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Wednesday, 15 August 2007
Page: 1


Senator ABETZ (Minister for Fisheries, Forestry and Conservation) (9:32 AM) —I move:

That these bills be now read a second time.

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

Leave granted.

The speeches read as follows—

NATIONAL HEALTH AMENDMENT (PHARMACEUTICAL BENEFITS) BILL 2007

The National Health Amendment (Pharmaceutical Benefits) Bill 2007 contains amendments for two different purposes.

Schedule 1 of the Bill proposes changes to the Health Insurance Act 1973 and the National Health Act 1953 to implement a 2007 Budget measure.  The amendments extend prescribing under the Pharmaceutical Benefits Scheme (PBS) to include optometrists as PBS prescribers, which will allow optometrists to prescribe some eye medicines as pharmaceutical benefits.

The PBS has been providing affordable access to high quality medicines for all Australians for over fifty years.  By subsidising the cost of PBS medicines and limiting the amount that people pay for prescriptions at the point of sale, it delivers benefits directly and immediately for the medicines people need—when and where they need them—through local pharmacies and hospitals in the community.  In addition, the PBS Safety Net protects individuals and families who require a large number of medicines from high cumulative costs.  The PBS serves Australians well and is regarded as one of the best systems of its kind in the world.

Under the current PBS legislation, the prescribing of PBS medicines is limited to medical practitioners and dental practitioners.  Under state and territory laws, optometrists can be accredited to prescribe certain eye medicines. However, as an optometrist’s prescription cannot be used under the PBS, the cost of the prescription to the patient is the full dispensed price.  If the patient is referred by the optometrist to a medical practitioner to obtain a PBS prescription, this can result in inconvenience and cost to the patient, a possible delay in treatment, and additional costs to government under Medicare.

The Bill amends the Health Insurance Act 1973 and the National Health Act 1953 to provide for:

  • suitably qualified optometrists to be approved as authorised optometrists able to prescribe medicines as pharmaceutical benefits;
  • optometrists to be regulated as PBS prescribers in a similar way to doctors and dentists;
  • the PBS medicines for prescribing by optometrists to be specified in a separate list; and
  • entitlements associated with pharmaceutical benefits, including subsidies and PBS Safety Net benefits, to apply for PBS prescriptions written by optometrists.

Optometrists who are accredited to prescribe under state or territory legislation will be able to apply to Medicare Australia for approval to prescribe pharmaceutical benefits as an authorised optometrist. 

Applications will be required to satisfy certain criteria to ensure that optometrists are suitably qualified.  Approvals will be subject to conditions, as determined by the Minister for Health and Ageing by legislative instrument.  Optometrists will need to establish that they have the necessary professional registration and prescribing accreditation under state or territory requirements prior to approval to prescribe PBS medicines.

An approval as an authorised optometrist will be able to be suspended or revoked in the event that the optometrist no longer meets the criteria for approval, breaches a condition of approval or engages in inappropriate practice.  Reconsideration and review processes will apply for decisions to reject an application for approval, or suspend or revoke an approval.  Optometrists will be subject to the same arrangements under the Professional Services Review Scheme regarding conduct and appropriate practice as those that apply to other practitioners who prescribe pharmaceutical benefits.

The Bill introduces a new term, PBS prescriber, to describe collectively medical practitioners, participating dental practitioners and authorised optometrists as practitioners authorised to prescribe under the PBS.  PBS prescriber is used in amendments where it is intended that the same provisions will apply to authorised optometrists as for medical practitioners and participating dental practitioners.  For PBS prescriptions, this includes the circumstances in which a person is entitled to have a prescription supplied as a pharmaceutical benefit, the patient payment amounts to be taken into account for the purposes of the PBS Safety Net, and the recording of Medicare card information.

The medicines for prescribing by authorised optometrists will be determined by the Minister for Health and Ageing taking into account the advice of the Pharmaceutical Benefits Advisory Committee.  The list of medicines is expected to include a limited range of eye drops and eye ointments and will be specified by legislative instrument separately from other PBS medicines.

PBS prescriptions written by authorised optometrists will be able to be dispensed by community pharmacies and hospitals which supply PBS medicines.

The changes proposed for optometrist prescribing under the PBS also apply to the Repatriation Pharmaceutical Benefits Scheme.

Commencement of these amendments is in two stages.  Provisions relating to approval of optometrists as PBS prescribers commence on Royal Assent to allow application and approval processes to proceed before 1 January 2008.  Provisions relating to the writing of prescriptions by authorised optometrists, dispensing, payment of subsidies and application of Safety Net entitlements as pharmaceutical benefits commence on 1 January 2008.  Amendments to regulations will also be required to give effect to the new prescribing arrangements.

Subsidies for optometrist prescriptions will make better use of optometrist services, reduce delays in access to eye treatments, reduce costs to consumers and support continuity of therapy for chronic eye conditions.  The benefits are expected to be particularly significant for concession card holders and people in rural and regional areas.

PBS prescribing by optometrists may help to free up GP and specialist medical resources for other uses.  As a result of consultations with the ophthalmologist profession, the Government has decided to allow PBS prescribing based around the range of drugs permitted by the most restrictive State, and consistent with the advice of the Pharmaceutical Benefits Advisory Committee.

This component of the Bill demonstrates the Government’s commitment to having a PBS which reflects developments in professional practice.  The new arrangements are sensible and practical, and build on well-established PBS procedures.  There are safeguards to ensure that optometrists are adequately qualified prior to approval and that appropriate practice standards are maintained.

Schedule 2 of the Bill proposes minor amendments to the National Health Act 1953 to clarify the meaning of section 90, for granting approval to pharmacists to supply pharmaceutical benefits.

Pharmacists are approved under the Act for the purpose of supplying pharmaceutical benefits to their local community.  It is important that the public can obtain pharmaceutical benefits at the pharmacy of their choice and there are an appropriate number of pharmacies to meet community need. 

The Act currently uses the term “at or from” premises in relation to the supply of pharmaceutical benefits by approved pharmacists.  This means, if an approved pharmacist is conducting a mail order business, there is no need for the pharmacist to have a shop-front pharmacy supplying to their local community.

The proposed amendments provide that an approved pharmacist must supply pharmaceutical benefits “at” their pharmacy - that is, to have a shop-front for people to physically attend the pharmacy.  In addition, an approved pharmacist may also choose to supply pharmaceutical benefits “from” their pharmacy to people who do not physically attend the pharmacy, for example, to nursing home residents or to a person by mail order.

The Act also uses the term “on demand” to describe how pharmaceutical benefits are supplied.  This term does not adequately describe the intent that a pharmacy should be open reasonable hours for the purpose of supplying pharmaceutical benefits to their local community.

The proposed amendments also provide that a pharmacy must be accessible to the public during reasonable times.  Reasonable times, generally means providing pharmaceutical benefits during normal business hours.  What is considered reasonable times may vary according to the particular circumstances, for example, in a heavily populated urban area it would be expected that a pharmacy open for at least standard business hours, each working week.  However, in a small rural town where a pharmacy may be serviced by a pharmacist from another town, something less than standard business hours may be acceptable. 

For consistency, the proposed amendments also provide that the Secretary may cancel an approval if the approved pharmacist is not supplying pharmaceutical benefits “at” the pharmacy, or if the premises are not accessible at reasonable times by the public for the purpose of receiving pharmaceutical benefits.


OFFSHORE PETROLEUM AMENDMENT (MISCELLANEOUS MEASURES) BILL 2007

Senators would be aware that the Offshore Petroleum Act 2006 received Royal Assent on 29 March 2006.  The Offshore Petroleum Act was a rewrite of the Petroleum (Submerged Lands) Act 1967, which has been the primary legislation for the administration of Australia’s offshore petroleum resources for 40 years. The Offshore Petroleum Act is a more user-friendly enactment that will reduce compliance costs for governments and the industry.

This Amendment Bill has three elements.  Firstly to clarify provisions to ensure they operate the way that was intended, to make some technical corrections and a minor policy change.  Secondly, a policy change repealing section 327 which gives the Minister certain emergency powers in the Bass Strait. Finally, to convert geodetic data references of the area descriptions in the Act from Australian Geodetic Datum to the current the Geodetic Datum of Australia. 

Mr President, I would now like to take Senators through some of the key measures contained in the Bill.

The Bill ensures that the duration of certain production licences remains unchanged. While it was the intention that production licences due for their first renewal be renewed for 21 years, the effect of amendments made in 1998 to the Petroleum (Submerged Lands) Act is that licensees on their first renewal are entitled to licences of an indefinite duration.  This error has been corrected in the Offshore Petroleum Act.  These amendments ensure that the licensees, who renewed their production licences for the first time since 1998 but before the Offshore Petroleum Act comes into force, will have the indefinite term licences they are entitled to.

The Bill also clarifies the definition of ‘coastal waters’.  The Offshore Constitutional Settlement provides that the States and the Northern Territory have control over the ‘coastal waters’ adjacent to their land territory.  These coastal waters are 3 nautical miles from a ‘baseline’; this is essentially the low water mark of the coast.  These amendments ensure that the baseline that the ‘coastal waters’ are measured from is the correct 3 nautical mile baseline.

The Bill also proposes a minor policy change and repeals section 327 which allows the Minister to exercise his emergency powers in the Area to be Avoided, offshore Victoria in the Gippsland Basin.  The Minister has never exercised these powers.  The section is proposed to be repealed because a more comprehensive and broader security regime has been implemented under Maritime Transport and Offshore Facilities Security Act 2003.

The amendments to the datum are part of the Government’s Australia Spatial Data Infrastructure Program. Amendments made to the Petroleum (Submerged Lands) Act in 2001, paved the way for the move to the Geocentric Data of Australia, known as GDA94.  GDA94 is essentially a response to increased use of the Global Positioning System for surveying, navigation and similar purposes. It is important to note that there will be no shift in the position in any petroleum title area as a result of the changes.

The Bill incorporates the conversion of all of the points describing the ‘offshore areas’ in Schedules 1 and the ‘area to be avoided’ in Schedule 2.

I commend the Bill to the honourable Senators and present the explanatory memorandum.

Ordered that further consideration of the second reading of these bills be adjourned to the first sitting day of the next period of sittings, in accordance with standing order 111.

Ordered that the bills be listed on the Notice Paper as separate orders of the day.