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Thursday, 1 June 1989
Page: 3208


Senator WATSON(12.50) —I wish to draw the Senate's attention to certain problems facing thousands of Australian pharmacists-problems created by this present Federal Government and its very erratic administration of the pharmaceutical benefits scheme (PBS). The blame for these measures must be sheeted home to the Minister for Community Services and Health, Dr Blewett, and especially the Minister for Housing and Aged Care (Mr Staples), who is responsible for the pharmaceutical benefits scheme. I think it is really quite extraordinary that a Commonwealth department should be making policy decisions on the run, and yet that is exactly what Community Services and Health has been doing under these Ministers.

I think it is worth looking at some of the recent Government decisions in this area. Heavily prescribed drugs were suddenly made highly restricted last August, only to be restored to their former status a few weeks later because of the overwhelming protests from medical and pharmacy spokesmen throughout the country.

Let me refer to some of the people who have criticised the Government's cavalier policies on pharmaceutical benefits. The distinguished former President of the Royal Australian College of Physicians, Professor Priscilla Kincaid-Smith, CBE, stated in relation to the authority listing of ACE inhibitors:

Authority listing of ACE inhibitors is a serious blow to all who believe in preventive medicine.

The Government's response was to brand Professor Kincaid-Smith's comments as `alarmist nonsense'. I wonder whether they accuse the editor of the Medical Journal of Australia of similar nonsense for that journal making the following remarks in August 1988 regarding the placing of 53 drugs on the `authority only' list:

This decision did not include any assessment of the efficacy or cost-effectiveness of the drugs, simply their monthly cost. No discussions with medical or pharmaceutical professions took place before the decision about authority restrictions was made.

The Federal Government made a submission to the Pharmaceutical Benefits Tribunal that the Tribunal should make an absolute cut in pharmacists' national health scheme dispensing fees-something never before contemplated by any Federal government and a step which has ruptured the relationship between chemists and the Government.

The next step on the Government's chaotic course was for the Government to insist last month on the de-listing of 12 widely used brands of drugs, which are then to be restored to the PBS list on 1 August. Recently in Tasmania-and this is not surprising-there was a State-wide pharmacy strike, when 174 of the 177 pharmacies in the State were closed for more than three hours and more than 600 chemists and their staffs attended rallies in Hobart, Launceston and Burnie. This was the first ever stoppage in the history of the profession and an action which was not taken lightly.

Honourable senators would know that pharmacists are basically conservative people and that they have taken up a career path which is devoted to the service of the community. The Government in general, and regrettably Mr Staples in particular, unfortunately have tried to smear the reputation of pharmacists in Tasmania when they stopped work and, more recently, when similar action was also taken in New South Wales. The inference that the Government tries to promote is that pharmacists are wealthy and living off the system.

Let us examine some of the comments of the Minister in charge of the PBS, Mr Staples, on 9 March. The Minister described the Pharmacy Guild of Australia as running a `scare campaign' amongst the sick and elderly in order to boost members' income. On 9 May, he compounded this slander by describing the Pharmacy Guild as `the biggest spreader of misinformation of any national organisation in this country'. This is wholly incorrect and is the sort of statement that is made only behind the protection of parliamentary privilege.

The vast majority of pharmacists in Tasmania, and I am sure in all of the other States, have heavy overdrafts to carry on their businesses because of the high overheads that they have to sustain. They provide a service to the community under very rigid guidelines, both from their professional bodies such as the Pharmacy Guild and the Pharmaceutical Society of Australia, and from the pharmacy boards in each State and Territory. Most of them are earning average and, in many cases, below average weekly earnings.

The Hawke Government has taken an aggressive stance and anybody who denies this should have witnessed the comments of Mr Staples in Burnie recently when he was presented with a petition against changes to the pharmaceutical benefits scheme. Unfortunately, the situation has now been reached where no pharmacist in private practice in Australia has a great deal of confidence in Mr Staples and the current policies of the Government. This has been exacerbated by strikes, marches and even legal action in the courts.

While this Government tries to cut the returns to pharmacists, these same people have had to fund salary increases, rent increases, an impending 3 per cent superannuation award and the loss of time due to the 38-hour week. There are approximately 5,200 pharmacies in Australia. They are not only a major component of the small business sector but also a major employer of women. It is worth reminding the Government that 60 per cent of pharmacists and 99 per cent of pharmacy assistants are women. I think it is appropriate at this stage that I should comment that I do have a vested interest because my wife is a salaried pharmacist on a part time basis. Certainly these people will remember the Government's actions when they next vote.

Along with many of my colleagues, I have been inundated with letters from individual pharmacists, who have always been apolitical and have been prompted to write in protest as never before. They have drawn my attention to many aspects of the maladministration of the scheme, including a lack of adequate supply of replacement generic drugs; and the de-listing of many products-only to have them relisted subsequently, confusing both the professionals and the patients. Indeed, there has also been a lot of confusion about the availability of drugs. Other problems include the 5.2 per cent surcharge on wholesale prices and continual delays in PBS payments. Unfortunately, Tasmanian pharmacists seem to be singled out for special treatment in this area. Problems are also treated by the late payment of the national health scheme claim results. The April statement introduced by Mr Keating proposes a reduction in dispensing margins from 25 per cent to 10 per cent and a dispensing fee of $3.30 discounted by 25 per cent.

How is this Government handling the problems? It has set aside $1.1m to pay for the extra staff needed to process `authority only' forms; $2m has been earmarked to educate doctors on prescribing practices; and it has wasted thousands of dollars on sending out ridiculous red and white capsules to medical practitioners and pharmacists-a cost only revealed by Senator Cook after a probing question posed by my colleague, Senator Sue Knowles. Therefore, the Government's answer is to pour more money into an already bloated bureaucracy to administer more and more red tape while thousands of chemist shops throughout Australia shut their doors and pharmacists quite simply go bankrupt. Unfortunately, it is going to be the remote areas of Australia, the small country towns, that will lose this sort of service.

The fine print of the April statement shows that spending on the PBS will be cut by $31m in 1989-90; by $96m in 1990-91; and by $156m in 1991-92. These figures clearly demonstrate just how deliberately the Government is white-anting the scheme which has, up until now, received bipartisan support for approximately 40 years. The facts of the matter are that the administration of PBS in recent times under this Hawke Government has been quite hopeless and bad in the extreme. I am sure that members of the Government, especially Ministers, who have represented the Department of Community Services and Health in this place over the past few years, have been privately embarrassed to have to defend some of the policies-particularly policies that have been made on the run-that have come out from this Department. The coalition promises a complete review of the pharmaceutical benefits scheme, so as not to humble pharmacists to the point of bankruptcy, deny patients urgently needed medication and unnecessarily disrupt what was previously an efficient scheme which delivered the service for which it was established.