Nick Xenophon (SA, Independent) Share this | Hansard source

Senator Hanson-Young has been to that pharmacy many times, and I think many others have as well. It is the only late-night pharmacy, and if you happen to be there between 10 pm and midnight, when all the other pharmacies in the metropolitan area seem to shut down, and hardly any others are open, you will see the Midnight Pharmacy full of parents with their young kids, or maybe the kids are in the car with the other parent. They are getting some urgent medications. This is the sort of situation Senator Leyonhjelm mentioned.

In my constituent's case, the Midnight Pharmacy was in breach of the location rules and had all sorts of technical difficulties in relation to that. But fortunately ministerial intervention prevailed, because there is a safety valve in the legislation. I am grateful to the former minister, Minister Dutton, for appropriately using ministerial intervention in relation to that, because there was a compelling case for that pharmacy to be open. It provides a community service late at night. It is open from 7am to midnight—the longest hours of any pharmacy in South Australia, as I understand it. So there is a discretion. There must always be a discretion in terms of hard and fast rules, but I think, on balance, the location rules do provide a basis for pharmacies to invest and to make a contribution to the local community by providing a service. I do not support, under any circumstances, Coles and Woolworths having pharmacies in their stores or controlling pharmacies. I think that would lead to a race to the bottom. That is my fear. I would rather it be run by as many small community businesses as possible. There are some chains or franchises, such as Terry White, but my understanding is that the Terry White pharmacies are owned by individual franchise owners. So I do not think this image that Mr White owns 150 pharmacies is accurate at all.

This piece of legislation is important, as the Pharmacy Guild points out. This gives effect to the PBS Access and Sustainability Package, which was formally announced by the Minister for Health on 27 May 2015. The government has made it clear, according to the Pharmacy Guild, that the bill's passage is a prerequisite to commencing the Sixth Community Pharmacy Agreement on 1 July 2015. I agree with the guild when it says that this agreement is critically important to securing the future of Australia's 5,450 community pharmacies, the jobs of their hardworking staff and the health care of the millions of patients who rely on them for their medicines. Without the investment contained in the Sixth Community Pharmacy Agreement, community pharmacies face an unsustainable future due to the flow-on impact on the remuneration from PBS reforms.

I think it is fair to say that, on any reasonable analysis, the heavy lifting, in terms of cutbacks in health, has been borne disproportionately by the community pharmacy sector. I disclose that I happen to have two cousins who are pharmacists, and they tell me first hand of the pressures they face in their businesses. They are not gilding the lily. They tell me about the pressures that they face as community pharmacists—about the hours they have had to cut back for staff, as a result of accelerated price disclosure. I disagree fundamentally with the government for going back on its word in terms of accelerated price disclosure. The shocks were too sharp and too severe for community pharmacies in this country. Price transparency is of course unambiguously good thing, but the way it was implemented caused a lot of harm to the community pharmacy sector. We know that there have been a number of layoffs from the 60,000 employees. I have spoken to a number of pharmacists who are really, genuinely doing it tough. The goodwill of their businesses has been destroyed at the stroke of a government pen. All I ask is that there be some equity in this. If there are going to be savings and cutbacks in the health system it needs to be done in a way that is proportionate and fair and does not adversely impact on consumers and patients. That is my concern in relation to this. I unambiguously think that we need to have that debate.

I welcome Senator Leyonhjelm's amendment about the location rules. I think it is healthy to debate and discuss these issues. I have had one experience with location rules. Peter Angelos operates Midnight Pharmacy on Frome Street in the city near the corner of Wakefield Street. I am not sure if I am allowed to give a plug to a business as this is being broadcast through the national broadcaster, but I will say that he, like many other community pharmacists, provides a valuable service. This service is a good service because it is there for consumers who, after being in hospital or having taken their kids to the Women's and Children's Hospital, invariably get referred, late at night, to the Midnight Pharmacy on Frome Street.

I think we need to be very careful about changing the location rules, because, with 425 country towns only having one pharmacy operating, the consequences of losing a pharmacy in such a community could be devastating. It could also be very concerning in a particular suburb, where people have to travel even further to see a local pharmacist to get the quality advice in terms of that frontline of medical services that pharmacies give.

I think that the Sixth Community Pharmacy Agreement, whilst by no means ideal, does give some breathing space for community pharmacies. I think there needs to be transparency. Let us see how they are doing. I think they are very happy to open their books in terms of how pharmacies are doing, as other members of the medical profession should be. But if you look at the savings in the health sector, it seems that community pharmacies have borne a disproportionate burden in relation to that.

I want to raise one issue with the minister, which has been raised by the Generic Medicines Industry Association in a circular letter to senators. They have asked us to consider and remember that the proposed legislation makes a technical amendment to the National Health Act that will enable substitution to occur if appropriate. It does not mandate that that substitution will happen, and therefore the questions that I put to the minister—and I hope she is in a position to answer them—are, and I am quoting directly from the GMiA letter of June 21:

Do you trust the TGA to assess medicines for quality, safety and efficacy?

And the letter states:

Just like all medicines in Australia, biosimilars have to be approved by the TGA and meet stringent quality, safety and efficacy standards. Therefore Australians can be assured that biosimilars used in Australia have passed the test for safety. There are no special leave passes on safety for biosimilars.

The next question is:

Do you trust the PBAC for all products that are currently available and publically funded?

The commentary in the GMiA letter is:

The PBAC is an independent committee of experts who make decisions on a $10 billion annual budget. Over five years, this is a bigger budget than the Community Pharmacy Agreement. If you trust this committee to make decisions to list new medicines on the PBS, why wouldn't you trust them to follow the same principles of evidence-based decision making for biosimilars?

The GMiA says that if the answer to these questions is yes they urge us to support the passage of the legislation. So I just wanted to get some clarification in relation to that. In terms of biosimilars, I think it is reasonable to ask what the safeguards are—that you are actually getting precise substitutions so it is the same medication and it will have the same effect on the patient. I think these are important issues that need to be considered. Having said that, I look forward to the passage of this particular bill, and the debate in the committee stage.