National Health Amendment (Pharmaceutical Benefits) Bill

Mr STEPHEN JONES (Whitlam) (18:51): It is a great honour to follow my friend, the member for Dobell, in speaking on the National Health Amendment (Pharmaceutical Benefits) Bill 2016. She brings to the parliament and the subject matter before the parliament decades of experience as a professional pharmacist, and I understand that she is very passionate about this subject matter—as I am. So I will be supporting the bill, as will Labor. It marginally improves access to PBS medicines, and that is something we have to support. I note that it has broad support from a range of stakeholders, including the Pharmacy Guild and the Royal Australian College of General Practitioners.

The bill allows for decision making to be automated by delegating ministerial, department, secretary and chief executive decision making to computer programs. This is something that will probably concern many who are following this quite closely, for reasons which I will outline quite shortly. The authorities remain responsible for the decisions of computers and automated decisions may be overridden by those authorities. Decisions that are currently reviewable by the Administrative Appeals Tribunal will remain reviewable.

I do have concerns. I share some of the concerns of the people listening in. I am concerned that this government is not up to the task of managing this program. That is not something that I say lightly. The Turnbull government has repeatedly bungled IT projects, including the 2016 census, which is a famous bungling of an IT project, but also the availability of Medicare and PBS data on In addition to that, the Centrelink debt scandal is something that the government has unfortunately visited on thousands of innocent Australians who did nothing but lawfully claim a Centrelink benefit. Data matching is nothing new—it has been going on for decades—but the way this government has managed the program has meant that there are literally thousands and thousands of Australians who are having their lives turned upside down because of the mismanagement of the Minister for Human Services and, ultimately, the Turnbull government. Against this background we have some concerns about the government's capacity to manage what would otherwise be fair and reasonable legislation.

The bill will mean that pharmacists will not have to submit hard copies of prescriptions to the human services department for reconciliation. It will also allow for approvals for certain prescriptions to be granted online. That is nothing more than this process meeting the 21st century, so it warrants our support. The bill includes a number of safeguards regarding the use of computer programs—for example, in the area of access to medicines after a disaster. The bill also allows for pharmacists to supply pharmaceutical benefits at nearby alternative premises for up to six months after a disaster such as a fire or flood. It will allow pharmacists to apply to the secretary of the health department for permission to operate from alternative premises. These measures are designed to maintain a supply and access to medicines after a disaster. That is a perfectly reasonable and sensible arrangement that warrants our support.

Currently access to PBS benefits for an individual ceases prior to the day of their death. This is consistent with social security legislation, where other benefits are payable from the date of the death. The bill extends the date of coverage until the day of somebody passing away. I think all reasonable people would think that that is something that everyone in this place should support, as well.

This bill sits within a broader context where the government has mismanaged healthcare policy, healthcare delivery and budget initiatives in relation to the health sector since that debacle of a budget, the 2014 budget. Nothing fundamental has changed in their approach to these issues. That is why people are right to be concerned about any proposition that comes before parliament that has to do with the management of either Medicare, the Pharmaceutical Benefits Scheme, funding of our health and hospitals or even the health workforce more broadly. The government, as everybody here would recall, tried to introduce a GP tax—a tax on sick people who are trying to visit their doctor. There were five attempts to get this proposition through the parliament. God knows how many attempts there were to get it through their own party room, but there were at least five attempts to get it through the parliament. When parliament refused to do the bidding of the government, they decided that they were going to try to force doctors to do what parliament had refused to do. The mechanism for doing that was to freeze Medicare rebates so that doctors would be forced to pass those extra costs on to their patients, many of whom had no capacity to pay.

In the end Medicare payments have been frozen for so long that GP clinics have started levying up-front fees on their own patients, something which the government denies, but every member in this place knows is happening, because as they make their way around their electorates they see signs on the counter which announce to them and to anybody else who walks into that doctor's surgery that because of the decisions of this government they are going to have to increase fees, cease bulk-billing and pass those costs on to their patients.

In addition to freezing Medicare rebates there have been cuts to hospital funding. But directly in the area of medicines policy there have been increases in co-payments for patients. The $5 hike in prescription costs is going to push the cost of medicines beyond the means of many low-income Australians. The government wants to increase co-payments by $5 for general patients and by 80c for concessional patients. The people that need the help the most, that is the poor, the elderly and the sick, will be worst hit by the Liberals' and Nationals' plans to cut the PBS. A general patient, for example, filling two scripts per month—and that is not at all unusual—will be $100 a year worse off on medicines alone. Let's not forget that they have already had to go and see their doctor, and they are probably going to see their doctor several times a month, so that person is out of pocket every time they go and see their doctor by increasing amounts.

There is an alarming trend for people to delay medical treatment because they simply cannot afford the costs. This has been modelled by the Australian Social Health Atlases and, because of this independent research, we know that the incidence of this is occurring and increasing, but not uniformly—in wealthy parts of the country, the problem is less than in areas where there are people of lower SES backgrounds. Take the Prime Minister's electorate of Wentworth: around seven people in every 100 are in the situation where they are delaying medical treatment because they cannot afford it. That is at the lower end of the scale and, for each of those seven people, that is seven people too many. But I want to compare it to regional Australia, where I have a deep and abiding interest. If you look right across regional Australia, there are 16 people per 100 who are delaying medical treatment because they simply cannot afford it. This bill will do nothing to make that situation any better. In fact, the policies of the government are doing nothing to make that situation any better.

There are many regional electorates around the country where this is a significant problem. I am very close to the Illawarra and South Coast area. I look at what is happening in the electorate of Gilmore, where 13 out of every 100 people in the Shoalhaven and Eurobodalla area are delaying medical treatment already, but the member for Gilmore is supporting policies, proposals and legislation that will increase the costs of general prescriptions by $5 and for pensioners by 80c. This is an electorate that has the second-highest number of pensioners in any electorate in the country. I would have thought that the member for Gilmore would use this as an opportunity to make a very strong statement about her opposition to the government's medicines policies, which are going to make medicines more expensive for people within her electorate.

I also would have expected the member for New England to be doing the same thing. The Leader of the National Party, the Hon. Barnaby Joyce, has some real hotspots in his area where people are delaying medical treatment because they cannot afford the bills. In some towns in his electorate, there are as many as 15 people out of every 100 who are delaying medical treatment because they cannot afford it yet he is a member of an executive and a government that are voting to make the situation worse.

In the electorate of Page, where the member has also supported initiatives, there is a very high number of retirees, low-income workers and pensioners. The member for Page is voting to increase the costs for general patients for each and every prescription by $5 per prescription and by 80c for every prescription for pensioners. This is in an electorate where 14 per cent of people—that is, 14 out of every 100 people in the Clarence Valley—are delaying medical attention because they cannot afford it. Right here, right now, they are doing it, and the policies of the government are making this worse.

The Bureau of Statistics Patient Experience Survey shows that up to 10 per cent of people are already delaying or avoiding filling a prescription due to the cost of that prescription. Now, of course, we would have even better data on this had the government not, as one of its very first initiatives, closed down the COAG data collection and reporting process, which enabled a clear line of sight to every state and region in the country to see what was happening in these critical areas of measurement and to see how we can better refine health care in the area of medicines and, in particular, in the area of the Commonwealth responsibility in relation to the Pharmaceutical Benefits Scheme.

While we are supporting the bill before the House, we are not supporting the general thrust of the government's policy, which is making it harder for people to see a doctor, making it more difficult for people to get into a hospital and making it more expensive for people to get the medicines that their doctor is prescribing to them. This is not a recipe for good health care; this is a prescription to ensure that the inequalities that exist between regional and city Australia and between the wealthy and the poor in this country will get worse, and it requires urgent attention.