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Thursday, 27 March 2003
Page: 10332


Senator IAN CAMPBELL (Parliamentary Secretary to the Treasurer) (9:56 AM) —I table the explanatory memorandum relating to the bill and move:

That this bill be now read a second time.

I seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

The speech read as follows—

Pharmaceutical Benefits Scheme (PBS)

The Pharmaceutical Benefits Advisory Committee (PBAC) is a committee of experts that makes recommendations to the Minister as to the drugs and medicinal preparations that are to be subsidised through the Pharmaceutical Benefits Scheme (PBS). The PBAC must give consideration to the effectiveness and cost of drugs and medicinal preparations and their comparison with alternative therapies, including non-drug therapies.

The PBAC currently consists of a Chairperson and eleven other members. Eight members must be selected from the following groups: consumers, health economists, practising community pharmacists, general practitioners, clinical pharmacologists, and specialists—with at least one member selected from each of these groups. Members from these groups must be appointed from nominations made from bodies prescribed by the Regulations. The Minister appoints the remaining members based on qualifications and/or experience in a field relevant to the functions of the PBAC that would enable them to contribute meaningfully to its deliberations.

These amendments provide for the PBAC membership to be increased by up to four persons, in an order to cope more effectively with the current situation, whereby the minority of medical specialists on the Committee have experienced a substantially increased workload. The membership will consist of a Chairperson, with not less than eleven and not more than fifteen other members. In order to retain the current ratio of the number of members nominated by external organisations to the number of members appointed by the Minister, these amendments also provide that not less than two-thirds of the total number of members be selected from nominations by the prescribed organisations.

The Bill also makes a number of other minor amendments in relation to the PBS.

(a) Under normal PBS supply arrangements, most medicines are supplied by community pharmacies on the prescription of a medical practitioner. However, section 100 of the National Health Act 1953 has for many years provided an important mechanism to enable special distribution arrangements for medicines where, in particular circumstances, the normal PBS supply arrangements are not convenient or efficient. The amendments in this Bill will make it clear that special supply arrangements can be used for the funding of particular medicines that are not available through the normal operation of the PBS.

(b) A pharmacist must obtain approval to supply pharmaceutical benefits from particular premises, and thus must obtain a new approval before relocating to other premises. Occasionally a pharmacist relocates without applying for approval, and cannot be paid for any pharmaceutical benefits supplied from those unapproved premises.

(c) In these circumstances the pharmacist has been asked to apply for approval at the relocated pharmacy and, if the application is approved, the pharmacist has then requested and received an act of grace payment and/or waiver of recovery for 90% of the value of the benefits supplied from the unapproved pharmacy. These amendments will give the pharmacist an entitlement to receive the 90% payment or waiver once the relocation is approved.

(d) Amendments in this Bill will allow an agent to make and sign an application for a PBS safety net concession or entitlement card, or for an additional or replacement card on behalf of an applicant where a person who has qualified for the card is unable to sign the application.

(e) This Bill also provides that determinations of forms, strengths and brands of PBS medicines and their maximum quantities and repeats will apply to the supply of pharmaceutical benefits by hospitals in the same way as they do to pharmaceutical benefits supplied by pharmacies. This has become necessary due to the introduction of arrangements with some States for the supply of pharmaceutical benefits by public hospitals to out-patients, day-admitted patients and admitted patients on discharge.

(f) The Bill will also make clear that the decision-maker (be it the Secretary, or the Minister) has the discretion whether or not to cancel an approval to supply pharmaceutical benefits.

Simplified Claiming

Where a service is provided as part of a Medical Purchaser Provider Agreement (MPPA) the National Health Act 1953 requires that the provider of medical services forward all accounts to the Health Fund. If this provision is not complied with, the Health Fund is prevented from paying benefits in excess of 25% of the MBS fee.

This requirement creates an anomaly between MPPA arrangements and other gap cover arrangements, to the detriment of consumers. The Health Fund is prohibited from extending coverage to any gap that may exist, and the member is left with an unexpected out-of-pocket expense. The Bill removes this anomaly

The proposal is in line with the HIC's electronic commerce strategic direction and the Commonwealth Government's On-Line strategy, and will include stringent confidentiality and privacy requirements. The new arrangements will facilitate the checking of a patients Medicare and Health Fund Benefits eligibility prior to service provision and consequently will greatly assist and enhance the provision of informed financial consent from the consumer to providers of medical services.

Specialist Recognition

This Bill amends the Health Insurance Act 1973 (the Act) to restore specialist recognition status, for the purpose of ensuring access to Medicare benefits at the specialist rebate level, correcting an unintended consequence of earlier legislation.

Overseas Doctors

An unintended consequence of the Health Legislation Amendment (Medical Practitioners' Qualifications and Other Measures) Act 2001 allowed all overseas trained doctors to receive Medicare benefits for assistance at operations in areas that are not districts of workforce shortage.

This proposed amendment to section 19AB of the Act clarifies the intent of Government policy regarding maldistribution in the Australian medical workforce and the resulting difficulties experienced by some rural communities in accessing general practitioner services. Overseas trained doctors who are undertaking a bona fide training program and have an occupational trainee visa will continue to be able to claim Medicare benefits when they assist at operations as part of their training program. This will allow the Government to continue to facilitate the exchange of medical knowledge between Australia and other countries. However, all other overseas trained doctors must commit to provide services in districts of workforce shortage if they wish to access Medicare.

Technical Amendments

Schedule 5 does not seek to make substantive changes but seeks to correct typographical errors, punctuation errors, incorrect cross-references and other minor consequential changes in the Aged Care Act 1997 and the Health Insurance Act 1973. There are no policy changes. No amendment will result in any change to the substance of the law. The quality of the text of some sections of the Acts will be improved, making the law more accessible, but this Schedule will not result in any change to the substance of the law.

Ordered that further consideration of this bill be adjourned to the first day of the next period of sittings, in accordance with standing order 111.