Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

The House calls on the government to negotiate with relevant bodies regarding the cost of dispensing chemotherapy drugs and to ensure that dispensing can continue to occur without disrupting patients. This has been another disastrously handled policy by this government. We are now six months on from when I gave notice of this motion. We have had a Senate inquiry which clearly identified there were problems, and stakeholders have provided compelling evidence, and I thank them very much for that. Indeed, the Clinical Oncology Society of Australia said:

If there is no longer an income stream to maintain the clinical pharmacy services associated with the supply of chemotherapy, this is likely to affect the cost of care and patient access. Centres will close or pass on the additional costs to patients in order to remain viable.

The Pharmacy Guild of Australia stated:

Ongoing care for all Australian cancer patients, regardless of their type of cancer, is being put at risk by the current arrangements.

Other evidence to the committee found:

The service of preparing chemotherapy medication is highly complex, expensive and labour-intensive, and demands an environment and investment does not compromise on quality.

The government gave an undertaking last November to examine the 'cost of delivering vital chemotherapy services'. Incredibly, there is still no long-term solution. Earlier this month, on the eve of the Senate inquiry's report, the government rushed out an announcement. The supposed funding 'boost' is to start in July, but will cease in December 2013, providing no long-term certainty for patients, clinicians or providers, and smacks more of politics than it does of pragmatic solution. The government knew a potential issue existed with the cost of dispensing well before I gave notice of this motion, but failed to act. The inability to resolve or make a decision on funding for chemotherapy services is typical of the chaos and dysfunction of the Gillard government.

As stated in the inquiry's report:

1.12 The latest review follows a previous commitment given six months prior to this latest announcement to examine the 'cost of delivering vital chemotherapy services'. 1.13 The latest announcement prolongs uncertainty and undermines the effective and efficient delivery of treatments for cancer patients and their families. It points to a lack of appreciation for the critical implications being felt by chemotherapy services …

1.14 Despite the announcement, the Government is still unable to detail for providers of chemotherapy services and their patients any definitive long-term funding solution.

Vulnerable patients requiring these services do not need the stress of being caught in a disagreement over funding that continues to drag on. This should have been a priority for the government and it should have been resolved last year. Minister Plibersek needs to explain what the government has been doing in its negotiations and why patients and clinicians now have to wait for another review. I gave notice of this motion, as I say, last November. The government was not able to negotiate an outcome over the Christmas and New Year period, so the minister needs to explain how negotiations will be undertaken when the interim funding ceases at the end of this December.

I would like to make clear that the coalition does support price disclosure. The coalition's reforms were negotiated cooperatively with the sector in 2007 and are estimated to provide up to $5.8 billion in savings over a 10-year period. This has helped to support the sustainability of the PBS. But where broader anomalies arise from time to time with dispensing pharmaceuticals, particularly where there is a risk to patient services, it should be properly and transparently reviewed by the government and responded to. The issue here is a government that has deliberately dragged its feet on a very, very important issue. Only due to parliamentary pressure, including the Senate inquiry and this motion, did the government belatedly announce a review.

However, this is a government with a chequered history, to say the least, and it is certainly chequered when it comes to pharmaceutical policy. Labor signed a memorandum of understanding with Medicines Australia in May 2010 to provide 'policy certainty', in its own words, to the sector in return for additional savings of $1.9 billion over five years. Yet, within months, Labor effectively broke its promise and changed the convention on how governments list medicines on the PBS. Indeed, in February 2011, the Gillard government refused to list a number of medicines on the PBS that had been recommended by the independent Pharmaceutical Benefits Advisory Committee, blaming its 'fiscal circumstances'. It was a case in point on the consequences of this Labor government's economic mismanagement and fiscal recklessness. The move denied patients timely access to new medicines that had been independently assessed by the PBAC.

Again, after substantial political pressure and a Senate inquiry initiated by the coalition, the government agreed to list the deferred medicines in September 2011. However, this matter still has not been resolved and there remains a great deal of policy uncertainty around the listing process. Similarly, the chemotherapy issue remains another unresolved issue for this government. Six months from the giving of notice of the motion we are considering today, the government has failed to provide a genuine, long-term solution.

In closing, it is obvious from all of the government's actions that they pushed this out to December 2013, trying again, in their expectation of not having the competence to win the next election, to create some difficulty for an incoming government. It is a cruel political hoax being perpetrated on those chemotherapy patients as well as the providers around the country. To play politics in this area is completely unacceptable. I call on the government to provide a more long-term resolution to this very important issue. That necessitated us taking the action we did in the Senate inquiry and also in this motion. Yet again, the government stand condemned.

Shayne Neumann (Blair, Australian Labor Party, Parliamentary Secretary for Health and Ageing) Share this | Link to this | Hansard source

It is not us on this side of the House who are playing politics and it is not our motion before the chamber. It is their motion before the chamber, so they are the ones playing politics on this issue. That is the reality. Do not blame us for something that you are trying to play politics on.

The models in relation to funding for chemotherapy is actually quite a complex area of policy. There are arrangements, including the efficient funding of chemotherapy, which was put in place to ensure patients can continue to get access to vital cancer drugs at a price that is affordable for themselves and for the government. These arrangements were developed in parallel with the expanded and accelerated price disclosure measure and the Fifth Community Pharmacy Agreement.

In fact, in relation to the expanded and accelerated price disclosure measure, the coalition have had more positions than you could poke a stick at. At times, they have said that they support it; at other times, they have voted against it. Now the shadow minister comes to this chamber and says he now supports it. I would like to see some consistency from those opposite in relation to that measure.

There are no suggestions, by the way, from any stakeholders that the efficiencies generated for taxpayers by the EFC and the EAPD are inappropriate. The situation is that in late 2012, as a consequence of the expected impact of upcoming price reductions in a certain drug, known as Docetaxel, and another range of drugs in relation to chemotherapy, the industry raised some concerns in relation to the sustainability of chemotherapy infusion preparation services. There are about 100 dispensers, through pharmacists, of this particular drug and other chemotherapy drugs around the country. There are about 5,000 pharmacists in total and about 100 who do this particularly complex form of administration of a chemotherapy drug in terms of preparation. Without the cross-subsidy available from the high price that the government was paying for these drugs, stakeholders associated with this, including some of the pharmacists, actually said that services would shift from private to public hospitals and that there was a threat of services closing.

In fact what the Minister for Health did was act appropriately, and expeditiously requested that DoHA visit organisations, investigate the issue and listen to stakeholders. Senior members of staff from DoHA visited a number of chemotherapy suppliers and third-party chemotherapy compounders in private hospitals to discuss this issue. The matter came before the Senate Community Affairs Committee for inquiry and report. The shadow minister was selective in his quoting, so I will quote what the single recommendation of that committee said on 10 May 2013 at paragraph 3.41. It said:

The committee recommends that the government and industry parties, through the review, continue the examination of issues in chemotherapy drug pricing to ensure that existing funds under the Fifth Community Pharmacy Agreement as already agreed are appropriately directed to reflect the costs and benefits of the supply of chemotherapy drugs, and to ensure the ongoing supply of these drugs across all services, particularly in rural and regional areas.

In fact, on 5 May, the minister appropriately announced a review of funding arrangements for chemotherapy services. We are going to support this motion with amendments that reflect what the government are doing in announcing a review, which will operate until later this year. It will be undertaken independently with transparency and stakeholders will be consulted. We provided $29.7 million in the 2013-14 budget to pay providers an additional $60 for each chemotherapy infusion on an interim basis for a period of six months. That funding will cover the review period from 1 July 2013 until end December 2013 and will be provided in addition to the current $76.37.

I want to make it clear because if you listen to the shadow minister you would think that, somehow, there was absolute chaos in relation to this issue. Throughout this whole process the price paid by patients for chemotherapy drugs has not changed, and it will not change. The most paid for the drugs for a whole course of treatment is currently $5.90 for a concession patient or $36.10 for a general patient.

The review will be consumer focused and will provide opportunities for patients, stakeholders and providers who are involved in this industry to engage and provide suggestions on the future long-term approach. As I said, the review will be transparent and independent of government. The government want to identify and find a long-term solution in relation to this issue. It wants to make sure that cross-subsidisation is not required to support the viability of chemotherapy services across the country. We have undertaken this action because we want a long-term solution and long-term arrangements put in place. This government can be very proud of what we have done in relation to cancer treatment. We have provided 30 new drugs in relation to the PBS. We have provided and approved those drugs for 15 different cancers at an additional cost of $1.3 billion to the Pharmaceutical Benefits Scheme since 2007.

We have also welcomed the policy of the accelerated and expanded price disclosure of items on the PBS. We have had a consistent position in relation to that, unlike those opposite. We are very proud of what we have done to improve cancer services across the country. In addition to the new PBS cancer treatments I have outlined, we have committed $3.5 billion since 2007 to improve the prevention, detection and treatment of cancer. This includes in the recent budget $226 million over four years to deliver the Gillard government's world-leading cancer care package. That involves cancer prevention, detection, support and research. Critically ill patients waiting for bone marrow transplants will have a better chance to get life-saving help through this initiative, with around 280 critically ill patients expected to be approved for the bone marrow transplant program in 2013-14.

This initiative also provides new funding for CanTeen, the Australian organisation for young people living with cancer, to support a national network of specialist services for 12- to 24-year-olds who are living with cancer, a group often felt to be left out in terms of cancer treatment, identification and publicity. We have also provided funding for the successful McGrath Foundation to continue to expand the foundation's Breast Care Nurses initiative, expanding the number of government funded nurses from the current 44 to 57. In addition, we have provided in this budget $55.7 million to expand the BreastScreen Australia Program, increasing participation by women aged 70 to 74, ensuring more women are tested for breast cancer as they get older, because we know the risk is higher as women age. We have also provided an additional $18.5 million for the Australian Prostate Cancer Research centre's program, including in my home state of Queensland an amount of $6.2 million at the Princess Alexandra Hospital in Brisbane, about 40 or 50 kilometres down the road from where I live. This will mean improved testing, diagnosis and treatment for people with prostate cancer.

I outline some of these initiatives, including the initiatives that we have undertaken in the budget, the National Bowel Cancer Screening Program and additional help in relation to lung cancer, because I think it is necessary to put on the public record that we are really determined to make sure we deal with this issue. When we say we are involved in world-leading cancer care, we are making those investments, including in relation to breast, cervical, prostate and bowel cancer, to make sure we achieve an international benchmark. If you listened to the shadow minister in relation to this issue, you would think it is chaos, tragedy and despair. It is not. In fact, we are investing a massive amount of money to make sure this scourge, which affects every Australian family, is dealt with as best we can. Unlike those opposite, who want to close down Medicare Locals and strip funding to health services, as their state colleagues in Queensland and Victoria have done, we are determined to make sure that our health services, including breast cancer treatment and prostate cancer treatment, are rolled out in such a way that Australian people, whether they live in Queensland, New South Wales, Victoria or any other state or territory, can get the help they want. We are investing for the future in terms of health services, while those opposite will cut, cut and cut.

Paul Fletcher (Bradfield, Liberal Party) Share this | Link to this | Hansard source

I am pleased to speak on this motion concerning the price reduction of chemotherapy drug docetaxel. The has put forward a blizzard of irrelevant considerations, because the motion before the House this evening deals with the specific circumstances in which the price reduction for chemotherapy drug docetaxel was imposed on the healthcare sector. This price reduction occurred at very short notice and generated very substantial concern amongst the providers of chemotherapy care.

Concerns were raised with me by a major private hospital in my electorate, the Sydney Adventist Hospital. In a letter written to me late last year, the chief executive of the hospital informed me of his concerns that this cut in the funding available under the Pharmaceutical Benefits Scheme for docetaxel would put at risk the current system for the preparation and supply of chemotherapy drugs through private hospitals and private clinics. He made the point that the cut in funding was of the order of 72 per cent—by any measure an extremely substantial reduction. He made the point that at his hospital there is an expectation of providing approximately 5,181 treatment sessions for chemotherapy patients in that year. He also pointed out that private hospitals and oncology clinics provide 60 per cent of all life-saving chemotherapy services in Australia. Accordingly, what we have here is an episode by which the current government has imposed, at short notice, a very dramatic reduction in the funding available under the PBS for docetaxel, which will have substantial flow-through effects on the capacity of the private hospital sector and private oncology clinics to provide life-saving chemotherapy services.

The concerns raised with me by the Sydney Adventist Hospital were also raised by a number of constituents. Families blighted by cancer, who are working through a treatment program, are now very anxious about the impacts on their treatment program of this very sharp reduction in the funding made available under the PBS for docetaxel. Let me quote from a letter I received from Debbie Quirk of St Ives who had this to say:

My family is touched by cancer with my husband having bowel cancer and undergoing a number of operations and chemotherapy treatments, which he is still receiving. We are concerned at the long-term implications of the federal government's 1 December ongoing changes to the PBS and the future funding of chemotherapy drugs. This concern is adding to the already significant impact that cancer has had on our lives.

There could be no more articulate statement of the reasoning behind the motion moved by the shadow minister and which we are debating this evening because that motion is underpinned by the opposition's concern for the impact on so many patients of this very dramatic reduction at very short notice in the funding available under the PBS. If patients are to be served in the most efficient way, if their treatment is to be carried out in a way which is most responsive to their clinical needs, it is very important that the funding arrangements which lie behind that treatment are managed in a consistent and long-term fashion. Unfortunately, we have seen precisely the opposite from this government. Indeed, it is surprising to learn that significant changes to the funding model were proposed as long ago as 2009 by pharmacists, oncologists and private hospitals. Unfortunately the government's response at that time was to introduce a short-term solution and what we have now seen is that that short-term solution has played out in ways that are causing great anxiety and stress to patients. I call upon the government, in the terms of this motion, to immediately resolve this very serious issue.

Deborah O'Neill (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on this motion concerning the funding of chemotherapy drugs. I note the opening remarks of my colleague who spoke first for the government in this debate that it is indeed a motion brought to the House by the opposition, one that might well have been much better handle more quietly and with less alarm for those who are, with their families, facing the very significant challenge of managing a diagnosis of cancer and then the treatment of cancer. The fearmongering which has become part of the methodology of those opposite, the generation of headlines over more judicious and more careful and more responsible management of key policy issues for this country, is seen on display here today. Nonetheless, I would like to put on the record a few of the important facts with regard to the issue before the chair.

The reality is that, since the initial concerns were raised in 2012 about the price reduction of Docetaxel and the potential impact on patient services, the Department of Health and Ageing has been undertaking some pretty detailed investigations into chemotherapy and the funding arrangements to make sure that these can be continued in a safe and stable way. Some chemotherapy providers were using the inflated price the government paid them to cross-subsidise the cost of delivery. I do not think we can underestimate the complexity of some of these chemotherapy drugs being produced, distributed and administered to patients.

But, with the price drop of several of the chemotherapy drugs—because the generic drug became available and entered the market—some providers complained that they could not continue to use that model. They could not continue to use that model because, instead of the government paying an excessive price for a drug which was now generic and available at a reasonable price, the government decided to get good value for money for Australian taxpayers—while continuing to provide for the highest standard of medical care for Australian people. So this broken model needed review.

I note that, in the period between this private member's matter being brought before us and now, we had, very importantly, the outcome of the Senate Community Affairs References Committee inquiry into chemotherapy funding. The report was tabled as recently as 10 May. It recommended that the government and industry parties, through the review—they had proposed a review—continue the examination of issues in chemotherapy drug pricing to ensure that existing funds under the Fifth Community Pharmacy Agreement are appropriately directed to reflect the costs and benefits of the supply of chemotherapy drugs and to ensure the ongoing supply of these drugs across all services, particularly in rural and regional areas. That is exactly what is going on and I am pleased to note that the member for Dickson put on the record that there is agreement between the government and the opposition with regard to the Expanded and Accelerated Price Disclosure policy.

This policy continues to work the way it was intended—bringing the price the government pays for the drugs into line with the market price of those drugs. That is transparency and that is fairness. It also saves taxpayers' money and that money has allowed and will allow the government to make investments in critical treatments for consumers and for sufferers of cancers other than the one the Docetaxel drug—which seems to have been the real stimulus for this conversation—is intended for.

Since 2007, this government has committed $1.5 billion for cancer medicines. I know, from my own family and personal experience, that the provision of these drugs is vital. I hope that, as things move forward, some of the unnecessary vitriol in this debate dissipates and that a quieter, more thoughtful and careful conversation proceeds to achieve the best outcomes for the Australian population. (Time expired)

Dan Tehan (Wannon, Liberal Party) Share this | Link to this | Hansard source

I rise tonight to give a very considered and thoughtful speech on this issue of chemotherapy drugs. I will start by going back to 28 November 2012, when this issue was first raised. It was raised by the shadow minister for health in the House, but it is worth noting, when it comes to thoughtful consideration, that it was first raised by Independent Senator Nick Xenophon in the Senate.

So this went across party lines because there was real concern about the government's incompetent handling of this issue. It was not an issue that anyone wants to be raising but it was an issue that we felt compelled to raise. The motion was not hysterical. It was a very calm, considered motion that had been put through, calling on the government to negotiate with stakeholders—hardly alarming—to ensure the continued delivery of chemotherapy drugs without disruption to patients by resolving dispensing cost issues and avoiding further unintended consequences.

That last bit is one of the keys to this motion, because this is the government of unintended consequences. Everything that it does, it fails to have a proper process for. It fails to think what might be the scenarios that their actions might lead to. What we see time and time again is unintended consequence after unintended consequence. That is why we are here tonight to try and get the government to solve these unintended consequences. What is the greatest of those unintended consequences at the moment? It is the fact that we still do not have a long-term solution to this problem. This is not something that we have just raised. As I referred to at the very start, this was something raised on 28 November. Yet still we have speakers from the government here tonight unable to say what the solution will be. As a matter of fact, they have outsourced it. They have said, 'We don't know what to do. We don't know how to handle this issue. We can't deal with it. It is too complicated for us.' They are putting their hands up and saying, 'We're going to defer it till after the election.'

Now that might be a very simple solution for the government but it is not a simple solution for those cancer patients who need this chemotherapy issue resolved and they need it resolved now. They do not want to see it postponed into the future. They want to see the government say, 'We have the wherewithal to be able to deal with this issue. It is not hard. It is not complicated. We have a bureaucracy behind us. We can solve this issue.' If the government fails to act quickly, many of the most vulnerable patients may be forced into the public hospital system. In and of itself, you would think, okay, that is not great because we are going to put more pressure on the public health system. But what has the government done in the MYEFO? Not only are they pushing these patients into the public health system but they then cut funding to the public health system. In Victoria they cut $104 million.

An honourable member: That is a misrepresentation.

It is not a misrepresentation. You come up with a short-term solution to put patients into the public health system and then you cut funding to it. What type of incompetence is this? Where does the logic flow that you would put more pressure on your public health system and then cut funding to it—illogical? It is hard to fathom that we could get this type of incompetence, yet here we are tonight. All of us here on both sides would like to see this issue resolved. We have offered on this side to work with the government to help you to resolve it but we do not get any admitting: 'We can't do our job. Please could you come over and give us a hand and allow us to do it.' There is nothing along those lines. None of us want to be here tonight, but we once again call on the government to do what they should be doing: govern the country and fix this problem.

Honourable members: Hear! Hear!

Geoff Lyons (Bass, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on this motion proposed by the member for Dickson regarding chemotherapy drugs. Since 2007, the government has invested $3.7 billion to improve cancer prevention, detection, treatment, research and infrastructure. Since this time, with an additional $1.3 billion, the Labor government has listed 30 new medicines to treat 15 different types of cancers on the Pharmaceutical Benefits Scheme, saving many more patients over $5,000 per treatment.

The government acknowledges that there has been community concern with regard to the impact of price disclosure on funding for chemotherapy infusion medicines. On 5 May this year Minister Plibersek announced a major review into the way chemotherapy is funded, and provided a way for ensuring cancer patients have continued access to quality, affordable treatment.

I note the support of shadow minister Dutton for the policy of price disclosure and the aim that Australian taxpayers should pay the market price for PBS medicines, including chemo infusions. In terms of point 3 of the member for Dickson's motion, the Gillard government wants to ensure that cancer patients do not experience any interruption in their treatment while we closely examine how much we should be paying to support the ongoing viability of chemotherapy providers.

The review followed talks between the federal government and the Pharmacy Guild of Australia over appropriate subsidies for dispensing chemotherapy after the reduction in price the government pays for a key chemotherapy drug, docetaxel. For many years the government has been paying 20 per cent to 75 per cent above the market price for this drug. These inflated prices have meant the government has paid, in some instances, $2,800 above the market price. I strongly believe that taxpayers should not be paying inflated prices for medicines that are no longer covered by the patient and are being sold to pharmacies at much lower prices. To bring the price the government pays into line with the market price, on 1 December 2012 the price the government paid for this cancer drug dropped by 76 per cent.

I note that in the 2013-14 budget the federal Labor government increased support for young people living with cancer. Young people who are diagnosed with cancer will better be able to get the care and support they need under this government's funding boost. The Gillard government is providing an additional $18.3 million over four years for youth cancer networks around Australia, building on the $15 million already provided for the networks. I am pleased to say that the Launceston General Hospital in Bass is a partner in this project. We have expanded the breast cancer screening for women, which is very important. And we know that detecting cancer early means better outcomes for patients. The 2013 federal budget included $55.7 million to expand the breast cancer target screening program for women aged between 70 and 74. This means that 70,000 more women will now receive a mammogram-reminder letter from BreastScreen Australia.

The Commonwealth Department of Health and Ageing has investigated these issues, including with site visits to regional hospitals, and has an ongoing contact with the Pharmacy Guild of Australia. The government continues to discuss the issues with the Pharmacy Guild, with a view to ensuring sustainability of the supply and dispensing of chemotherapy medicines. The government accepts that the dispensing of cancer treatments is more complex than other types of treatments. This is why oncology pharmacists are paid $77 in preparation fees plus mark-ups for chemotherapy infusions.

In closing, I am proud of the government's record in improving cancer services. In addition to listing 30 new cancer treatments since 2007 the government has also committed around $2.5 billion to improve the detection and treatment of cancer. Recently, the Minister for Health, the Hon. Tanya Plibersek came to my electorate of Bass to officially open the Northern Cancer Support Centre, which is proving to be an important place, where sufferers and their families, friends and carers can go for support.

We are supporting patients in regional areas through the construction of regional cancer centres and associated accommodation facilities. These achievements demonstrate that this government is committed to providing cancer patients with the best treatments and services, no matter where they live. Australian cancer patients now have the best overall survival rates in the world, and our new cancer packages will continue to improve the lives of all Australians touched by cancer.

Alex Hawke (Mitchell, Liberal Party) Share this | Link to this | Hansard source

I rise to support the motion of the federal member for Dickson, the shadow minister for health and ageing. In doing so I want to note that the government members opposite seem to be avoiding the central issue of the motion, and that is the concerns of key stakeholders in relation to the price reduction of the chemotherapy drug docetaxel and its potential broad impact on the treatment of cancer patients.

Members opposite have failed to understand that this is a concern of the sector, including the private sector, which provides up to 50 per cent of all cancer care in Australia. More than 13,000 lifesaving infusions are prepared and dispensed by community and private hospital pharmacies for cancer patients each week.

Central to this issue is cross-subsidisation. The member for Robertson mentioned the report of the Senate Community Affairs References Committee, and I want to refer to the additional comments from coalition senators—the member for Robertson should read them. Their comments noted that there is not a good understanding of cross-subsidisation, which is what is at the centre of this motion today. Nobody is saying that cross-subsidisation is the best system possible but continually this government interferes in an area, it ignores the advice of a sector, it blunders on through with a noble objective and it ends up doing a lot of damage to everybody. That is exactly what has happened here. We are hearing that from the sector itself. The sector says, quite clearly:

The largest provider of private day oncology services on the North Shore and northwest Sydney—

near my electorate—

the Sydney Adventist Hospital, said the funding approach could lead to “cessation of all chemotherapy infusions, provision of a limited range of treatments and pharmacy staff reductions”.

Nobody would want to see that. If the sector is telling us that if cross-subsidisation is removed and we do not have anything better to replace it with that could lead to the cessation of treatment, then obviously you have to do something about it. Of course we do not want to be here today discussing a motion in relation to cancer treatment and chemotherapy drugs—nobody wants to politicise these issues. These are not political footballs. But the sector is saying they cannot convince the government, and they cannot convince the member for Robertson, about this issue—that they have a problem. So we have put forward a reasonable and measured motion that calls on the government to consult with the sector, that says to negotiate on the price about this.

If the government do have a noble and objective intention of saving taxpayers' money—they will not get any argument from me about saving taxpayers' money—they must have something to replace it with that is better. You must have a better alternative. It is not right to leave people in serious health situations in the lurch. That is what we have seen here. Last year, in November, we saw Senator Nick Xenophon, an Independent—no friend of the opposition's—side with the shadow minister for health to say what an issue this is. Even the Greens offered their support. Maybe the government could have a look at that and say that if all these people are saying there is a concern, there might be a concern.

The government itself has basically acknowledged the problem. In its recent announcement on 5 May 2013 it said it would initiate a funding review into chemotherapy and provide $29.7 million in the 2013-14 budget to provide an additional $60 for each chemotherapy infusion for only six months. This was basically an admission of failure that what it attempted to do last year was never going to work, that the patients in the sector are saying this is not going to work, and it took the government six months to respond. That is the criticism we have of this government—it is not rigorous with the detail; it is not across the detail. When those opposite attempt to do something with the highest and most noble of intentions, they never have any understanding of what it is they are trying to do—of the follow-through that is necessary and how to ameliorate the impact it will have on people on the way through. In other words, they are not good change managers and they certainly cannot manage change effectively to deliver competent government policy across a range of sectors.

The opposition senators, who examined this issue rigorously, said that the failure to satisfactorily resolve this issue early was a demonstration of policy ineptitude and laziness in the government. It does not matter whether you are listening to the Pharmacy Guild or the Clinical Oncology Society or the San hospital in Sydney, or any of the constituents of mine, whether it is Kay from West Pennant Hills, Bronwyn from Castle Hill or Christina from Castle Hill—I have dozens of letters—they all express serious concerns about what the federal government was doing late last year with the future funding of chemotherapy drugs. How is that a good situation? Of course we acknowledge that cross-subsidisation may not be the best outcome but, if you are going to replace it with something, have something better to replace it with before you go and make the lives of people demonstrably worse.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

This motion on chemotherapy drugs is one of the most disappointing motions I have debated in this parliament. I believe that members on both sides of this House want to ensure that patients who are living with cancer, are being treated for cancer, get the best possible medications available. I believe that members of this parliament want to see the list of available drugs expanded, and I believe that people who are undergoing cancer treatment do not want to see members of parliament politicising an issue as important as this.

Both sides of this House have done many things that they can be proud of in relation to cancer treatment and the ongoing research that provides cutting-edge treatments for people who are living with cancer or who have just been diagnosed with cancer. All members would be well aware of the proud history that we have here, in Australia. We have the best cancer survival rate in the world. That does not come about because the government is shirking its responsibility; rather, it comes about because the government is committed to ensuring that cancer patients receive the best possible treatment and that there is investment in cancer services.

Members on this side of the House have already stated that, since 2007, the government has committed $3.5 billion to improve the detection, prevention and treatment of cancer. It includes an extra $226 million in this year's budget over four years to deliver the government's World Leading Cancer Care package to improve cancer prevention, detection, support and research. Critically ill patients waiting for bone marrow transplants will have a better chance to get life saving help under this initiative. In addition, it will provide new funding for CanTeen, the Australian organisation for young people living with cancer. It will also provide extended funding for the McGrath Foundation, which I think every member of this House would acknowledge has been very successful. In my own electorate, many constituents have spoken to me about the need to expand cancer treatment and detection and then later they have come back to me saying, 'Thank you very much for what the government has done in this area.'

Today we are looking at chemotherapy drugs—and here I would like to turn to the motion moved by the member for Dickson and say that what he should be doing is working with the government. He has given some initial cooperation. He has indicated his cooperation but when you see this sort of motion before the House you know exactly where the member for Dickson is coming from. On 5 May this year, the minister announced a review into the funding of chemotherapy services, because we know how important it is that people receiving treatment continue to get that treatment. We know how important it is to ensure that new treatments come on line. We know how important it is to ensure that, as a government, we pay the correct amount of money for the drugs that people are using, and we need to know that the people who are receiving the treatment are paying the amount of money that they need to. The broad aim of this review is to gain a detailed understanding of all aspects of chemotherapy funding. It is not an ad hoc approach, as those on the other side are suggesting. The broad aim of the review is to ensure that there will be consultation with all stakeholders. It is a very inclusive review and, as members have previously mentioned, there was also a review undertaken by the Senate committee.

It is time that those on the other side of this House stopped playing politics. They should stop trying to prey on people who look to government for support. They should stop trying to create fear and uncertainty. They should stop trying to prey on people whom they should be supporting and looking after. I think there has been enough of this. It just says to me that, if this opposition were ever allowed to become the government of this country, there would be much more of this and the people of Australia could be well and truly let down. (Time expired)

John Alexander (Bennelong, Liberal Party) Share this | Link to this | Hansard source

I thank the member for Dickson, the shadow minister for health, for moving this important private member's motion. I note that the member submitted this motion in November last year and that his concerns have also been investigated by the Senate Community Affairs References Committee, which released its report earlier this month. I support the member for Dickson's call for the government to negotiate with stakeholders and to ensure that, as a result, pharmacists can continue to dispense chemotherapy drugs without disrupting patients.

Earlier today I was honoured to host another Parliamentary Friends of Medicines event and to welcome senior members of the Pharmacy Guild as they launched a paper about reducing financial burden on society. We are all aware that our health budget comprises a large part of our nation's expenditure and all would agree that these costs need to be managed in the most efficient and prudent way. However, the key difference with this budget item is that we are talking about the health of our constituents, and thereby the health of our nation.

This government's failure to administer a reliable funding framework for the delivery of chemotherapy services to Australia's cancer sufferers is a perfect example of how not to manage health related budgetary matters. To add weight to this saga, the government's failure to resolve this issue in a timely fashion is, and I quote from the Senate report, 'a demonstration of its policy ineptitude and laziness. According to evidence of many witnesses, this lack of a timely resolution may put at risk affordable and quality care and access to treatment for cancer patients'.

The array of critics of this government's management of this issue was seemingly endless. The Clinical Oncology Society of Australia said: 'If there is no longer an income stream to maintain the clinical pharmacy services associated with the supply of chemotherapy, this is likely to affect the cost of care and patient access.' The Pharmacy Guild of Australia said: 'Ongoing care for all Australian cancer patients, regardless of their type of cancer, is being put at risk by the current arrangements.' Sydney Adventist Hospital, the largest provider of private day oncology services on the North Shore and the north-west of Sydney said the funding approach could lead to a 'cessation of all chemotherapy infusions, provision of a limited range of treatments and pharmacy staff reductions'.

The Medical Oncology Group of Australia and Private Cancer Physicians of Australia said 'The current remuneration model for chemotherapy does not reflect how contemporary cancer services are delivered.' The key result of the Senate committee report is that the current chemotherapy funding model is neither transparent nor sustainable. And so finally, just a few weeks ago, the government admitted to its own mess and announced it will provide an additional $60 for each chemotherapy infusion—but only for six months.

How this short-term announcement provides any stability to the industry or certainty to cancer patients and their families is beyond me. All it does is get them past the September election. How convenient. It is clear that this government is still unable to detail for providers of chemotherapy services and their patients any definitive long-term funding solution. This is not a debate about price disclosure. The patented medicine in question was developed by Bennelong based company Sanofi.

Companies like Sanofi are very willing to participate in a conversation on the important role that they can play as part of this process and the important savings that are derived after their patent period has expired. This is an issue about cancer sufferers and chemotherapy providers, both of whom are wholly dependent on a viable long-term funding solution for the sustainable provision of cancer treatment services.

The government's delay on this matter has forced many private chemotherapy providers to absorb huge costs. The Sydney Adventist Hospital Pharmacy that services my electorate has estimated a $1.6 million financial shortfall as a result of the government's changes to the PBS since April 2010. It is clear that the government must, at the earliest opportunity, commence a genuine negotiation with stakeholders to effect a sustainable solution to this crisis in our health-care system.

As the Member for Dickson said earlier, vulnerable cancer patients do not need the stress of the uncertainty created by this government to add even more pressure on top of the challenges they are already facing. I congratulate the member on this motion and commend it in the strongest possible terms to the House. (Time expired)

John Murphy (Reid, Australian Labor Party) Share this | Link to this | Hansard source

The government is willing to support the motion put forward by the shadow minister for health with amendments; however, I note with concern that, as usual, the opposition distorts the facts and attempts to frighten the sick, as it infers the government's drug-price disclosure policy will somehow disrupt the delivery of life-saving drugs to cancer patients.

The Pharmaceutical Benefits Scheme that pays for these drugs is a Commonwealth government scheme which gives Australians affordable access to necessary medicines and, interestingly, the PBS was started in 1948 as an initiative of the Chifley Labor government with free medicines for pensioners and a list of 139 'life-saving and disease preventing' medicines that were free of charge for others in the community.

Today Labor's PBS scheme is available to all Australian residents who hold a current Medicare card and the government subsidises the cost of medicine for most medical conditions, in particular for expensive drugs such as Docetaxel that are used to treat cancers. It is evident that the shadow minister for health is arguing not for the rights of cancer patients or the taxpayers but for the chemotherapy providers who were, it appeared, benefiting from the continuation of the previously high price that the government was paying for patented drugs like Docetaxel that have subsequently seen a drop in price following the expiry of their patent. Docetaxel is a derivative of Taxol, an anti-cancer drug that was first isolated in 1967 from the bark of the Pacific yew tree by scientists at the National Cancer Institute, an agency of the United States government that is funded by United States taxpayers.

Given that most of the important discoveries of medical science have been made in universities and public institutions, I would argue that, instead of simply paying endless sums to the companies that commercially exploit these findings, more funds should be made available to the university and research institute scientists and workers who actually find drugs like Taxol and similar substances. The most profound discovery in biology, that of the structure of DNA or deoxyribonucleic acid, was made 60 years by the Cambridge University scientists Francis Crick and James Watson yet, as far as I know, no member of the opposition has made any mention of the importance of this finding that is key to the development of treatment of cancers, diseases that are fundamentally disorders of the genes, themselves structures composed of molecules of DNA. I have no doubt that, if Crick and Watson had applied for research funding from an Abbott government, they would have been refused support on the grounds that such work had no commercial benefit and would not produce products useful for industry.

Is that fanciful? Perhaps not given that Dr Brendan Nelson, the then Howard government's minister, set up a Robb Pierre style committee of public safety to overlook research funding applications. That committee was composed of individuals who had neither training nor expertise in the proposals that they were vetting yet there was great concern that research grants may have been disallowed by ignorant individuals whose only qualifications were loyalty to the Liberal Party.

I have no doubt that an Abbott government would hasten to re-establish such a committee, given the evident hostility to science and rational policy-making shown by the opposition. Of course, the opposition will, if given the chance, slash funding for medical research given its profound hostility to scientists and their work as exemplified by the denial of the reality of climate change and the attacks on research funding under the failed Howard government.

In contrast, our government, determined to support medical research, has committed $3.7 billion since 2007 to improve the detection, prevention and treatment of cancer. The government's policy of an expanded and accelerated price disclosure for the cost of drugs is working to bring the price that the government pays for these substances into line with the prevailing market price.

In concluding, although some may seek the assistance of the shadow minister for health to complain that the monetary advantage that they previously enjoyed has been diminished, in the end the taxpayers and the patients will benefit from the reduction in outlays for particular drugs and, after all, it is for the patients that these policy changes have been introduced by our government.

Debate adjourned.