Mr LEE(5.20 p.m.) —The National Health (Budget Measures) Amendment Bill contains four measures, and we will be opposing three of them. The three measures in question all increase the price people have to pay for essential medicines. The first increases the cost to pensioners, the second increases the cost to families, and the third changes the indexation rounding rules for essential pharmaceuticals, and that has the effect of increasing the cost of these co-payments in future.

The Labor opposition will oppose these measures because they represent broken promises on the part of the government, and the Labor opposition will oppose them because they are unfair. We will oppose them because we believe access to essential health services is a key responsibility of the national government. In one of his headland speeches to the Australian Council of Social Service in October last year entitled `Fair Australia', the then opposition leader and current Prime Minister (Mr Howard) promised `to maintain the real value of pensions and other social security benefits'. This legislation breaks that promise. This legislation shows that the Prime Minister could not be trusted last October.

The Prime Minister prides himself on having higher standards than the rest of us. An important test of the trust which many pensioners placed in him is this particular legislation. For every pensioner out there who decided to trust the Prime Minister's word, for every pensioner who decided to give the Liberal Party and the Prime Minister a go, their faith and their trust have been betrayed with this legislation.

I would like to turn to the first measure, which increases the cost of pharmaceuticals for pensioners. We think this is the worst measure, mainly because of that direct effect on pensioners. The Prime Minister in this legislation is forcing pensioners to pay $3.20 for each prescription, which is an increase of 50c for each script. For the first time this measure breaks the link between what pensioners have to pay and the compensation they receive through their pension.

Until the election of this government, no pensioner was worse off because they needed medicines. When Labor introduced the co-payment for pharmaceuticals, we guaranteed that all pensioners would get more than enough in compensation. Those pensioners who needed 52 or more prescriptions a year did not lose a cent. If you did not need that many scripts a year, you were a little bit better off.

This government has changed all that. This government has destroyed the principle that pensioners should not have to eat into their limited resources for essential medicines. Now pensioners will have to dig into their pockets every time they need to go to the chemist. The dishonesty about this legislation and this measure is continued in the second reading speech of the absent Minister for Health and Family Services (Dr Wooldridge). I quote:

It is important to note that the `safety net' arrangements under the PBS are not changing, thus maintaining the high level of protection afforded under this scheme. The annual concessional limit to access the safety net will remain as 52 times the patient contribution at $166.40.

The minister tries to argue that `it is important to note that the safety net arrangements under the PBS are not changing'. It takes a twisted form of logic for the minister to argue that an increase in the safety net for pensioners from $140.40 to $166.40 is no change. That is obviously not true. Either the government has set out to deliberately mislead this House and the Australian people or this minister does not understand the impact of the measures that he has introduced into this parliament.

Let me give an example. An age pensioner, perhaps living off nothing but the base pension, can reside in a nursing home and as a result pays 87.5 per cent of their pension for their accommodation. This leaves that nursing home resident living off the base pension with around $30 a week to pay for their toiletries, clothing, telephone calls, transport arrangements and pharmaceuticals. If these pensioners have to fill a prescription once a week or more—and tens of thousands of pensioners do—then because of this government's callous and dishonest changes they lose $26 a year, which represents almost one week's income for the pensioner residing in a nursing home living on the base pension.

Obviously, the Prime Minister's commitment to look after the least well off in our community was not a core commitment. It was one of these disposable commitments. This legislation will cost ordinary pensioners $323 million. It is not just the Labor Party that opposes these measures. I would like to quote from a few articles in Pensioners Voice, probably one of the largest newspapers circulating amongst pensioners in my state. An editorial in the August 1996 edition of Pensioners Voice said:

The proposed cuts to funding for community services such as Meals on Wheels and home nursing, as well as the proposed changes to the Pharmaceutical Benefits Scheme show a blatant disregard for older people.

. . . . . . . . .

Older people will not take these proposals and cuts without a fight.

In Pensioners Voice of September this year, an article under the headline `Federal Budget: Not really a Fair Go' said:

The day after the budget was released the Daily Telegraph's headlines read: "A Fair Go", indicating that the budget had given Australians a fair deal.

If this is the case, then all Australians must not include older people. Instead of giving older people "a fair go", this Budget seems to have targeted older people who are frail, sick and one of the most vulnerable groups in our community.

The increase in prescription charges will hurt the sickest older people and may mean some people, particularly renters, will find it difficult affording the medicines they need.

That is what a newspaper, the voice of pensioners, in my state says about these changes. It is quite clear that people who are living on the pension will pay that extra $323 million as a result of this government's decision to increase by 50c a script the cost of essential medicines for pensioners.

But pensioners will not be the only ones hit by this measure. Families too will be hit by this attack on access to essential medicines. The Howard government is lifting the maximum cost of pharmaceuticals to $20 a script for families. If a parent suffers from high blood pressure or diabetes, or if a child has asthma, families may need four or more drugs a week. These families will have to find $80 a month to pay for their medicines. Families will have to pay up to $2.60 more for every prescription and could be almost $100 a year worse off.

I would like to again take issue with a comment that is contained in the minister's second reading speech. He claims:

Members will note that many general users of the scheme will now reach the safety net limit quicker, using fewer prescriptions.

I hope that the department did not write that, because there is very clear attempt to mislead this House in that second reading speech. The claim that general users will now reach the safety net limit quicker using fewer prescriptions obviously indicates that, because families will be paying more, they will reach the safety limit quicker. To suggest in some way that people will be better off because they will be paying more for their scripts is quite ludicrous. I think the minister would have a great deal of trouble trying to convince some of the families in his own electorate that they will be better off paying $20 for a script rather than $17.20. But if the minister wants to try then he is welcome to do so.

While the unintended honesty of that particular measure is welcomed, it would appear that this is being trumpeted as some virtue of the government's policy. It is quite ridiculous to suggest that ordinary families will be pleased to reach the safety net faster because they are required by this government to pay more for their prescriptions. This attack on families is the sort of thing which is hidden away in this government's slick and sneaky budget. Big neon signs announce the family tax initiative, but higher prices for medicines are one example of the many measures which eat away at any benefits families may be entitled to. This measure will take $180 million from the pockets of general users and ordinary Australian families, in addition to the $323 million which the first measure takes away from pensioners.

Also hidden away in the fine print of this bill is the third measure we oppose—that is, a sneaky change which saves $56 million at the expense of those who need medicines and which goes a long way to showing the difference in the approach to social issues between the Labor Party and coalition.

Each year the pharmaceutical co-payments for both families and pensioners are indexed for inflation. The Howard government has changed the way this will be done. Instead of rounding down to get an even figure to the nearest 10c, they will sometimes be rounded up and sometimes be rounded down. The government's change is the economist's approach, and it is not always the right one.

We believe that, in areas like this where small changes in fees can have a big impact on people with very little income, it is important to err on the side of the battlers that we hear the Prime Minister claim to speak for so often.   Those battlers will be the ones hit by this government's change in the indexation arrangements. Those battlers will be the ones who have to pay the extra $56 million as a result of the changes in the indexation arrangements. The battling families will be the ones who have to pay an extra $180 million for the increase in the maximum payment for general users. The battling pensioners will be the ones paying $323 million as a result of the higher charge for those users of the pharmaceutical benefits scheme.

The fourth measure in this bill, which we do support, is the restriction of pharmaceutical benefits to Australian citizens, permanent residents and visitors to Australia from countries with which we have reciprocal health care agreements. Visitors from other countries should not expect the taxpayers of Australia to subsidise their pharmaceuticals while they are on holidays in Australia. When Australians travel overseas, I would hope that they do not expect other countries to subsidise their medication. We would expect those expenses to be covered by travel insurance. Visitors to Australia with travel insurance will be able to claim these costs back from their insurer. That is the appropriate way in which these costs should be met.

While the opposition supports this measure, I would like to seek an assurance from the government that there will be a practical and workable approach taken by the Health Insurance Commission in dealing with pharmacists on this issue. My understanding from the government and the department is that pharmacists will be expected to check that a person is eligible for the subsidies that are provided under the pharmaceutical benefits scheme to Australian citizens, permanent residents and also visitors to Australia from countries with which we have reciprocal agreements. I would be concerned if onerous and bureaucratic obligations were placed on pharmacists in implementing this particular decision. When the minister sums up at the end of the second reading debate, I would appreciate an assurance from him that new, onerous, bureaucratic obligations will not be placed on pharmacists as a result of this provision.

I would also be interested in the minister's view on what extent Australia should extend the subsidies available under the pharmaceutical benefits scheme to all eligible overseas representatives. I can understand that ambassadors from other countries to Australia might be entitled to certain rights under international treaties. But I am not quite sure if Australian diplomats serving in other countries also expect their families and staff who work at overseas embassies to be entitled to all of the pharmaceutical concessions that nationals of those countries receive.

I think there is a question as to whether PBS concessions should be extended not only to ambassadors from other countries serving in Australia but also to their children and to the staff who work at those embassies in Australia. I am sure many of those countries can afford to meet the cost of their pharmaceuticals, or perhaps countries should require staff who are serving at overseas embassies in Australia to have sufficient travel insurance to meet those costs.

I would also like to take this opportunity to place on record some serious concerns I have about one other measure that is referred to in the legislation. I have grave concerns about the government's intention to consider de-listing important drugs used in the treatment of hypertension. I am concerned that the government will approach this review with the same cold-hearted accountant's viewpoint which led to the atrocious decision to abolish the Commonwealth dental health program that we have discussed earlier today. I can assure the minister that the opposition will keep a very close eye on developments in this area and will be active in alerting appropriate community groups to this threat so that, unlike many other measures in this budget, the groups affected may actually have an opportunity to comment on a policy before the government locks itself into defending appalling social policy.

In conclusion, I reiterate that the opposition will oppose three of the measures contained in the legislation but will agree to the fourth measure. The three measures which we are opposing are the increase in the cost of pharmaceuticals for pensioners, the increase in the cost of essential medication for families and the changes in the indexation rounding rules which will hit families and pensioners.

We believe that, with this particular legislation, the government has broken the promises that it made before the election in saying that pensioner concessions would be maintained. We believe that the Prime Minister has betrayed the trust he sought from large numbers of pensioners. For many pensioners in my own electorate, this is one measure in particular that is often raised with me. I would say to the Prime Minister that many people in my electorate, who trusted him and thought that he was entitled to have a go, will hold this against him come the time of the next election. For all of these reasons, the opposition opposes the measures that I have outlined in my speech today.