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- Start of Business
- NOTICE PAPER
- EXTRADITION AMENDMENT BILL 1990
- APPROPRIATION BILL (No. 1) 1990-91
- QUESTIONS WITHOUT NOTICE
- DISTINGUISHED VISITORS
QUESTIONS WITHOUT NOTICE
(Mr HULLS, Mr KERIN)
(Mr LAVARCH, Mr HAWKE)
(Mr REITH, Mr KEATING)
TRADE WITH CHINA: IRON ORE
(Mrs JAKOBSEN, Mr GRIFFITHS)
(Mr GRACE, Mr BEAZLEY)
AUSTRALIAN MINING INDUSTRY COUNCIL
(Mr CHANEY, Mr HAWKE)
(Mr O'NEIL, Mr BEAZLEY)
AUSTRALIAN MINING INDUSTRY COUNCIL
(Mr CHANEY, Mrs KELLY)
(Mr LEE, Mr HOWE)
(Mr CHANEY, Mrs KELLY)
(Mr COURTICE, Mr SIMMONS)
- WOOL INDUSTRY
- PRESENTATION OF PAPERS
- JOINT COMMITTEE ON THE NATIONAL CRIME AUTHORITY
- ABORIGINAL DEATHS IN CUSTODY
- ECONOMIC AND ENVIRONMENTAL DECISIONS
- SEX DISCRIMINATION AMENDMENT BILL 1990
- STEVEDORING INDUSTRY LEVY AMENDMENT BILL 1990
- STEVEDORING INDUSTRY LEGISLATION AMENDMENT BILL 1990
- CARRIAGE OF GOODS BY SEA BILL 1990
- AUSTRALIA COUNCIL AMENDMENT BILL 1990
- CUSTOMS TARIFF AMENDMENT BILL 1990
- TAXATION LAWS AMENDMENT BILL (No. 4) 1990
- EUROPEAN BANK FOR RECONSTRUCTION AND DEVELOPMENT BILL 1990
- JOINT STANDING COMMITTEE ON MIGRATION REGULATIONS
SOCIAL WELFARE LEGISLATION (PHARMACEUTICAL BENEFITS) AMENDMENT BILL 1990
SOCIAL SECURITY AND VETERANS' AFFAIRS LEGISLATION AMENDMENT BILL (No. 2) 1990
- SOCIAL WELFARE LEGISLATION (PHARMACEUTICAL BENEFITS) AMENDMENT BILL 1990
Wednesday, 12 September 1990
Ms McHUGH(9.57) —Fancy some of us getting riled earlier when the honourable member for O'Connor (Mr Tuckey) spoke! It was a momentary aberration. The problem is that the honourable member who has just spoken speaks in that insulting vein all the time. Many people outside this place might not know to take no notice of him and may well take notice of him. So honourable members can imagine why some of us get momentarily riled at a time when perhaps we should not.
In addressing some of the remarks made by honourable members opposite, I thought that I would confine myself to the comments of the honourable member for Warringah (Mr MacKellar) when he cast aspersions on the independence of the Pharmaceutical Benefits Remuneration Tribunal. He described how it was originally set up and how it is operating today. I thought that I might even comment on the way in which some honourable members opposite compared the problem of the hoarding of drugs with bulk billing. That particular honourable member commented that it was a bit like people taking too easily a visit to a doctor. I was going to say on that that I leave judgment on medical matters to the professional people. I have great faith and trust in individual doctors and always have had.
I am concerned about taking the financial worry from those people who have no means. But after the comments from those opposite and the extraordinary insults about bludging on Medicare, I think I will have a few words to say about what I think of a public health system. It is a bit like what I think about a public education system. I think it should be good enough for everyone in the community. If there is a health system good enough for those without means, it is good enough for me. If there is a public education system good enough for people with no money, it is good enough for me. I will contribute to it through my taxes. Through my taxes I will contribute to having a health care system good enough for everyone, and that includes me.
Dr Bob Woods —Did you send your kids to private schools?
Ms McHUGH —I do not send my children to private schools. My entire family went to public schools. I was one of a group of teachers in public schools. All my children went to public schools and all my family seeks medical attention covered by Medicare because it is the best system. How dare members opposite show such contempt for the medical profession as to say, as has been said in this place, that there is a difference between the sort of health care people get on Medicare and the sort of health care they get privately.
I suppose it is similar to education in that some people believe that children get better education in private schools than that provided in the public school system. That is certainly not the case. I will say again and again that I will contribute to a decent health system and to a decent education system through my taxes. Do not let honourable members opposite talk to me about bludging.
I will return to the legislation. It is very interesting for me to be able to speak on this as I am one of the members of parliament who was attacked so terribly during the last election campaign by the pharmacists. It is very good to see now exactly what we have come up with and to examine it. As honourable members know, other speakers have examined very carefully and in great detail the reason for the pharmaceutical benefits scheme (PBS), why it has to be looked at now and why the Government believed it was necessary for the changes to be made that are being made.
I will not repeat all those details, but I will focus, as many other honourable members have done, on the changes that have been made for age pensioners. This is particularly relevant in the light of the blatant scare tactics which have been used not only in this place but by a great many pharmacists-certainly not all members of the pharmacy profession, but a great many. As we all know, pensioners are amongst the most vulnerable people in our community. On fixed incomes they are always vulnerable. They are vulnerable as patients. As they get older they need more and more care and they become more and more dependent on those who care for them. They have greater dependency and they have a need for greater security. They have become dependent on doctors' prescription habits.
It is very difficult to change the habits that have developed. There is a dependency that is very hard to break. This legislation, gently and slowly, is beginning to break some of those bad habits. We do not know who began the cycle of dependency. Maybe it was the doctors, through their methods of prescription. Maybe it was the patients. But someone has to break that unhealthy habit.
The pensioners, of course, are the most vulnerable to scare tactics and they always have been. Was not the honourable member who spoke before me-he has just left the chamber-among those who indulged in the worst scare tactics I have ever seen until the pharmacy decision was about to be taken? At the time of the assets test he was one of those who began that knocking on the wood. You remember, Madam Deputy Speaker, do you not, that knocking on the wood every time the assets test was mentioned? It was supposed to be the inspector knocking on the pensioners' doors to take the gold fillings out of their teeth. Do honourable members remember all that? Talk about attacking the vulnerable and scaring people!
Many honourable members opposite have mentioned the alarm and great worry amongst pensioners. It is no wonder, with some of the stories that were told. I shall tell the House what happened in my electorate during the last campaign. It went on for months, but on election day the white-coated pharmacists were actually telling pensioners going into the booths that, if they voted for Mrs McHugh, she would take their medicine away from them-not just everything else; I would take their medicine away from them. What a thing to say to pensioners! So the vulnerability of pensioners is extreme and the way they have been exploited in this way, and again tonight, is absolutely appalling.
Some pharmacists have indulged in this sort of manipulating of pensioners for some time. One in my electorate has a notice in his window saying, `Free pensioner prescriptions here', as if that is the only place people get them free. I just wonder what the overcharging in some other areas could be that has been mentioned many times tonight.
Here we see again how these vulnerable people in our community are exploited and attacked. In this case it is pensioners and the chronically ill. They are being used as political pawns as the Government tries to strengthen the PBS and to make sure that it continues to fulfil its primary objective, which is to ensure that everyone-those with means and those without-has access to affordable drugs at a price that they can afford. Other speakers, including the Minister for Aged, Family and Health Services (Mr Staples) in his second reading speech, said that this objective was in danger of being undermined had the changes proposed in this Bill not been put forward.
With the use of the scare tactics I have just been discussing against such a vulnerable section of the community, is it any wonder that pensioner groups reacted so badly to what they thought would happen? I reacted very badly indeed when I first heard about the $2.50 charge, until I looked very carefully at what was happening. I discovered that, like all the programs in the retirement income development that has been going on in the Government, this has been extremely well thought through. Members opposite have said quite the contrary, but if there is one thing that has happened in great detail for the last couple of years, it has been that this whole PBS issue has been extremely well thought through. It would be extraordinary to imagine that what has been done now has been done in some cavalier, ad hoc fashion, if one thought of the amount of work that has been put into this scheme in recent years.
The package of measures is designed to restructure the PBS in a well thought out way and in a way that will not adversely impact on age pensioners. As has been said before, the proposed $2.50 prescription charge for pensioners will be offset by a simultaneous $2.50 per week pharmaceutical supplement. That, in combination with the $130 per year threshold for the safety net, will mean no net cost to pensioners as a result of these changes. Madam Deputy Speaker, has the clock stopped?
Madam DEPUTY SPEAKER (Mrs Sullivan) —No. I am assured that it is still going.
Ms McHUGH —A great deal of concern has been expressed about the possible impact of these changes on pensioners who may use a high quantity of medications in a very short time-that is, more than one prescription a week. Therefore, there was a potential problem in that the chronically ill may have been temporarily disadvantaged. Pensioner groups alerted the Government to this problem. As usual, the Government listened, as it did during the travels to the Gold Coast of the Prime Minister's task force on retirement income, and will now act. Yesterday's press release issued by the Minister for Aged, Family and Health Services, the Minister for Community Services and Health (Mr Howe), and the Minister for Social Security (Senator Richardson) outlined exactly what the Government has proposed.
To ensure that chronically ill, full-rate pensioners are not disadvantaged in the short term, they will receive a $50 pharmaceutical supplement lump sum in November. This will cover and protect those pensioners who may have to use a high quantity of medications over a short time. This replaces the $2.50 increase for the 20-week period to March 1991. What is more, if before the March 1991 pension increase those pensioners need more than 20 prescription items covered by the $50 lump sum, they can be provided with a further $32.50 advance. Anyone can see that this has been extremely well thought through and that no one will be disadvantaged. In the long term a program which has suffered terribly in the past will be improved.
As the Minister said, the old PBS was encouraging waste and allowing doctors to overprescribe because there are no price signals in the scheme. Health care professionals became concerned about the level of ill health which was occurring because of the inappropriate use of medication, and several Opposition members have talked about the number of people who have been hospitalised as a result. It is a terrible blow to me to hear these stories because I put my total faith in the medical profession-not in its politics, but in the dispensing of medication.
The Minister gave the example that Ministers for Health have been receiving letters from the relatives of elderly people pointing out cases of the hoarding of medication. That is not only potentially dangerous but also highly costly.
There is much evidence available to suggest that the unrestricted availability of free prescriptions has led to high levels of prescribing by doctors-and there are numerous instances of this. In fact, it is one of the reasons why PBS costs have blown out by 56 per cent over the past three years. So the introduction of the $2.50 charge, which is compensated, should act as a price signal at the point of sale and at the point where the doctor actually prescribes the drug. There is now a clear incentive, which must appeal to Opposition members, not to overprescribe.
Honourable members opposite have spoken about the need to take note of market forces in this area. That is something the Government has had the courage to do in this particular case. In an article in today's Australian Financial Review, Louise Dodson says just that-that as well as cost control, the Government is actually introducing some market reality into a protected and subsidised system.
I conclude on another note introduced in the article by Louise Dodson-the health of the pharmacy profession. Seeing that I am perhaps more aware than anyone else in the country of the fears expressed by members of the pharmacy profession about what might happen to them, I should like to quote from Louise Dodson's article. In relation to women in pharmacy:
Pharmacists themselves are also changing . . . over 40 per cent of male pharmacists are expected to retire in the next decade and that women under the age of 30 are almost double the number of young male entrants to pharmacy.
Feminisation will mean that many more chemists will want to be employees in large operations rather than the previously predominant owner-operators.
That is a quote from Mr Feros of the health consultancy group, Feros Riley and Associates. Of course, many of those women pharmacists will be heading those organisations. The article concludes:
The restructuring process is likely to benefit strongly the pharmacists who stay in business and who become larger.
As in the metamorphosis of the corner grocery shop into the modern supermarket chain, changes are painful for the business operator and consumer alike.
But, although it will be vastly different, the future of the pharmacy industry is assured.
Pharmacy is going through a revolution, with a pace of change not seen before.
That is a very comforting note for the pharmacists, and there are a great many of them in my electorate. As far as I know, not one pharmacy has yet closed. Indeed, of the nine that are within about 100 metres of my electorate office, one pharmacy has been added, so there are now 10 rather than nine pharmacies within 100 metres of my electorate office.
As the House has spent the whole of tonight talking about how he consumer has been protected and helped, particularly those who are most vulnerable-the pensioners in the PBS-let me, caring so much for the pharmacists in my electorate in particular, conclude on that very strong note of optimism for them and their profession.
Madam DEPUTY SPEAKER —Order! Before I call the next honourable member, I wish to clarify the matter of the timing of the last speech, since the honourable member apparently thought the clock showed the wrong time. The record shows that the honourable member commenced her speech at 9.56 and a half minutes. The Clerk and I checked the countdown on the time the honourable member had left, and it was correct.