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Monday, 15 June 2009
Page: 3140

Senator SIEWERT (4:51 PM) —We made our position clear on this bill the first time we considered it. I am not going to go through all the comments that I made last time but I do want to reiterate a number of our points and put the reasoning behind the Greens position on this National Health Amendment (Pharmaceutical and Other Benefits—Cost Recovery) Bill 2008 [No. 2]. In principle we support the cost recovery mechanism. The pharmaceutical industry makes a great deal of money from the PBS. We believe that, in general, cost recovery makes sense given the large amount of money the industry makes out of the PBS and the large cost of the scheme to the taxpayer. The Greens strongly support the PBS. We think that it is appropriate that the industry pays for cost recovery.

When we originally looked at this bill, we were concerned about the independence of the PABC. As a result of the two inquiries we had, our questions to government and our looking at the legislation in detail, we were somewhat assured that it did not undermine the independence of the PABC. We had particular concern about non-orphan drugs—those specialised drugs that are used for purposes for which they are not listed. Those drugs include some used in specialist and rare cancer treatment and some that are used in Aboriginal communities. A number of drugs have proved to be very beneficial for palliative care. These drugs are often used in low volumes but it is quite an expensive process to list them. So we were concerned to ensure that those drugs were protected in any cost recovery scheme.

The other issue we were concerned about at the time was the fact that the regulations, if I can remind the chamber, were made public the day that the Senate Standing Committee on Community Affairs was due to report on this legislation. We were extremely disappointed about that. We did not think it was good process given that this particular piece of legislation was going to significantly impact not only the industry but also stakeholders. There was a particular level of concern around those non-orphan drugs, particularly from people involved in palliative care. In fact, we had a number of submissions to the Senate inquiry about that specific issue. Following that, the government referred the regulations to committee. So the community affairs committee has had two inquiries into this bill: one into the bill itself and the second into the regulations. Once we had had a look at the legislation, it helped to allay a lot of the concerns of the Greens, but there were terms in the legislation that were confusing and not adequately defined. When we go into committee, I will seek government assurance around some of those definitions.

There has been a lot of concern in the industry and amongst those that rely on non-orphan drugs as to the impact of this legislation. Although a lot of the issues have been dealt with, we think it is appropriate that there be a review around its impact. We believe it would increase transparency and accountability to look at the application of the cost recovery processes, so we will be moving an amendment to the legislation. I understand that it has support from the government and that the opposition, as we just heard, will be supporting it. In fact, the amendment incorporates amendments put by the opposition in terms of annual reporting. I will go through those amendments in more detail in the committee stage. Whilst the government has made further attempts to improve the regulations, this is a substantive change. We are not sure whether this legislation and the cost recovery process is going to have the impact that people are worried about in terms of making it impossible for non-orphan drugs to go through the process, even with fees waived or reduced.

Senator Fielding has circulated some amendments around the minister retaining discretion to waive fees. I signal right now that the Greens have very strong concerns about those particular amendments. Again, I will go into more detail in committee, but we are very concerned that those amendments go way beyond what is already in the regulations and that they could introduce an element that undermines the independence of the PABC. The legislation has been at pains not to do that. We are very concerned that these amendments may do just what we have all been trying to avoid.

The Greens will be supporting this legislation provided the amendment is accepted. We believe the amendment provides the safeguards to ensure that this legislation is not adversely impacting those groups that everybody in this chamber, from my recollection from the previous debate, was at pains to protect. Those are the small groups who use the non-orphan drugs, those drugs that are low volume and that are too expensive to put through the process if there is not a fee waiver process. We will obviously make our decision once we see what the government does with the amendments that the Greens are proposing.