CHECK AGAINST DELITVERY EMBARQOED UINTIL DELIVERY
SPEECH BY PRIME MINISTER
ANNUAL GEN4ERAL MEETING, PHARMACY GUILD OF AUSTRALIA, SOUTH
AUSTRALIA BRANCH
ADELAIDE, 28 SEPTEMBER 1990
Peter Staples
Colin Johns
Members of the South Australian Branch of the Pharmacy
Guild
One of the most time worn phrases of political speeches is
the traditional introductory comment: it is a pleasure to
be here tontight.
On this special occasion, let me invest that sentiment with
new meaning and relevance.
It truly LCL a pleasure to be here tonight because my
presence as Prime Minister, speaking to this meeting of the
Pharmacy Guild, confirms a very pleasing fact.
Over the last twelve months the Federal Government and the
Pharmacy Guild had something of a blue and it was a
beauty. Some pharmacists not only disagreed with much of what my
Government was proposing for your industry, they even, as
was their democratic right, did what they could at the March
election to make sure that I ceased being Prime Minister.
And it is revealing no state secret to say that, for the
Government's part, we too were at times exasperated by, and
disagreed with, some of the things the Guild was then
proposing. But tonight, that is behind us. We have, I hope, brought
those, deep divisioins and feelings of bitterness to a full
stop, and c: an open a new chapter in the relationship between
the Pharmacy Guild and the Federal Government.
Indeed, we are entitled to be doubly pleased because the
reconciliation we have reached gives the Government and
pharmacists a sound base on which to build.
2
Tonight, we can look to the future with confidence that we
have achieved a major reform of public policy which will
have enduring benefits for all Australians.
Let me spend some moments putting this achievement in its
full historical perspective.
A hundred years ago it was the physician who was the main
provider of care for the ill.
But with the invention, first, of aspirin in the 1890s,' and
then in succeeding decades of a never-ending range of new
pharmaceuticals, the primary health care role of the
physician has increasingly been shared by the pharmacist.
Today we take for granted that the pharmacist can dispense
medication for a vast, even awe inspiring, range of
conditions diabetes, high blood pressure, cardio-vascular
disease, even cancer.
Families have increasingly looked to pharmacists as a source
of convenient, efficient and reliable advice about the
health of everyone from the unborn and very young to the
very old.
And pharmacists have increasingly brought new skills and
professionalism to the task of meeting those needs.
Of course the growing availability of new medication has
been accompanied by many questions ethical, medical,
economic that demand attention.
No-one, not least governments and medical professionals, can
today ignore the implications of questions such as:
how to ensure the cost-effectiveness of some
treatments; how to achieve the most equitable distribution of
the costs of health care;
how to encourage individuals to take
responsibility for their own health; and
how to strike the right balance between prevention
and cure.
The involvement of the Federal Government as a source of
funding for pharmaceuticals adds a new layer of complexity
to such issues.
The social goal of ensuring the greatest degree of good
health for the greatest numbec of individuals needs to be
weighed in the balance with considerations of equitable
availability and efficient public funding.
In Australia, the Pharmaceutical Benefits Scheme has served
us well f or some forty years, providing essential
medications at affordable prices.
Through the Scheme, the Commonwealth has in recent years met
some 70 per cent of the cost of pharmaceuticals used by
Australians. Nine out of every ten pharmaceuticals for which a doctor' s
prescription is required are listed on the Schedule that
underpins 1: he Scheme.
SO it is truly a Scheme for all Australians.
But throughout the 1980s, it became increasingly clear to
Commonwealth Governments that without a major restructuring
the Pharmaceutical Benefits Scheme was in jeopardy.
It had taken almost forty years from 1948 to 1985 for
the costs of the Scheme to reach half a billion dollars.
But it took only another four years for costs to double to
$ 1 billion.. And as the Budget documents this year made
clear, it would have taken only another three years for
those costs to double again, to more than $ 2 billion had
the Federal Government not proceeded with its reform
package. It was, of course, the need to restructure the costs of the
Scheme a need that had been recognised by the Tribunal
that ultimately lay at the root of the divisions between the
Federal Government and the Pharmacy Guild.
It's not my intention tonight to rake over the coals of what
every headline writer in the country came to describe as
" the Chemists' Dispute" or what the placards and leaflets
and shop-front posters described in less flattering terms.
But I do want to emphasise that broader historical context I
have outlined, so that we can see the final outcome in its
true light.
The debate between us was too often cast as a battle of
short-term considerations for pharmacists, the immediate
question of maintaining income and employment levels and for
the Government, on behalf of the taxpayers, the pressing
need for cost containment.
What was really at stake, and what has been genuinely
safeguarded by the package of measures on which we have
agreed, was the viability of pharmaceutical health care
itself and, by extension, the good health and well being
of our fellow Australians.
There are -three principal elements to the package: reforms
to retail pharmacy, initiatives in minimum pricing
arrangements, and substantial changes in patient co-payment
arrangements.
First, in the retail pharmacy area, we have agreed on
changes to the remuneration formula; amalgamation payments
and-employee redundancy payments funded on a 50/ 50 basis; a
temporary freeze on new approvals for pharmacies; and
limited flexibility on the prices of items below the maximum
general patient contribution level in return for proper
information on prices being made available to patients.
Some of these changes are still subject to deliberations of
the Pharmaceutical Benefits Remuneration Tribunal.
Second, we have shown our determination through minimum
pricing initiatives to protect Australians from the high
cost of necessary pharmaceuticals.
This safeguards one of the great success stories of
Australian health policies, namely the relatively low cost
by international standards of Australian drug prices.
Third, by introducing fees for pensioners' prescriptions and
by increasing the maximum general patient contribution, we
have incorporated genuinely effective price signals into the
Pharmaceuticals Scheme.
Safety nets will protect people, especially the chronically
ill, from open-ended costs and of course we have fully
offset pensioner price increases with a pension increase of
$ 2.50 a week.
But we had been concerned by the mounting evidence
suggesting that some people were using more pharmaceuticals
than was necessary, or even good, for them. Introducing a
small patient contribution encourages people to obtain only
genuinely needed drugs rather than take whatever is on offer
simply because it is free.
So good economics in this case is also good health policy.
My friends
The Pharmaceutical Benefits Scheme is an integral part of
Australia's comprehensive health policy. It does not exist
in a vacuum.
As politicians, as health professionals, as ordinary
Australians, we need to see our individual contributions to
health policy and administration in Australia in its broader
context. Our joint negotiations over the last few months will ensure
Australia takes the Pharmaceutical Benefits Scheme into the
21st Century as an affactive and vital contribution to the
well being cf our fellow citizens.
I appreciate that it cannot have been easy for the Pharmacy
Guild to convince its members to accept lower receipts on
many prescriptions.
Likewise, you probably understand that it was not easy for
the Government to alienate, however briefly, such a highly
respected profession as Pharmacy particularly in the lead
up to, and during, an election campaign.
On both sides -we have only succeeded because we have kept
our eye on the long-term goal.
I want to pay tribute to those Guild leaders who at
different times throughout the dispute showed their
leadership and their capacity to negotiate fairly and
honestly, abandoning neither the legitimate interests of
their members nor the belief that effective and successful
solutions could be found and in this respect I pay a
particular tribute to you Colin Johns.
It is my hope that these changes can now be implemented with
a spirit cof co-operation between Government and Pharmacy.
The last t: hing we want is to see any of the issues dragged
back in bitterness to the Tribunal.
I believe Government and Pharmacy can return to, and can
improve on, the constructive relationship we enjoyed for
most of the 1980s.
I shall certainly be working towards this end and I look
forward to working with Colin Johns and the Guild.
You probably recall the line from " Yes, Minister" where
Sir Humphrey confides that the surest way of killing off a
policy proposal is to describe it to a politician as
" courageous"
Together we have proved Sir Humphrey wrong.
We took the courageous decision because it was the right
decision.
As a resu: lt, we can each of us tonight declare that we have
achieved reforms of fundamental and lasting value.
That is why, as I said at the outset, it is truly a pleasure
to be here.