purchase their medicines at the reduced rate. It would have forced patients—and the PBS safety net, just to remind members of the House, is about people with chronic illnesses—to pay $1.3 billion more for medicines over four years. It would have caused even more Australians to skip essential medicines. It was only Labor's opposition in this parliament that stopped the government from implementing the measure that was in the 2014 budget, and every time members of the Australian community hear the current Minister for Health boasting about his supposed excellent record in relation to the provision of medicines to Australians they need to remember that this current Prime Minister and this current Minister for Health were part of the cabinet in 2014 that wanted to make medicines more expensive for every Australian. This Prime Minister and this health minister were part of the cabinet which brought a budget to this parliament for approval in 2014 that would have had the effect of making medicines more expensive for every Australian. That measure was on top of this government's appalling record of delaying PBS listings.

Let's pause for a moment to reflect on the fact that Labor introduced the Pharmaceutical Benefits Scheme under Ben Chifley. It was a great achievement. It has become, since then, a national institution which has benefited generations of Australians. The PBS is far too important to allow any side of politics, any political party, to seek the kind of cheap, temporary, partisan advantage that this grubby self-serving health minister seeks to engage in almost every time he stands up to answer a dorothy dixer in question time. Almost every time he does a press conference, we hear from him about how wonderful he is and how wonderful his government is now that he has been so generous as to list some further drug that has been recommended for listing by the Pharmaceutical Benefits Advisory Committee. No previous minister for health has sought to engage in that kind of self-serving behaviour. No previous minister for health has sought to say that it's because of his administration or because of his political party's orientation that these drugs, whatever they may be, are listed. This minister has taken it to a whole new level, because not only does he claim some personal credit for the government extending listings that are recommended by a committee which is intended to be non-partisan, bipartisan and disinterested in every sense and disconnected from drug companies—that's what PBAC is there for, to get separation from the drug companies, to get separation from vested interests and, particularly, to get some separation from political game playing—but this Minister for Health seeks constantly to engage in the seeking of partisan advantage by claiming that some special credit should reflect on him. And he engages in a nasty, untruthful comparison with his imagined version—because it is not a real version—of Labor's record over six years in office.

Let's just think about what has been the actual record of the government in delaying PBS listings. Let's look at last month when the Pharmaceutical Benefits Advisory Committee having made public their recommendations from the July meeting, which took the total number of drugs waiting to be listed by the current Minister for Health to more than 60. These are drugs that have been recommended for listing by independent experts—that's what the Pharmaceutical Benefits Advisory Committee is—and the reason the listings are recommended is that these are drugs that, finally, after clinical trials and after examination of their costs, stack up.

An example might be a drug called Symdeko. I heard the member for Higgins talking about cystic fibrosis drugs before. It's a shame to hear someone as knowledgeable about the health system as the member for Higgins merely reciting talking points that have been written for her by the Minister for Health's office. Her knowledge of the health system is far greater than his, I am certain, after her many decades of work for the Australian community both as a treating professional and as an academic. In particular, I refer to her work at the Murdoch Children's Research Institute. I've got the utmost respect for the knowledge and competence of the member for Higgins, and it is disappointing that she's been forced to just recite talking points provided to her by the Minister for Health. If we go to cystic fibrosis drugs, we can look at Symdeko. It's a life-changing cystic fibrosis drug. It treats the most common cystic fibrosis mutation, and that extends life expectancy and improves quality of life. The minister made a promise to those with cystic fibrosis that they'd have access to Symdeko on the PBS as soon as it was approved. It's six months since that was recommended back in March, and there is no word on when or even if the government intends to list it. Speaking with Ray Hadley on 2GB, the minister was asked by a listener about the delay in listing drugs that can help people suffering with cystic fibrosis. He said:

… I think it’s important that the cystic fibrosis community knows that, you actually wonder what keeps a minister up at night—this. It’s the new medicines and the new listings and getting them there …

Clearly, he's recovered his ability to sleep through the night, because he's actually asleep at the wheel when it comes to listing approved drugs on the PBS.

We have a minister who loves to pat himself on the back, a minister who loves to hold purpose-specific—drug-specific at that—press conferences, where he associates himself with a particular sufferer or the family of a sufferer and pats himself on the back every time the government finds the money through the Expenditure Review Committee or the budget processes to approve the listings that have been recommended by the Pharmaceutical Benefits Advisory Committee. If he's responsible for the listings, he's also responsible for every drug which he refuses to list—every drug which he sleeps through the night on and neglects to list. He needs to stop the delay on PBS listings and start treating Australian patients with respect. A good start would be to stop these grubby self-serving press conferences and claims for credit which he does not deserve.

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