Jordon Steele-John (WA, Australian Greens) Share this | Hansard source

I speak on behalf of the Australian Greens in support of the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023. It really is an energising title that they've given to this piece of legislation! However, I want to use the opportunity to say to the Senate that the availability of medication on the Pharmaceutical Benefits Scheme has been insufficient for our community time and time again. On multiple occasions, in my role of health spokesperson for the Australian Greens, community groups have come to us and very clearly said that either they can't access the medications they need under the PBS or it just doesn't go far enough in providing the financial subsidy needed for them to access the medications affordably.

For instance, my office is contacted daily by people fighting to get access to insulin, to cancer medications, to basic medications that they need and rely on, quite frankly, to prevent their pain, to manage their symptoms and to provide them with effective treatment. I'm sure there are many people in the chamber this afternoon who live with medical conditions. It's really hard to manage these conditions as well as life with the meds that you need in order to manage them properly—let alone if you're managing the condition and managing life and are not able to access the meds because you can't afford them or they're not on the PBS in the first place.

The Greens have welcomed Minister Butler's announcement of a six-month access period to fast-track insulin medication Fiasp and also Fiasp FlexTouch to be part of the PBS, particularly for people who have type 1 diabetes. It's a step in the right direction. We have welcomed it. But it really is on the government to do a bit better in this space. I mean, we've got a situation where people's lives are at risk. They shouldn't need to share their story with the media to achieve and outcome. I'd imagine that many people here are quite used to that phenomenon, right? There's a situation where somebody needs medication urgently. They raise it with their local member. Maybe they raise it with their minister. Nothing happens, so they go to the media, a fuss is created and then eventually something occurs.

That's great community advocacy, and congratulations to the people for doing it. But I think we should just stop for a moment and consider whether that's actually how the system should work. Ministers are paid very well for their time and have very large staffs, working alongside massive departments. I think most people would assume that people become ministers and people work for departments and so on and so forth in order to, like, do a job, right? And that job surely should be proactively going out and finding the gaps before they have to be brought to the government's attention because somebody is in crisis. It is hard enough to be in the crisis, let alone to feel comfortable disclosing it to the media—going through the stresses and strains of that—in order to get your medication. And that solves just that one thing.

Ministers are applauded for doing this, for responding to individual case-by-case basis issues, but really, it speaks to the deeper systemic problem of what the job of a minister and the department is. What's the point? Surely it should be to do work on behalf of the people to proactively get ahead of these things. We need to see foresight in this space. We need to see medications coming onto the PBS in a way that ends this kind of perpetual catch-up that has to be played and this individual crisis-by-crisis based action.

The community need to be consulted sooner and better. If you go out there and talk to people, if you talk to patient advocacy organisations, they will tell you what needs to be added, because often these folks have gone to those organisations first to flag the concern. So there could be a bit of authentic engagement with patient advocacy groups, and maybe—this is a radical idea—you could engage with them in the same way as you would engage with very well cashed up, very influential organisations that might lobby you. You know, put the hat on and think: 'Well, this is a rare condition, this is a small cohort of people, it's a pricey drug, but if this was the AMA, maybe we'd pick up the phone. Maybe we'd sit down and have a conversation earlier because we know if those people got in the media we would have to deal with it.' I understand why these good, effective—I say 'good' in the sense that they have mastered the art of lobbying—organisations are responded to by government in the way that they are, but again, just because I understand it, just because there is a logic to it, it doesn't mean it is right. It doesn't mean that is how it should work. The reality is that as a member of the executive government to be lucky enough to do that and be that, you can actually chart your own course. You can actually decide that the small, often-ignored, peak body for a rare pain condition gets the spot in your diary that would be got by a larger, better funded, better known organisation. You can actually make that decision.

The Greens will always fight to reduce co-payments and ensure that the access to and affordability of medications on the PBS is something that is brought down on behalf of the community. In particular, as my second reading amendment addresses today, it is essential that First Nations people have access to medications that they require, when they require them, in order to meet our obligations. Let's hope we think of moral obligations in this sense, but there are also committed obligations under the Closing the Gap targets. Making sure that First Nations people have the opportunity to access their medications when they need them and where they need them is a key part of closing the gap.

One such step forward in this process was the Closing the Gap PBS Co-payment Program, which was established in 2010 to improve access to affordable PBS medicines for First Nations people who are living with or at risk of chronic disease. Yet public hospital pharmacists are currently unable to supply PBS medicines to First Nations people under the Closing the Gap PBS Co-payment Program, and this hampers quite seriously Australia's efforts to close the gap in healthcare outcomes for First Nations people. It means that doctors cannot supply medicine at the lower co-payment rate in hospitals, because they are excluded from the co-payment measure. It also prevents the provision of expert advice related to the new medication regime by pharmacists who have, basically, counselled them during a patient's in-patient stay. This results, at the end of the day, in inequitable, higher out-of-pocket costs and co-payments for First Nations people or situations in which the patients miss out on medicines altogether, increasing the risk of readmission to hospital. So we have a situation where the system, as it currently functions, increases the rate at which people are readmitted to hospital, precisely at the moment when we need to be freeing up capacity in our hospitals, particularly in rural and regional contexts.

My amendment asks the Senate to call on the Australian government to enable public hospital pharmacists to supply PBS medicines under the Closing the Gap co-payment program. Additionally, I note that the scope of the Closing the Gap PBS co-payment measure needs to be extended to cancer medications and highly specialised drugs listed on various Section 100 programs on the PBS, which are currently excluded from the program.

In addition to calling on the government to enable public hospital pharmacists to supply PBS medicines under the Closing the Gap co-payment program to First Nations people who are registered for the program, my amendment also seeks to ensure that this is done immediately. Time is a critical factor here to improve access and equity in relation to medications. This is in line with the call for national leadership from First Nations bodies in Australia, particularly the National Aboriginal Community Controlled Health Organisation and the Society of Hospital Pharmacists, who, in their recent budget submission, costed this measure at approximately $1.2 million. I have the great honour of being the foreign affairs spokesperson for the Australian Greens, and I work closely with my colleagues in the areas of defence as well. I've spent a long time in the defence and foreign affairs estimates hearings with Senator Shoebridge and others, and I can tell you now that our defence programs in Australia lose $1.2 million down the back of a couch before breakfast. So this is not a lot of money in the grand scheme of the Australian government, yet it would change lives.

I call on the Senate to support this amendment and for the Labor government to act immediately to ensure that these changes occur. I move:

At the end of the motion, add "but the Senate:

(a) notes that the Closing the Gap Pharmaceutical Benefits Scheme (PBS)Co-payment Program was established in July 2010 to improve access to affordable PBS medicines for First Nations people living with, or at risk of, chronic disease; and

(b) agrees that:

(i) poor access to medications can compromise a person's health and cause preventable hospital readmissions,

(ii) public hospital pharmacists are currently unable to supply PBS medicines to First Nations people under the Closing the Gap PBS Co-payment Program and this hampers Australia's efforts to close the gap in healthcare outcomes for First Nations peoples; and

(iii) the Australian Government should enable public hospital pharmacists to supply PBS medicines under the Closing the Gap PBS Co-payment Program to First Nations people, to improve equity of access to medications".