Andrew Wallace (Fisher, Liberal National Party) Share this | Link to this | Hansard source

I move:

That this House acknowledges that:

(1) the Government:

(a) has not consulted with or listened to the genuine concerns of community pharmacists in regard to its proposed pharmaceutical 60-day dispensing changes; and

(b) must provide a strong guarantee that this change will not:

(i) harm the viability of community pharmacies;

(ii) affect medicine supplies especially in regional and rural communities; and

(iii) increase the stockpiling and wastage of medicines;

(2) the increased cost of living has placed enormous pressure on Australians, but questions remain on whether this policy will have perverse and unintended consequences; and

(3) community pharmacists play an integral role in the provision of primary healthcare in Australia, particularly in rural and regional Australia, as they stepped up when the nation needed them most through the COVID-19 pandemic and they deserve the support of the Government.

I move this motion in utter exasperation. I'm at a loss when I try to understand why this Labor government would even consider its radical changes to the dispensing of medicines. I know that there is a natural predisposition because there will be some savings initially for the public. I understand why the public would think that that is a good thing. However—and I know those opposite don't really care about regional and rural Australia—community pharmacies and industry professionals across my electorate of Fisher have reached out to me very upset at the impact that Labor's decision will have on their services. Their customers and clients, many vulnerable Australians living beyond the big cities, have spoken to me about their own fears about access to health care, and they are right to be afraid. Labor has slashed mental health funding. They have hacked at a decade of progress on Medicare. They've dismantled our world-class telehealth system. They promised urgent care clinics would be built, and 12 months on we don't even know where they'll be. They've abandoned primary health care in regional Queensland at the state and federal level, and now, just like last time, this federal Labor government is making vital medicines more difficult to access for Australians in need.

An honourable member: That's completely untrue.

The government said this would be a cost-of-living measure, but who will benefit? By all accounts, this move will cripple small businesses and reduce supply, and families in regional Australia will pay the price.

You see, this is the difference between those opposite and those in opposition. The government believe that they are the doyens of all things. They believe that big government knows best without consulting the people who will be impacted. Did the government consult with pharmacies? Did they talk to small rural and regional pharmacies as to the impact that this would have? And it's not just the impact upon the pharmacies; it's the impact it will have if and when those pharmacies actually have to close up shop because they can't make a dollar anymore. Did they think about that? They won't guarantee supply for rural and regional communities or smaller pharmacies. They haven't thought about medicine stockpiling. They can't answer these questions because they have no idea. Why is that? It is because they didn't consult. Their priorities are out of order. They are out of touch with the needs of everyday Australians—

and they are patently out of depth, as you can tell by the level of their interjections.

Community pharmacists and small business owners are already contending with Labor's cost-of-living crisis. They are now facing a crushing blow from this arrogant Labor government. Community pharmacies are telling me that this decision could cost them everything, and our communities will ultimately pay the price. I think especially of a community pharmacy in one of my rural towns, Montville, a community that no longer has a GP, thanks to state and federal Labor. Now their pharmacy is at risk of closing its doors. That's the cost of a Labor government. Marie from Sippy Downs and Warren from Golden Beach share concerns of the impact that this will have on the communities they service. Stan from Maleny called the move 'disastrous'. John from Mooloolaba said it was reckless and irresponsible. Reckless, irresponsible, disastrous—that's a three-word slogan for the Albanese Labor government.

The idea that pharmacies would close left, right and centre across regional Australia would have been a ludicrous proposition just 12 months ago. Our pharmacies played a vital role in helping our country through the COVID-19 pandemic. The idea that any government would reward their hard work with this reckless intervention is astounding. It is just plain wrong. But after just 12 months of a callous and careless Labor government, Australians are not surprised. Australian families and their businesses always pay more under Labor.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

Is there a seconder for the motion?

Angie Bell (Moncrieff, Liberal National Party, Shadow Minister for Early Childhood Education) Share this | Link to this | Hansard source

I second the motion and reserve my right to speak.

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

I really am very loath to get involved in negativity and argument about this motion. As you know, Madam Deputy Speaker Chesters, I've worked in the healthcare system for over 40 years. I've had a great relationship with all of my local pharmacists and I've appreciated their hard work, in particular the work that they did to stay open and provide services for their patients during the pandemic. I know how hard many of them work.

This policy that the member for Fisher has described is actually sensible healthcare policy that will deliver better and more efficient healthcare outcomes for the whole of Australia. There is no doubt that this is long overdue. This has been talked about in healthcare circles for 20 or 30 years. The idea that someone who is stable on a long-term medication has to go back to their pharmacy every 30 days to get repeat prescriptions is crazy. The idea that people have to go back to their GPs every few months to get repeat prescriptions is also crazy. That's why the government is extending the GP prescription time to 12 months and is allowing people to pick up 60 days—two months supply—of their regular, long-term medications without having to go back every 30 days to the pharmacies. It's sensible, it's efficient and it saves money. It is better healthcare policy. This is a bit like taxis versus Uber. Uber has changed the system. It's more efficient. People like it and people want it.

I have the biggest electorate in Australia by population. I've had not one patient complain to me about the 60-day prescribing. There have been lots of complaints from pharmacists. They were consulted. They're the ones that walked away from the table. The Pharmacy Guild walked away from discussions. They drew a line in the sand and then walked away. I'm encouraging them to come back to the table to talk about how we can help their pharmacies, which, by the way, have been earning record incomes in the last five years. I'm saying, 'Come back to the table, and let's talk about this.' But this is sensible healthcare policy. It is better for patients. It's better for our system. It gives GPs more time to deal with patients, and we know that, in the last 10 years, there has been an exodus of general practitioners. We just haven't been able to get them. The previous government sat on their hands and did nothing, and, when we introduce sensible healthcare policy, all we get from the opposition is negativity and argument. As I say, I have the greatest respect for our local pharmacists, but this is the 21st century. We must make our systems more efficient. We must make them work better for patients, and this is a start. As the minister has noted, we understand very well that the Pharmacy Guild has to represent their members and we understand what they're talking about, but they are the ones that walked away from the table. They must come back, and we must talk about how we can make our system more efficient.

The Pharmacy Guild uses ridiculous arguments like, 'More children are going to die of overdose because of this.' There's absolutely no evidence of this whatsoever, yet they keep on saying silly things like that. They're talking about compliance issues. Compliance will actually be better with 60-day prescribing, and it is crazy that they would say otherwise. We know there is a problem with young males in particular who are on regular medication going back and getting repeat scripts and getting their medication from the pharmacy. This will make compliance better. The 300 medications that will be covered under this policy will be introduced slowly. There will be no increase in medicine shortages over those we have now. We've had medicine shortages because of the policies of the previous government over the last 10 years. We've learned how to deal with that, as have pharmacies. It's important to note that nearly a million Australians every year are forced to go without their prescriptions because of cost, and this will reduce cost to patients and make it more efficient. More people will be able to afford their medications because of this 60-day prescribing. This policy is important. It brings benefits to over six million Australians who won't have to go back every 30 days the pharmacy to get medications they may well have been stable on for over 20 years.

This is good policy. There will not be increased medication shortages. I doubt very much that businesses will go broke and close. This is not true; this is a fallacy. This government is doing what is best for healthcare policy, and the minister is to be congratulated.

Angie Bell (Moncrieff, Liberal National Party, Shadow Minister for Early Childhood Education) Share this | Link to this | Hansard source

The coalition strongly supports affordable access to medicines for all Australians, and we have a strong record to prove it. When we were last in government, we listed more than 2,900 new or amended medicines on the PBS, at an overall investment of around $16.5 billion. However, many concerns have been raised with me in my office by community pharmacists about what impact the government's 60-day dispensing change will have on their small and family business. In fact, many are concerned this this change could force the cost of other items to increase, so that Australians end up paying more during a time when they are already doing it tough. Like many of Labor's policies, it sounds good, but there are always consequences down the line, including what it will mean for the many thousands of people employed by a pharmacy. We've just heard the member for Macarthur describe this policy as an interrupter, like Uber. Well, this certainly is an interrupter to small and family businesses—those pharmacists who own pharmacies across the Gold Coast in my electorate. The challenges will be diabolical for 5,700 community pharmacies across the nation, 120 of which are based on the Gold Coast—which is the small-business capital of our nation, with 72,000 small businesses. That's what many of these pharmacies are—small and family businesses, and I will always stand up for those small-business and family business owners.

Earlier this month I met with local Gold Coast community pharmacists and representatives from the Pharmacy Guild—Kyril, John, Anand, Amanda, James and Paul—to listen to their concerns surrounding these changes. Their message was abundantly clear: these changes will be dire for small and family businesses within the sector. James, who owns three pharmacies in my electorate, said that if these changes were implemented he would see the bottom line of his business halved. Even worse, James said that under these changes he'd have no choice but to close one of his businesses and it would become impossible for his business to stay afloat. This is simply not good enough. Labor is sending small and family business to the wall—intentionally.

Australia is currently facing a medicine shortage, and many of my local pharmacists have warned that half of the eligible medications under the 60-day dispensing changes are already in low supply. Double-dispensing medications that are already low in supply will only add to that supply shortage. What's the government's plan to address that? I'm guessing they probably don't have one. Not only will these changes lead to further stress on our local community pharmacists but there is also concern that customers will panic-buy and stockpile medication, leading to further shortages and increased medication wastage. Nothing about this is good for small or family businesses, remembering that they employ thousands of people across our nation.

While the coalition have been listening to the genuine concerns of pharmacists and the Pharmacy Guild, their concerns have fallen on deaf ears when it comes to this Albanese government. James said that in one of his pharmacies, 54 per cent of his dispensary script numbers will be eligible for 60-day dispensing, and because of that he'll experience a drop of 20 per cent of his gross profit. When you're running a business, 20 per cent of your gross profit goes into the salary bill. These changes will mean that he will have to let go 12 of his 31 staff members—who also have their own families—across his three businesses. That's 12 more people on the unemployment line from just one small, family business that is a pharmacy. All the pharmacists I spoke with echoed those metrics and are completely distressed about the changes. They are calling out for a lifeline and this government is offering them exactly nothing.

There are so many questions the government needs to answer regarding these changes. How will they ensure that regional and rural communities—which they don't care about—are able to access the required supply of medications? How will they ensure small community pharmacies are able to access the required supply of medications? How will they prevent stockpiling of medicines? Can they guarantee that community pharmacies will not be negatively impacted by these changes? If they can't answer these simple questions, how are our community pharmacies meant to have any confidence whatsoever in the government and their decision-making?

The coalition acknowledge the current cost-of-living crisis faced by Australians living with chronic illness. We have been calling on the government to provide a strong guarantee that this change will not harm the viability of community pharmacies. We also want to ensure the policy does not have perverse impacts for Australians more broadly, including pharmacy closures which, in turn, would put pressure on the health system. Why do Australians always pay more under this government?

Louise Miller-Frost (Boothby, Australian Labor Party) Share this | Link to this | Hansard source

I am particularly pleased to speak to the member for Fisher's motion on why people will spend less on medicines under Labor. It is ironic that those opposite put up something about the cost-of-living issue and yet all they can come up with are scare tactics and complaints. The change referred to in this motion was one announced as part of this month's budget, when the health minister—and my electoral neighbour and colleague—Mark Butler, announced that the government would be introducing 60-day prescribing and dispensing for stable, ongoing conditions. What this will mean, in effect, is cheaper medicines for at least six million Australians who take one or more of the 320 common medicines safety-assessed by the PBAC for this scheme. The list of medicines includes common medicines for blood pressure and cholesterol as well as other regular ones, and patients will save up to $180 a year per medicine. Those on healthcare cards will save $43.80 a year per medicine. The change brings Australia into line with comparable countries like the UK, France and Canada. New Zealand has had 90-day dispensing for over two decades—the world didn't end!

This change was a recommendation of the independent Pharmaceutical Benefits Advisory Committee in 2018 and was ignored by the former government. It's a recommendation that could have saved Australians millions of dollars a year for the past five years, but it was ignored.

Let's be clear, the purpose of the health budget is to improve the health of Australians. Overseas evidence shows that longer dispensing times is not only safe but it actually increases medication compliance by up to 20 per cent. Why would this be? When medications are affordable, people are more likely to be able to take all of their medicines regularly as prescribed. Each year, over a million Australians delay or go without medication because they can't afford it. Secondly, if you're going to have a gap in your medication, it's likely to be at the end of your script because, perhaps, you haven't been to your GP on time or, perhaps, you haven't been to the pharmacy to refill it. Gaps in regular medications have impacts on the management of chronic conditions and risk factors. This is good policy.

There's another great benefit of this move to longer dispensing times. That is, patients won't have to attend their GP to get prescription renewals so regularly, and this means GPs will be freed up to see other patients. We all know how hard it is to get in to see a GP after six years of Medicare rebate freezes under those opposite impacted the number of doctors choosing to become GPs. So this move is clearly the right thing to do for patients.

However, I acknowledge that it has impacts on community pharmacists, and I have spoken to many of them. Community pharmacy provides an important and essential role in our system, and I know the minister for health is committed to ensuring this remains the case. The Australian health system is a blended public and private system, and it's important to the health system as a whole that we have a strong community pharmacy sector. However, we don't have unlimited resources and the health budget needs to make decisions in the best interests of Australian patients. We are a country with an ageing population and a rising prevalence of chronic disease. Demand for health services is rising, and we need to make sure that the system is efficient. This policy aims to address an inefficiency in the health system that sees Australian taxpayers and patients pay more for essential services than they need to, it ties up GPs for script renewals and it drives poorer health results from medication non-compliance. This change affects 1.5 per cent of pharmacy revenue.

Crucially, every dollar saved by the government through this change will be reinvested in community pharmacies. Pharmacists have increasingly become providers of immunisation services. They will be funded to reach out in aged care for pharmacy reviews. Some states are running trials or inquiries into prescribing rights for pharmacists for certain medications or conditions. This will require a change of business model for community pharmacy, but pharmacists and, yes, the pharmacy owners have been crying out for expanded scope of practice for years, and this health minister is looking into it. To be clear, the minister is looking into it because the entire health system needs a rethink, needs change, in order to meet the changing and growing needs of Australians. Perhaps the Pharmacy Guild should return to the negotiating table.

Every year nearly a million Australians are forced to delay or go without medicine that their doctor has told them is necessary for their health because they can't afford it. This will fix that.

Rowan Ramsey (Grey, Liberal Party) Share this | Link to this | Hansard source

It's quite clear to me that this announcement in the budget is what I would call thought-bubble politics. It's: 'Hey, I've got a good idea. Let's try it!'—trying it without consulting and with very little road testing or consideration of the consequences. On the face of it, we have something that looks like not a bad idea: two-month prescriptions. Certainly that'll suit me okay, thank you, even though it would be fair to say that I probably don't need a reduction in cost. Fewer visits to the pharmacy will save me time, and there will be a $1.2 billion saving to the budget over the forward estimates. What's not to like? Let's get out there and sell it. But let's not tell the pharmacists. After all, they're filthy, stinking rich, and they will only whinge about the changes.

But the government did not give the pharmacy industry sufficient insight into this change, and those on that side of the chamber have demonstrated that they have a dearth of practical experience. It's fair to say they do have one member who, I believe, has been a pharmacist. I don't think she's speaking today on this bill. But if they'd thought this through, they may well have considered what impact the loss of income may have on community pharmacies.

There are visits to aged-care facilities. The previous member mentioned visits for aged-care facilities, and I'll come back to them in a moment. There are hospital visits to inspect drug cabinets, dispensing dates, how staff are actually managing the dispensing of drugs and staff education. There are the blister packs. There is a payment for blister packs, but it will halve under this policy. I was speaking to a number of pharmacies in small towns who actually deliver the blister packs. There's no payment for that. There's a knock on the door: 'How are you, Mrs Jones? Here's your blister pack.' That's a very welcome call from the pharmacy and their staff. Furthermore, regular visits to the pharmacy—with stable pharmacists and stable workers—is a chance to size people up as they walk across the floor to you. Is that too much? Who knows?

I've taken quite a number of calls from pharmacists. They commonly expect to take a hit of a couple hundred thousand dollars to their bottom line on this and they're now wondering what kind of impact that will have on the net worth of their business. It's clear to me that, if this is a good idea, it should have been part of the Seventh Community Pharmacy Agreement, which will need to be negotiated again within the next 18 months. If there is to be a payment for aged-care visits or if there is to be an increased payment for blister packs, it should have been done at the same time that the government was proposing to slash their income. At the moment it has just caused a heap of instability.

I was speaking to a young pharmacist in a small country town. She has owned the pharmacy for four months. She bought it on the figures of the last two years. She has taken out a significant loan and she does not know the full impact on her business yet. I said to her, 'What will you do?' She said, 'Something will probably have to go.' I said, 'Where do you go for that?' She said, 'It'll have to be a staff member—or two—or perhaps I will have to get rid of my backfill pharmacist who gives me a holiday, because I don't think I'll be able to afford that, and we will have to get rid of some of the services that we are offering in the community for little or no pay, and that includes the aged-care visits.' She certainly can't see any savings—and this is a matter for another debate, I'm sure—in her electricity bill.

The predominance of PBS prescriptions go to the over-55s, and of course, as we age, the percentage of people on multiple prescriptions increases. It's worth noting that the PBS safety net is at $262.80 at the moment, and many people on those concessions will meet that headline amount in April, May or even June. For those people, there will be no saving at all. It'll be $262.80 this year, and it'll be $262.80 under the changes. It is interesting that a government that says it is about addressing the cost of living is actually giving a break to someone like me and not to an age pensioner. It seems to be a very blunt way of addressing these issues, and that is why I say again that it should have been part of the seventh pharmacy agreement. This should be done in global consideration, not in a one-hit, out-here-on-its-own, thought-bubble process. That's what you get when you don't think through the processes. It seems to me there has been little consultation, no consideration and no plan.

Josh Wilson (Fremantle, Australian Labor Party) Share this | Link to this | Hansard source

There is no question that community pharmacies are a vital part of our primary healthcare ecosystem. That has been the case for a long time. It was brought home to all of us with even greater clarity through the experience of the pandemic, and I know that pharmacies in Fremantle, East Fremantle and Cockburn are building blocks of wellbeing in the communities I'm fortunate to represent. The Albanese government sees two things very clearly. First is the fact that our primary healthcare system as a whole needs some fairly urgent remedial care and attention after a decade of neglect.

Second is the fact that cost-of-living pressures are causing too many Australians to choose between important medicines or perhaps to skip taking these medicines altogether. In the budget that has just been handed down, we have put in place a phased transition to 60-day dispensing arrangements for a range of medicines that Australians need for the management of chronic health conditions. This motion, while apparently supporting the change, calls on the government to strongly guarantee various things. Perhaps those opposite should reflect on the fact that their government completely failed to provide full-cycle funding for the programs under the seventh community pharmacy agreement.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I am very sorry but the time allotted to this debate has expired. The debate is adjourned and a resumption of the debate will be made an order of the day for the next sitting.

Sitting suspended from 13:30 to 16:00