Paul Scarr (Queensland, Liberal Party) Share this | Link to this | Hansard source

I'll just recap some of the more general points I was making yesterday, particularly for those listening to this debate for the first time. It should be noted that the opposition, the Liberal and National parties, are supporting the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023, for the obvious reason that it makes a lot of sense.

This legislation closes a loophole where a pharmacy holds a licence in a company name to engage in the PBS and provide medications to the Australian people through the PBS system. There can be circumstances where a director of that company has been found to have engaged in misconduct in the supply of those pharmaceuticals. Unless you close the loophole, the company that holds the licence for the pharmacy could continue to supply those medicines under the PBS, notwithstanding the fact that the director has been found to have engaged in misconduct under the PBS. It makes absolute sense to close that loophole. The opposition are supporting the government in this regard.

The debate of this bill though has opened up other areas of discussion. Contributions have been made by senators across the chamber in relation to the PBS. That is where I will continue my remarks. The first point I want to make is that, from my perspective, the Pharmaceutical Benefits Scheme is a core function of government. I believe the Australian government have a moral obligation to make sure that we provide affordable medications to the Australian people. It is a core function of government. Those listening today will hear debate in relation to other grandiose schemes that have been proposed by the Albanese government, including a $15 billion National Reconstruction Fund, which from my perspective is not a core function of government. Every dollar spent on those grandiose schemes is a dollar that can't be spent on the core functions of government, such as the PBS. That's the first point I make.

The second point I make is that the previous coalition government had a proud history of managing the economy in such a responsible way that 3,000 medicines—approximately 30 a month—were added to the PBS during the term of the last coalition government. I have met people in the community. I recollect one particular conversation I had before the 2019 election, when I was first elected to this place, where I met a beautiful young woman who was suffering from a chronic illness. If she had been forced to buy the medication for that illness out of her own pocked, it would have cost her $250,000 a year, but the previous coalition government had added that medicine to the PBS, so it cost virtually nothing to buy that medicine. We are a rich country. We should be able to provide that service to the Australian people. I'm proud that, before the last election, I served in a government which did provide that service to the Australian people. That's a core function of government.

In that context, what has happened with the PBS since the last election? On 2 March 2023 I received an email from a lady in the western suburbs of Brisbane in relation to her diabetes insulin medication called Fiasp. She could be your mother, your aunt, your sister or a dear friend This is what she wrote: 'I'm a type 1 insulin-dependent diabetic, and have been for over 52 years now. This morning, at 8.42 am'—she sent this email at 10.41 am, two hours after this event—'I received a phone call from my chemist, informing me that, as of 1 April 2023'—bear in mind that she sent this email at the beginning of March, so she had less than one month's notice—'my insulin that I use in my pump will be withdrawn from the PBS listing. This being the case, then, my insulin purchase on script will go from $30 per filling of five boxes to approximately $220 for the same.'

This medication for insulin was on the PBS list. This lady and approximately 15,000 other Australians were accessing this medication, and then all of a sudden, because of ministerial inaction on the part of the relevant minister in the government, this insulin was taken off the list. This lady, and no doubt thousands of others, found out about it because her chemist rang her and said, 'By the way, your medication is going up from $30 to $220.' This is what she says—they are her words, not mine. They are not the words of a politician, but her words. She says: 'What the hell! This is a life drug for me, and I know it is not your doing, but if you could please assist in finding out what is happening here, that would be very much appreciated. I do know there are other alternative insulin is available that are still on the PBS, but I was moved to specifically enter this insulin due to the benefits of a quicker acting insulin for me.' The government said earlier this week that there are alternatives, but the thing about this medication for this lady and thousands of other Australians is that it is faster acting. Her medical specialist put her on this specific medication which was on the PBS and then, due to ministerial inaction on behalf of the relevant Albanese government minister, it's off the PBS. She continues: 'I've attached for your information the letter that was received by my chemist informing them of this PBS change. Please have someone in the federal government take a look at this, as I know I will not be the only person impacted by this terrible decision-making.' This is poor government, poor administration, poor ministerial oversight with respect to the PBS.

Australians should not be put in the position where they have been put onto a drug that's on the PBS, on medical advice, that's working for them and then they find out from a phone call from the chemist that all of a sudden it's coming off the PBS. The minister should actually apologise to the cohort of 15,000 Australians who have been put in this position. It is unbelievable, to be frank. There was no ministerial intervention to make sure that this drug could stay on the list. There was no consultation with the 15,000 Australians who were taking this drug. There was no warning that it was coming off the PBS. This lady, like thousands of others, found out from a phone call from the chemist. There's no understanding whatsoever that people are on this medication—they've been advised by their medical specialist to be on this medication—because it gives them therapeutic benefits that other drugs don't provide.

So I say to those opposite that the PBS is a core function. Instead of being distracted by utopian fantasies of the National Reconstruction Fund et cetera, get back to the core business of providing health services to Australians.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I too rise to speak on the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023. I acknowledge that the substance of this bill is important, and the opposition will be supporting the bill because, obviously, it provides greater protection around the integrity of our PBS. We all know that the Pharmaceutical Benefits Scheme is an absolute foundational pillar of Australia's health system, and protecting its integrity is something that we believe is extraordinarily important because we need to make sure that Australians continue to have access to affordable medicines. As cost-of-living pressures continue to go up, never before has it been more important that Australians do have that access to affordable medicines. For that reason I foreshadow that I will be moving a second reading amendment because I want to acknowledge the importance of the government continuing what the coalition started, and that is making sure that we have the best possible record when it comes to ensuring that Australians have affordable access to critical medicines.

We are very proud of the fact that when we were in government we listed nearly 3,000 new or amended medicines on the PBS, which represented an extraordinary amount of listings each and every month. We know that, in the final years of the previous Labor government, they stopped listing medicines because they ran out of money. So we will continue to put pressure on this government to make sure that Australians can continue to have access to those affordable medicines—because that is the government's job; that is the reason they are here.

We heard Senator Scarr referring to a particular medication called Fiasp, which is a very innovative form of insulin that is relied on by over 15,000 Australians. We know that at the beginning of March this government sought to no longer enable this drug to be listed on the PBS because of price decisions that were being made which meant that, as of 1 April, this drug would no longer be available. Anybody who has not realised how difficult it would be for 15,000 Australians, or more, to get an appointment with an endocrinologist to get their medication changed in the space of less than one month is not living in the real world.

Obviously, we were pleased that Minister Butler decided that he would temporarily intervene and give an extension of time before this drug was taken off the PBS. But the reality is that all he has done is kick the can down the road, because in October exactly the same situation is going to be confronting those 15,000 Australians who rely on this amazing medication, because once again it will be taken off the PBS. So it is really, really tragic that, already, so early in the term of this government, it is not continuing to provide the medication, and we are starting to see medications come off the PBS.

Equally, one of the things that we were very proud of in government was that, whenever the PBAC made a recommendation about the value of a new drug coming onto the market, or a drug being made available in a different context, we actually approved them and were able to get them quickly and easily into the hands of Australians who relied on them. So to find out that, despite the Pharmaceutical Benefits Advisory Committee recommending that a drug that is provided to people with cystic fibrosis, a drug by the name of Trikafta which we had listed for use by people aged 12 and over—once the PBAC had made the recommendation that it was a safe and appropriate drug for children aged between six and 11 who suffer from cystic fibrosis, I suppose we all assumed that the government would make this drug available. Well, so far, the bid on behalf of those young Australians who suffer from cystic fibrosis, those young Australians who, like everybody else, deserve the best possible chance of living their best possible lives—they have been denied it. In another instance of this government undermining the strength of the Pharmaceutical Benefits Scheme, it has not listed this drug for those 500 young children—where this could make a life-changing difference to their lives.

We would say to the government: please support our second reading amendment, which will ensure Tricafta is available for young children aged between five and 12 who suffer from cystic fibrosis. Make sure you use your ministerial discretion, Minister Butler, to enable those 15,000 or so people who live with diabetes, who have had their lives changed by this innovative drug called Fiasp—please, government, stop worrying so much and putting your budget bottom line ahead of the lives and wellbeing of Australians who rely on these amazing drugs. These drugs were made available under the previous government but so far appear not to be a priority for the government we have in place.

It's really sad that, in all the broken promises we have seen this government break so far, whether they be issues in relation to cost of living, electricity prices which were supposed to be coming down by $275—there is nothing more unconscionable than breaking promises to Australians who rely on lifesaving and life-changing medications, which is what we are seeing here. I would be very disappointed if we didn't see the government support the second reading amendment that has been put forward by the coalition, to seek that they reinstate the drug Fiasp for insulin-dependent diabetics and list Tricafta for those young Australians. It can make so much difference in their lives. It would be a great sign of good faith on your behalf, government, if you would be prepared to do that. Unless we are prepared to prioritise our health system, particularly this pillar—that is, making sure that our Pharmaceutical Benefits Scheme is the best it possibly can be—you are not doing your job. We support the bill, but we seek your support in amending it to make it better.

Malarndirri McCarthy (NT, Australian Labor Party, Assistant Minister for Indigenous Australians) Share this | Link to this | Hansard source

I thank senators for their contributions on the National Health Amendment (Effect of Prosecution—Approved Pharmacist Corporations) Bill 2023. 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, and this government understands the importance of the PBS remaining sustainable into the future so that we can continue investing in new medicines for the community. Integrity of public funds and effective PBS compliance is 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. This 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 has been charged with, or convicted of, a PBS related offence. This will ensure the power applies equally to all approvals.

I note the amendment from Senator Ruston. The Australian government is committed to ensuring Australians have access to affordable medicines recommended by PBAC. The government has delivered on its election commitment to cut the cost of medications for millions of Australians by reducing the PBS co-payment to $30 per script. Since 1 July 2022 the government has committed additional funding for 67 new and amended listings. There are longstanding considered processes for PBS listings through PBAC, not second reading amendments. The PBS provides Australians with access to vital medicines, and the government is working to ensure all people have affordable access to the medicines they need. The Department of Health and Aged Care is working with states and territories on expanded access for the Closing the Gap program for patients in public hospitals. More specifically, this bill will protect the integrity of the PBS, so that we can keep investing in new and better medicines in future.

Again, I thank senators for their contributions to the bill.

Jess Walsh (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

The question is that the second reading amendment moved by Senator Steele-John be agreed to.

Question agreed to.

Susan McDonald (Queensland, National Party, Shadow Minister for Resources) Share this | Link to this | Hansard source

At the request of Senator Ruston, I move:

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

(a) notes the former Coalition Government's strong record on affordable medicines, having listed almost 3,000 new or amended medicines on the Pharmaceutical Benefits Scheme (PBS), including the innovative diabetes drug Fiasp; and

(b) calls on the Government to:

(i) reaffirm the former Coalition Government's commitment to listing all medicines on the PBS that have been approved by the Pharmaceutical Benefits Advisory Committee (PBAC),

(ii) urgently intervene to ensure Fiasp remains permanently available on the PBS for the 15,000 Australians who rely on it, and

(iii) urgently list Tricafta on the PBS for children 6-11 years old with cystic fibrosis, noting PBAC recommended it be listed in November last year".

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

TEELE-JOHN () (): I seek to have sections (b)(ii) and (b)(iii) considered separately to sections (a) through to (b)(i).

(Quorum formed)

Jess Walsh (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Before I put the question on the motion moved by Senator Ruston, the minister is seeking the call.

Malarndirri McCarthy (NT, Australian Labor Party, Assistant Minister for Indigenous Australians) Share this | Link to this | Hansard source

In my excitement, I made an error in my summing-up in saying $30 million when I meant to say $30.

Jess Walsh (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

The question before the chamber now is that paragraphs (a) and (b)(i) of the second reading amendment of Senator Ruston be agreed to.

Question agreed to.

The question before the chamber now is that paragraphs (b)(ii) and (b)(iii) of Senator Ruston's second reading amendment be agreed to.

Question agreed to.

The question now is that the motion for the second reading be agreed to.

Question agreed to.

Bill read a second time.