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Thursday, 16 February 2012
Page: 1606


Mr BALDWIN (Paterson) (11:26): I rise today to address the National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill 2011. This bill has the potential to help a vast array of patients right across my electorate of Paterson. However, it is critical that patient care is the utmost consideration. Any additional powers given to pharmacists must be carefully capped, reviewed and assessed.

This bill has two important functions. Firstly, it will allow pharmacists to supply medicines without prescription under certain circumstances. Those require the patient to have been prescribed the medicine for at least six months. The patient must also be taking the medicine immediately prior to requesting a continued supply from their pharmacist. Secondly, the bill will allow residents of an aged-care facility to access their medication, based on a standardised medical chart. They will also be able to claim their rebate directly, for those medicines on the Pharmaceutical Benefits Scheme. This move is supported by the Australian Medical Association, as it is hoped to cut red tape for doctors and other health professionals.

For my electorate of Paterson, the latter is particularly significant, as we have the fourth-highest median age in the country. Australian Bureau of Statistics data shows that the median age for Paterson residents in June 2009 was 42.6, compared with a national average of 36.8. That figure continues to grow higher in our region, which is attractive to retirees thanks to its proximity to Sydney, beaches, recreational facilities and more. It is actually the perfect sea-change, tree-change environment for people to retire to. The rising median age also means that many of the doctors in Paterson are retiring themselves, and services cannot always be duplicated straightaway.

Many rural and regional areas across Australia are also dealing with doctor shortages. As the ABC detailed on 21 November 2011:

GP Access says more doctors are choosing to work fewer hours which is adding to the critical doctor shortage in the Hunter.

A senate inquiry has been set up to look at the factors affecting the supply of health services and medical professionals in rural areas.

GP Access Practice Workforce officer Jenni Scott says historically, doctors used to work around the clock to tend to patients.

But she says that is now a thing of the past.

"The work life balance that's permeating all workforce scenarios is the same in general practice," she said.

"Doctors going into the practice want to go to work, do their work but also go home and be with their families or do other things that are part and parcel of life these days."

The role of new 'Medicare Locals' organisations like the Hunter's GP Access will come under scrutiny as part of the senate inquiry.

Ms Scott says the doctor to patient ratio in some areas is very concerning.

"The preferred GP population ratio usually quoted as approximately 1:1100 or 1:1200," she said

"But the relevant ratio for some of our smaller communities is usually 1:2000.

It goes without saying that mechanisms like this, which can reduce the pressure on waiting times and costs to constituents and the government alike for simple consultations like those for repeat scripts, could have a positive impact.

In my electorate office I receive quite a number of complaints from people who go to the doctor simply for a repeat script to be issued but are charged $50 to $60 for something that takes but moments. There are some doctors who simply run it through a bulk-billing, but the majority of doctors in my area charge the full fee of $50 to $60 just for issuing a repeat script.

There are also a number of local aged-care facilities right across Paterson that could stand to benefit, from Largs Lodge in the west to Regis the Gardens in the east, Barclay Gardens in the north and Raymond Terrace Gardens Nursing Centre in the south of the electorate. Having to obtain a prescription for long-term medication can be costly and timely, and there are certain circumstances where this will alleviate the burden on aged-care providers. For example, there is currently a situation in Bulahdelah, in my electorate, where the local GP, Dr Habashi, has had to take sick leave. He has been off sick for a number of months and there is no indication of when he will return, yet there is no permanent replacement doctor. The two closest major centres are Newcastle and Taree, which are 96 kilometres and 75 kilometres away respectively. Doctors in Forster-Tuncurry and Tea Gardens have been working hard to assist, taking what patients they can on top of their own extreme workloads. However, this is not an adequate solution to the problem. As the resident GP, Dr Habashi was also responsible for patient care at the Bulahdelah Nursing Home and the Bulahdelah Hospital. With this legislation in place, many of the nursing home residents would be able to continue to access their medications without having to place further burden on the temporary doctors.

The benefits seem quite straightforward. However, with any initiative like this, it is important that ideals of ease and convenience do not overshadow what is the most important thing, that being the patients' safety and wellbeing. That is why the coalition will move amendments to ensure that this new program is adequately reviewed and monitored.

The government has already limited the scope of this legislation in the first instance in a bid to ensure safety as the program is rolled out. Those medicines that can be dispensed without a prescription will be limited to oral hormonal contraceptives, known as the pill, and lipid modifying agents, which are drugs to lower cholesterol. Past experience of these two medicines shows they are usually well tolerated and have a good safety profile. Provided the scheme is rolled out successfully, the hope is that other chronic therapy medicines will be added to the list. From personal experience with things like asthma preventatives, I know that Ventolin is available over the counter, but some of the stronger preventatives, which are regular script items, should also be included in this list, provided an asthma management plan is in place.

The coalition's amendments would ensure that review mechanisms are included in the legislation. We believe it is vitally important that the program is assessed after two years, with statistics and results made public. The government has given guarantees that it will do so; however, it should be put directly into the legislation. The health of patients is far too important to simply take the government at its word. After all, this is the same Prime Minister who said, 'There will be no carbon tax under a government I lead.' Prime Minister Julia Gillard also said she would be more likely to play full forward for the Bulldogs than challenge Kevin Rudd for the Labor leadership. So we have real concerns in trusting this Prime Minister with the health of our nation, placing her word.

It is worth noting that some emergency options for pharmacists already exist. Under the current legislation, pharmacists can dispense a medication on the Pharmaceutical Benefits Scheme without a written prescription if they speak to the patient's doctor on the phone. They then need to get a written prescription from that doctor within a week. Proponents of the bill argue that the existing legislation puts pharmacists at financial risk, because a PBS claim cannot be made if that written prescription is not received within seven days. Of course, by that stage, they have already dispensed the medication.

Further, state regulations allow pharmacists to supply three days worth of medicine where it is just not possible for a patient to get a script. However, if getting medicine this way, the patient has to pay the full cost rather than the PBS co-payment, and the pharmacist has to break a full pack to provide it. The patient is also back in the doctor's surgery within a couple of days to get a full script. This bill would, therefore, largely prevent these problems from occurring. It could also represent significant cost savings for individuals by ensuring they do not have to pay for a doctor consultation every time they need a script repeated. This would also provide cost benefit to the government, because the Medicare rebate for that visitation would not be required.

With the cost of everyday living skyrocketing and the carbon tax set to boost everyday household costs from July this year, any cost savings for the individual will be most welcome. This past year, under the Gillard Labor government, there has been no net job growth for the first time in two decades. That is clear evidence of a struggling economy and tough times for workers and their families.

Health is certainly not an issue that people can easily put aside. People cannot do without their medications if they do not have enough money that week. Just one missed blood pressure dosage could result in a heart attack, while one missed pill could cause unwanted pregnancy.

The National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill has some great potential in the Paterson electorate. In regional areas such as ours, distance, limited travel options, doctor waiting times and cost-of-living pressures mean that access to health facilities is not always easy. Our government should be working hard to cut red tape, and for this I commend it. However, patient care has to always be at the top of one's mind. The government should always be accountable for the decisions it makes with regard to our health system, and it is vital that we review new initiatives like these to ensure that the outcomes they are designed to meet are indeed being fulfilled.

With the coalition's amendments, this bill has great potential for my constituents in Paterson, and therefore I look forward to supporting the amendments to the bill. Hopefully, they will be carried, and the bill will be carried as a whole.