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Wednesday, 8 February 2012
Page: 345

Mr WYATT (Hasluck) (18:52): I rise to support the National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill 2011 and I welcome the proposed changes to the act. Let me assure the member for Blair that it is not a matter of carping or complaining. Rather, it gives us the opportunity to review and reconsider those elements that are extremely strong within this proposed amendment and the changes that will be implemented, and it gives us the opportunity to make adjustments so that we better service the community. Allowing the supply of pharmaceuticals without a prescription by a pharmacist is, under certain conditions, a constructive initiative and extends point of access for primary health care for those who have a need of those services. Every one of us has pockets in the electorate in which the levels of disadvantage or age or income are factors in the way in which people access or do not access medical services, in particular GPs.

When you talk to people it is apparent that they certainly trust their pharmacists. They are seen as a crucial point to which you can go and seek sound advice on a medical condition which, while without the opportunity that you would have with a medical practitioner, is nevertheless still valued. This is particularly relevant to families and individuals who struggle with the increasing cost of living and limited access to a doctor. I want to remind members that this change is desired by and highly beneficial to Australians living in regional, rural and remote areas of this country, and is certainly beneficial to the residents of my electorate in Hasluck. Sometimes we overlook and take for granted that there are avenues of access that are not always consistent across any region. The geographic diversity of this country is challenging for the way that we keep that continual supply of medicines, particularly prescribed medicines, to those with chronic conditions.

The enablement of the supply of pharmaceuticals by a pharmacist is welcomed and ensures compliance with regimes of prescribed treatment. There are some medications that if you stop them suddenly they have a detrimental effect. I am pleased that the government has put forward this amendment because it enables the continuity of compliance and the continuity of prevention of the onset of an illness beyond the point of damage which is consistent with a regime of treatment that holds the condition at bay and gives an individual quality of life. It also means that the constituents within my seat will now have better access to important medications that they require to improve or maintain their health service as opposed to breaking the cycle of continuity of their medication.

Eligible pharmaceuticals and the conditions for supply will be determined by the legislative instrument and allow for the supply of and PBS claiming of pharmaceuticals in residential aged-care facilities based on a standardised medical chart rather than requiring a doctor to write a separate prescription. This is particularly important given the shortage of general practitioners and doctors in rural and regional Australia and in some capital cities where the ratio of patients to practitioners is unacceptably high. This is particularly relevant to those residents in the Gosnells area of the seat of Hasluck. The result is there are patients who require medication for a chronic, ongoing health condition running out of prescribed medications and having to wait to see their local medical practitioner. In some areas of my electorate it can be several days before you can get to see your local doctor, and in this instance the 'jeopardisation' of the continuity of prescribed medication becomes problematic.

The bill enacts initiatives agreed between the Pharmacy Guild and the government in 2010 under the Fifth Community Pharmacy Agreement, which includes the continued dispensing initiative—which I again commend the government for—the medical chart initiative and the technical amendments regarding prescriptions for the supply of pharmaceutical benefits. The strength of the benefits is beneficial ultimately for some of the chronic therapy medicines and allows continual dispensing. Even though the intent of the bill is evident and the coalition is concerned that the specificity of detail is not in the legislation but conveyed through ministerial statements or upon advice from the department, having worked as a senior bureaucrat I know that the detail is often left to the regulatory framework that can follow this or, alternatively, to the guidelines that are established under which the administering pharmacist would provide medications. Nevertheless, it would have been good to know the details of the process that will enable the distribution of those pharmaceuticals and certainly to know what some of the restrictions may be, if there are any at all.

The Australian Medical Association is strongly opposed to continued dispensing. It has said that:

… the Bill in its current form would permit a significant change in the professional role of pharmacists that the AMA believes is not in the best interests of patients or the professional relationship between doctors and pharmacists.

I concur with their sentiment. Nevertheless, the intent is that we enable multiple points of access to the ongoing supply of prescription medications required for the medical treatment of any individual. Again, I go back to the point that the trust that exists for pharmacists is extremely high. For me, it is a good practical way of ensuring that the relationship with both the pharmacist and the medical practitioner is critical to the ongoing treatment and case management plans for patients.

Currently, there are mechanisms in place for continued dispensing to occur—the owing prescription protocols where a pharmacist can supply a PBS medicine after contacting the patient's doctor by phone and the script is provided within seven days. The issues for pharmacists include the administrative difficulty for pharmacists and the financial risks as PBS claims cannot be made if the script is not provided. Whilst it is a good stopgap measure, these new amendments now alleviate that and allow people to better access the ongoing care that they need without having to worry that the seven-day requirement will not be met because they have been unable to get in to see their local doctor. I know that within my own seat are people who have to wait up to 14 days to see their local GP. If they go, they go and get their script but are charged for a full consultation. Emergency supply provision under state and territory regulations allows a three-day emergency supply of essential medication, where it is not possible for the patient—

Debate interrupted.