Speech - National Health Amendment (Pharmaceutical Benefits) Bill
23 July 2014
16 July 2014
It is with regret that I speak today on the National Health Amendment (Pharmaceuticals Benefits) Bill 2014, the regret being that the increased cost of pharmaceuticals is expected to cost Australians more than $1.3 billion over the next four years.
This bill increases the Pharmaceutical Benefits Scheme's co-payment for general patients by $5 to $42.70 and for concessional patients by 80c to $6.90 from 1 January 2015. It also increases the concessional PBS safety net threshold by two prescriptions per year and the general safety net threshold by 10 per cent for every year for four years from 2015 to 2018. These extra charges are in addition to the usual increases of CPI and indexation.
As I said at the outset, the bill is expected to cost Australians more than $1.3 billion over the next four years. Labor will oppose this $1.3 billion tax increase on medicines because it will hurt every Australian. Every pensioner, every parent, everyone unemployed, every low-income earner, people with disability, our veterans—no-one escapes this tax. It is yet another impost that this Abbott Liberal government is putting on the cost of living of every Australian. We know that people are already deferring the purchase of prescriptions and some are not having them filled at all. That is not something this government wants to talk about, yet it is the brutal reality for so many people already struggling to make ends meet.
I remind the House that prescriptions are for sick people who need help and need medicine now. The COAG Reform Council report produced in early June this year found that 8.5 per cent of people in the 2012-13 year delayed or did not have prescriptions filled due to cost. In disadvantaged areas, this figure rises to 12.14 per cent, while for Indigenous Australians it is an astounding 36.4 per cent. That 36.4 per cent of Indigenous Australians currently do not have prescriptions filled due to costs is truly alarming. That this bill seeks to increase these costs even further is beyond belief and highlights once again the poor choices and wrong priorities of the Abbott Liberal government. The recent COAG Reform Council report confirmed what many of us have suspected—that the health of Indigenous Australians continues to be poorer than the health of non-Indigenous Australians on most indicators. The council also reported that more than 12 per cent of Indigenous Australians delayed or cancelled a trip to the GP because of cost.
What are the outcomes for Indigenous Australians? Life expectancy at birth is still about 10 years less than for the non-Indigenous population. Lung cancer rates are twice as high, and smoking rates are more than double. Closing the Gap initiatives are making some progress in some health areas but the COAG Reform Council report has warned that the goal to close the life expectancy gap by 2013 is most unlikely to be met. Cost is clearly seen as a determining factor for Indigenous Australians to seek the health care and medicines they need. In response to the proposed introduction of a $7 GP co-payment, Aboriginal and Torres Strait Islander Social Justice Commissioner Mick Gooda noted that Indigenous people currently access Medicare services at a rate which is almost one third lower than what is required on a needs basis and rightly put the argument that Aboriginal and Torres Strait Islander people need encouragement to access medical services, not more barriers.
Make no mistake, this increase to the PBS will be another barrier. Indigenous Australians in my electorate of Newcastle—and more broadly around the country, I might add—are some of the sickest, the poorest and the most marginalised people in our country. Sadly, this government is already cutting primary healthcare services to Newcastle's Aboriginal community, with funding cuts causing the closure of the Awabakal Medical Service's Deadly Choices program that helped young Aboriginal people in my electorate of Newcastle make better health and lifestyle choices. It was a truly great preventative health program that this government saw no value in and walked away from.
On the other hand, the Awabakal Medical Service are not walking away from their people and I would like to take this opportunity to let the House know about the launch of a new health service for Newcastle's Indigenous people that I gratefully attended last week. Awabakal have launched their own mobile health clinic that will be staffed by a full time GP, a midwife, an Aboriginal health worker and a hearing specialist. Their new clinic is a true outreach program that will play a vital role in delivering primary healthcare and education services to the local Indigenous community. Awabakal Medical Services have every right to feel betrayed by this government, but they are doing what they can to keep delivering the best health care to their people. I applaud them for their determination and commitment in the face of no assistance from the Abbott Liberal government.
This bill is being dressed up as a system sustainability measure when in fact it has nothing to do with sustainability or the existing PBS structure. If this were really about the sustainability of the health system this revenue would be going back into the PBS or into Medicare. Instead, the funds raised will be directed to the government's Medical Research Fund for sometime in the future. Do not get me wrong, I am a big supporter of medical research and the work our Australians scientists do. I am proud to host a number of world-leading scientists in my electorate of Newcastle who work out of the University of Newcastle and the Hunter Medical Research Institute. They deliver outstanding results in their key research areas of brain and mental health, cancer, cardiovascular health, pregnancy and reproduction, and immunity, vaccines and asthma. Scientists like Professor Phil Hansbro—who is leading the way in the race to develop urgently needed treatments for airway inflammation disorders like asthma—are making ground-breaking discoveries. But not once have the scientific research community asked for their funding to be sourced by taxing the sick and the poor. Governments have always found a way to fund medical research in the past and have seen the value of directly investing in medical research without taxing the poor and the sick.
These PBS changes and the GP tax are not measures of sustainability; they are part of a longstanding ideological campaign to get rid of Australia's universal healthcare scheme, and to create a two-tiered, user-pays system where your bank balance determines the health care you will receive.
The PBS is growing, but it is growing in a sustainable way and at a much slower rate than was expected. The reason that this has happened is no accident: it is because of the measures Labor took—measures, I might add, opposed by and campaigned furiously against by those opposite—to make the PBS sustainable without punishing patients. The PBS price disclosure reforms, overseen by Labor during two terms of government, have ensured that the PBS is sustainable and has delivered billions of dollars in savings. At the moment the government spends around $9 billion per year on the PBS. Accelerated price disclosure has slowed the real rate of PBS growth and has put the PBS on a sustainable footing. In Labor's last budget, there were changes that were expected to deliver more than $1.8 billion in savings. Taking the package announced in 2007 through to 2017-18, the savings will be closer to $20 billion. At present the PBS safety net threshold for general patients is $1,421. Once the PBS safety net is reached, general patients only pay $6 per script. For concessional patients, the PBS safety net threshold is $360, and concessional patients pay no additional out-of-pocket costs for medicines once the safety net is reached. But this bill proposes to increase the PBS safety net by 10 per cent, plus an annual CPI indexation on 1 January each year. This bill's proposals for increases in the PBS safety net will mean that we end up with more expensive medicines for the most vulnerable people in the community—those that are physically and financially challenged—at the same time as we are pulling the safety net further and further away from those who rely upon it.
The condemnation of this government's plan to destroy universal healthcare is widespread. Residents in my electorate of Newcastle are adding their voices to the thousands across the nation which are opposed to these cruel cuts to health funding, to the increase to the PBS and to the new GP tax. In late June, I joined 500 Novocastrians who voiced their concerns about this government's plan to destroy universal health care. The Shadow Assistant Health Minister and my Hunter Labor colleagues, the member for Shortland and the member for Charlton, joined me at the 'Save Medicare' rally, where we heard from those who will be hit hardest by the cruel GP tax—pensioners, families and low-income earners. For many there, this was the first rally they had ever attended. This included a woman of more than 80 years of age. These were not radicals or serial protesters; they were members of the general community who are concerned about their future, and the future of our healthcare system, under this government.
At that rally we also heard from a Registered Nurse who works at Newcastle's John Hunter Hospital. He shares the concerns of other health professionals and peak bodies, who believe that the cost impost posed by visiting a GP will be a double whammy for hospital emergency departments, which are looking at longer wait times, more people attending their emergency centres to avoid the GP tax, and more sick people whose health will deteriorate as they avoid seeing their GP. Interestingly, another attendee at the event who did not speak to the assembly but spoke to the media after the event, about his opposition to the GP tax and its effect on Australians' health, was a New South Wales Liberal state member. When asked about his thoughts on the GP tax, the New South Wales Liberal state member for Swansea, Garry Edwards said: 'Ideologically, I'm not in favour of this and, quite frankly, I think I speak on behalf of my electorate and my community; the majority of the community don't agree with it either'—I think that the community of Swansea is not alone. I don't think there's one community in Australia that believes this new tax is fair. I would suggest that the state Liberal member for Swansea might want to have a chat to some of his federal Liberal colleagues here in this place. If only those on the other side of this House had the nerve to speak out on behalf of their communities against these cruel hits to Australians, we would have seen more than five speakers from the government side listed to speak on this important bill before the House today.
It is not just Labor who thinks that these changes to the PBS are a bad idea, it is the experts and advocacy groups as well. The Pharmacy Guild of Australia has criticised the increase in the cost of medicines for consumers and has argued that it will be particularly hard on the elderly, in light of the other social security changes being made. The Consumers Health Forum has expressed grave concerns about the growing out-of-pocket expenses for Australians in health care. Michael Moore, the CEO of the Public Health Association of Australia, has stated that the measures are inequitable and will affect society's most vulnerable members. He argues that 'the people to whom this is most important are the vulnerable, such as Aboriginals and Torres Strait Islanders, people from low socio-economic backgrounds or from non-English speaking backgrounds, and the elderly.'
This government will leave a legacy that most would be ashamed to leave. Perhaps that is why we see such a lack of members opposite speaking in this debate. Their names, however, will be marked in the Hansard as having supported these cruel cuts and taxes. And then their absence today will be all the more notable: they had an opportunity to defend the health of their communities—but they were missing in action.