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Thursday, 13 May 1999
Page: 5466


Mr HARDGRAVE (11:16 AM) —I also speak in favour of the National Health Amendment Bill (No. 1) 1999 , because it is commonsense legislation and something long overdue. I am pleased that the Australian Labor Party are also lending their support to this finetuning of the Pharmaceutical Benefits Scheme. It is a $2.8 billion a year investment by the federal government in Australia's health to make sure that pharmaceuticals are available to those who need them rather than those who can afford them, as the member for Bruce quite rightly said.

I think it is important to note that what we are amending today is an act of parliament which was passed in the era of that great Liberal Sir Robert Menzies—the 1953 act. Over 50 years the Pharmaceutical Benefits Scheme has been operating and providing consistent, reliable, timely and affordable access to important medicines for all Australians. The member for Bruce noted that originally 139 medicines were caught within the Pharmaceutical Benefits Scheme.


Mr Griffin —I wish I had some now.


Mr HARDGRAVE —He says he could use some now, as the shadow parliamentary secretary for health. He would like to be a walking advocate for the Pharmaceutical Benefits Scheme in his entire being. From 139 in the original act back in the early 1950s in the Menzies government, in the Howard government era we now have something like 2,000 different brands and formulations of prescription medicines which are medical safe and clinically effective as well as being cost-effective.

A lot of people do not really well understand how some medicines get on the list and some do not. The Commonwealth government employs the services of a chemist so that the clinically sound, clinically effective and medically safe approach is guaranteed. But it also puts pressure back on the major pharmaceutical providers to make sure that they are providing cost-effective brands once a subsidy is put on a particular brand of medicine to make it available at a more affordable price for the consumer. We are also making sure that we are not paying a heavier subsidy per medicine than we may necessarily have to.

I think all members in this place get constituents coming to them saying, `My doctor says X brand, and it is not on the pharmaceutical benefits list.' From time to time we will get those inquiries.

I must say that the minister has never shut the door in my face, and I thank the Minister for Health and Aged Care, Dr Wooldridge, for his generous approach to listening to any alternative views from a clinical and medical viewpoint as to whether or not a particular brand that is on the list is as good as a brand that perhaps should be on the list. I can think of a number of instances where some brands that have been pushed onto me by concerned constituents have ended up on the Pharmaceutical Benefits Scheme list as a result of a rethink or a reappraisal.

That in itself shows the flexibility and the ongoing generosity of the system, but it is not simply a matter of a particular brand or brands prescribed by a doctor suddenly being on the list. They have to prove to be medically and clinically safe and effective as well as being cost-effective. At the end of the day, the taxpayer is meeting the cost of the Pharmaceutical Benefits Scheme and I do not think any taxpayer would begrudge that contribution as it stands.

The member for Bruce suggested it was $160 a year per taxpayer on average that finances this scheme. I guess that is a simple equation into the $2.8 billion a year that the scheme costs, and I suspect his figure is right. Most Australians on average will have about six prescriptions off the PBS medicines each year. A lot of Australians probably do not appreciate that even things commonly purchased like paracetamol, the Panamax brand, which a few of my chemist mates call `pensioner paracetamol' because it comes at a cheaper price on script, are themselves heavily subsidised.

The one thing that all Australians—whether they be in the taxpaying system or the benefit receiving system or both—should try to do is to always consider that access to a script in the form of, say, paracetamol does cost money in the form of a subsidy. A box of Panamax is worth about $7.40. The taxpayer subsidises the price down to $3.20 on a script, and about $4.50 without a script on a retail price, so access to paracetamol is also, as I understand it, subsidised. I have had occasions in this place to report, in lamentable terms, those who have gone to a doctor to get a script, paid via bulk-bill and picked up their paracetamol for $3.20 to save themselves $1.30 off the retail price. They have added more money to the overall cost of public health in this country. I think we all have a responsibility to exercise in looking for cost savings.

The federal government subsidises the cost of 75 per cent of prescription medicines in this country. We have to make sure that those who need them get them—not just those who can afford it. What this is about today is trying to prune around $20 million off the cost of that. We want to make sure that the particular practice whereby $20 million is currently lost in subsidised medicines out of the country—by people exporting Pharmaceutical Benefits Scheme medicines overseas with the purpose of trying to retail them on the black market in other countries where they are more expensive—is outlawed and stopped. It has always been outlawed but this will add an additional set of measures that will bring some hefty penalties, including up to a two-year gaol term for somebody found participating in this particular act.

It is an important measure. It is a measure that is good commonsense. The export of pharmaceuticals purchased under the PBS for redistribution in those other countries should be stopped, and that is why both sides of politics are supporting this particular measure. It is important to know that those who may plan to leave the country for extended periods of time, and understandably export Pharmaceutical Benefits Scheme medicines, are not going to find themselves in trouble as long as the prescription labels do not relate to somebody else. In other words, if a prescription label for somebody else is exported out of the country or if the label has been defaced or removed so that the identification of the person to whom they were supplied is hidden, understandably there would be some concern about whether or not it is legitimate. Those sorts of matters are important to qualify. Large quantities that cannot be reasonably considered to be personal use will also obviously draw some attention from the Australian Customs Service. If the Australian Customs Service mistakenly detains a person's legitimate medication, the Customs officers will have the discretion to detain only some of the medication, allowing the traveller to retain the remainder.

Once this bill is enacted, the ACS will forward the medication to the Health Insurance Commission. The HIC will examine the medication to establish whether the medication is a prescription drug or a prohibited export. If the medication is neither, it will be returned to the person to whom it belongs. If the HIC determines the medication is a prohibited export, it will pass it on to the appropriate agency and it will also invite the person to apply in writing within 60 days for its return.

The sensible measures contained within this bill show that the government is not being pedantic but is determined to ensure that the benefits of the PBS are maintained in Australia and that people do not simply take medication offshore for some additional personal benefit, as has been the practice on too many occasions in this country.

The current legislative deficiency needs to be remedied early. Without a system for control over the export of drugs and medicinal preparations, the PBS will continue to be exposed to inappropriate practices which result in the Australian taxpayer funding supplies of medicines either for the treatment of persons who are not residents of Australia or for sale overseas on the black market.

I support the bill. It is worth restating the government's commitment to the concept of the PBS. We believe strongly that Australians should be able to gain access to the 75 per cent of prescription medicines that are subsidised by the federal government. We have never said no to entertaining another viewpoint on what should or should not be on the list. In my state of Queensland, asthma sufferers perhaps do not realise fully the extent of pharmaceutical subsidies that are applied. Some medicines would otherwise be very costly indeed for Australians. Medicine for asthma could cost up to $60 a prescription without the PBS. Medicine for high cholesterol could cost up to $120 and medicine for stomach ulcers could cost up to $125 without this scheme.

The PBS is an important scheme. It provides a safety net to concessional patients and pension recipients, who pay only $3.20 per script. General patients pay $20.30 per prescription. Also, concessional patients have to pay for no more than a maximum number of scripts per year. The integrity of this very sensible scheme is worth protecting, and this bill certainly does that. I congratulate the minister for health, who is at the table, on his administration of this area of his portfolio.