Bob Katter (Kennedy, Katter's Australian Party) Share this | Link to this | Hansard source

I return to what I was saying previously. The minister is saying, 'We'll cut the costs.' You want to know what you're doing in this place. On the face of it, you say that, instead of having to go to the pharmacy twice in 60 days, now you just go in once. So this halves the income for a pharmacist. As I said previously—there's no doubt in my mind. I say: hold on a minute; if you halve the income for pharmacists, a lot of them are going to go broke. Where are you going with this? I don't notice any pharmacists in my area running around in Mercedes-Benz motor cars and going on trips overseas. What are you going to do—just wipe them out?

I've always said: in politics, follow the money trail if you see something that you don't understand, and say, 'What's going on here?' So, if you're going to halve the income for pharmacists—some of the most highly respected people in our society—who's going to benefit from that? Is the consumer going to benefit? To some degree, yes. But it's a very small degree to which the consumer is going to benefit. Who benefits? Well, if there are a whole lot of the owner-operator pharmacies going broke then of course it's the big two who benefit—here we go again! It's Woolworths and Coles. And now we've got the two giants, Terry White and—the second company is eluding me at the present moment. Those two companies are on 42 per cent of the market now.

There is no doubt that this move will give them another 12 or 14 per cent, and that's what's speculated inside the industry. Their percentage will now go into the mid-50s; from there, it will pay them to pay big money and go to over 60 per cent; and from there it's like Woolworths and Coles and they can charge anything they like. They've got no competition. So what appears, on the face of it, to be moronic stupidity that will wipe out one in four pharmacists in Australia—of course, in the small towns, forget about your pharmacy, it'll be gone!

The thing that always intrigues me about politicians in Australia today that is so fundamentally different from the politicians 40 years ago—40 years ago they cared about people. I remember saying to the much maligned Bjelke-Petersen, 'I have a portfolio that is manned by whitefellas, and it's a blackfella portfolio.' He said, 'What do you want to do?' I said, 'Obviously, I want to change it over to blackfellas, of course.' He said, 'Bob, we don't sack.' I said: 'No, it's a policy of nonreplacement. Within three years, we'll just about achieve that goal.' He again said, 'But, Bob, we don't sack.' We cared about people; we didn't want to go around sacking people.

We lost government in 1990, and within five years the ALP had sacked 12,000 railwaymen and 2½ thousand electricity workers. We had to go to computerisation, so there should have been a reduction in employment. We employed 22,000 in 1979, and 10 years later we were employing 21,000 in 1989. When the ALP came in, they were employing 7,000. So here we have it again. Don't you care about people, and don't you understand that these pharmacists are going to be destroyed?

I just want to say a few words on what a great group of people pharmacists are. Trent Twomey, head of the Pharmacy Guild of Australia, was head of Advance Cairns. He and I were instrumental in getting the Gordonvale CBD road made into a two-lane divided highway, which is very safe and very quick for people to get to work or move out of Cairns. He played a very real role in getting the alternative route, and I must say the Prime Minister, Anthony Albanese, played a very key role as well in the alternative route that cuts the round trip from the huge fruit and vegetable growing area of Far North Queensland to Melbourne by 1,800 kilometres. It's a wonderful breakthrough in saving our fruit and vegetable growers both for tropical fruit and vegetables coming out of Far North Queensland and for temperate fruit and vegetables coming out of Victoria. Trent Twomey played a key role in that. He's the head of the Pharmacy Guild of Australia, but in that case he was with Advance Cairns.

Michael Collins, in my own hometown of Charters Towers, put in a lot of money—I can't divulge how much, but it was an awful lot of money—to get the North Queensland Cowboys rugby league team going, which has been a great and exciting thing for the people of North Queensland.

Madam Deputy Speaker Chesters, I don't mind people ignoring me, but I do object when they're talking to each other across the chamber, which I think is exceptionally rude and bad mannered. My parents brought me up to not speak while other people are speaking, but obviously their parents didn't bring them up that way. So I'd ask you, Madam Deputy Speaker, to please stop them from talking across the chamber while I'm trying to talk. Thank you.

I used the case of Michael Collins, who is so typical of pharmacists. He put real money in to get the Cowboys going, which is a wonderful thing for North Queensland. He got rugby league going in Charters Towers. He was one of five or six of us that met and got rugby league going in our own town, where three or four teams are now playing. He did a hell of a lot to rescue the schools in Charters Towers when they got into trouble—the huge boarding schools that provide a wonderful service to people of the outback, where they can go away to boarding school. He was the commentator for the country music festival and the race club. These people contribute to our community. Why would you hit these people? Why would you halve their incomes? What's the benefit to the Australian people? Infinitesimal. But what is the value to the two giants in the pharmacy industry? Colossal.

I will repeat what I said earlier today. The spokesman, the assistant minister for health in the Senate, let the cat out of the bag. As I said: follow the money trail. She said—and I must say it was quite a stupid comment and quite damaging to her party, for those that picked it up—'We haven't been able to speak to the Pharmacy Guild, but we have spoken to Chemist Warehouse.' Yeah, I bet you did! You spoke to Chemist Warehouse because this will enable them and their other competitor to move into a Woolworths-Coles position in the Australian economy. For some reason, the governments of Australia and the politicians in this place have no understanding of economics. Obviously, if you have a free market system, you'll say, 'Oh, a free and open market system will deliver you cheaper prices.' No, it won't; it will deliver you an oligopoly. This is what it's done in almost every area of concern that we have in Australia.

I will again refer to Woolworths and Coles. We have a potato grower that ploughs the field. Then he has to till the field. Then he has to plant the potato. Then he has to irrigate the potato. Then he has to fertilise the potato and keep the pests and diseases out—a lot of work. Then he has to pull it out of the ground, put it on a truck and take it to town. In the town, Woolworths and Coles take the potato out and put it on the shelf. He gets 45c per kilogram, and they get $4.20 per kilogram! And that's what's going to happen here. There's not the slightest doubt in my mind that once they get what the ALP is delivering to them, an oligopolistic marketplace, they will charge what they like. So, in the short term, you can say, 'Competition will reduce the price' Yeah. But in the long term you will have an oligopoly and you'll know what pricing is about.

I want to say one other thing about pharmacists. They are the first line. I myself had an interesting case. I had a little pimple thing on the side of my face that was itchy, and I raced down to the pharmacy, which was still open at nearly 10 o'clock at night, and I said: 'I just want something because it's a bit itchy. It's just a little pimple.' And the pharmacist said: 'No, I think that's shingles. That's very serious indeed.' At five to 10, the doctor was still in, so I raced down to the doctor, and she said: 'It's shingles. In 24 hours you might die.' (Time expired)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Is the amendment seconded?

Michael McCormack (Riverina, National Party, Shadow Minister for International Development and the Pacific) Share this | Link to this | Hansard source

I second the amendment, and I reserve my right to speak.

Emma McBride (Dobell, Australian Labor Party, Assistant Minister for Mental Health and Suicide Prevention) Share this | Link to this | Hansard source

I thank the members for their contributions to the debate on this bill. The National Health Amendment (Supporting Patient Access to Cheaper Medicines and Other Measures) Bill 2024 will support a strong pharmacy sector, deliver cheaper medicines and boost pharmacy services across the country. The Albanese government has already saved Australians more than $370 million on the cost of their medicines.

This bill supports the implementation of the Eighth Community Pharmacy Agreement by delivering on the commitment to establish an additional community supply support payment for eligible supplies of pharmaceutical benefits made by approved pharmacists. This will provide a means through which the Commonwealth is able to provide the necessary level of support to community pharmacies for the dispensing of PBS medicines, and ensure continued access for Australians to these medicines without increasing the cost to patients.

This bill will provide more equitable access to cheaper medicines for all patients by replacing the optional $1 discount with a reduction in the patient co-payment for all patients. This will be achieved by freezing the indexation of the PBS general patient co-payment for one year and freezing the indexation of the PBS concessional patient co-payment for five years. This will mean that the cost of PBS medicines will remain constant.

The government is committed to all Australians being able to access high-quality health care. This includes timely, reliable and affordable access to necessary medicines through the Pharmaceutical Benefits Scheme.

I remind members of how central the cost of medicine is to the budgeting in every Australian household. When I worked in community pharmacy, I would have patients come in with a handful of prescriptions, asking me as a pharmacist which prescription they could avoid filling or delay filling. I've also had parents, having visited the GP with two sick children, asking if they could get just one antibiotic prescription filled to share between them.

Our government understood this pressure from the day we took office, and, under the leadership of the Prime Minister and the health minister, we are delivering real cost-of-living relief across the country. This bill means all Australians will have more equitable access to cheaper medicines. As a pharmacist, a local MP and an assistant health minister, I commend the bill.

Milton Dick (Speaker) Share this | Link to this | Hansard source

The question is that the amendment be agreed to.

Milton Dick (Speaker) Share this | Link to this | Hansard source

The question now is that this bill be now read a second time.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.