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Thursday, 11 June 1970

Mr Les Johnson (HUGHES, NEW SOUTH WALES) - I support the honourable member for Capricornia (Dr Everingham) in his contention that the situation in regard to this matter should be expressed more clearly and be above board. I am pleased to note that half the battle has already been won. It is not very long ago that the Minister contended in the Committee of this House that it was unreasonable to expect the names of the doctors who sit on this committee to be known to the public. In a matter of a week or 2 he has completely reversed his attitude in this regard. The previous contention was that the doctors concerned would be inundated with representations from pharmaceutical companies and the like. Now, the amendment provides that these doctors' names are to be published in the Commonwealth 'Gazette'.

The Opposition sensibly enough contended that anyone - particularly the big drug companies with all the resources at their disposal - would find out in any case who were the people who decide which drugs should come on to the free medicine list of this country. The Minister refused to accept the counsel and fairly sensible contention that was being made by the Opposition. But the matter has come from another place on several occasions, and the sheer weight of numbers and the sheer insistence by the other place has caused a further evaluation and a capitulation by the Minister and the Government. Apparently there has not yet been sufficient pressure in regard to this other matter. How many honourable members sitting in the Committee tonight have received representations from patients, and especially from doctors? The doctors are the more significant ones, particularly those who contend that a drug is essential to the wellbeing of a patient and that because of its price it ought to be included in the free list.

Often we make representations to the Minister. We receive a reply to the effect that the Committee has determined that there is a substitute that is available in respect of a certain drug. But the doctor steadfastly says: 'I have conducted clinical trials in regard to this and other patients, and I refuse to accept this. In the interests of my patient I still want you to continue your efforts to get this particular drug included in the free medicine list.' We are talking in terms of very big money when we talk about these things, and not only the wellbeing of people, as significant as that is. In fact, there can be nothing more significant than this. We are now in an era of increasing accountability. Members of the public have an expectation about accountability. People cannot sit in remote places any more, pontificating and dropping decisions from great heights, without expecting others to say: 'Why have you done that?' I believe that this principle applies to the matter under consideration.

The rights of the subservient and the rights of the citizen are expanding. The rights of the medical profession, of the pharmacists and of the people in these allied fields are expanding. Indeed, the rights of the manufacturers themselves ought to be expanding. They ought to have the opportunity to know why their drug has not been accepted if it measures up to therapeutic and other standards. There are some people in this country who are very well informed about these things and who contend that the brand name system which seems to be predominant in regard to drugs on the free medical list is doing a great disservice to the people of this country. They contend that we are paying for brand names. Lots of people say we would be much better off to have a generic system, that we should use generic names instead of brand names, and that if we did this we would save a great deal of money.

I remember raising this matter in the House some years ago. I had good advice from people who were well informed on the matter, and it received a lot of attention from the then Minister for Health, who has since passed on. As a consequence of these representations we were able to save this country many millions of dollars. We established that the same drug under various trade names was being financed by the Commonwealth in relation to the pensioner medical scheme and the free medical scheme. It was found that there was an enormous variation of price being paid not only by the public but also by the Government itself. As I say, because of the rationalised approach many millions of dollars were saved.

I want to draw attention to the enormous financial consequences that are involved in this matter. According to the annual report of the Department of Health the total cost of pharmaceutical benefits in 1968-69, including patients' contributions on prescription benefits available to the general public, amounted to $136m. This indicates the highly competitive state of the matter that we are talking about. If a drug is admitted to the free medical list by this committee it may be worth hundreds of thousands of dollars. We know the highly competitive state that exists. The drug companies in this country are in the main sycophants of overseas companies. About 95% of the 120 major drug companies in this country are subsidiaries of overseas concerns. If one conducts a study into these matters one can ascertain that drugs produced are obtainable more inexpensively in other countries than they are made available in Australia by the same company. A bonanza is operating in Australia for drug companies.

I believe it is necessary to contrive a means by which these things should be brought under close scrutiny. This House has made some inroads into this principle tonight in several ways. We have decided that the people who make the decisions are no longer to be obscured or hidden from public view. I believe it is necessary that their decisions should be exposed. Mr Chairman, I draw your attention to the fact that last year, according to the DirectorGeneral's report, 44 new items were added to the list and there were 71 new strengths and forms of existing benefits. Although that number is considerable it can be established that they represent an infinitesimal proportion of the number of submissions made to this Committee. I do not care what the Committee is nor how well informed it is. Like most citizens I am not prepared to concede any rights, any decision making, to anyone unless I have an opportunity of knowing the reasons why they arrive at those decisions. I believe it is even more important when the matter involves this country in such enormous amounts of money. Last year the overall benefit prescription volume increased by $5m or 9% to $60m. It amounts to many millions of dollars.

I believe that pharmacists, doctors and others who are involved professionally in this industry take the view that the more exposure there is the better. The Minister has said that to do so would intensify public controversy. I think they are the very words he used. Would there be something wrong with a development of this kind? What is wrong with intensifying public controversy when life and death are involved? What is wrong with requiring people to account for themselves when somebody contends that certain drugs are necessary and a committee in an obscure back room is saying that it is not necessary to include such drugs on the list? One wonders why the Minister is so prone to see virtues in such a situation.I strongly recommend that the Committee should give the recommendations from another place the utmost support so that these matters can be ventilated and the whole matter of determining which drugs are made available to pensioners and people who benefit from the free medicne scheme can receive the ventilation and public examination which it deserves.

Question resolved in the affirmative.

Resolution reported; report adopted.


That Mr Holten. Mr Kelly, and Dr Forbes be appointed a committee to draw up reasons for the House of Representatives disagreeing to amendments Nos 3 and 8 of the Senate.

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