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Thursday, 16 February 2012
Page: 1615


Mr MATHESON (Macarthur) (11:59): The National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill 2011 amends the National Health Act 1953 by introducing a number of initiatives agreed between the Pharmacy Guild of Australia and the government in 2010 under the Fifth Community Pharmacy Agreement. These include the Continued Dispensing of Pharmaceutical Benefits Scheme in Defined Circumstance, which seeks to allow the supply of pharmaceuticals by approved pharmacists without prescription under certain conditions and the Supply and PBS Claiming from a Medication Chart in Residential Aged Care Facilities initiative, which allows for the supply and claiming of pharmaceuticals listed on the Pharmaceutical Benefits Scheme, the PBS, in residential aged-care facilities. The bill provides for the use of a standardised medical chart for supply and for PBS claims, rather than requiring a doctor to write a separate prescription. Finally, the National Health Amendment (Fifth Community Pharmacy Agreement Initiatives) Bill makes technical amendments through schedule 3 to allow the minister to make determinations in relation to the maximum quantity of, or repeats for, a particular medicine.

The continued dispensing initiative, as outlined in schedule 1 of this bill, allows for the supply of pharmaceuticals by pharmacists without a prescription under certain conditions. There are currently some provisions available to allow pharmacists to provide consumers with prescription medication without a script; however, these provisions are cumbersome and expensive for both the pharmacist and the consumer. The first is what is called the 'owing prescription' protocol, under which a pharmacist can supply a PBS medicine after contacting the patient's doctor by phone. This protocol places the pharmacist at financial risk as it relies on the doctor to provide the pharmacy with the prescription within seven days in order for the PBS claim to be made.

A second option allowing pharmacists to provide prescription medication without a script is the existence, under state and territory regulations, of emergency supply provisions. These provisions enable a consumer to purchase a three-day emergency supply of an essential medication in circumstances where it is not reasonably practical for that patient to acquire a script. The medicine is not subsidised through the PBS, so the consumer must pay full price. This practice can also result in the pharmacist having to break a full pack to provide three days supply. A number of local pharmacists have complained to me that these provisions can result in a wastage of prescription medication while leaving consumers out of pocket and with only a very limited supply of medication.

The continued dispensing initiative will help to relieve some of these issues for medications covered by the initiative. This is very true in regional areas of Macarthur, where patient to GP ratios are above 4,000 patients to one GP. A better solution to this problem would be for the government to deliver more doctors for the Macarthur region. However, this initiative does at least provide patients with a longer window of opportunity to see their doctor if their script runs out. I can report that local pharmacists in Macarthur are enthusiastic about the benefits of the continued dispensing initiative.

Unfortunately, there is no real certainty in this bill about which medications will be covered by the initiative. The department's consultation paper and the second reading speech of the previous Minister for Health and Ageing identified two groups of medication which will be covered by this initiative. These are oral hormonal contraceptives—the pill—and cholesterol-lowering drugs. The department's consultation paper claims that these two groups were selected because they are well tolerated and have a good safety profile. However, due to the astounding lack of detail in the bill, the eligible pharmaceuticals items and the conditions of supply are not specified and will be determined by ministerial determination.

In addition, this bill should have, at the very least, set out the specific circumstances under which continued dispensing can occur. The department's consultation paper advises that the ministerial determination will refer to the Guidelines for the continued dispensing of eligible prescribed medicines by pharmacists. These guidelines were developed by the Pharmaceutical Society of Australia in consultation with stakeholders and set out the professional standards which must be adhered to under this initiative.

The sheer lack of detail in this bill means that ministerial determinations will set out all the circumstances for dispensing under this bill. The minister will also determine the protocols for consumer safety and for the integrity of this initiative, as well as list the items or pharmaceutical benefits which are eligible to be supplied by pharmacists under the continued dispensing arrangements. I would prefer to actually see the draft legislative instruments. The minister's office has promised that this information will be tabled in due course. This is another case of the government providing little to no detail and asking the coalition, hat in hand, to just trust them. At the very least, future changes to eligible pharmaceuticals and conditions should be done by legislative instrument, allowing parliamentary scrutiny and disallowance.

I will now speak about the second initiative in the bill, the medication chart initiative, which will allow for the supply and claiming of pharmaceuticals based on a standardised medical chart in residential aged-care facilities. The Macarthur electorate is fast becoming a destination for aged-care and retirement living. Local residents and their families, as well as their doctors, are very excited about this initiative as proposed in the Fifth Community Pharmacy Agreement.

This measure will help to reduce the administrative burden in aged-care facilities and improve patient safety. I hope that this initiative will provide a better outcome for all stakeholders, especially doctors and patients. The Australian Medical Association also supports chart based prescribing in residential aged care as it will 'significantly reduce red tape for medical practitioners'.

The Fifth Community Pharmacy Agreement will provide $15.4 billion over a five-year period for community pharmacy. Community pharmacy has transformed Australia's pharmaceutical industry over many years, providing affordable pharmaceuticals to communities all over Australia, especially those in remote and regional Australia. The coalition provided solid and stable policy for community pharmacy while in government and we continue that support today.

The Pharmacy Guild negotiated with the government in good faith, making a number of large concessions, to arrive at the Fifth Community Pharmacy Agreement. While I support the Fifth Community Pharmacy Agreement and the initiatives that have come from the agreement, this bill—schedule 1 in particular—shows the Australian people what a woeful lack of attention to detail this government pays to its legislation. For example, this bill has absolutely no details whatsoever about what an approved pharmacist would be, it contains no details about what would be in place to protect consumer safety and prevent the misuse of this initiative and there are no details about what medications will be available under these initiatives. I hope that we do not see a repeat of the incompetence and deception displayed by the previous Minister for Health and Ageing when she signed a memorandum of understanding with Medicines Australia to provide policy stability in return for $1.9 billion of savings in the PBS.

This recent agreement includes speeding up the addition of new medicines to the PBS. It took this government until September last year to list medicines that were deferred from February. It also announced last year that there would be further deferrals in future for new medicines subsidised through the PBS. The lack of detail in this bill does not bode well. All I can say is that this government has a shameful record of failing to keep its promises.

I cannot see how this government can see it as being appropriate to deny patients access to their medication, especially the elderly and those suffering from long-term illnesses, at the same time as it sees fit to spend hundreds of millions of dollars on dodgy advertising about the carbon tax—including handing out funding to indoctrinate toddlers and schoolchildren. I will not oppose this bill. However, I believe this government needs to start paying more attention to detail and that it should include more operational aspects in this legislation if it wants to deliver any certainty to the pharmaceutical industry.