Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I thank the minister for introducing the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023, as accountability and trust in medical professions and our healthcare industry are all too important today, not only within the industry at large but within the general public as well. This is an interesting bill. It seems simple, and I think there's pretty much general agreement across the parliament that this is a good thing, but it is also a demonstration of how medical practice has changed in the more than 40 years I've worked as a paediatrician. In days gone by people had their own general practitioner, often in a solo practice, providing after-hours care, home visits and pretty much holistic care for the whole family. My uncle Hyam Emdur was a GP in Newtown for over 60 years. When he was 91, and still practising, I asked him, 'Uncle Hyam, why don't you retire?' And he said, 'Because I hate gardening and I'm too young for bowls.' Practice has changed since those days.

We used to have the community pharmacists who'd run his pharmacy, often staying open all hours, day and night, compounding medications, making up medications, making up children's medications and solutions, and really working very hard for the community. But these days things have changed, and we are now in an era of corporate medicine and corporate pharmacies. Most of us who live in the cities know that there are now things like Chemist Warehouse and the pharmacy chains that provide most of the care. And the pharmacy business has changed as has, indeed, the amount of money that we spend on medication. This legislation tackles the complicated issue of inappropriate PBS prescribing by pharmacists, company directors and company owners and holds to account those individuals who act in a fraudulent manner so that they can be prosecuted. The legislation was introduced years ago, without the knowledge that corporate pharmacies would be the order of the day as they are now.

I do have some concerns about fraudulent practice in the pharmaceutical and pharmacy industries, the same as in medical practice. There are always outliers—doctors, pharmacists, other health professionals—who are willing to take risks to make money. This bill is important, as it focuses on the issue of inconsistency. The power to suspend or revoke the approval of a pharmacist who was charged or convicted of PBS related offences applied previously only if they were an individual pharmacist, not if they were working for a company. Currently, it does not apply where the approval is held by a pharmacist operating in a company structure, and that is now the majority of pharmacists in Australia. This bill, thankfully, rectifies this as it provides discretionary power to the minister and the secretary to suspend or revoke the approval of a pharmacist who has been prosecuted on PBS fraud offences, regardless of whether the approval is held by an individual or held under a company structure.

If we fail to act, fraud will continue to take healthcare funding away from those who need it most. We know that our pharmaceuticals costs are increasing, with millions of dollars being inappropriately taken from taxpayers and the Department of Health by criminals through fraudulent behaviour. A notable example of this occurred in June 2022, when a former New South Wales pharmacist was sentenced to more than six years imprisonment for conspiring to defraud taxpayers of more than $19 million through fraudulent PBS claims. I can see how this could happen, particularly in higher-turnover pharmacies. It's true that it happens rarely, but it does happen and the potential is there, so it is very important that we have legislation that can deal with these sorts of situations in corporate pharmacy practices. It is very disturbing that this could happen and also very sad. It's abuse against our healthcare system.

This legislation will strengthen the government's ability to protect public expenditure through the PBS, and again, it highlights the Labor government's commitment to protecting, strengthening and restoring faith in health care. It also forms part of our plan to address the cost of medications and to bolster the PBS. For example, as of 1 January this year, our government helped millions of Australians save money on their medications by reducing general co-payments for scripts by $12.50. It is the first time this has happened in the history of the PBS, and it is very important for constituents in my electorate of Macarthur and, indeed, across the country. Particularly for families who have a number of children who often require medications for things like asthma and respiratory infections, reducing those costs significantly improves cost-of-living pressures for many families throughout Australia. It's worth noting that Labor has a strong history on health care, with the PBS being introduced by the Curtin and Chifley governments in 1949, Medibank by Gough Whitlam in 1973 and Medicare under Hawke in 1984.

I look forward to the Albanese Labor government bolstering our track record on health over the coming term, but there are storm clouds there. I cannot stress enough the importance of having appropriate access to primary care for some of the most disadvantaged Australians. At the moment, we are at risk of developing a two-tier health system. I know that, in my electorate of Macarthur and in other disadvantaged areas around the country, many people are struggling to access primary health care. This is putting enormous pressure on our hospital emergency departments and on our GPs—and on our students, because fewer and fewer of them are wanting to enter general practice. We need to make sure that we are providing incentives for people to train as general practitioners and make sure that we are supporting our GPs to continue to bulk bill and to see some of the most disadvantaged people in our communities.

As I've said, this bill strengthens the government's ability to improve compliance and reduce inappropriate practice by corporations, directors and indeed some pharmacists. I'm pleased to note that many industry stakeholders such as the Pharmacy Guild and the Pharmaceutical Society of Australia support this. It's another small step by the Albanese Labor government under health minister Mark Butler, improving access to care, making sure that the reputation of Australia's healthcare system remains one of the best in the world and making sure that people can continue to access 21st century health care in an economy that is under stress because of worldwide events. In this parliament we can ensure that we close loopholes for fraudulent abuses against the PBS. We can improve access to care. We can protect the integrity of our health system and provide Australians with peace of mind that they are getting the very best and most efficient health care system we can provide for them.

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

I rise to speak on the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023. Firstly, I want to commend the member for Macarthur for his contribution but also for his record in this space. I quickly want to touch on the two-tiered health system that he mentioned. I share his concern. As a young man growing up, raised by a single mum with five kids, I was fortunate to be a beneficiary of the Medicare system and the healthcare system that we have. We do need to do everything we can to ensure that this system is sustainable, that there is not a two-tiered system and that everyone can have access to health care. That sustainability is so important, as is the PBS.

This bill is important because the PBS is a key part of providing all Australians with medicine and reducing the costs. We need to make choices. We can't afford to put every medicine on the PBS, but we need to do everything we can to put as many medicines as possible on the scheme. The reality is that the people who need those don't need it by choice; clearly it is a cost burden on them that they have to invest in. I have heard horror stories of people in my electorate having to decide between buying food, getting their medicine or paying their power bills. That's the reality of the cost-of-living crisis that we are in. It's an ongoing struggle that Australians have had for many years and will continue to have. That's why we need to do all we can to continue to support the PBS.

I'm glad that this bill has bipartisan support. It's why I wanted to speak on it and share my contribution. The coalition does have a strong track record of providing Australians with timely and affordable access to effective medicines, cancer treatments and services, and the coalition remains absolutely committed to ensuring Australians have access to affordable medicines when they need them. We have a proud record on affordable medicines, having listed almost 3,000 new or amended medicines on the PBS when we were in government. As the cost of living skyrockets, the PBS is going to be more vital than ever for families and for pensioners. Whatever we can do to ensure the sustainability of the PBS is important.

This bill, National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023 amends the National Health Act 1953 to support the sustainability and operation of the Pharmaceutical Benefits Scheme. When a pharmacist has been approved to supply pharmaceutical benefits at a particular premises, the approved pharmacist can then make claims for payments from the Commonwealth in relation to the supply of these benefits. The bill extends the discretionary power of the secretary and the Minister for Health and Aged Care to suspend or revoke approval for a pharmacist to supply pharmaceutical benefits at a particular premises irrespective of whether the approval is held by an individual or under a company structure. Currently if an approval is held by an approved pharmacist corporation and a director is charged with a PBS related offence, they can continue to receive payments from the Commonwealth despite being charged for fraudulently claiming these payments. The government has noted that the measures support a sustainable PBS, which is vital, and the integrity of public funds to ensure that these can be invested in access to new and improved medicines.

But we do have some concerns that the government are not prioritising investments in improved access to potentially life-saving or life-changing medicines. Earlier this month the Labor government quietly removed a life-changing diabetes insulin from the PBS, Fiasp. It's an innovative mealtime insulin that balances blood sugar control at a faster rate than other insulins. I've got family members who have diabetes. I know it's a disease that no-one chooses. It is one that you have to have your medications for, and if you don't the effects down the line are significant. The former coalition government listed Fiasp on the PBS in 2019, ensuring affordable access to this insulin for 15,000 families coping with type 1 diabetes. The government's decision to suddenly remove Fiasp from the PBS will send the price soaring up to $280 per script. They must be transparent with Australian diabetes patients and admit whether they actually took any steps to support the commercial viability of Fiasp remaining on the PBS.

We know Minister Butler has the power to intervene, and it appears that in this case he chose not to. The question is: did they even try to find a solution for the 15,000 patients who rely on this medicine or did they just sit on their hands and enjoy the money savings that came with its removal? The government needs to understand that this decision to tear away the quality of life that the medicine affords over 15,000 people and their families—

Government Members:

Government members interjecting—

Aaron Violi (Casey, Liberal Party) Share this | Link to this | Hansard source

I'll take the interjections. If it's been resolved, that's fantastic and that's a great result. I'm very happy to say it's been resolved. I'm really happy with that. That's a great result for Australian people and those 15,000 families. It is wonderful to hear that.

Labor went to the election with the promise of cheaper medicine. It looks like that has been resolved. I'll continue to hold the government to account to make sure they are, but I'm happy to put my hand up and say that if those facts are wrong, they're wrong. I'll give the government credit and give the minister credit: he listened and he changed. That's what I think we need to do in this House. As an opposition we need to hold the government to account, but we also need to say when the minister listened and changed his mind. I applaud him for that. I'll continue, as I said, to hold the government to account on their broken promises because it is significant with rising cost-of-living pressures. This is the time that we need to look after the PBS.

As I said, Australians are doing it tough at the moment, and rising prices are affecting all Australians. This bill does support the sustainability of the PBS. I'm glad that this medicine is continuing to be on the PBS. We need to continue to support the sustainability of the system. I will do that whenever I can, along with the coalition, with our strong track record on the sustainability and integrity of this scheme.

Ged Kearney (Cooper, Australian Labor Party, Assistant Minister for Health and Aged Care) Share this | Link to this | Hansard source

I thank members for their contributions to the debate on the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023, particularly the members for Farrer, Macarthur and Casey. To clarify: Fiasp hasn't gone back on the PBS, but we've extended the ability for people to collect it on script for the next six months while they consult with their GPs to convert to other appropriate medications. That process is ongoing. I just wanted to clarify that that's what's happening. There are very suitable alternatives to that drug for people to use.

For your constituents and for all Australians: the Pharmaceutical Benefits Scheme has provided affordable access to medicines for over 70 years. The Australian government is committed to protecting the integrity of Medicare, which includes the PBS. The government understands the importance of the PBS remaining sustainable into the future so that we can continue investing in new medicines for the community, and that includes the process which the previous member was so critical of. Integrity of public funds and effective PBS compliance are a vital component of this commitment. The government needs to adapt its compliance arrangements for bodies corporate in recognition of the fact that they are increasingly involved in the ownership and operation of pharmacies. The bill strengthens compliance powers, especially the ability to protect the PBS from abuse and inappropriate practice by pharmacists who are directors of bodies corporate. Currently, the discretionary power to suspend or revoke an approval to supply pharmaceutical benefits only applies to individual pharmacists. The amendment will extend the discretionary power to a pharmacist who is operating under a company structure and who has been charged with or convicted of a PBS related offence. This will ensure that the power applies equally to all approvals.

I would like to thank those stakeholders who provided input into these changes during consultation on the bill. The PBS provides Australians with access to vital medicines, and this bill will protect the integrity of the PBS so that we can keep investing in new and better medicines in the future. I thank the members for their interest and support.

Question agreed to.

Bill read a second time.