Anne Webster (Mallee, National Party, Shadow Assistant Minister for Regional Health) Share this | Hansard source

I rise as shadow assistant minister for regional health to address this important legislation that is a product of a strongly contested debate here in Canberra, giving effect to the measures in the federal budget that reflect the Eighth Community Pharmacy Agreement. It was a rocky road to the Eighth Community Pharmacy Agreement, as I pointed out in May 2023. At that point in time, the Minister for Health and Aged Care had brought in 60-day medicine dispensing in the previous budget without consulting the Pharmacy Guild, the Pharmaceutical Society of Australia or any other pharmaceutical body.

Labor didn't care about the impacts the decision would have on pharmacy businesses, especially in regional communities such as mine, where economies of scale do not protect small businesses from the losses they face. Thanks to the advocacy of the coalition and pharmacists, Labor were brought kicking and screaming to a sensible outcome. To that end, I move the following amendment that has been circulated in my name:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes:

(1) the measures contained in this bill are only a result of sustained advocacy from the Pharmacy Guild of Australia and other groups with the support of the Coalition; and

(2) the bill is recognition by the Government that its initial approach to 60-day dispensing would have caused damage to all Australians who rely on their local community pharmacist".

If Labor had listened at the time, pharmacists like Alexander Look from Ouyen would have been able to tell them about the precarious state of the medication supply chain. There have been shortages of common medications, including those used for infection, diabetes, blood pressure and mental health conditions. Mr Look's pharmacy is the sole provider within a nearly 100 kilometre radius, making access to basic medications an arduous journey for some of his customers.

The coalition recognises that many community pharmacies are small family businesses and that it was always unreasonable to expect them to shoulder the costs of this policy alone. Indeed, just yesterday, in the other place, we saw yet another dog's breakfast outcome between Labor and the Greens that is now asking pharmacists to bear another burden. A cobbled together deal now sees Labor committing pharmacists from later this year to be the only legal outlet to sell vapes. Pharmacists no more want to sell vapes than doctors want to prescribe them. We don't ask pharmacists to sell alcohol or street drugs, and the fallout from this dodgy Senate deal is still to come.

The disgrace here is that yet again the Pharmacy Guild were not consulted. The first thing they heard about pharmacies selling vapes was the Greens media release last night. True to form, the Albanese Labor government's initial and poorly consulted 60-day prescribing plans would have devastated regional communities. Labor's scorched earth approach to regional Australia has left some regional towns with their pharmacist as the sole primary healthcare provider. The loss of those pharmacies would have been catastrophic. The coalition's longstanding concern for rural, regional and remote communities to access primary care has been underpinned by the revised agreement, providing additional funding for the Regional Pharmacy Maintenance Allowance, as part of the $1.05 billion over five years for a range of programs. The additional support will hopefully mitigate concerns for the viability of community pharmacies, particularly those in the bush.

Let me paint a picture for those opposite of what life looks like beyond comfortable metropolitan electorates. Many regional, rural and remote Australians don't have urgent care clinics. In fact, 40 of the 58 electorates with them are currently held by Labor. Remote Australians and some in rural Australia don't have any urgent care at all, other than the hard work of the Royal Flying Doctor Service. The urgent care regional Australians do have in regional hospitals is fast diminishing, with more and more urgent care incidents requiring flights to a capital city for treatment. In part, the crisis of diminishing urgent care is due to a combination of federal and state Labor governments actively working to merge country health services. Even the funding granted for hospital upgrades has been put on the go-slow. Residents of Maryborough and Swan Hill in my electorate have both been told to wait around another 18 months or more for their state funded hospital upgrades to actually open. Victorian Labor are penny pinching from regional health in projects costing less than $150 million, yet there has been a $200 billion cost blowout just from the Melbourne Suburban Rail Loop, which has gone from $16 billion to $216 billion so far. State and federal Labor's scorched-earth approach to regional health will see fewer hospitals and other urgent care clinics close to where people live.

The fact of the matter is that increasing primary preventive care in the regions is critical if we want to see a reduction in the need for urgent care of any sort. The numbers don't lie. Regional Australians have more than double the number of potentially avoidable deaths compared with city people. Rural, regional and remote Australians have a higher incidence of cancer with lower survival rates and a higher prevalence of arthritis, asthma, chronic kidney disease, obstructive pulmonary disease, coronary heart disease, stroke and vascular disease and diabetes. Many of these conditions are preventable, yet the frontline workers on preventive healthcare—GPs—number just 2.7 per thousand rural and remote Australians compared to 4.3 in the cities. Wellbeing analysis released last month revealed that, in my electorate of Mallee in North-West Victoria, four shires—Loddon, Pyrenees, Buloke and Central Goldfields—had the lowest wellbeing in the state.

The buck stops with Minister Butler and the state health ministers taking the remarkable step last week of writing to the minister saying the state health system is in national crisis and urging a resumption of health funding talks. The uplift of federal funding from 40 to 45 per cent by 2033 isn't enough for the states. They want that to be the minimum funding. The states also want more than the triple bulk-billing incentive for GPs, with bulk-billing rates down 11 per cent since Labor took office. It is ironic that states that tried to harvest bulk-billing incentives through a sneaky GP tax want to see more federal money sent to GPs to lift bulk-billing. While you would hope Labor are genuinely focus on improving regional health, the minister would do well to keep an eye on state treasurers eyeing off the extra earnings for doctors and incentives for them to bulk-bill and practice in regional Australia for another tax grab in the future.

While state and federal Labor undermine healthcare service delivery and fail to make meaningful inroads on improving preventive and primary care access, we see regional Australians left with very few primary care providers in their communities. Let me give an example about the prevalence of skin cancer in my own community. I had a skin cancer removed in late May, and I took the opportunity to promote skin cancer awareness in our community. In the Mildura area, according to the Australian Cancer Atlas, we have 25 per cent fewer skin cancer detections than the national average, and yet we have excess deaths from skin cancer up 34 per cent from the national average. For that reason, I've been working with stakeholders to secure a Vectra imaging machine for Mildura so we can provide better preventive health care for skin cancer. Fifteen Vectra machines have been deployed in Queensland, New South Wales and Victoria as part of an Australian Centre of Excellence in Melanoma Imaging & Diagnosis trial, each costing about $10 million. But, as is so often the case when it comes to health care in my electorate, the nearest scanner is in Bendigo. Thankfully, my work pushing for a Vectra machine in Mildura is bearing fruit, and I believe there will be a positive announcement shortly.

I have also been promoting preventive health to fight back against heart disease. The tragic passing of a local Mildura resident, Scott Umback, who died of heart attack while waiting for emergency treatment, galvanised our community to take action. Scott's wife, Katrina, worked with me on promoting the case for bringing this important heart health screening initiative to rural and regional communities where it is needed most. I've worked with stakeholders to ensure we have heart checks in my electorate, due to the absence of catheterisation or a cath lab in Mildura. I hope to rectify that in the coming years. But, again, I keep coming up against the same Labor roadblocks that say my electorate isn't worthy enough. Even so, my co-chair of the Parliamentary Friends of Rural and Regional Health, the member for Gilmore, worked with me on staging an event to promote heart checks, and this inspired Novartis and the Shane Warne Legacy project to join forces to bring heart checks to Mallee and now to Gilmore. Across May and June, Shane Warne Legacy took their heart health awareness and screening campaign into Mallee, screening over 1,168 participants. Shockingly, over 81.7 per cent had one or more risk factors for cardiovascular disease. The testing in Mildura, Swan Hill and Horsham included pharmacist led heart health screens in community locations such as shopping centres, at sports events and field days and in Priceline pharmacies.

Mallee data highlighted a huge cardiovascular risk in regional Victoria, with many stats being higher than the national average. While 81.7 per cent of participants had at least one cardiovascular risk factor—which include high blood pressure, high cholesterol or a BMI over 30—10.4 per cent of people screened had all three. Of those tested, 42.5 per cent were immediately referred to their GP for risk management and treatment discussions. These results highlight the importance of regular health check-ups, as many CVD risk factors are not symptomatic until a health crisis like a heart attack or stroke occurs.

The testing program has now moved to Gilmore. I look forward to seeing the report from there and further promotion of preventative health. In this instance of heart checks in partnership with pharmacists, I'm grateful to Novartis and Shane Warne Legacy for working with me on this proactive preventive health initiative. Two years of government underinvestment in the health of regional Australia has left regional Australians at risk. In opposition, it's important to me to work with organisations that promote preventive action so people can address health risks at the earliest opportunity and be managed at a primary-care level rather than at urgent care clinics following an emergency.

I visited the Priceline pharmacy in Horsham last week, promoting the heart checks, and I'm so grateful for the many community pharmacists that reached out to me from my electorate concerned about Labor's 60-day dispensing policy originally. Labor botched their handling of the 60-day dispensing policy, and the coalition pressured the government into negotiating this new Eighth Community Pharmacy Agreement to better acknowledge the important work of community pharmacies.

The pharmacists turned out in force here at Parliament House in September, and Minister Butler wouldn't even meet with them. Pharmacists sat in the gallery in white coats, and the minister wouldn't even look them in the eye. Behind closed doors, however, clearly the message had been received loud and clear. Here we are today endorsing $26.5 billion in funding over five years through the Eighth Community Pharmacy Agreement, including a $3 billion funding boost secured through recent negotiations. The coalition will support this bill because it is the result of our strong advocacy on behalf of Australia's community pharmacy sector, which provides critical primary care to our communities.

The recent round of Senate estimates has also left us questioning the impact of the government's cheaper medicines package that resulted from this new agreement. The department could not explain how the removal of a $1 discount and the freezing of the current price of medications will make medicines cheaper. The coalition will always stand up for both cheaper medicines and a viable community pharmacy sector. The new agreement is a win for community pharmacies, but questions remain as to how much Australians will save in comparison to the taxpayer dollars spent to fix the government's mistake. Therefore, I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes:

(1) the measures contained in this bill are only a result of sustained advocacy from the Pharmacy Guild of Australia and other groups with the support of the Coalition; and

(2) the bill is recognition by the Government that its initial approach to 60-day dispensing would have caused damage to all Australians who rely on their local community pharmacist".

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